News 10/5/22

Top News

UnitedHealth finalizes its $7.8 billion acquisition of Change Healthcare, which it has merged with its Optum business. Change Healthcare has requested that Nasdaq de-list its stock from the exchange.

Reader Comments

From Apoagathos: “Re: CHI Catholic Health Initiatives. Looks like they were the victim of a ransomware attack yesterday.” CommonSpirit Health, CHI’s parent company, experienced an IT security incident Monday that impacted some of CHI’s facilities. CHI took some of its systems offline, including Epic.

Webinars

October 12 (Wednesday) 1 ET. “In Praise of the Problem-Oriented Medical Record (POMR).” Sponsor: Intelligent Medical Objects. Presenters: Amanda Heidemann, MD, CMIO, KeyCare; Amber Sieja, MD, senior medical director of informatics, UCHealth and Ambulatory Services; Jim Thompson, MD, physician informaticist, IMO. The problem-oriented medical record – initially developed in the 1960s by Lawrence Weed, MD – brought important structure to paper charting, and in particular, the problem list. Yet, today, the tool that was once the gold standard for organizing and making sense of patient history is often cluttered and unmanageable. Fortunately, tools and strategies exist to help make the problem list more meaningful, helping to synthesize patient data, highlight insights, and support patient care. The expert panel will share their experiences with POMR, including documentation practices and tools to improve workflows and efficiency, the impact of POMR and charting on the overall health of a patient, and the challenges and obstacles clinicians face when practicing POMR and charting and how they can be overcome.

October 18 (Tuesday) 2 ET. “Patient Payment Trends 2022: Learn All The Secrets.” Sponsor: Mend. Presenter: Matt McBride, MBA, co-founder and CEO, Mend. Many industries offer frictionless payments, but healthcare still sends paper bills to patients who are demanding modern conveniences. This webinar will review consumer sentiment on healthcare payments, recent changes to the Telephone Consumer Protection Act that create opportunities for new patient financial engagement, and new tactics to collect more payments faster from patients.

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

Acquisitions, Funding, Business, and Stock

CTG acquires Eleviant Tech, a digital transformation company specializing in mobile, cloud, robotic process automation, and AI across multiple verticals including healthcare.

People

ChartSpan names Nic Erickson (Anthem) VP of patient enrollment and clinical operations.

Appalachian Regional Healthcare (KY) promotes VP of IT and CTO Mike Roberts to the additional role of CISO.

Jeff Silverman (Qualifacts) joins AccessOne as its first chief revenue officer.

Announcements and Implementations

Harnett Health (NC) switches from Meditech to Epic as part of its affiliation with Cape Fear Valley Health.

Government and Politics

ONC launches a dedicated information blocking webpage ahead of the October 6 information-sharing compliance deadline. It will host virtual office hours on October 6 and 27 to help healthcare stakeholders better understand information sharing under ONC’s information-blocking regulations. 

Other

Five months into the role, Cerebral CEO David Mou, MD shares several things the online mental healthcare company is doing in light of federal and media scrutiny around its prescribing, marketing, and patient identity verification practices:

• Expanding internal infrastructure and safeguards to prioritize the most vulnerable patients, especially those at risk for suicide.
• Improving patient ID verification protocols and software to ensure information is accurate and that treatment isn’t offered to minors.
• Reallocating resources from marketing to clinical quality efforts.
• Establishing a Quality Commission of outside experts to conduct performance reviews.

STAT reports that Epic now recommends that its sepsis prediction model be trained on a hospital’s own data before clinical use, and that the company has changed its definition of sepsis onset to a more commonly accepted standard. Epic’s model came under scrutiny earlier this year when a study in JAMA Internal Medicine found that it did not retroactively identify two-thirds of sepsis patients.

Sponsor Updates

• The Ascom US team participates in the Great Cycle Challenge to help beat kids’ cancer.
• Azara Healthcare integrates FindHelp’s social services referral and reporting tool with its Azara DRVS and Care Connect solutions.
• CHIME releases a new Leader2Leader Podcast featuring Oracle Cerner Chief Health Officer Nasim Afsar, MD “Advancing Health Equity.”
• Clinical Architecture EVP Carol Macumber receives the HL7’s 2022 W. Edward Hammond, PhD, Volunteer of the Year Award.
• Wolters Kluwer Health updates its Ovid medical research platform with two new, curated research collections – the Public Health Advantage collection and the Evidence-Based Health collection.
• Baker Tilly publishes its “Healthcare M&A Update H1 2022.”
• Southeast Kansas Mental Health Center upgrades its adoption of Netsmart’s CareFabric platform in support of it becoming a Certified Community Behavioral Health Clinic.

Blog Posts

• AHUG 2022: Impressions of User Group Meetings (Agfa HealthCare)
• Determining the MS-DRG – Clinical Documentation Improvement (AGS Health)
• Build vs. buy and the capabilities that matter in healthcare IT (Arcadia)
• Hospital-at-home as a care delivery model (Baker Tilly)
• A 988 IT Infrastructure Conversation with Bamboo Health’s Carol Tsang (Bamboo Health)
• Physician opinion: Preparing for the changing role of the practicing physician (Bravado Health)
• By Initiating Pas, Providers Can Give Pharmacists Time with Patients (CoverMyMeds)
• Fear, Uncertainty, and Doubt: The Promise of Cloud Computing in Healthcare (CTG)
• Data Standardization and APIs Can Help Pave the Way Toward Data-Driven Healthcare (Diameter Health)
• The Importance of Data Integration is Front-Page News (Dimensional Insight)
• 6 Tips for Becoming a Great Mentor (Divurgent)
• Back to School – for Your Practice, Too! (EClinicalWorks)
• Leader to Leader: A Data Revolution in a Consumer-First World (Clearsense)
• The Exponential Savings Potential for ACO Participants (ChartSpan)

Contacts

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

Morning Headlines 10/4/22

CTG Acquires Eleviant Tech to Accelerate Digital Transformation Strategy and Portfolio Innovation

CTG acquires Eleviant Tech, a digital transformation company specializing in mobile, cloud, robotic process automation, and AI across multiple verticals including healthcare.

Optum and Change Healthcare Complete Combination

UnitedHealth finalizes its $8 billion acquisition of Change Healthcare, which it will merge with its Optum business.

EHNAC and CARIN Alliance Announce New CARIN Code of Conduct Accreditation Program

The Electronic Healthcare Network Accreditation Commission and the CARIN Alliance, a collaborative focused on consumer-directed health data exchange, launch an accreditation program to bring the CARIN Code of Conduct and EHNAC’s criteria review process to healthcare stakeholders.

Curbside Consult with Dr. Jayne 10/3/22

For those organizations participating in the Medicare Promoting Interoperability Program, Monday, October 3 marks the last day to begin your 90-day reporting period. Eligible hospitals and Critical Access Hospitals that don’t successfully attest will be hit with a “downward Medicare payment adjustment,” also known as a penalty. Participants must also use Certified EHR Technology, report on the safe use of opioid medications, complete a Security Risk Analysis, and document a self-assessment using the SAFER Guides. Hospitals spend a tremendous amount of resources trying to make sure they hit all the requirements, so for those of you immersed in this work – may the odds be ever in your favor.

A friend of mine sent over this job posting from Amazon. They asked my opinion about the posting itself and if I could read between the lines to figure out what the job is really about. It reads to me more like a business development or sales role, specifically targeting telehealth, imaging, and analytics. In the job posting, Amazon has an entire paragraph about its inclusive culture and specific focus on race, ethnicity, and gender diversity. However, they missed the mark on actual physician inclusivity, since the preferred qualification is MD – I suppose DO and internationally-trained physicians need not apply.

News of the Weird: We see writeups of healthcare fraud all the time, but it’s been a while since I’ve seen one that is tied to a sex worker scheme. The Department of Justice announced that nine defendants in California have been hit with criminal charges related to sex services that were billed to their labor union’s health insurance plan. There are more than $2.1 million in claims at stake. Seven of the defendants are dockworkers at the Port of Long Beach.

The 46-year-old ringleader was charged with one count each of conspiracy to commit healthcare fraud and aggravated identity theft. She owned three clinics that provided chiropractic treatments, acupuncture, and sexual services. Taking advantage of insurance plan policies that allowed chiropractic services without a deductible or out-of-pocket payments from patients, she hired women, including those from strip clubs, to perform sexual services. Claims were filed for chiropractic and physical therapy sessions that never occurred. Some claims were filed under the names of spouses and children, with kickbacks being paid to plan members in exchange for the false claims.

It’s not just COVID that has the attention of physicians: Norovirus causes a wicked gastroenteritis, and is feared by schools, day care providers, and cruise lines alike. Although cases declined in April 2020 due to changes in behavior due to the COVID pandemic, cases started increasing rapidly in January 2022. The number of outbreaks in the 2021-2022 surveillance year was triple the previous year. It’s simple advice – wash those hands, folks, and stay home if you have diarrhea.

I’ve written before about my sometimes love-hate relationship with wearables. Although I like my Garmin wristwatch (which also does passive activity tracking such as steps or sleep alongside active GPS activity-logging), it’s been temperamental of late. Sometimes I’ll attempt to synchronize it with my PC, and it randomly fails to import several days of step or sleep data, where other times it functions just fine. I did a lot of troubleshooting with Garmin this week and didn’t reach a satisfactory outcome, although they did offer a 20% discount on a new watch in the same line since my model is no longer made. Unfortunately, the units in the same line have more bells and whistles than I need, where other lines that are a better fit are excluded from the discount.

The experience has me looking for alternatives from other vendors, but I’m not sold on anything just yet. I was interested to see this opinion piece this week though, which talks about the potential liability issues for “prediagnostic” wearables including some smart watches. It notes that many of these technologies are not regulated as medical devices and that although patients may use them to assess their health, there are legal gray areas where liability is concerned. From the physician standpoint, it’s unclear what happens when particular product is recommended, and it turns out not to be accurate. The article goes into gory detail about the various types of liability and differing jurisdictions for claims, if readers are interested. One proposed solution would be for states to pass laws that specify that physicians receiving this “prediagnostic” data should manage it like any other patient self-reported information. This will definitely be an interesting area to watch in the coming years.

Over the last couple of years, we’ve all encountered changes to the ways we’re used to working. For me, going from having quite a bit of travel to having none at all was a major transition. I’m definitely back to traveling and have experienced two vendor conferences, a couple of company meetings, and some personal travel in the last six months. Other than HIMSS in the spring, I haven’t attended any general industry conferences, but that’s about to change since CHIME and HLTH are both on my docket for the coming months. I haven’t been to either of them previously so am looking for advice or recommendations on how to best navigate them. It looks like CHIME has added a clinical informatics pre-session, so I’ll have to figure out if I can squeeze that onto my dance card.

I didn’t make it to my specialty organization’s annual meeting due to conflicts, but several friends attended. One of them mentioned the keynote by author Malcolm Gladwell, who said of family physicians, “If there’s a problem with (trust in) healthcare, there’s no solution without you.” He went on to say, “You can’t solve it with better technology. You can’t solve it with better drugs. You can’t solve it with a fancy EMR. We solve it with communication, listening, and empathy.”

Unfortunately, that doesn’t necessarily align with what many patients want, which is cheap, transactional service-oriented encounters. It will be interesting to see how the family medicine community responds to the challenge and whether people flock to the specialty or continue to retire early. Either way, I’ve got my calendar marked for next year’s conference in Chicago so I can see where things are trending.

What are your conference plans for the coming months? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 10/3/22

Major in the United States Army and a Maryland Doctor Facing Federal Indictment for Allegedly Providing Confidential Health Information to a Purported Russian Representative to Assist Russia Related to the Conflict In Ukraine

Federal prosecutors indict US Army Major Jamie Lee Henry and his wife, Anna Gabrielian, for conspiracy and disclosing the health information of military personnel to assist Russia with its war against Ukraine.

Talkspace investor demands appointment of CEO, plan to stabilize stock price

Investor Firstime Ventures calls for therapy app vendor Talkspace to appoint a permanent CEO, share its long-term plan, and address rumors of a potential sale.

Grow Therapy Raises $75 Million to Expand Access to Affordable Mental Healthcare

Tech-enabled mental healthcare company Grow Therapy raises $75 million in a Series B funding round, bringing its total raised to $90 million.

Careviso Raises Over $17 million in Series B Funding to Enhance Transparency and Access for Diagnostic Testing

Patient access and transparency technology vendor Careviso raises $17 million in a Series B funding round.

Monday Morning Update 10/3/22

Top News

Federal prosecutors indict US Army Major Jamie Lee Henry and his wife, Anna Gabrielian, for conspiracy and disclosing the health information of military personnel to assist Russia with its war against Ukraine.

Henry was a staff internist stationed at Fort Bragg, and Gabrielian an anesthesiologist working at Johns Hopkins during the time of the alleged conspiracy. They met several times with an undercover FBI agent posing as a Russian Embassy employee to stress their level of dedication to aiding Russia, eventually handing over the health information of a number of patients at Fort Bragg and Johns Hopkins to demonstrate their ability to access data they believed Russia could then exploit.

They both face up to 15 years in prison.

Reader Comments

From Jaffer Traish: “Re: The White House Conference on Hunger, Nutrition, & Health. Many announcements listed on the White House fact sheet of commitments. There is an important interop commitment outlined here.” The White House introduced a national strategy on hunger, nutrition, and health at a conference last week, incorporating five pillars that include ensuring public and private healthcare systems address the nutritional needs of all people. To do this, the government recommends screening for food insecurity, incentivizing providers and payers to conduct screenings for food insecurity and other social determinants of health, and supporting the data infrastructure necessary to do so. Traish refers to HL7’s Sync for Social Initiative, which aims to help healthcare stakeholders “better integrate nutrition information within a patient’s electronic health record by accelerating a standards-based approach to implementing universal social needs screening.” Committed participants include Oracle-Cerner, Meditech, Epic, and a number of health systems, payers, and other vendors.

HIStalk Announcements and Requests

Most poll respondents are in favor of creating a SWIFT-like network for healthcare similar to that of banking, although a significant number aren’t sure what all that involves.

New poll to your right or here: What should HHS do with the October 6 deadline for information sharing?

Webinars

October 12 (Wednesday) 1 ET. “In Praise of the Problem-Oriented Medical Record (POMR).” Sponsor: Intelligent Medical Objects. Presenters: Amanda Heidemann, MD, CMIO, KeyCare; Amber Sieja, MD, senior medical director of informatics, UCHealth and Ambulatory Services; Jim Thompson, MD, physician informaticist, IMO. The problem-oriented medical record – initially developed in the 1960s by Lawrence Weed, MD – brought important structure to paper charting, and in particular, the problem list. Yet, today, the tool that was once the gold standard for organizing and making sense of patient history is often cluttered and unmanageable. Fortunately, tools and strategies exist to help make the problem list more meaningful, helping to synthesize patient data, highlight insights, and support patient care. The expert panel will share their experiences with POMR, including documentation practices and tools to improve workflows and efficiency, the impact of POMR and charting on the overall health of a patient, and the challenges and obstacles clinicians face when practicing POMR and charting and how they can be overcome.

October 18 (Tuesday) 2 ET. “Patient Payment Trends 2022: Learn All The Secrets.” Sponsor: Mend. Presenter: Matt McBride, MBA, co-founder and CEO, Mend. Many industries offer frictionless payments, but healthcare still sends paper bills to patients who are demanding modern conveniences. This webinar will review consumer sentiment on healthcare payments, recent changes to the Telephone Consumer Protection Act that create opportunities for new patient financial engagement, and new tactics to collect more payments faster from patients.

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

Acquisitions, Funding, Business, and Stock

Frustrated with Talkspace’s declining share price, lack of frontline leadership, and opaque business plans, investor Firstime Ventures calls for the therapy app vendor to appoint a permanent CEO, share its long-term plan, and address rumors of a potential sale. The company has reportedly received acquisition offers from Amwell and MindPath. It went public via a $1.4 billion SPAC in June 2021, but quickly lost stock market momentum. Its co-founder and CEO and head of clinical services both stepped down towards the end of 2021 due to lackluster Q3 results. Talkspace is likely still in the midst of a class-action lawsuit, filed earlier this year, that alleges it misled investors about its financials ahead of its IPO.

Sales

• Memorial Hermann Health System (TX) will switch from Oracle Cerner to Epic beginning early next year.
• EMedical Practice selects Sphere’s TrustCommerce payment processing software.
• Campbell County Health (WY) will go live on Epic next year.

People

Andrea Facini (Active Network) joins WebPT as chief product, marketing, and growth officer.

Verisma names GE Healthcare veteran Michael Fritts (Forced Physics DCT) COO, and promotes Julia Applegate to chief client officer.

Announcements and Implementations

Advata announces GA of Advata Smart AR, automated accounts receivable technology. The company was formed in June through the merging of six of Providence-owned Tegria legacy companies.

Verato develops Universal Identity technology, comprising patient data from EHRs, consumer data from CRMs and other demographic data sources, and provider data from national databases.

Allen County Regional Hospital (KS) goes live on Epic.

Meditech adds patient transport workflows, including an app for transport staff, to its Expanse EHR.

Government and Politics

Madigan Army Medical Center (WA) hosts a decommissioning ceremony for its Composite Health Care System. Science Applications International, now Leidos, was contracted to develop, design, and implement the system for the DoD in 1988. It rolled out across all military treatment facilities between 1992 and 1996, eventually running at 104 host sites with more than 100 interfaces with internal and external systems across the DoD and VA. It went live at Madigan in 1996, and experienced downtime only once, according to Col. (Dr.) David Owshalimpur, chief of nephrology at Madigan: “I always had it open during clinic days. If you knew the correct ‘cheat codes,’ you could fly through CHCS. It was also a much faster way to order labs, medications, and rads [radiological imaging] than AHLTA. So, CHCS was a nice backbone for both Essentris and AHTLA.” The medical center went live on MHS Genesis in 2017.

Other

Researchers at Houston Methodist develop analytics that predict hospitalization outcomes for geriatric patients with dementia on the first or second day of hospital admission with 95.6% accuracy. They hope to develop a corresponding mobile app for ICU and other hospital staff that will alert them to a patient’s likelihood of hospitalization and suggest interventions.

A survey of 115 healthcare executives finds that 55% believe integrating their disparate patient engagement capabilities will be a high priority in the coming year, though 84% believe it will be tough to accomplish with existing technology.

Sponsor Updates

• PerfectServe customer Bon Secours Mercy Health leverages the company’s Clinical Collaboration solution as part of its new Care Mobility project for nurse communication.
• Premier’s PINC AI Applied Sciences and partners AstraZeneca and Clinithink win a BWB Award for their use of technology-enabled healthcare solutions in the Digital Medicine category.
• RCxRules hosts a successful 2022 National User Conference.
• Surescripts releases a new There’s a Better Way: Smart Talk on Healthcare and Technology Podcast, “More is Not Always Better: Making Interoperability Work for Patients & Clinicians.”
• Upfront Healthcare achieves HITRUST risk-based, two-year certification to manage risk, improve security posture, and meet compliance requirements.
• Volpara Health wins a Gold Good Design Award for its Volpara Analytics mammography reporting and quality software.
• WebPT names Marcus Osborne (Walmart Health) to its Board of Directors.
• Wolters Kluwer Health acquires UK-based IJS Publishing Group, which offers peer-reviewed medical journals supporting scientists and authors.
• Vyne Medical will present at the MGMA Medical Practice Excellence: Leaders Conference October 9-12 in Boston.

Blog Posts

• Freezing the squeeze: The three A’s of efficiency (Nordic)
• Address Physician Burnout with Real-Time Prescription Benefit Tools (Arrive Health)
• How to Improve Patient Experiences and Reduce Healthcare Costs (PerfectServe)
• How Caregiving Has Changed Over the Years (Quil)
• Why you should attend Redox Connect Conference 2022 (Redox)
• Empower agents with AI call center capabilities (Talkdesk)
• Delivering on Denials: Novant’s Culture Creates Wins for Physicians, Patients, and Staff (Tegria)
• How to Create Better Physician Schedules: Integrating Technology and Data (TigerConnect)
• The Coming of Age of Cash-Based Practices (WebPT)
• How to enhance your experience when migrating to Epic (Verato)
• Zen Healthcare IT’s Guide to Understanding the Trusted Exchange Frameworks (Zen Healthcare IT)
• The Importance of Providing Meaningful Educational Resources to Your Patients (Zynx Health)

Contacts

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

Morning Headlines 9/30/22

Cerebral Treated a 17-Year-Old Without His Parents’ Consent. They Found Out the Day He Died.

The Wall Street Journal exposes lax patient identification verification at Cerebral, an online prescription drug company that has come under fire in recent months for potentially violating the Controlled Substances Act.

VA ‘not confident’ EHR issues preventing future rollouts are resolved following Oracle fix

VA Secretary Denis McDonough says it’s too soon to tell if an August EHR update by Oracle Cerner has finally fixed an “unknown queue” problem that caused thousands of clinical orders to disappear in an unmonitored inbox, causing patients to miss follow-up appointments.

Kahun Secures $8M Round for its ‘XAI’ Engine for Clinical Reasoning

Israel-based clinical assessment chatbot startup Kahun raises $8 million in a seed funding round.

News 9/30/22

Top News

The Wall Street Journal exposes lax patient identification verification at Cerebral, an online prescription drug company that has come under fire in recent months for potentially violating the Controlled Substances Act. An internal memo obtained by the paper says the company eschewed using its patient ID verification software because it slowed down the registration process, enabling some minors to receive treatment without parental consent. 

The company, which has raised $462 million, is facing an FTC investigation into its advertising and marketing, a federal inquiry into its prescribing practices, and the refusal of retail pharmacies like CVS and Walmart to fill its prescriptions.

Cerebral fired its founder and CEO in May and began laying off 350 employees in July.

Webinars

October 18 (Tuesday) 2 ET. “Patient Payment Trends 2022: Learn All The Secrets.” Sponsor: Mend. Presenter: Matt McBride, MBA, co-founder and CEO, Mend. Many industries offer frictionless payments, but healthcare still sends paper bills to patients who are demanding modern conveniences. This webinar will review consumer sentiment on healthcare payments, recent changes to the Telephone Consumer Protection Act that create opportunities for new patient financial engagement, and new tactics to collect more payments faster from patients.

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

Acquisitions, Funding, Business, and Stock

Kidney care company InterWell Health acquires Acumen Physician Solutions, the nephrology-focused EHR and practice management software division of Fresenius Medical Care. Acumen’s offerings include technology co-developed with Epic. Fresenius’ value-based care division, Fresenius Health Partners, merged with Cricket Health and InterWell last month.

Tech-enabled, senior-focused mental healthcare startup Rippl launches with $32 million in seed funding. The company will initially offer its virtual and home-based care programs through payers in the Seattle area.

People

Avel ECare promotes Kelly Rhone, MD to chief medical officer.

Dave Cassel (Safe Health Systems) joins Health Gorilla as SVP of customer success and operations.

Keltie Jamieson (Horizon Health Network) joins the Bermuda Hospitals Board as CIO ahead of its Cerner go-live next month.

Announcements and Implementations

Particle Health develops an API enabling EHR vendors to connect their customers to Carequality, CommonWell, and EHealth Exchange.

Christus Southeast Texas Health System launches a stroke-detection program using telestroke services from TeleSpecialists and care coordination software from Viz.ai.

Government and Politics

The FDA issues new guidance for clinical decision support software that should be regulated as medical devices, including AI-powered technologies that predict the likelihood of sepsis, heart-failure hospitalizations, and/or patient deterioration; as well as software that flags patients who may be addicted to opioids.

A GAO analysis of telehealth services used by Medicare beneficiaries between April 2019 and December 2020 finds that use of services increased from 5 million to 53 million visits – an increase in keeping with the temporary waiver of certain Medicare restrictions on telehealth during the pandemic, and that 5% of providers delivered 40% of services. Analysts recommend that CMS offer providers more concrete guidance on billing for audio-only visits, require providers to identify when virtual visits are conducted in patient homes, and assess the quality of virtual care delivered during the pandemic. It also recommends that OCR offer providers guidance on how to explain privacy and security risks to telemedicine patients.

VA Secretary Denis McDonough says it’s too soon to tell if an August EHR update by Oracle Cerner has finally fixed an “unknown queue” problem that caused thousands of clinical orders to disappear in an unmonitored inbox, causing patients to miss follow-up appointments. “We continue to have concerns about queues, unknown queues, unknown kind of areas where … veterans may end up,” he said. “I think that concern is significant enough that we’re not talking about a single, discrete issue that would suggest … a single discrete fix. But rather, they’re a pretty fundamental set of improvements. We’re continuing to make assessments about how big the challenge is.”

Other

Hurricane Ian leaves catastrophic damage caused by severe flooding, high winds, and power outages after hitting Florida’s West Coast Wednesday. Staff at HCA Florida Fawcett Hospital in Port Charlotte saw the ICU flood after its roof was blown off, and storm surge flood the lower level emergency room.

Sponsor Updates

• NTT Data sponsors The Children’s Inn Golf INNvitational.
• First Databank names Brittany Pritsch and Jasmine Stuckey research associates, and Nikki Sleeper regional manager.
• Get Well publishes a new case study, “Putting the patient first in digital care management.”
• Intelligent Medical Objects publishes a new case study featuring the University of Manchester, “Enhancing NLP with clinical terminology.”
• Netsmart announces its intent to become a Qualified Health Information Network.
• Sultan Bin Abdulaziz Humanitarian City in Dubai extends its contract with InterSystems for another five years.
• Clearsense publishes a new infographic, “6 Questions for Healthcare Data Transparency.”
• Zynx Health introduces a complimentary Monkeypox order set and care plan bundle.

Blog Posts

• The medical problem list toolkit (Intelligent Medical Objects)
• Execution Over Perfection: Use the ‘Gift of Constraints’ to Help Your Rehab Therapy Clinic Succeed (Net Health)
• AI in Radiology, part 5: How to amplify the impact of radiology reporting (Nuance)
• What’s a vCISO and Why Do You Need One? (Optimum Healthcare IT)
• Physician EHR as a Detriment to Patient Experience? (ChartLogic)

Contacts

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

EPtalk by Dr. Jayne 9/29/22

I spent some time in the wilderness this week, in an attempt to catch up on some sorely needed rest and relaxation. Unfortunately, changing time zones wasn’t terribly helpful on the rest piece, but there was definitely some relaxation and a lot of silliness as a group of adults tried to assemble a complicated Lego set while under the influence of cocktails. I had identified goals for this journey including completion of two specific hikes that I wasn’t able to manage on a previous trip. Although the first one was a success and helped me adjust to the altitude, the main event was a bust. I’m surprisingly OK with it and suppose I’ve reached the point in my life where the journey is equally as important as the destination, if not more. After my recent exposure to a patient injured while traveling, I’m also beyond grateful that the only problem I experienced was a close encounter between my favorite hiking pants and some tenacious tree sap.

It feels like everyone I know in the healthcare IT world is talking about the planned October 6 deadline for organizations to comply with the HHS information-sharing rule. Many care delivery organizations are relying on their EHR vendors to ensure compliance, which, depending on the vendor, has led to a flurry of last-minute upgrades. From what I hear around the virtual water cooler, vendor readiness has ranged from “competent” to “clueless,” with many vendors missing deadlines and others who are not communicating their status. This week, a group of high-profile stakeholders (including CHIME, the American Academy of Family Physicians, The American Hospital Association, and others) sent a plea to the Secretary of the US Department of Health and Human Services in an attempt to postpone the deadline. The letter asks for a one-year extension in addition to using warning communications before entities are subject to formal investigations or fines.

Reasons for a delay include: inability to support access to and exchange of electronic health information (EHI); lack of definition around EHI and confusion around the Office of the National Coordinator’s (ONC) EHI infographic; confusion on how exceptions can be applied when information cannot our should not be exchanged; concern around the protection of sensitive information such as drug use, mental health, and reproductive information; and lack of responsiveness to questions submitted to ONC. Specifically, from the patient perspective, the letter cites “the harm occurring when laboratory results and reports are released in instances of life threatening or life limiting diagnoses.” As someone who has been in that situation – which is hard to cope with even when you’re a practicing physician with medical knowledge and not just the average patient – I can support that concern completely. There will be harm, but it’s going to be impossible to quantify. If this effort were a research project, I can’t imagine the Institutional Review Board that would approve it.

Less exciting but also coming in October: it’s time for the annual updates to the ICD-10 database, effective October 1. Codes can be added, deleted, or revised. Incorrect coding can lead to payment delays or denials, so I hope everyone’s vendors and technology teams have this adequately covered. Some of the changes are certainly reflective of the times we’re living in, including: expansion of codes for various substance use disorders, indicating that the disorders are in remission; additional codes for reactions to severe stress; addition of codes for accidents related to electric bicycles; and three new codes for problems related to housing and economic circumstances. Other codes that caught my attention include six new codes for fractures related to cardiopulmonary resuscitation (CPR) and two additions for patient noncompliance with medical advice.

I was excited to see data released by Blue Cross NC addressing the increase in use of telehealth services. The company recently completed a two-year review of telehealth claims data. Based on recent trends, those covered by its policies will have access to 77 additional telehealth services effective January 1, 2023. Interesting data points: in 2020, the plan saw a 7,500% increase in telehealth claims; telehealth accounted for 47% of behavioral health visits and 10% of family medicine visits, but only 2% of specialist visits. The data is a little murky, though, because family medicine and pediatrics are listed separately from “primary care,” so I’m not sure what’s going on there, since both specialties are clearly considered primary care. I was amused by the fact that although the company’s spokesperson said the changes are “so members can access easy, affordable care no matter where they live,” the new policy specifically excludes members receiving care from out-of-state providers. Looks like vacationers might be incentivized to be less than truthful about their physical location in the name of better coverage.

Those who know that telehealth services won’t be covered by insurance might want to make sure they’re accessing care from a trusted site. One of my colleagues recently had a direct-to-consumer telehealth experience when they were trying to get relief from a rash that might have been related to insect bites but was instead told that they had been infected by flesh-eating bacteria. Although they requested a refund on the visit it was less than timely, and I’m pretty sure they’ll never use that vendor again.

Recently, I’ve been inundated with LinkedIn requests. Although some of them have been legitimate and likely triggered by networking at the recent Epic User Group meeting, others are entirely spammy. Word to the wise: I’m not going to accept your connection request if your profile doesn’t have a picture, only includes your first name, or if you’re asking me to buy something. Another pet peeve: those who prefix their names with “Dr.” without any credentials on their profile. I received a request today from someone I’ll anonymize as “Dr. Harley” and neither his first name nor his last name included “Harley.” Unless you’re a top-notch motorcycle mechanic, I’m not sure what you’re gaining by styling yourself this way.

Have you seen a burst of LinkedIn requests? Do you find them useful at all or just annoying? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 9/29/22

InterWell Health Enhances Capabilities to Transform Kidney Care with Addition of Acumen Physician Solutions

Kidney care company InterWell Health acquires Acumen Physician Solutions, which offers EHR and practice management software for nephrologists.

New Mental Health Company Led by Consumer Brand Industry Veterans to Revolutionize Mental Health Care Delivery for Seniors

Tech-enabled, senior-focused mental healthcare startup Rippl launches with $32 million in seed funding.

10 Healthcare Organizations Band Together to Urge HHS to Postpone Information Sharing Compliance Deadlines

Citing a lack of guidance on best practices and potential enforcement, plus a lack of preparedness on the part of some smaller vendors, provider organizations band together to urge HHS to give stakeholders an additional year to comply with the information-sharing compliance deadline, currently scheduled for October 6, 2022.

Morning Headlines 9/28/22

Prevalence and Sources of Duplicate Information in the Electronic Medical Record

A JAMA study of 104 million clinical notes made over six years within the Penn Medicine Health System finds that the total text of 50.1% had been copied from prior text written about the same patient.

DocSpera Raises $10 Million to Accelerate Commercialization of Automated Surgical Workflow Solutions to Hospitals and Ambulatory Surgery Centers

Surgical care coordination software vendor DocSpera raises $10 million in a Series B funding round.

Hospitals, other providers question State of Nebraska’s failure to pay health data provider

CyncHealth warns the Nebraska Department of Health and Human Services that it will no longer be able to operate the state’s HIE and PDMP if the department doesn’t make good on the $11 million owed on its contract.

News 9/28/22

Top News

A JAMA study of 104 million clinical notes made over six years within the Penn Medicine Health System finds that the total text of 50.1% had been copied from prior text written about the same patient. Duplication increased yearly, from 33% for notes written in 2015 to 54.2% for notes written in 2020.

The study’s authors say duplication “casts doubt on the veracity of all information in the medical record,” makes certain information hard to find, and causes information scatter.

The implications of copy-and-paste-induced “note bloat” were also mentioned in a recent JAMIA article, “Do electronic health record systems ‘dumb down’ clinicians?” The authors pointed out that the use of copy-and-paste is potentially misleading and dangerous. (Dr. Jayne offers a summary of and her thoughts on the members-only content here.)

Webinars

October 18 (Tuesday) 2 ET. “Patient Payment Trends 2022: Learn All The Secrets.” Sponsor: Mend. Presenter: Matt McBride, MBA, co-founder and CEO, Mend. Many industries offer frictionless payments, but healthcare still sends paper bills to patients who are demanding modern conveniences. This webinar will review consumer sentiment on healthcare payments, recent changes to the Telephone Consumer Protection Act that create opportunities for new patient financial engagement, and new tactics to collect more payments faster from patients.

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

Acquisitions, Funding, Business, and Stock

Surgical care coordination software vendor DocSpera raises $10 million in a Series B funding round.

The local paper looks at NeuroFlow’s new 16,000-square-foot office space in Philadelphia, its fifth location since launching at the University of Pennsylvania in 2016. The software company, which focuses on helping physical healthcare providers integrate behavioral healthcare services, has raised $32 million. I interviewed CEO Christopher Molaro in March.

Sales

• Baptist Health South Florida selects remote patient monitoring technology from Raziel Health.
• Mater Private Network will implement Meditech Expanse across its nine facilities in Ireland by 2024.

People

Excela Health (PA) names Vasanth Balu (Optum) SVP and CIO.

Everbridge names David Alexander (F5) chief marketing officer.

David Peterson (AccuReg) joins Edifecs as SVP of marketing.

CereHealth promotes Shane Quint to president and CTO.

Bamboo Health hires Russell Olsen (WebPT) as chief product officer.

Announcements and Implementations

Watertown Regional Medical Center (MA) launches a remote monitoring program for patients with chronic conditions using technology from Cadence.

Clearsense adds Alexandria Charts, unstructured clinical data analysis technology developed by UPMC Enterprises, to its data management software.

AGS Health announces GA of AI-powered, automated revenue cycle management services.

Allegheny Health Network (PA) adds appointment scheduling capabilities from DocASAP, part of Optum, to its Epic patient portal.

Government and Politics

The 20th Medical Group at Shaw Air Force Base (SC), Naval Hospital Jacksonville and Naval Branch Health Clinics Jacksonville, Key West, and Mayport (FL), and the 14th Medical Group at Columbus Air Force Base (MS) go live on MHS Genesis. CAFB has warned patients that hackers have created fake MHS Genesis website links to take advantage of the system transition, and to only use the official MHS Genesis website address to access information.

VA officials consider proposing new patient care eligibility standards in the coming months, including pushing veterans to telemedicine appointments before giving them the option of care outside of the VA system.

CyncHealth warns the Nebraska Department of Health and Human Services that it will no longer be able to operate the state’s HIE and PDMP if the department doesn’t make good on the $11 million owed on its contract. State officials have blamed the payment shortage on changes in federal funding. CyncHealth, meanwhile, has had to borrow money to pay its 75 employees, and has been unable to pay some of its technology vendors.

Other

An analysis of NHS England prescription and patient safety data reveals that 98 hospital trusts saw an increase in prescription errors in 2021, while 105 saw a decrease. Records indicate that 6,000 patients suffered some level of harm from those errors, with 49 experiencing severe harm and 29 leading to death. Nearly one in six NHS England facilities have yet to implement electronic prescribing.

A digital artist discovers that her medical photos are now part of a data set used to train AI image generators, despite signing a consent form indicating they were not to be shared.

Sponsor Updates

• Arcadia will host its annual Aggregate Conference October 12-14 in Chicago.
• Bamboo Health will sponsor Tufts University’s Women in Tech even October 1 in Boston.
• Biofourmis will present at DTxEast September 28 in Boston.
• ChartSpan partners with the South Carolina Medical Association.
• CHIME releases a new 30^th Anniversary Podcast, “Unity with Rick Skinner, 1999 Board Chair.”
• Clearwater will present at the Virginia HIMSS Fall Conference September 26-28 in Williamsburg, VA.
• Cloudwave will exhibit at the New England HIMSS Regional NH/VT Fall Conference September 28.
• CoverMyMeds employees have spent 1,508 hours volunteering with 100-plus organizations as part of the company’s CoverMyCommunity initiative.
• Diameter Health will present at the virtual NLP Summit October 4.

Blog Posts

• Virtual waiting rooms: How to create a five-star telehealth experience (AdvancedMD)
• Value-based care and fully delegated risk: Which model is right for your healthcare organization? (Arcadia)
• Leverage internal audit to minimize risk in medical leadership contracting and compensation processes (Baker Tilly)
• Simplifying administrative tasks for improved health outcomes and enhanced provider experience (Bravado Health)
• Digital Certificates Help Protect Healthcare Data from Cyberattack (Philips Capsule)
• Takeaways from the Chicago Care Coordination Summit (CarePort Health)
• Healthcare IT Service Desk: How to Improve Work Life Balance and Satisfaction (CereCore)
• True marriage of health and tech is needed to improve lives globally (Oracle Cerner)
• Physician EHR as a Detriment to Patient Experience? (ChartLogic)
• That Hospital EHR System Costs Too Much (EClinicalWorks)

Contacts

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

Morning Headlines 9/27/22

Clarus acquires California software company

Call triage software vendor Clarus acquires Call Simplified, which specializes in after-hours call management.

Health startup Olive fires CFO and CPO

Healthcare automation company Olive reportedly fires CFO Ali Byrd and Chief Product Officer Rohan D’Souza, a little over two months after laying off 450 employees.

PracticeTek Acquires GrowthPlug to Help Healthcare Practices Modernize

PracticeTek, a retail healthcare practice management company, acquires practice marketing and patient relationship management firm GrowthPlug.

Curbside Consult with Dr. Jayne 9/26/22

It seems like lately I have been seeing more of the patient side of healthcare than I care to. That trend continued this week as I was again pulled into the caregiver role. A close friend experienced an accident while far from home, leading to injuries that prevented them from traveling under their original arrangements. Initially, I was engaged to help arrange travel that would get them home quickly, while also accommodating medical needs. That was an adventure in itself, involving lots of phone calls, some hypothesizing about the patient’s condition, a remote airport, dense fog, and a circling plane that ultimately had to be diverted before making another attempt the next day. That kind of experience is certainly nerve-wracking for those trying to coordinate things from afar and even worse for the patient.

Because I wasn’t able to speak with the medical team at the hospital where they were treated, I was hoping to get a greater understanding of the clinical picture by reviewing the notes available in the hospital’s patient portal once the patient made it back home. Initially, I just had the information from the discharge packet, which was lacking some important elements, namely three of the four diagnoses that I expected to see based on the patient’s description of the situation and the other data on the discharge summary. However, there was an access code for the patient portal, so I was eager for the patient to login and take a look.

Unfortunately, there was a problem with accessing the portal, because despite keying in the access code and the patient’s demographic information, it wouldn’t allow us to proceed. We tried to make an account from scratch without the access code, and that didn’t work either. For some reason the system wasn’t able to validate the patient’s information. Of course, the patient knew their own demographics, and the date of birth and name were featured correctly on the discharge paperwork, so we could only hypothesize that the Social Security Number was wrong. Upon making it home, the patient called the portal assistance number on the discharge paperwork only to be told that no one could assist because it was a weekend. I joked that I hoped there weren’t any typos in the insurance information that was entered, because dealing with a denied claim can be a months-long challenge.

On Monday, the patient called the number given with the failed portal login message, and was immediately transferred not to a patient assistance line but to the hospital’s internal IT department, who couldn’t assist. After three more transfers and 40 minutes of being on hold, they finally hung up and called the Emergency Department directly. It turns out that there wasn’t a typo in the Social Security Number, but rather that it hadn’t been entered at all when the patient was registered by the Emergency Department. The receptionist was able to add it to the account, allowing the patient to finally access their information five days after the visit. We were able to see the patient’s Emergency Department progress note as well as the Radiology reports, but unfortunately there was no access to the images that would certainly be of interest to any physician with whom they’d follow up, given the nature of the injuries. There was no information on how to get the images, so we assumed there would have to be another phone call to the hospital.

On one hand, I wished the patient had known to request copies of the images while they were still at the hospital – but most patients don’t think of that, and a patient with a head injury who was having memory issues at the time definitely shouldn’t be expected to be responsible for that. The care team knew the patient was from out of state – in the facilities where I’ve worked in recent years, we’ve always been able to create a CD with images in that type of situation. It doesn’t sound like anyone offered that as an option, at least as far as the patient can remember. On the other hand, the patient doesn’t necessarily remember giving anyone a photo ID, which would be surprising in a hospital that’s part of a large integrated delivery network. At least they remember giving someone an insurance card, but all bets are off as to how the financial part of this experience will play out.

In looking at the Emergency Department note, its contents confirmed my suspicions about missing diagnoses. The physician mentioned several different findings that should have triggered additional diagnoses for the visit, but apparently didn’t. He also failed to mention the patient’s significantly elevated blood pressure and didn’t enter any comments for the patient as far as when they should follow up with someone, and what kind of physician would be advised. As a physician who has spent the last 15 years practicing in emergency care facilities, it was appalling. In every facility where I’ve worked, we’ve been encouraged to put all pertinent diagnoses on the chart and to ensure that there is a follow-up instruction noted for each and every one.

We can talk about patient engagement, quality transparency, and cost comparisons all we like, but in reality, all of that goes out the window when you require emergency care. This patient didn’t have the opportunity to shop around, to vet the qualifications of those that might be treating them or see what the cost might be for what is clearly going to be an out-of-network visit. They were prudently taken to the nearest emergency facility, which is the right thing to do when you’ve experienced head trauma, loss of consciousness, and blunt chest trauma. Unfortunately, what we call our healthcare system let them down, and without advice from their friend who happens to be a physician, they (like many patients) might be unsure of what should be done next.

The lack of follow-up is particularly concerning, especially since the patient was far from home, had fractures requiring follow-up, and the emergency physician provided less than two days’ worth of prescription pain medication. This kind of thing often leads to patients taking massive quantities of over-the-counter medications as a result and isn’t ideal in a patient with elevated blood pressures. Even if the Emergency Department had a policy to only give a set quantity of pain medications, there was no option given for local follow-up either. The patient is lucky they didn’t have complications, but their pain was poorly managed and I can’t imagine traveling in that state.

I’ve thought a lot about this situation the last few days, and particularly about the health system involved. Although the hospital was somewhat remote, the health system isn’t, and frankly I expect a little better from an organization whose core values include compassion and accountability, and whose website talks about advocating for each patient it serves. I’m glad I can help the patient navigate this situation, but the need to embrace a BYOD strategy (Bring Your Own Doctor rather than Device in this case) is a sad commentary on how patients experience healthcare more often than we think. I hope some hospital administrator reads this and questions whether this might have gone on in their organization, because based on my experience as a consultant, this situation is far from unique.

What has been your worst experience as a patient? How did you manage it? Leave a comment or email me.

Email Dr. Jayne.

HIStalk Interviews Julie Bonello, Advisor and Former CIO

Julie Bonello, RN, MS is a career CIO who is now offering advisory services for integrated care delivery models.

Tell me about yourself and your career.

I began as a pediatric intensive care nurse. I got my bachelor’s at Rush. I also had an art background. I went into research after that, and I found through using all the statistical packages that I was interested in computer science. While I was still in nursing working in research, I completed my master’s in computer science.

At that point, I jumped into health IT and then went into consulting for several years. I became a CIO in 1990 and have had five CIO positions throughout my career, mostly in the greater Chicagoland area, except for recently with Presbyterian Healthcare Services in Albuquerque.

Did your nurse background make your CIO job easier or give you a trump card to play when sorting out priorities?

I guess it was known that I’m a nurse, but I didn’t often bring it out. Not only was I a nurse, but I also had the opportunity to be oversee medical records and rev cycle. Over my career, I had strong operational knowledge. My depth of knowledge in terms of how the business actually operated and how care was delivered was always my greatest strength as CIO and understanding how technology could be used to support the business in a way that didn’t overly complicate and didn’t fragment care. I could speak with the clinicians in a way they could understand.

Sometimes as a CIO or when you’re in IT, you can step into other people’s swim lanes because you are just trying to help figure out how to leverage technology successfully. Sometimes that would happen to me, maybe more so than other people because I understood the operation so much.

How have you seen the CIO role change?

IT has become several areas within a health system. Often you’ll have a digital team. Analytics has grown significantly, so how you divvy up the data side and the analytics side has become important. As you move to cloud, it is important to figure out a consistent IT service model for all IT areas.

As we have parsed out different IT responsibilities into some other areas and as we have also changed our operating model or our IT service model, it is important for a CIO to understand the business, how care is delivered, and health IT. You’ve always had third-party relationships, but now with population health and the move to the greater continuum of care services, many health systems are partnering with third parties that have very different technology platforms. The need to understand how they can all work together simply to improve care is important, as is your relationship with your payers and understanding how your contract strategy impacts your technology strategy and interoperability. It’s very complex and has many stakeholders.

Some health systems bring in technology outsiders who have no healthcare experience, while others prefer hiring C-level IT people who understand the business and how IT can support it. How do you contrast those approaches?

It depends on how you want to structure IT. You can’t leverage technology within healthcare unless you understand healthcare and healthcare IT. If you bring in someone from the outside and make the CIO a technology position, more like a CTO, then you need someone else to help translate how the functional side of your application strategy can meet your business goals. You’re going to have to figure that out. It all depends on how you want to organize all the pieces, but fragmenting IT makes it hard to ensure cost efficiency and consistent service levels while minimizing security risk.

We’ve already seen that with a lot of the technology startups. If they go too far into using technology people without knowing the business or healthcare IT, they’re not going to be able to meet their goals. There’s a balance. You must find out how you can get it all, and there are a lot of different ways that you can do it, but you need to leverage technology to meet your business. To do that, you must understand the business and healthcare IT while driving forward with technology innovation and measuring as you go. Healthcare and HIT is complex.

Health systems have gone from running innovation centers and investing in health IT companies to acquiring and running for-profit companies. What is the impact on the IT department?

There are a lot of avenues that health systems are taking in addition to investing in startups. As someone who has been in the business a really long time, you have to figure out a way to provide healthcare simply. If you can figure that out in a way that you can pull all your partners together into a service model that is integrated and supported by an integrated technology platform that you measure, everyone’s on the same page, and their goals are the same in improving care, then great. But if you’re not all on the same page, then you might not be simplifying care.

How did you, as a C-level health system executive, see value-based care?

I focused on provider-payer integration, leveraging technology for clinical redesign and aligned with the contract strategy. You have a partnership with all your payers. If you design your care, your reimbursement, and your measurement of that and design your contract strategy to go along with that, with your payers included, I’ve seen an improvement in quality. Payer-provider integration is important.

My last three CIO jobs have been focused on understanding payer integration. That can move the needle. Now I will say that often when we design our care and measure our care, it’s not done through integrated clinical workflow with payers and providers together. They’re separate workflows.

What kind of integration or cooperation do you see between health systems and payers?

In 2015 when I was at Rush Health, I was the CIO of the clinically integrated network. The clinically integrated network oversaw the entire contract strategy for the network. We worked closely with the payers on our technology and interoperability strategy. We received information from our payers and then derived intelligence from that. We worked on what was then a rudimentary system to get the derived intelligence back into the record for follow up by the providers and care coordinators.

When you have a feedback loop getting follow up information to the providers and the care team and you’re working on interoperability, bringing information into that record so that everyone has access to it, that’s where I started to see real change.

What are you working on now?

Provider-payer integration, implementing interoperability to support a longitudinal patient record, deriving intelligence from the shared data, and getting that back into the record to improve care. My focus continues to be in these areas because I know it can really improve care. I’ve spent the last three CIO jobs focusing on how you include IT in working together with the business in designing the different governance structures that you need in place and the different service models for integrated delivery.

As we start to think through how we want to provide care across the continuum and we establish new partnerships with new companies, you’re changing the staffing model. You’re changing your care team. You’ve got a lot of different providers, but you need a consistent service model, because your patients don’t understand how you’ve now organized across many different groups of people. You must come up with an integrated clinical workflow and an integrated service design and then ensure the design is built and integrated across the entire technology platform with technology services to manage and monitor across all as well.

Both our clinical/business operating model and our IT operating models are changing. With a shift to cloud modernization, we have new third-party IT relationships, so we are changing the IT operating model, too. A change in the operating model requires new integrated governance, structures, processes. and services to ensure success.

How are you going to manage and monitor that in your health system to do that? Because it’s not just going to be within your clinics now and within the inpatient environment. It’s going to be in your home. It’s going to be all over the place as you establish new third-party relationships. That’s what I’m really trying to do, because I see that there’s more fragmentation now than ever before, and it concerns me. Interoperability or sharing data and getting it into the longitudinal record will be key.

What reflections do you have on your long CIO career and what you hope to see in the future?

I hope to see an integrated care model with a technology platform and interoperability that supports it. When we look at how we manage our healthcare in the future, we will have leaders and management structures that manage across the continuum for all that we are doing for that patient, across all of our partners in the integrated delivery model and ensuring that an interoperable technology platform is managed and monitored across the entire continuum. It requires a more integrated approach across the continuum and one that includes our payers. I think we are getting there.

I’ve been a CIO for over 30 years on the front lines. I’m at the twilight of my career, so I decided to step back and devote my time and expertise in the areas I have mentioned, where I can make a difference. I want to help improve care.

Morning Headlines 9/26/22

The Watch Is Ticking: A Five-Year Plan to Harness Wearable Health Tech

Tony Blair Institute for Global Change recommends that the UK government recruit 30% of adults to participate in wearables-powered public health interventions, restart pilots that motivate people to improve nutrition and exercise, and give people over 50 years of age free devices if they meet activity targets.

Dozens of Dartmouth Health staff being shifted to Texas-based billing company

Fifty Dartmouth Health (NH) employees will transition to employment with Conifer Health Solutions, which manages the health system’s billing and collections.

Claro Healthcare to Join Kaufman Hall

Kaufman Hall will acquire clinical documentation consulting firm Claro Healthcare.

IT restructuring at Bangor hospital’s parent organization affects more than 100 employees

Covenant Health outsources some IT functions, most notably cybersecurity, to Long80, which will offer employment to the 104 affected health system employees.

Monday Morning Update 9/26/22

Top News

Tony Blair Institute for Global Change recommends that the UK government recruit 30% of adults to participate in wearables-powered public health interventions by 2027.

It also recommends that the government restart pilots that motivate people to improve nutrition and exercise and to give people over 50 years of age free devices if they meet activity targets.

The executive summary says that the Department of Health & Social Care focuses on managing patient demand, but only one paragraph mentions prevention, which it says is essential to NHS’s survival.

HIStalk Announcements and Requests

Questionable terminology aside, the “quiet quitting” thing might be real — 45% of poll respondents say they aren’t willing to work as hard now as they did two years ago.

New poll to your right or here, following up on my conversation with Lyniate’s Erkan Akyuz: Should healthcare create a member-owned network, like banking’s SWIFT, so participants can exchange information reliably and cost-effectively?

I got my COVID booster and flu shot Thursday in the same arm at Walgreens, with no problems except a little bit of dull soreness if I rub it just right. Mrs. H had moderate fatigue and whole-body muscle aches after her injections, which leads me to hope that my minimal reaction was due to luck rather than failure to mount a robust immune response. I’m still embarrassed that the primary output is a paper card with scrawled entries, but at least Walgreens keeps an electronic record and I keep photos of my two-card set on my phone for whomever is the first person to ask to see them.

For prospective HIStalk sponsors (everybody else cover your ears): sign up now and beat 2023’s price increase, the first in many years. Tell Lorre you’re in. I appreciate the support, and my influential readers are usually interested in hearing about companies that provide it. A 2021 survey found that 94% of readers gain interest in a company that they read about on HIStalk, while 82% say they have a higher interest in my sponsors (who don’t gain any influence over what I write, in case you didn’t know that already).

Webinars

October 18 (Tuesday) 2 ET. “Patient Payment Trends 2022: Learn All The Secrets.” Sponsor: Mend. Presenter: Matt McBride, MBA, co-founder and CEO, Mend. Many industries offer frictionless payments, but healthcare still sends paper bills to patients who are demanding modern conveniences. This webinar will review consumer sentiment on healthcare payments, recent changes to the Telephone Consumer Protection Act that create opportunities for new patient financial engagement, and new tactics to collect more payments faster from patients.

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

Acquisitions, Funding, Business, and Stock

Kaufman Hall will acquire clinical documentation consulting firm Claro Healthcare.

Covenant Health outsources some IT functions, most notably cybersecurity, to Long80, which will offer employment to the 104 affected health system employees. Long80 is a collaboration between global IT services provider GAVS Technologies and Premier, Inc.

Announcements and Implementations

UnitedHealth Group’s Optum increases licensing fees for academic institutions to use its de-identified insurance claims data, forcing researchers to scramble for alternatives to spending tens of of thousands of dollars per study.

South Korea-based Hanwha Techwin integrates its intelligent IP pan-tilt-zoom cameras with Epic, which will allow hospital staff to monitor patients remotely by video and to conduct two-way communication with a remote sitter.

Government and Politics

Former HHS officials challenge an HHS OIG report’s findings that its HHS Protect system of hospital COVID-19 data collection using technology from TeleTracking, which was implemented in nine days, did not meet basic cybersecurity standards. OIG rescinded the report, citing inaccuracies, and says it will reissue a revised version.

Other

Sansum Clinic CIO Sean Johnson, RN, MHA (aka Professor Sean – he’s also a MHA adjunct at USC) posts the first in a series of nicely done consumer-focused YouTube courses called “Healthcare 101.”

Lumeris VP Rick Goddard, MS posted this graphic (click to enlarge) on LinkedIn that shows the relative strength of healthcare’s vertical integrators (Optum, CVS, Amazon, and local health systems) in each part of the care continuum. I might suggest adding Walmart and Walgreens to the chart. (You can check out his original blog on the topic here.)

Two of Saturday’s top stories in the New York Times involve the profits that are being generated by tax-exempt health systems:

• Providence’s “Rev-Up” program – designed by consulting firm McKinsey at a cost of $45 million — strong-armed patients to pay bills even if they were legally entitled to free care. The article notes that Providence avoids paying $1 billion per year in taxes while offering a low percentage of charity care, pays its CEO $10 million per year, and runs a Wall Street-style venture capital fund as part of its $10 billion reserves.
• Bon Secours Mercy Health, which generated $100 million per year in profit from inner city Richmond Community Hospital by taking advantage of 340B drug discounts and then investing the mark-up profits in wealthy neighborhoods. The Times says Bon Secours made $1 billion in profit last year, avoided $440 million in taxes as a non-profit, and paid its CEO $6 million. It says that the city gave Bon Secours a below-market lease on land to expand Richmond Community’s facilities and to open a nursing school, but the chain instead built luxury apartments and turned the hospital into a “glorified emergency room” in stripping services and shutting down its ICU. The 340B discount allows Richmond Community to buy a $25,000 per dose cancer drug for $3,400, giving the hospital an overall 44% profit margin, the highest in the state. A former Richmond Community ED doctor summarizes, “Bon Secours was basically laundering money through this poor hospital to its wealthy outposts.”

Sponsor Updates

• Ascom publishes a new report, “Nursing Satisfaction: What Matters Most at Work.”
• Oracle Cerner expands its partnership with customer King Faisal Specialist Hospital & Research Centre in Saudi Arabia to include developing shared ideas and research around data and AI.
• Optimum Healthcare IT advances to Elite Partner status in the ServiceNow Partner Program.
• Quil publishes a “Caregiver Discussion Guide.”
• Volpara Health launches a professional services program to help customers maximize the value of their high-risk cancer assessment programs.
• PodSass features SyTrue CEO Kyle Silvestro on its latest podcast.
• TigerConnect releases a new episode of The Connected Care Team Podcast, “Coordinating Clinical Workflows at CommonSpirit.”
• Volpara Health will sell RevealDx’s RevealAI-Lung, AI-powered software that helps accelerate lung cancer diagnosis and reduce unnecessary procedures, in Australia and New Zealand.
• WebPT publishes “The Complete Guide to Physical Therapy Billing.”
• West Monroe publishes a new client story, “MyEyeDr: A new digital scheduling experience increases online bookings by 2.5 times.”
• Wolters Kluwer Health publishes a new case study, “Conway Regional achieves sepsis program quality and financial goals.”

Blog Posts

• 5 metrics for a more effective utilization management program (Olive)
• Digital-first for Better Patient Outreach and Improved Response (Orbita)
• Why Providers and Patients Benefit from Value-Based Care (PatientBond)
• ONC Cures Act Final Rule: 4 Tips for Compliance by October 6 (Pivot Point Consulting)
• Research Needs Robust Data: The CDC Utilizes the PINC AI Healthcare Database (Premier)
• How Smart Speakers Can Enhance Aging at Home (Quil)
• Insights from the RCxRules 2022 National User Conference: Staffing Shortages and Remote Work are Still Top of Mind (RCxRules)
• Ophthalmology: this is enterprise imaging (Sectra)
• Soothing the Economic Sting with the Inflation Reduction Act – and Health Technology (Surescripts)
• How to leverage AI in the contact center to improve health plan member experience (Talkdesk)
• Social Determinants of Health: Where Do We Start? (Zynx Health)

HIStalk sponsors exhibiting at AHIMA October 9-12 in Columbus, OH include:

• AGS Health
• Clinical Architecture
• Intelligent Medical Objects
• Nuance
• Nym Health
• Optum
• Wolters Kluwer

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Morning Headlines 9/23/22

Acquisition Failures at VA Lead to Congressional Calls for Enhanced Oversight

Several members of the House Veterans’ Affairs Committee want to increase congressional oversight of the VA’s technology acquisitions, citing as examples its $2 billion supply chain management system adopted from the DoD and Oracle Cerner, which analysts predict will ultimately cost $58 billion.

NTT DATA Announces Intent To Acquire Apisero To Enhance MuleSoft Data Integration Capabilities

NTT Data will acquire MuleSoft consulting firm Apisero.

Bicycle Health Announces $5 Million Investment From Cobalt Ventures to Scale Its Virtual Opioid Use Disorder Treatment

Virtual opioid addiction treatment company Bicycle Health raises $5 million as part of a Series B round, bringing its total raised to $83 million.