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Morning Headlines 10/27/21

October 26, 2021 Headlines No Comments

Clearlake Capital Backed NThrive to Acquire TransUnion’s Healthcare Business

RCM platform vendor NThrive and its financial backer Clearlake Capital Group will acquire TransUnion Healthcare, the data and analytics business of TransUnion, for $1.7 billion in cash.

Anomaly Raises $17 Million To Scale Precision Payments Platform Across Healthcare Industry

Anomaly, whose platform identifies payment and billing errors before they occur, raises $17 million in a Series A funding round.

Arine Raises $11M Series A to Scale Medication Optimization Platform

Medication management optimization software startup Arine raises $11 million in a Series A funding round led by 111° West Capital Partners and Katalyst Ventures.

News 10/27/21

October 26, 2021 News No Comments

Top News

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Revenue cycle management platform vendor NThrive and its financial backer Clearlake Capital Group will acquire TransUnion Healthcare, the data and analytics business of TransUnion, for $1.7 billion in cash.

TransUnion reportedly started fielding offers for the business in early September 2021.

TransUnion Healthcare will generate $190 million in revenue this year in serving 1,850 hospitals and 650,000 physicians.

The companies expect the deal to close in Q4.


Reader Comments

From Anointed One: “Re: HIMSS Accelerate. Is anyone actually using this? They are hiring executives like it’s going to take off and I don’t see it.” I didn’t see anything interesting when I first gave it a test drive and still don’t. The skimpy content is mostly HIMSS people trying unsuccessfully to drum up conversations, pitches for HIMSS events, and the Healthcare IT News crew linking to their stories. I occasionally dampen the enthusiasm of people who think that an online platform is needed to support unmet demand for health IT collaboration (I bought this cool hammer – anybody got a nail?) with these observations from experience in watching similar sites die young:

  • Sites like Accelerate rely on unpaid participants to create content for each other to consume. Few people are interested in doing that, especially busy executives.
  • Free or not, sites need to be clear on what they offer and why users should care. It’s not enough to just put up a discussion site and wait for participation to skyrocket.
  • It has always been hard to build and keep an online audience whose needs are inconsistent and who have many alternatives.
  • Use of information sharing sites is nearly always sporadic because people don’t log on until they need something from other users (a question answered, a contact provided, experience shared) and then go MIA until their next need arises.
  • Discussion sites are like unhosted parties, where just telling people to drop by, bring their own food and drink, and join unknown strangers who have nothing better to do is sure to fail.

Webinars

October 28 (Thursday) 1 ET. “A New Streamlined Approach to Documentation and Problem List Management in Cerner Millennium.” Sponsor: Intelligent Medical Objects. Presenters: Deepak Pillai, MD, physician informaticist, IMO; David Arco, product manager, IMO; Nicole Douglas, senior product marketing manager, IMO. IMO and Cerner announce the launch of the IMO Core CSmart app, an in-workflow offering to improve clinical documentation and problem list management in Cerner Millennium. The presenters will review the challenges and bottlenecks of clinical documentation and problem list management, discuss how streamlined workflows within Cerner Millennium can reduce clinician HIT burden, and demonstrate how IMO Core CSmart can help clinicians document with ease and specificity, improve HCC coding, and make problem lists more relevant. Additional sessions will be offered on November 17 and December 1.

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


Acquisitions, Funding, Business, and Stock

Anomaly, whose platform identifies payment and billing errors before they occur, raises $17 million in a Series A funding round.


Sales

  • Northwell Health (NY) will implement Cedar’s after-visit patient engagement and payment software.
  • Kingman Regional Medical Center (AZ) selects Oneview Healthcare’s Care Experience technology.
  • LifePoint Health expands its use of Loyal’s patient experience technology solutions and will implement its new platform.
  • SCL Health will create a centralized OB hub using PeriGen’s PeriWatch Command Center enterprise-wide telehealth platform.
  • CloudWave announces that seven healthcare organizations have gone live on its recently announced OpSus Cloud Services, which offers managed hosting, disaster recovery, systems management, security, backup, and archiving services that support 125 healthcare applications.

People

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CitiusTech promotes Bhaskar Sambasivan, MEng to CEO. Co-founders Rizwan Koita (CEO) and Jagdish Moorjani (COO) will leave their executive positions but remain on the company’s board.

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Mercury Healthcare (formerly known as Healthgrades) names Chris Hackney (Cision) chief product officer and Manish Goel (Envision Pharma Group) CTO.


Announcements and Implementations

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Redox develops a connector to Microsoft Cloud for Healthcare, giving Microsoft Azure users the ability to convert legacy EHR data to the FHIR R4 standard.

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Amazon launches Alexa Smart Properties for healthcare facilities, giving hospitals an easy way to deploy and manage Alexa devices across the enterprise. Early adopters include Boston Children’s Hospital, Cedars-Sinai (CA), BayCare (FL), and Houston Methodist.

Vodafone and Deloitte create a strategic alliance and digital solutions accelerator.

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Cerner launches Cerner Enviza, an operating unit that combines expertise from Cerner and its acquired real world data vendor Kantar Health.


Government and Politics

Britain’s finance ministry will allocate $2.9 billion for technology improvements across the NHS as part of an $8 billion spending package aimed at decreasing appointment wait times.


Other

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Stamford Hospital and Stamford Health Medical Group recover from a server failure late last week that forced them to enact downtime procedures, including diverting ambulances and rescheduling elective procedures.


Sponsor Updates

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  • CoverMyMeds raises $175,000 for cancer research.
  • Netsmart will exhibit at the 2021 LeadingAge Annual Meeting and Expo through October 27 in Atlanta.
  • The Northwest Regional Primary Care Association features Azara Health in “How Automated Outreach with Luma Health & Azara is Helping an Alaska FQHC Keep Patients Healthier.”
  • About partners with The Baldridge Foundation to develop new LeaderDialogue content for healthcare leaders.
  • Cerner VP and CNO Melissa Solito, RN wins the G2Xchange’s Leading for Impact, Women in Leadership award.
  • ChartSpan publishes a new guide, “Help Me Choose: SaaS versus Fully Managed Chronic Care Management.”

Blog Posts


Contacts

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

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Morning Headlines 10/26/21

October 25, 2021 Headlines No Comments

Amazon Brings Alexa to Senior Living Communities and Healthcare Systems with Alexa Smart Properties

Amazon launches Alexa Smart Properties for healthcare facilities, giving hospitals an easy way to deploy and manage Alexa devices across the enterprise.

Clinigence Holdings Announces The Acquisition Of ProCare Health

Population health management company Clinigence acquires managed services organization ProCare Health.

UK Plans $8 Billion Package to Boost Health Service Capacity

Britain’s finance ministry will allocate $2.9 billion for technology improvements across the NHS as part of an $8 billion spending package aimed at increasing capacity.

Curbside Consult with Dr. Jayne 10/25/21

October 25, 2021 Dr. Jayne 1 Comment

I always enjoy reading other physicians’ blogs and “A Country Doctor Writes” doesn’t disappoint. When your tagline is “notes from a doctor with a laptop, a house call bag, and a fountain pen,” how can you go wrong? A recent piece titled “American Primary Care is a Big Waste of Time (When…)” had some really good points. He mentions that using scribes in medicine is “almost medieval” and draws a parallel to how books were copied prior to the invention of the printing press. Where other fields are focused on scaling and automation, US primary care is still “doing things one patient at a time.”

I don’t disagree, but I think it’s important to note that there are a number of cultural factors behind how we do things in addition to the technical ones. It’s still difficult at times to get patients to participate in group visits or group classes regarding their health issues, and the pandemic didn’t make that any easier. Our consumer-driven culture and the need to obsessively groom our patient satisfaction scores don’t always support our efforts to streamline care or create consistent workflow processes. Team-based care can certainly help, although some organizations are better at it than others. One of the first things he notes as a time saver is something I’ve been begging physicians to do for years – creating standing orders for health maintenance or preventive measures and letting appropriate support staff enable those activities.

His next point is something I hadn’t thought about in such a clear context, that physicians are “forced to act as if we only see our patients once – ever, instead of over several visits year in and year out. We can’t see you quickly for your sore throat or UTI, because a visit without the required screenings hurts our quality ratings.” This became much more of an issue with the transition to EHR and the Meaningful Use incentive programs, where physicians were tasked with capturing a tremendous amount of information when the patient presented for their first visit of the calendar year. He points to asynchronous interactions via email, events, and other modalities as potential solutions, although he notes that some physicians are still reluctant to embrace these methods because they’re still paid primarily based on direct patient interactions.

I’d like to see greater flexibility by healthcare organizations to accept data flowing into their EHR from other sources. As I’ve mentioned in previous posts, I still work with health systems that don’t recognize other hospitals’ data for the purpose of satisfying gaps in care, even though it’s available on the system and visible to the patient and providers. EHR technology now supports this, but for some reason, administrators have chosen not to turn it on at one of my sites of care, so there’s always some confusion at the beginning of a visit.

He notes that unless physicians in the traditional US primary care model can adapt, patients will move away to concierge medicine, direct primary care, retail clinics, and other care environments. Some practices are definitely better than others at adapting to new models of care and harnessing the payments available when they participate. Some of my colleagues have refined their practices to the point where their quality scores are so outstanding that they can command additional bonuses beyond what anyone else in the region receives because they’ve embraced new models. Others are electing to retire early, and some are just reacting to changes in the marketplace rather than trying to proactively evolve their practices.

This theme isn’t limited to the musings of a country doctor, however. The Harvard Business Review dove into the topic recently with an eye-catching headline that “The US Health Care System Isn’t Built for Primary Care.” Citing this spring’s report from the National Academies of Sciences, Engineering, and Medicine, they note the conclusion that “primary care is the only medical discipline where a greater supply produces improvements in population health, longer lives, and greater health equity.” The author notes that “current efforts to wring ‘value’ from primary care by focusing on diagnostic algorithms and quality metrics reveal fundamental misunderstandings of primary care’s purpose. The attempts to apply processes and technology designed for subspecialty care to the delivery of primary care have proven insufficient to support the complex work of the primary care team.”

The article poses that unlike other specialties, “the heart of primary care’s success remains a unique relationship between physicians and patients built on trust.” Although I’d like to agree, and a decade ago I might have, there has been a substantial erosion of that trust over the last two decades. When patients had to start changing primary care physicians when their employers went with cheaper insurance plans each year, those relationships became less valuable. The evolution from patient to consumer and customer further eroded the relationship, and new generations who never experienced the ”old-time family doctor” visit didn’t understand its value as they prioritized convenience and speed given their busy lives. The pandemic has put that shifting trust into focus, where some patients are more likely to believe things they read on social media than to trust the advice of their primary care physician.

The section headed by “Primary Care Doctors Are Not Subspecialists” was particularly thought-provoking. Where procedural subspecialists are more likely to be served by checklists, templates, and process-driven approaches, primary care has to be more dynamic. Often the outcomes of primary care are achieved over a period of years rather than months, which makes it more challenging to understand the cost/benefit equation. Money that is spent by commercial insurers during a patient’s employed years might not lead to savings until disease is prevented or caught early, at a time when the patient might be covered by another payer or even by Medicare.

The author lists three places to focus on reinventing primary care, and they’re all things that plenty of others have been saying.

First, we need to reform the payment model since the US spends 50% less on primary care than any other developed nation. Future payment models must support multidisciplinary primary care, and according to the author, “should include predictable cash flow up front, in recognition of primary care as a common good in society.” We’ve tried to do that in the past with capitated payments with varying degrees of success, and although there are organizations that have figured out how to do this well, others seem to want to reinvent the wheel rather than learning from experience.

Second, the author notes a need to fix EHR technology, to create systems that are “clinical first” and are integrated across all facets of healthcare. Now that we’re over the initial implementation hurdles, it’s time for healthcare organizations to optimize what they have and to push their vendors to deliver additional capabilities and efficiencies.

Third, the author proposes that we change medical education. Many practicing physicians were trained in “big hospitals that glamorize subspecialty and inpatient care.” As someone whose medical school didn’t even have a department of family medicine, I know what that’s like. Hearing comments like “you’re too smart to do primary care” isn’t going to encourage the best and brightest to gravitate to the field (although more people in my class went into family medicine than general surgery, which was a blow to the surgical egos at my institution but gives me some hope).

Technology is at the intersection of many of these concepts and will need to keep pace with other changes as the healthcare environment evolves. EHR and other clinical systems vendors have been varyingly successful at this, with some systems moving towards greater integration in a logical fashion but others growing by acquisition and bolt-on solutions, which adds to the feeling of fragmented care. There’s plenty of discussion about “disruption” and “innovation,” but some days it just feels like we’re nibbling around the edges of the problem. A couple of organizations are poised to make some significant change, and I’m eager to see what they come up with.

Not everyone is going to need subspecialty care in their lifetime, but all of us are consumers of primary care services. Do we know the answers but just need to implement them, or are there solutions we’re still not talking about? Leave a comment or email me.

Email Dr. Jayne.

HIStalk Interviews Mike Linnert, CEO, Actium Health

October 25, 2021 Interviews No Comments

Mike Linnert, MBA is founder and CEO of Actium Health (formerly known as SymphonyRM) of Palo Alto, CA.

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Tell me about yourself and the company.

Actium Health helps health systems and payers with CRM intelligence. We take all the data they have about their members and identify “next best actions” to drive lifetime value for the members. Before founding Actium Health, I grew up doing similar things for companies in the wireless and financial services industries, and before that, I was investing in consumer internet companies.

What could “next best action” look like for me as an individual consumer, both inside and outside healthcare?

Starting outside healthcare, the goal is to drive lifetime value for a customer relationship. Some “next best actions” don’t have revenue or profit associated with them in the near term, but their investment is in the long-term relationship.

I’ll give you some of the simplest ones I started with. When I was in the wireless industry way back in the early 2000s, you might have called the call center with a question about your bill. While we had you, we might have observed that last month you could have saved $3 had you been on the 100-messages plan instead of the 50-messages plan. You as a consumer would think, “Great! That’s great,” and we as the wireless provider would feel like, “We helped you save some money, but also we probably encouraged you to do more texting, which is something that we wanted you to do anyway because it attaches you to your device more.” Things that you liked about our service, and in the long run, we probably decreased your propensity to churn. And if we increased your usage of text messaging, we hopefully increased the value that you saw from us.

As you get more complex, you can think about perhaps your wealth advisor at your bank. At any given time, your wealth advisor might know that you forgot to make your 529 education contribution for one of your kids, you didn’t make an IRA contribution this year, you haven’t rebalanced your portfolio, or mortgage rates have gone down and you could potentially refinance your mortgage and save some money. The ”next best action” involves which of those things is most valuable to you. I’m a wealth advisor, so my job is to stand by you, not to stand by the products and broadcast out to you, “Hey, this product fits you.” I stand by you, you tell me about your needs, and then I say, “Here’s the most important thing. I know your kids are important to you. If we only have five minutes to talk today, let me focus on the 529 plan.” But to do that, I have to come up with what the most valuable thing is for you. We bring AI to do that on behalf of the wealth advisor or the health advisors here in healthcare.

Is it uncomfortable for providers to think of the lifetime value of a given patient and to reach out to them to offer more services, either to bring in more revenue, to benefit the patient, or both?

It shouldn’t be. The goal is to drive the lifetime value of the relationship. If I ever slammed you products you don’t need, I should assume that you’re going to turn and go somewhere else. Maybe there’s some near-term profit, but over the long run, you’re not going to be with me any more. You’re going to find somebody who takes care of your needs better.

In the financial services example I gave, the goal was to say, “What is most valuable to you and to our relationship?” In healthcare, let’s assume that I’m on a value-based care model with my local health system. The health system knows that I’m past due for a colonoscopy, and maybe they know that I haven’t seen a primary care doc in the last three years. Maybe from looking at their data, they suspect I’m high probability for having kidney disease and don’t know it.

At least for me as a patient, I would love it if the health system didn’t worry about whether they were violating the revenue goal, or violating something about our relationship, and instead felt a moral imperative to reach out and tell me, “Hey Mike, based on the data we have, we think it’s worth you taking this health risk assessment for kidney disease” or “here are the top three reasons that you should come in and see your primary care doc.” I would like them to be reaching out.

Certainly what I don’t want, and what would be violation of HIPAA marketing, is for them to be hawking drugs that may or may not fit me, or to let me know that they have a new partnership with a local imaging center and I should consider going there. Those aren’t the things I want. But I do want things that help drive health for me and my family.

Some patients, especially younger ones, don’t necessarily see the value of ongoing engagement with a health system or primary care physician. How do providers convince them of the value of that engagement or use “next best actions” to address their needs?

You have to step back and, again, talk about what drives lifetime value. Your point is exactly right. What drives lifetime value for my dad in the health system is very different from what drives lifetime value for my son in the health system. My dad wants to know that the health system is proactively thinking about him, looking at the data they have about him, and proactively reaching out to engage him. My son wants to know that they are there if he needs them, so maybe they let them know that he can schedule through text messages or which simple conditions could be managed at urgent care at a lower cost and shorter wait time than the ER.

You have to think about what these things are for each cohort. That is the whole point of the “next best actions” approach. We are developing one-to-one dialogues that for each customer, think uniquely about the things that we have that can create value. I’m not trying to upsell and cross-sell so much as I’m trying to up-serve and cross-serve. If I serve you better, that will drive the loyalty.

I’ll give you a stat so you have a sense of why I think this is important. If I look at Verizon and AT&T, I might say it’s customer churn. I haven’t looked in a while, but last time I looked, it was around two to three percent. Two to three percent of their customers leave them each year. Health system churn, from our back of the envelope math, is between 20 and 30%. It is 10X. What we think we provide is a highly personalized, highly customized solution. You have to ask ourselves why that’s happening.

Healthcare switching costs might be lower than for changing cell providers, and some degree of unavoidable churn occurs because people change employers or their insurance changes. Some people also don’t need or have any provider interaction in a given year. Is healthcare different where they might come back to a provider when they need them or decide that someone else might address their problem more readily?

The difference between total churn and addressable churn is absolutely important. Someone may have moved away someone or switch to plans your physicians aren’t in. But that doesn’t put a big enough dent in the 10X difference that you would say, “This isn’t important to me.” For a lot of health systems, if you haven’t been in to see your primary care or other doctor in two to three years, they make you re-onboard. You have to go see a nurse again before you can see the doctor. We don’t want to do that.

We especially don’t want to do that for the younger generation you mentioned. We’re just helping them. They may not want to see a doctor for one to two years. But during those years, those patients have been thinking about their health. I saw a study that said that the average American spends 11 to 12 hours a month online reading about health information.During that time, I promise you that the people online who are giving them that health information —  it could be Google, it could be other health websites — they want those members, patients, or customers as customers of theirs, too. People realized that the lifetime value of having a customer relationship centered on healthcare is very high.

The other big trend that’s happening right now is value-based care coming on scene. Value-based care is enabling a lot of competitors to build lucrative businesses around having deep customer relationships. In the old model of healthcare, to make a lot of money, you had to have a lot of specialists, because that’s where the money was. In value-based care, you can make a lot of money by keeping people healthy and having good, loyal relationships. You see people like One Medical, VillageMD, Walmart and CVS getting in and saying, “If there’s a new way to have consumer service-based relationships with patients and healthcare, that’s an opportunity.”

How does a health system run “next best action” programs for both their population health and marketing programs without confusing the consumer and making sure that each campaign’s messages are appropriate?

This is where you have the two-canoe problem, with fee-for-service and value-based care competing. But if you scratch a little deeper and look at individual contracts and different incentives, you probably have closer to a 200-canoe problem, with different people and different incentives. But that’s the whole point of the “next best action,” one-to-one dialogue approach. We want to figure out for everybody, what is the most valuable thing we can say to you based on what we know about you?

Let me give you an example of what the differences could look like. I’m going to give you some directional numbers that aren’t exactly correct. If I was a health system, I might ask, what is the value to me as the health system of bringing someone in for a breast cancer screening? Of course there’s value in that I am supporting my patients, but if I look at it on a dollar basis, I would say for every 100 screens I do, I’m going to do about 10 diagnostic follow-ups. I’m probably going to discover one case of cancer, and about half of those I’ll end up treating. Just ballpark numbers there.

For most health systems, if you did the expected value of the margin at each level there and multiplied them up, you’d get about $250. And if I get really good at predicting that women in this cohort are six times more likely than average, reaching out to those women and getting them in is potentially worth $1,500 to me, six times more than average. If I flip it around and ask the community, “What’s it worth if I reach out to you, invite you to come in, and we find that you have cancer and you weren’t otherwise going to come in?” it’s a lot. Because if you didn’t come in, that cancer was going to be much worse by the time we found it.

In a value-based care world, where I make money is by not finding cancer, or finding it so early so I stave off the later costs. That’s worth $250 for an average fee-for-service, but double that on a value-based care contract, closer to $500, to be doing those screenings to avoid the cost of finding later-stage cancer. That’s in addition to bonuses that I unlock or business value I unlock because I hit five stars on my screening, or because I met some threshold in a contract, and I’m able to market my Medicare Advantage plan differently. If you start to take all those into account, you start to realize that for health systems that are truly in value-based care models, there’s enormous value to proactively reach into the community and find people who have cancer and don’t know it. Or reaching into underserved communities and pulling people in that need care from us.

A survey written up on your website found that consumers perceive that their doctors and hospitals ignored them during the pandemic by not answering their phones or reaching out. What is the opportunity for health systems to move ahead from that?

I’m going to give you three quick examples. From January 2020 until now, our customers have increased proactive digital outreach by 10X, and I think there’s still another 10X to go. I think my health system should be reaching out to me at least once a month proactively with, “Here’s your family health income statement and balance sheet” or “Here are new services we have” or “Here are things you should know about what’s going on in the community.”

Second, I move around between health systems. Kaiser is not a customer of ours, but I’m going to mention something they did. During COVID at the peak, Kaiser was sending me three emails a month or even per week on some occasions. Three emails a week. And they were valuable, meaty emails. I liked reading them. They were telling me about positivity rates in my community. Stuff that I was really curious about and stuff that, had they not said it, I would have gone on Google. Kaiser was providing me a service.

The third thing is that last year, cancer diagnosis in the US was down by about half. We didn’t cure cancer last year. What did happen is that half of all the cancers that we probably would normally have discovered got worse. They went untreated, they went undiscovered. Health systems, to my way of thinking, have almost a moral imperative to be reaching out to people, to be looking through the data and saying, “Where are the communities that are most underserved? Who are the people that we think are at higher risk of breast cancer? How do we reach out to them and get them in for screening?” Most of those screenings are free. We have a free service that helps you discover and stave off cancer. That’s not to say anything about kidney disease and all the other diseases that went unaddressed faster that we need to get back to.

Where do you see the industry and the company in the next 3-4 years?

We’ve been talking for a long time that healthcare is a consumer service. If we are a consumer service, then there are some things that are fundamentally true, and you can look around at other consumer service industries. Most importantly, we need to stop thinking about patients as customers. We need to start thinking about people as members. Members have a recurring relationship with you. It’s enduring, it needs to be taken care of, and if you don’t, other people are going to come take your members. And if we have members, then we need to be thinking about how to drive value, delight, and loyalty among our members. Value means value they get from us, delight how happy they are, and loyalty our ability to influence behavior. We do that with “next best actions.”

Value-based care is the sport of the future. It may take a while, but it is the sport of the future. That pay-vider model is coming fast. New competitors are coming in to take advantage of that if our current health systems don’t. Our job is to work with today’s health systems and payers to say, this what’s coming. We can help you bridge the gap to this membership model. To this proactive engagement, where you drive value, delight, and loyalty. We have the portfolio of “next best actions” to do it. At least as I know it today, we are the only company that is working with healthcare providers that hang expected values on “next best actions,” and that is critical to investing and making them happen.

Morning Headlines 10/25/21

October 24, 2021 Headlines No Comments

23andMe to buy telehealth firm Lemonaid for $400 mln

Consumer DNA testing company 23andMe will acquire telemedicine and online pharmacy vendor Lemonaid for $400 million in cash and shares.

Cerner CEO acknowledges more layoffs are coming

Cerner President and CEO David Feinberg, MD, MBA confirms an anonymous employee’s Reddit comment that Cerner will lay off 150 workers in early November.

Oak Street Health Acquires Virtual Specialty Care Provider RubiconMD

Medicare primary care provider Oak Street Health acquires RubiconMD, which offers PCPs electronic patient consults with specialists.

Monday Morning Update 10/25/21

October 24, 2021 News 5 Comments

Top News

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Consumer DNA testing company 23andMe will acquire telemedicine and online pharmacy vendor Lemonaid for $400 million in cash and shares.

23andMe says the acquisition it will extend its ancestry foundation into information about health risks and treatment that will “transform the traditional primary care experience and make personalized healthcare a reality.”

23andMe went public in June 2021 via a SPAC merger that valued the company at more than $3 billion. Shares are up 2% since versus the Nasdaq’s 8% gain.


Reader Comments

From HLTH Watcher: “Re: HLTH and ViVE conferences. Does reader feedback encourage you to attend? I’m considering it for next year or the year after depending on how HIMSS22 goes.” Maybe. Below are the attendee comments I received. My personal challenges with attending to write up the proceeds for HIStalk are: (a) as an introvert, I don’t love attending conferences; (b) I pay my own way to conferences using a phony job title instead of requesting a media pass so that I get a true on-the-ground impression of exhibitors, so my cost would be significant; (c) ViVE ends five days before HIMSS starts, leaving me unsure how to get the most out of two back-to-back conferences in Florida without sensory overload; and (d) HLTH22 is in Las Vegas, a city I avoid whenever possible. I’m sure HIMSS is watching closely since the new competitive threats of HLTH and CHIME could siphon off some of the HIMSS decision-making audience that has kept exhibitors paying, although HLTH momentum could fade if the stock market takes a hit that deflates some high-flying digital health startups that it draws. Meanwhile, HIMSS updates its conference page to reflect HIMSS22, which will offer both an in-person and digital track. The exhibitor count is at 378.

From John Moore: “Re: HLTH. I attended and it’s mostly a conference for smaller VC-backed companies and their investment partners. Exhibit hall was quiet with exceedingly few end user buyers and customers. Small companies had the ability to meet with larger health IT incumbents for potential partnerships. The good part of HLTH is that no other event outside of JPMorgan brings in executives from all facets of healthcare, which provides a broader perspective. The not-so-good is that outside the love fest between startups and their investors, there’s not much for users or patients, it has excessive glamor and glitz, and it’s definitely not worth the expense of attending unless you have networking objectives.”

From Dan Nigrin: “Re: HLTH. I was again impressed. The content and exhibitors represent the future of our industry. At least 100 small startups had friendly people stationed in their small spaces ready to explain things intermingled with larger companies instead of being relegated to some faraway exhibition space. Equally interesting was the gradual entry of more traditional HIT vendors. Panel and keynote discussions were interesting and relevant, many of them with standing room only. Disclaimer – I’m on the CHIME board, which is putting on VIVE together with HLTH this spring.”

From Diligent Scribe: “Re: HLTH. The exhibit hall was never overwhelmingly crowded, but flow of folks was consistent. It felt about perfect since booths were spaced but the exhibit hall didn’t feel bare. As a first-time attendee, what struck me was the quality of attendees and the variety of titles they represented. such as lots of transformation and innovation folks. This led to deep, high-quality conversations in our booth as well as offering a tremendous opportunity to talk with existing and prospective partners. The educational sessions were informative and not a regurgitation of the same old, same old. I felt it was a worthwhile use of my time and the company’s expense, to the point that I’m considering skipping HIMSS next year and just doing CHIME, VIVE, and HLTH since all three together cost less than HIMSS and likely deliver better results due to their content and the audience.”

From Love Doctor: “Re: Surescripts medication histories. Our health system received a patient safety notification that medication histories from two pharmacies were missing the slash or hyphen in the dose, which could cause a dose of ‘take 1-2 tablets a day as needed’ to display as ‘take 1 2 tablets a day as needed’ in Epic. Surescripts has removed the dosage portion of the medication history and Epic has provided a list of patients whose reconciled histories were impacted and removed those that were uncreconciled.” 


HIStalk Announcements and Requests

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Two-thirds of providers failed to review the available medical records from other providers in the most recent encounter of poll respondents.

New poll to your right or here: Which healthcare organization provided the poorest customer service in your recent personal or family experience?

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Welcome to new HIStalk Platinum Sponsor Verato. The McLean, VA-based company — the identity experts for healthcare — enables better care everywhere by providing the single source of truth for identity to organizations across the care continuum, including providers, payers, healthcare technology, life sciences, public health, and HIE organizations. Over 70 of the most respected brands in healthcare rely on Verato’s next-generation cloud identity resolution platform for a complete and trusted 360-degree view of their patients, provider networks, and customers in their communities. Organizations can integrate with its HITRUST-certified platform at every step of the care journey across CRM, EHR, enterprise analytics, and digital health experiences quickly and at scale. Thanks to Verato for supporting HIStalk.

I found this explainer video for Verato’s MPI on YouTube.


Webinars

October 28 (Thursday) 1 ET. “A New Streamlined Approach to Documentation and Problem List Management in Cerner Millennium.” Sponsor: Intelligent Medical Objects. Presenters: Deepak Pillai, MD, physician informaticist, IMO; David Arco, product manager, IMO; Nicole Douglas, senior product marketing manager, IMO. IMO and Cerner announce the launch of the IMO Core CSmart app, an in-workflow offering to improve clinical documentation and problem list management in Cerner Millennium. The presenters will review the challenges and bottlenecks of clinical documentation and problem list management, discuss how streamlined workflows within Cerner Millennium can reduce clinician HIT burden, and demonstrate how IMO Core CSmart can help clinicians document with ease and specificity, improve HCC coding, and make problem lists more relevant. Additional sessions will be offered on November 17 and December 1.

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


Acquisitions, Funding, Business, and Stock

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Cerner President and CEO David Feinberg, MD, MBA confirms an anonymous employee’s Reddit comment that Cerner will lay off 150 workers in early November.

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Shares in London-based digital health tools vendor Babylon Health closed their first day of trading Friday up 18% following its SPAC merger, making founder and CEO Ali Parsadoust, PhD a billionaire. The company predicts 2022 revenue of $710 million and that its losses will turn into profit in 2024.

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Medicare primary care provider Oak Street Health acquires RubiconMD, which offers PCPs electronic patient consults with specialists.


Sales

  • Hendrix Medical Center (TX) goes live on a newly created TeleMFM (maternal-fetal medicine) service offered by SOC Telemed and Ob Hospitalist Group. SOC program allows 94% of women with high-risk pregnancies to receive prenatal care and delivery services in their own communities instead of seeing specialists in urban centers.

People

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KONZA National Network hires Jeff Messer (ToolWatch) as COO/CFO.

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David Finn, MA (CynergisTek) joins CHIME as VP over its affiliated professional groups.

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Hillrom promotes J. B. Leeming to area VP of digital health.


Announcements and Implementations

Ninety-one percent of surveyed healthcare professionals say that fixing broken administrative processes is healthcare’s most urgent need for improving patient care, while patients having their medication history readily available to any provider they see would do the most to improve their outcomes. Nearly all healthcare professionals in the Olive-sponsored survey predict that healthcare AI use will be widespread by 2026, but patients remain skeptical.


Government and Politics

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A Florida state audit finds that case managers of its compensation program for brain-damaged children didn’t consult experts and instead Googled medications, therapy, supplies, and surgeries to decide which were medically necessary. The organization amassed $1.5 billion in assets while sometimes arbitrarily denying or delaying care while offering no appeals process for parents. It did not use a system to track denials or complaints, leading the state’s CFO to observe, “Why is a program of this size doing record-keeping with CD-ROMs?” The program’s executive director resigned on September 21 ahead of the report’s release.


Other

The employee relations department of Phoenix Children’s Hospital (AZ) emails 370 unvaccinated employees using CC:, thus exposing the list of recipients to all. I was thinking as I was writing this that not many people have seen an actual “carbon copy,” just as many computer users know the “save” icon even though it depicts a floppy disk that they have never physically touched.


Sponsor Updates

  • Olive launches The Library, a marketplace offering key distribution channels for industry pioneers.
  • Ascom and Ellkay bolster their respective offerings with RingCentral’s message, video, phone, and call center capabilities.
  • RxRevu receives Cerner’s Partner of the Year Award.
  • Sectra publishes a case study, “One for all – native support for automated breast ultrasound in Sectra’s expanded breast imaging PACS.”
  • Spok publishes a new infographic, “Burnout in healthcare contact centers.”
  • Waystar will exhibit and present at the MGMA MPE21 Conference October 24-27 in San Diego.
  • West Monroe publishes a client story, “Demand for a seamless patient experience drove this health system to innovate – and led to 5X faster results.”
  • Vyne Medical plants hundreds of trees as part of its “Growing Vyne Day” environmental sustainability effort.

HIStalk sponsors exhibiting at the CHIME Fall Forum October 27-30 in San Diego include Bluetree, Clearwater, Meditech, Divurgent, Ellkay, Optimum Healthcare IT, Clearsense, Imprivata, Cerner, HCI Group, Spok, InterSystems, Infor, Quil, Experian Health, and Agfa HealthCare.

Blog Posts


Contacts

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

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Weekender 10/22/21

October 22, 2021 Weekender No Comments

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Weekly News Recap

  • Vanderbilt University Medical Center reports that patient-to-clinician messages doubled when it started posting lab results immediately to its patient portal as required by the Cures Act.
  • Virtual care company Babylon begins trading on the NYSE via a SPAC merger that values the company at $4 billion.
  • Microsoft enhances Cloud for Healthcare and Teams with expanded virtual visit capabilities.
  • General Catalyst and Jefferson Health form an innovation partnership in which the health system will use technologies from the venture capital firm’s Health Assurance Network of companies.
  • The merged Grand Rounds Health and Doctor on Demand rebrand as Included Health.
  • Transcarent announces that it will offer Walmart’s pharmacy services to its self-insured employer customers.

Best Reader Comments

Appreciate the shift in language from “follow the science” to “evidenced-based.” The latter may be less intimidating and widen the door for more shared decision making as the patient and provider collect and review the “evidence” together. (Quynh Tran)

Love it when someone relatively new to the industry has all the answers and calls out the “crooks in the room” who don’t have all the answers – or does have them but they don’t want to share them?! (Steve Ex Twitter)

Am I the only one who thinks that the ratio of “Innovation Conferences” to “actual implemented, at scale innovation” is probably the highest in our industry compared to other sectors? Somehow, other industries keep making my life better through innovation without needing to have some many innovation conferences :). What gives? (Ghost of Andromeda)

Can we talk about how pretty much all of the interoperability standards for healthcare are not secured? HL7 is not an inherently secure protocol. DICOM is not an inherently secure protocol. I don’t think X12 are inherently secure protocols either. The protocols don’t support any native encryption and have little to no authorization/authentication mechanisms. So our healthcare InfoSec friends basically have two overlapping options: 1) encapsulate these messages in a protocol that is secure; 2) Use network microsegmentation to limit which endpoints on your network are allowed to talk to your databases. The problem with #1 is that while it’s doable in theory, and there is even an RFC for doing this with X12, I haven’t seen any commercial products or solutions that implement it. (Elizabeth H. H. Holmes)

Correct that HL7 v2, DICOM, X12 etc. do not have security in the protocols themselves – they are routinely secured by microsegmentation as detailed. I’m not persuaded that it’s more mistake prone than the alternatives – and it’s at least easier to test (but does need testing). FHIR is different – it’s built on the the web stack in order to get web level security. But as the report shows, that requires actual commitment to security to get right. But #2: a commit to metasploit… sounds like a good idea for someone to do. (Grahame Grieve)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. K from Arizona, who asked for hands-on math learning tools for her special education class of fourth and fifth graders. She reports, “The materials have arrived, and my students have loved using them during virtual teaching and learning! Thank you for supporting education and helping students develop a love of math! These math materials are awesome at inspiring students to keep learning and to be able to visualize important math concepts.”

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TV show “The View” demotes its health and safety manager Nurse Wendy after two fully vaccinated hosts tested positive – apparently falsely –-for COVID-19 minutes before Vice-President Kamala Harris was scheduled to go on in late September. The hosts tested negative several times after the incident despite their original positive PCR test. Host Sunny Hostin was angered because her surgeon husband had to be pulled out of the OR because of her false positive and the incident required her medical information to be revealed without her authorization. The show had previously honored Wendy Livingston, RN with an extensive on-air tribute as a healthcare hero.

A Seattle man is indicted for impersonating a nurse for 10 years by stealing the identity of a former college classmate. He had been discovered and fired several times but kept finding new nurse jobs, most recently as a care home’s director of nursing.

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A hospital ED nurse wheels a stretcher to the helicopter ambulance only to see that the occupant is her boyfriend – who is also an ED nurse at the same hospital – who dropped to his knee to ask her to marry him. She said yes.


In Case You Missed It


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Morning Headlines 10/22/21

October 21, 2021 Headlines No Comments

Association of Immediate Release of Test Results to Patients With Implications for Clinical Workflow

Vanderbilt University Medical Center finds that immediately releasing lab results to the patient portal, as required by the Cures Act, was associated with a doubling of the number of patient-to-clinician messages that were sent immediately afterward.

Chubb Can’t Sidestep Settlement For Canceled Trade Show

A federal court rules that the insurer for HIMSS20 has to cover the organization’s settlement with exhibitors of the cancelled conference.

Babylon, one of the world’s fastest-growing digital healthcare companies, to begin trading on the New York Stock Exchange under the ticker BBLN

Virtual care company Babylon combines with SPAC Alkuri Global Acquisition Corp. to begin trading on the NYSE.

Ann Arbor’s Workit Health raises $118M in Series C funding round

WorkitHealth, developer of a virtual care app for addiction treatment, raises $118 million in a Series C funding round.

News 10/22/21

October 21, 2021 News No Comments

Top News

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Vanderbilt University Medical Center finds that immediately releasing lab results to the patient portal, as required by the Cures Act, was associated with a doubling of the number of patient-to-clinician messages that were sent immediately afterward.

The percentage of patients that saw their results before their provider had reviewed them jumped from 10% to 40%.

The report didn’t investigate whether patient questions about their results drove the increased messaging.

VUMC delayed release of results to patients based on test sensitivity and complexity until January 2021, which it met Cures Act requirements.

The authors question whether the unintended consequences of immediately sending results to patients, such as patient wellbeing and clinician workload, outweigh the benefits. 


Reader Comments

From Dolla Bill: “Re: executive compensation. Obscene and pointless – you can only spend so much.” Business ambition is another ultimately pointless diversion in the continuum of birth to death since we all know that hearses don’t pull U-Hauls. We all strive in our own ways to earn “gone, but not forgotten” status even though the legacy we create – other than our children – usually fades away after one generation no matter what we leave behind.

From Periodically Panned: “Re: new health IT publications. Seen these? New HDM and something from Modern Healthcare.” Health Data Management has been resurrected as part of a South Carolina non-profit health collaborative, while Modern Healthcare owner Crain Communications has announced a “digital media brand” that rolls up some databases it bought via an acquisition this summer. I didn’t see anything on either website that hasn’t been amply covered elsewhere and most of their content would have been irrelevant to me personally, but it’s the opinion of a potential audience rather than mine that counts.

From HLTH on Wheels: “Re: HLTH21. What have readers said about the conference compared to HIMSS?” I haven’t heard from anyone who attended, but I’m interested as well, especially with regard to sponsors and the exhibit hall since those are what make or break a conference. Most of the social media comments I saw were from folks who focused on socializing or attending celebrity panel discussions for which in-person attendance seems to add little value over virtual viewing. Perhaps academically focused attendees could research the validity of the oft-repeated conference-goer claim that the networking alone makes in-person attendance worth it (they don’t usually add “to my employer, who is paying the cost.”)

From Rx Wrangler: “Re: Walmart and Surescripts. I heard that incorrectly barcoded medications caused medication reconciliation errors this past weekend, similar to incidents from 2014 in which special characters in a drug database caused prescriptions to be listed incorrectly. Have you heard anything?” I haven’t, but reports are welcome.

From Cricket: “Re: high-cost patients. See this Twitter thread from Jay Parkinson, MD, MPH.” I like it. Jay postulates that nearly all VCs are seeking investments that address the 5% of Americans that consume 50% of healthcare costs, but the reality is that improving their situation won’t move the needle much on overall costs because those people in the 5% fall into three groups:

  • Those who are chronically sick whose situation can be improved with interventions. That might reduce overall cost 3% at best.
  • Those who have an unpredictable incident, such as an accident, who will go back to being low spenders the next year.
  • Those who are dying expensively. It’s easy to predict who they are, but there’s little ROI to intervene because the health system is geared to take advantage of heroic Western medicine by making huge profits from their final months.

Webinars

October 28 (Thursday) 1 ET. “A New Streamlined Approach to Documentation and Problem List Management in Cerner Millennium.” Sponsor: Intelligent Medical Objects. Presenters: Deepak Pillai, MD, physician informaticist, IMO; David Arco, product manager, IMO; Nicole Douglas, senior product marketing manager, IMO. IMO and Cerner announce the launch of the IMO Core CSmart app, an in-workflow offering to improve clinical documentation and problem list management in Cerner Millennium. The presenters will review the challenges and bottlenecks of clinical documentation and problem list management, discuss how streamlined workflows within Cerner Millennium can reduce clinician HIT burden, and demonstrate how IMO Core CSmart can help clinicians document with ease and specificity, improve HCC coding, and make problem lists more relevant. Additional sessions will be offered on November 17 and December 1.

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


Acquisitions, Funding, Business, and Stock

Hackensack Meridian Health becomes one of the first health systems to use Google Workspace and Chrome OS devices (3,000 Chromebooks and Chromeboxes running Citrix) across its clinical and business environment. The health system will also deploy Google Cloud’s AI/ML solutions for screening and disease detection.

AI Visualize sues Nuance and Mach7 Technologies, demanding royalties for what the company says is infringement on its image-sharing technology patents. AI Visualize has a minimal web presence and seems to employ mostly patent attorneys.

Venture funds operated by investment firm Carlyle invest $430 million to take a majority position in clinical trials management and analytics platform vendor Saama.

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Microsoft announces enhancements to Cloud for Healthcare:

  • Microsoft Forms has been integrated into Bookings so that schedulers can collecting patient information while scheduling virtual visits.
  • Microsoft Teams adds a Waiting Room so that virtual visit patients can receive messages and notifications providers can send from their queue view.
  • Providers using Cerner PowerChart can launch virtual visits from the patient portal or SMS with no patient app download required. Multi-participant virtual visits will also be supported.

Sales

  • In the UK, NHS Wales chooses Australia-based Citadel Health’s Evolution VLab software for pathology, replacing three separate systems that manage 35 million tests each year.
  • Blue Shield of California will move toward real-time provider payments using AI/ML tools from Google Cloud.
  • Pharmacy benefits management company Vivid Clear Rx chooses Banjo Health’s prior authorization management solution.

People

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Hospital medical equipment tracking system vendor Cohealo hires Tom Cady (Kareo) as SVP/COO.


Announcements and Implementations

An InterSystems-sponsored study finds that 80% of surveyed health system executives don’t trust the data they use to make decisions. Half of the respondents say that lack of data integration and interoperability is the biggest barrier to achieving their strategic data analytics priorities.

The Vaccine Credential Initiative and The Commons Project will hold a webinar next week on using SMART Health Cards as a digital vaccination certificate that includes well-known speakers such as Andy Slavitt, John Halamka, Micky Tripathi, and Aneesh Chopra, 


Government and Politics

A federal court rules that the insurer for HIMSS20 has to cover the organization’s settlement with exhibitors of the cancelled conference.

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The Department of Defense’s program to use smart watches and rings to predict COVID-19 infections ends, with its former program manager blaming DoD’s sluggish innovation processes. A team that included Philips Healthcare ported a previously developed algorithm that mined EHR data to predict illness to commercially available wearables as a “check engine light” indication that something unusual is happening. The program manager says the big problem was that DoD needs to categorize projects to determine which regulations apply (is it a weapon, a platform, or a system?) and it could not decide if the tool was a medical device.


Sponsor Updates

  • EVisit launches the Change Healthcare Podcast featuring co-founder and CEO Bret Larsen and co-founder and CTO Miles Romney.
  • The Surescripts White Coat Award recognizes a dozen healthcare leaders for improvements in e-prescription accuracy and patient safety.
  • Everbridge launches its Unlocking Resilience Podcast with an episode featuring William Shatner, “Resilience Makes the Leader.”
  • Vyne Medical publishes a podcast titled “Connecting with Today’s Consumer: A Closer Look into the State of Healthcare Consumerism.”
  • Jvion publishes a new whitepaper, “Smart Healthcare: The AI-Enabled Patient and Population Healthcare Journey.”
  • Lyniate names Shelley Wehmeyer (Cerner) director of product marketing.
  • Meditech congratulates customer Kingman Regional Medical Center (AZ) for on receiving Health Current’s 2021 Health IT Innovation Award.
  • Nuance will present at the CHIME Fall Forum October 27-30 in San Diego.

Blog Posts


Contacts

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

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EPtalk by Dr. Jayne 10/21/21

October 21, 2021 Dr. Jayne No Comments

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There has been lots of chatter with my IT friends around the Windows 11 rollout. Most of the large organizations I’ve worked with over the years would rather risk letting their operating systems become so dated that they’re almost not supported rather than consider being on the cutting edge of a new release. I worked with several people who I thought would need to have Windows XP pried out of their cold dead hands, but somehow everyone survived their upgrades. From a consumer standpoint, several of my physician friends have run the “compatibility check” from Windows and are concerned that they may not be able to support the new release, but it’s usually due to requirements that they can meet but that aren’t enabled.

Apple is preparing to move AirPods into the medical device space. Temperature and posture sensors are on the horizon, as well as the ability to use them to augment hearing. Using them to check temperature in the ear isn’t a tremendous leap, but I’m less convinced about the posture sensor’s proposed slouch-detecting capabilities. AirPods Pro already have the “conversation boost” functionality, but it’s not clear whether they’re going to expand on this or offer something else for hearing loss. Having been part of plenty of dinner table conversations where dead hearing aid batteries have been a factor, I’m not sure how that’s going to play for Apple either.

As technology becomes smaller and has the potential to bring new diagnostic modalities to the bedside, it becomes more important to evaluate whether they’re really better than the status quo. There are some big discussions going on regarding whether robotic-assisted surgeries really deliver better outcomes than non-assisted procedures, and I’ve seen some pretty heated debates on the matter in the physician lounge. I enjoyed reading this article in JAMA Internal Medicine regarding so-called point-of-care ultrasound (POCUS). The headline sums it up: “Visually Satisfying Medicine or Evidence-Based Medicine?” Over the last several years, primary care journals have had plenty of editorials and discussions about the technology. It’s pretty slick, whether you’re using a dedicated device or something that hooks into your phone. But it requires training to interpret the images and seems to be best used by people who have the opportunity to use it frequently, rather than by individuals who might use it sporadically. The authors note that although “it has become the standard of care for most common bedside procedures” that “its use for diagnostic purposes is not as firmly grounded in evidence demonstrating net benefit on patient outcomes.”

They point out some key challenges for POCUS – that its use is somewhat informal and that images may not be accessible for later review. There is also a lack of clinical trials that have looked at key clinical outcomes such as length of stay or complications from a missed diagnosis. The variability between users is also a concern. They authors call for additional studies as well as the ability to capture images for later review. This may be a field where artificial intelligence might come into play to help with those retrospective reviews, flagging studies with concerning findings for immediate review as well as creating a quality assurance model for overall use. I always enjoy a scholarly article that has a little flair, and the description of POCUS use as “viscerally satisfying” is on track both for accuracy and in making my inner reader smile.

I had virtual drinks with a friend who works in the accountable care organization space and asked her what she thought about this piece regarding the transition to eCQM reporting. She agreed that the process is painful and shared some of her own experiences with the process. CMS is apparently listening and has pushed back the timeline for the transition, but it sounds like some of the EHR vendors might not be as on top of things as they need to be for ACO leaders to feel comfortable. It’s important to remember that ACOs might be dealing with data from dozens of disparate EHR platforms and making sure that the measure specifications are consistent is a significant challenge.

The article calls out a key challenge of electronic quality reporting, that users have to enter the data in the fields where the reports are looking for the reports to work. If there is a lot of dictation or speech recognition documentation being performed at the expense of discrete data entry, numbers aren’t going to look very good. Early in my consulting career, I worked with a number of health systems on their Meaningful Use efforts and it’s more difficult to change end user behavior than you might expect. My more successful clients baked discrete data entry into their physician compensation programs, which as you might expect led to a rapid transition.

JD Power released the results of its 2021 US Telehealth Satisfaction Study. Of the 4,600 patients surveyed, Teladoc was ranked number one for the time period from June 2020 to July 2021. The survey ranked providers based on customer satisfaction, consultation, enrollment, and billing / payment categories. Some interesting tidbits: although telehealth usage was consistent across generations, the highest use was among Generation Y (born 1977 to 1994) and the “Pre-Boomers” born before 1946. Top reasons for use include convenience, timeliness of care, and safety. Top concerns noted include difficulty accessing care and inconsistent service, which given the pandemic and its impact, I’m not surprised. Rounding out the top five, in order: Teladoc, MDLive, MyTelemedicine, Doctor on Demand, and LiveHealth.

Researchers at Stanford and UNC are looking at a wearable medical device that can deliver vaccines. The hope is that it will make it easier to distribute vaccines in underserved areas, but I’m sure there are plenty of people that will still see it as a product of a vast conspiracy. The 3D-printed vaccine patch works without the traditional injection and is said to also work more effectively than current delivery techniques. Using microneedles, the vaccine is delivered intradermally (into skin) rather than into muscle, creating a significant immune response. Part of the magic is that the 3D printing method allows creation of microneedles of controlled geometries which are difficult to manufacture via other means, which leads to greater retention of the vaccine within the skin. I’m a huge fan of prevention, so I can’t wait to see what they come up with next.

Fall is here in my world, with daily temperatures swinging 50 degrees during the course of a 24-hour period. I’m heading south for a little bit of sunshine before I have to deal with freezing temperatures and the potential of increasing COVID-19 transmission as people move their activities indoors. It will be good to get a little break because my latest project has me spinning in circles, but in a good way.

What are you doing to prepare for fall and ultimately winter? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 10/21/21

October 20, 2021 Headlines No Comments

GoCheck Raises $10 Million in New Funding to Protect More Children from Vision Impairment and Blindness

Digital vision screening technology vendor GoCheck raises $10 million in a funding round led by Hatteras Venture Partners and Pisgah Fund.

Bardavon Health Innovations Secures $90 Million in Series C Funding to Advance True MSK Technology Platform Beyond Workers’ Compensation Care

Worker compensation technology company Bardavon Health Innovations raises $90 million in a Series C funding round.

Marathon Health Unveils First-of-its-Kind Virtual Primary Healthcare

Occupational healthcare company Marathon Health launches a virtual primary care service for employees that includes telemedicine, remote patient monitoring, and care navigation and coordination.

Morning Headlines 10/20/21

October 19, 2021 Headlines No Comments

General Catalyst and Jefferson Health Announce Innovation Partnership

General Catalyst and Jefferson Health form an innovation partnership in which the health system will use technologies from the venture capital firm’s Health Assurance Network of companies.

Insiteflow Raises $2.3M to Accelerate Electronic Healthcare Record (EHR) Workflow Interoperability

Insiteflow will use a $2.3 million investment to further develop integration software that enhances the interoperability between third-party apps and EHRs.

TripleBlind Lands $24 Million in Series A Funding Led by General Catalyst and Mayo Clinic, in an Oversubscribed Round

Privacy-enforcing data sharing platform vendor TripleBlind raises $24 million in a Series A funding round that includes the participation of Mayo Clinic.

News 10/20/21

October 19, 2021 News No Comments

Top News

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General Catalyst and Jefferson Health form an innovation partnership in which the health system will use technologies from the venture capital firm’s Health Assurance Network of companies.

GC’s Health Assurance Network portfolio includes Commure, Tendo, Transcarent, and Olive.

The announcement suggests that Jefferson will de-emphasize the “hundreds of technology solutions who are vying for a piece of the hospital system’s growing technology budget” and instead will give preference to the General Catalyst-backed vendors.

Retiring Jefferson Health CEO Stephen Klasko, MD, MBA co-wrote “Unhealthcare: A Health Assurance Manifesto” with General Catalyst managing partner and billionaire Hemant Taneja last year.


Reader Comments

From Yuma Dew: “Re: having a PCP who knows you. It seems more important that they know your data.” I agree that “knowing about me” is a lot more important and achievable than “knowing me.” One of the most important clinician functions should be contributing and consuming patient data across providers, even though patients have low expectations and payers don’t seem to care. Thoughts:

  • My direct primary care doctor “knows me” because of the nature of that kind of relationship, but I doubt that has much impact on my health. She still documents the elements she needs to remember.
  • I don’t have records from other providers to review, but if I did, I should expect (and prepare to be disappointed) that they will be available if needed.
  • The provider should review my documentation before my visit, whether in-person or virtual, so they aren’t wasting our limited time together. Taking a 10-second glance at a printout before knocking on the exam room door is not ideal.
  • EHRs aren’t always ideal at allowing providers to tag those parts of a patient’s record that they find especially important or relevant.
  • The provider should document whatever is important to both of us even if it is in narrative form. My perception of symptoms her to-do items for down the road are as important as recording conveniently numeric lab or vital signs data. For that reason, Microsoft Word with speech-to-text might be a better documentation platform than an EHR if it didn’t have to generate bills.
  • We should all choose providers who value our data, maintain it rigorously, and share it with us so we can verify its accuracy and understand their thought process. That data should paint a concise picture for another provider who receives our records via interoperability.
  • Every provider who is being paid to work on the patient’s behalf — specialist, telehealth, therapist, pharmacy, urgent care, etc. — should be held accountable for documenting their work into the patient’s “permanent record” that at this stage of interoperability is mostly a pipe dream. By definition, they are documenting what is important to them, so that same information would likely be important to other providers and thus to the patient. Why should we expect less?

Webinars

October 28 (Thursday) 1 ET. “A New Streamlined Approach to Documentation and Problem List Management in Cerner Millennium.” Sponsor: Intelligent Medical Objects. Presenters: Deepak Pillai, MD, physician informaticist, IMO; David Arco, product manager, IMO; Nicole Douglas, senior product marketing manager, IMO. IMO and Cerner announce the launch of the IMO Core CSmart app, an in-workflow offering to improve clinical documentation and problem list management in Cerner Millennium. The presenters will review the challenges and bottlenecks of clinical documentation and problem list management, discuss how streamlined workflows within Cerner Millennium can reduce clinician HIT burden, and demonstrate how IMO Core CSmart can help clinicians document with ease and specificity, improve HCC coding, and make problem lists more relevant. Additional sessions will be offered on November 17 and December 1.

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


Acquisitions, Funding, Business, and Stock

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Israel-based Navina, whose AI model turns point-of-care data into a “Patient Portrait” for PCPs, raises $15 million in a Series A funding round. The co-founders worked in Israel’s military intelligence AI labs.

Privacy-enforcing data sharing platform vendor TripleBlind raises $24 million in a Series A funding round that includes the participation of Mayo Clinic.

Trinity Health (MI) invests $1 million in digital prescription referral vendor Xealth, increasing its Series B funding round to $25 million.

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Redi.Health raises $1.3 million in seed funding to develop technologies and services for chronic disease management. Offerings currently include a patient-facing app with medication management, symptom tracker, educational content, and PHR. The startup offers pharma support companies the ability to integrate their services with the app. Co-founder and CEO Luke Buchanan was previously with CoverMyMeds, as was co-founder and Head of Business Development Nate Rehm.

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Insiteflow raises $2.3 million. The company has developed integration software to enhance the interoperability between third-party apps and EHRs.

Health insurer software vendor HealthEdge will acquire Wellframe, which offers digital health management solutions for health plans.


Sales

  • UnityPoint Health (IA) will work with B.well Connected Health to offer patients access to all of its digital health tools in a single app.

People

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Fivos hires Susan Andrise (Global Payments) as CFO.

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Availity names former US Navy SEAL Jim McNary (Consortium Health Plans) COO.

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Remote patient monitoring platform vendor Veta Health hires James Sutcliffe (DayToDay Health) as CEO.


Announcements and Implementations

InnovaQor subsidiary Health Technology Solutions announces GA of virtual CIO services focused on IT infrastructure security and management.

Grand Rounds Health and Doctor on Demand rebrand as Included Health, the name of the healthcare navigation and care concierge vendor the merged companies acquired several months ago.


Other

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A CHIME survey of member CISOs finds that nearly 50% have experienced a phishing email or compromising business email at their organizations within the last year, while nearly 30% have suffered through an EHR or system outage. Fifteen percent have experienced a patient safety incident related to a cyber event, and 10% have had to divert patients as a result. Top areas of needed cybersecurity assistance include grants and federal assistance, and on-site guidance and expertise from cybersecurity experts associated with regional extension centers.


Sponsor Updates

  • Change Healthcare releases a new podcast, “Cost Transparency: Driving Better, More Informed Care Decisions.”
  • CHIME releases a new Digital Health Leaders Podcast featuring John Kravitz, chairman of the CHIME Board of Trustees and CIO of Geisinger Health, and Marc Potash, founder and CEO of Certify Global.
  • Clearwater Chief Risk Officer and SVP of Consulting Services Jon Moore will present at The Healthcare MSO Conference October 22 in
  • Dimensional Insight announces it has been named a top performer in KLAS Research’s “Data and Analytics Platforms 2021” report.
  • Tegria publishes a new case study featuring Engage, “EHR Implementation Project Transcends Multiple Natural Disasters.”
  • EZDI will exhibit at the ACDIS Conference October 25-28 in Dallas.
  • Healthcare Triangle advances to Google Cloud Premier Partner status based on its success in building, deploying, and managing Google Cloud solutions for healthcare and life sciences organizations

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Morning Headlines 10/19/21

October 18, 2021 Headlines No Comments

Grand Rounds Health and Doctor On Demand Rebrand as Included Health

Grand Rounds Health and Doctor on Demand rebrand as Included Health, the name of the healthcare navigation and care concierge vendor the newly merged companies acquired several months ago.

West Monroe eyes platform expansion after MSD deal

A strategic investment from MSD Partners will enable digital consulting firm West Monroe to expand in the US and abroad, beginning with the opening of a new London office next year.

CoverMyMeds, Beam vets found startup taking on chronic disease management

Redi.Health raises $1.3 million in seed funding to develop technologies and services for chronic disease management.

Curbside Consult with Dr. Jayne 10/18/21

October 18, 2021 Dr. Jayne 5 Comments

I was feeling a bit bummed this weekend, as I couldn’t attend the HLTH conference due to a previous commitment. I do a little dabbling in amateur radio and had been asked by a local radio club to be a station operator for the World Scout Organization’s “Jamboree on the Air” event. It’s held the same weekend in October every year and is a chance for young people around the world to talk to each other via radio (an internet component was added in 1995). There is always a big contingent from Germany on the air and it’s fun to try to have your scouts reach someone from every state as well as reaching international scouts. Women are typically a small percentage of any amateur radio gathering and I think it’s important for girls to have role models in tech hobbies, so I packed my gear and headed out.

Usually there is a lot of time for chitchat as you’re assembling antennas, staking them out, running cable, and figuring out how things are going to work when you’re trying to operate from a location you’ve never been. My team for the event included a search and rescue specialist, a retired Navy signal operator, an Eagle Scout, and a retired electrical engineer. Whenever people find out I’m a physician, they always ask where I practice, which can be tricky to explain based on what I do. When I mentioned that I’m only practicing virtually right now, the electrical engineer’s ears perked up. It turns out he’s got a little broader experience than electrical engineering. After receiving his degree in the 1960s, he started doing work in the then relatively new arena of biomedical engineering, specializing in the design of technology for the practice of nuclear medicine, but also in expanding the use of computers in healthcare.

Based on that, I figured I could go a little further and tell him that I spend the majority of my time working with electronic health records and emerging technologies such as chatbots, artificial intelligence, etc. and he was very interested. He asked if I had ever heard of “a guy named Larry Weed” and I said of course. Apparently my new radio friend had done some collaboration with him on his problem-knowledge coupler software in the 1980s and had some great firsthand stories about how that technology was received by physicians (not as well as it might have been) and how it evolved. It’s always interesting to learn from people who worked with the founders of our specialty and what they were like not only as innovators but as people. Had I gone to the HLTH conference, I certainly would have missed out on my own healthcare IT oral history project.

The day ended up being a lot of fun and hopefully we were able to get some young people interested in the art of radio. They enjoyed hearing how amateur radio operators can help in natural disasters and other emergencies, and they really loved learning how to craft Morse Code messages using some vintage code keys. Fortunately, conditions were such that they were able to chat with scouts on the radio from coast to coast, but the parents’ eyes were widest when they saw our teenage radio operator having a live Morse Code conversation with someone 2,000 miles away.

Online, they connected with scouts from Iceland, Taiwan, Finland, Japan, Cyprus, the UK, Serbia, and more. One of the highlights of the day was a radio “fox hunt” where the scouts had to use a directional antenna to find a hidden transmitter more than a quarter of a mile away, especially since the reward for successfully finding the fox involved chocolate chip cookies.

In addition to learning about Dr. Weed and his efforts, I picked up a couple of other tidbits along the way. The best radio tip was how to make an easily assembled and effective antenna mast out of a fiberglass paint roller extension pole, and needless to say I have since added one to my collection. We’ll have to see if the Homeowners Association has anything to say when I test it on my front lawn.

Back to HLTH, I’ve been getting some reports from the field, and it sounds like there is some good networking going on. Telehealth seems to be a hot topic, along with remote patient monitoring. I haven’t heard any grumbling about HLTH’s health and safety protocols, which involve not only proof of COVID-19 vaccination, but also a negative test within 72 hours of picking up your attendee badge at the conference. For those unable to get a test at an approved provider, onsite testing is available. Reading through the documentation on the HLTH website, the conference is picking up the tab for the onsite pre-event testing. It notes that optional testing will be available at no cost for anyone who wants to test throughout the event.

In the details, however, it specifies that attendees must have active US health insurance coverage “to receive free onsite services,” which tells me they’re not actually free — there just isn’t a patient payment required. We’ll all be paying for those “free” COVID tests that everyone is getting so they can attend events through higher insurance premiums and increased cost-sharing to the patient. As of this weekend, one of my local sports teams is requiring proof of vaccination or a timely negative test prior to attending events, and local urgent cares are already feeling the pressure.

Tuesday night is the HLTH Foundation Gala, and I hope people will share reports about the evening as well as photos of any sassy shoes or bedazzled masks they may encounter. I’m sure a lot of people have missed being able to dress up and go to events like these, so I’m betting at least one person will go all-out. At $250 per ticket, I hope the dinner is good and the entertainment is engaging. If not, the cocktails will certainly help. Maybe I’ll bust out some high heels and a martini glass and attend in spirit from my living room.

Are you at HLTH, and what’s your take on the event? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 10/18/21

October 17, 2021 Headlines No Comments

Walmart Selects Transcarent To Provide Go-to-Market Solution for Self-Insured Employers

Transcarent will offer Walmart’s pharmacy services to its self-insured employer customers.

West Monroe announces strategic investment by MSD Partners

MSD Partners will make a strategic investment in digital consulting firm West Monroe.

Right on Cue: NBA finds high-tech option for virus testing

The NBA will allow its players to self-test for COVID-19 via Cue Health, which provides a smartphone-connected nasal swab reader to provide results in 20 minutes.

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