Curbside Consult with Dr. Jayne 7/8/24

I enjoyed having some time off around the recent Independence Day holiday. Costco’s holiday cake did not disappoint, although I’m not entirely sure why it had 61 stars. Kudos to the cake decorator who managed to fit them all on there, even though there were a few spares. I hope everyone had a safe holiday and is heading back to their respective work weeks without any injuries that were caused by heat or fireworks.

Since I had some downtime, I worked through some training assignments for a new clinical employer. It’s always interesting to start at a new company and find out how they handle all the mandatory training sessions for providers. It’s not just HIPAA, but also Medicare-related fraud, waste, and abuse training, controlled substance training, and more.

The organization that I’m contracted with also includes cultural competency sessions as well as those on diversity and inclusion, rolling those up under a larger curriculum on being an effective clinician. One would hope that we learned these things during our training, but I understand their need to cover all their bases and make sure that everyone in the organization is operating under the same expectations.

Along with many of my colleagues who work in emergency and urgent care settings, sometimes we aren’t employed by the facility where we’ll be working. Many of us work for staffing companies or third-party medical groups that have contracted with the facilities to provide physicians. In addition to doing the training required by the organization that is actually paying us, we also have to do the mandatory trainings for the facilities where we’ll be working, even though the content is often similar. There’s no reciprocity for these trainings, sometimes not even within the same health system, and it can be mind-numbing to sit through so many duplicate sessions of the same content published under the auspices of different medical staff offices.

Depending on the situation, many physicians, especially those who are working for large, privately held telehealth providers, are considered independent contractors. The contracts are often heavily one-sided and physicians aren’t paid for the time spent in training, which is a bit of a double-edged sword as far as balancing attentiveness with the financial bottom line. I think most people would be more likely to pay attention if they’re being paid a fair rate for attending classes. However, when they’re asked to go through nearly a full day of training sessions without compensation, it seems like a recipe for people to multitask or otherwise not take the training seriously.

The training I completed this weekend had the added pain of misrepresenting the length of various modules, making it challenging to fit it into my allocated time frame. For example, a module that was advertised as “10 minutes” actually involved reading a densely formatted 40- page document, then attesting to having read and understood its contents. I’m no expert in reading comprehension, but I think that expecting someone to digest a full page of text in 15 seconds is unrealistic.

Even more concerning, that large document contained numerous links to other policies and procedures that we were also expected to attest to understanding, which is just ridiculous. I’m sure a good number of people just click through it and check the box, which isn’t going to serve them well if something bad happens. A couple of the links were broken, so I had to email the physician liaison team to get copies of the policies that I’m expected to read. I wonder how many of us are actually asking for the documents versus just going through the motions. Maybe asking for the documents from the broken links is a test to see if we actually read the pages.

Some of the other training sessions were sloppily constructed. For example, a 60-minute course contained three, 30-minute sessions. It feels like someone updated the training and threw something else into the course but didn’t update the learning management system with the correct information. The modules themselves had clearly been edited over time, and not with particular skill. Audio levels within a single recording ranged from virtually inaudible to painfully loud. 

Some of the written materials were pretty humorous. You have to wonder when a slide spells out “E-H-R” with intervening hyphens if it’s because they really don’t know that it’s simply “EHR” or whether they haven’t figured out how to adjust their slideware’s dictionary to keep it from autocorrecting to “HER.” There were also a couple of places where the voiceover incorrectly pronounced common medical words, which didn’t’ give me a lot of confidence.

The next piece of the onboarding that raised concerns was the organization’s demand for adherence to its conflict of interest policy, which basically says I can’t practice medicine anywhere else but at this facility. That conflicts with the whole ideal of being an independent contractor, and the idea certainly wasn’t included in any of the initial contracting documents that I signed.

Asking someone to sign a restrictive agreement after you’ve already contracted them is sneaky, to say the least. Other words that come to mind are “deceitful” and “unethical.” Another email was fired off, because I’m definitely not signing it. I only wish I had come across that little nugget sooner, because I wouldn’t have sat through several hours of unpaid training if that piece had been at the front.

I’m also wondering if there’s a whistleblower opportunity here, because if they are blocking the ability for independent contractors to have other employment, that sure sounds like a problem to me.

It’s sad when you feel burned out before you even start. I’m questioning whether I want to work for these people at all, even if we can resolve the various issues. If you can’t get the basics right, I have little confidence in your ability to support me through unwarranted patient complaints or a nuisance lawsuit.

I haven’t even made it to the EHR part of the training yet, which I was actually looking forward to because it’s always nice to see how someone else has their system configured and whether there are any tips and tricks that you didn’t already know. I’ll certainly chime in if I make it to the EHR training and strike gold.

What’s the most disappointing onboarding experience you’ve had? How does your current organization do better? Leave a comment or email me.

Email Dr. Jayne.

Readers Write: Revitalizing Healthcare’s Backbone by Empowering Nurse Leaders

Revitalizing Healthcare’s Backbone by Empowering Nurse Leaders
By Russ Richmond, MD

Russ Richmond, MD is co-founder and CEO of Laudio. 

Nursing remains one of the most challenging parts of the healthcare ecosystem. Frontline nurses who are contending with understaffing and concerns for patient care continue to raise alarms and exit their roles.

Beset with high turnover and burnout rates, nurse managers constantly grapple with handling high spans of control and associated challenges without sacrificing patient care, quality, and organizational outcomes. A recent report noted that 20% of nurse managers are contemplating leaving their positions, and that the average nurse manager stays in their role for just two years. These figures point to deeper structural issues with the current state of nursing leadership roles and the overdue need to bring technology to these problems.

Another recent report that was co-published by the American Organization for Nursing Leadership (AONL) noted that the median span of control for nurse managers is 46 direct reports, making genuine engagement with team members on a day-to-day basis nearly impossible. Even more startling, 25% of all inpatient nurse managers have over 78 direct reports, further hindering meaningful manager-employee engagement.

The report also drew a direct correlation between nurse managers with large spans of control and higher rates of burnout, turnover, and incremental overtime on their teams. These consequences have real financial implications for health systems, especially as staffing costs and turnover continue to be some of the largest detractors from financial and organizational stability in healthcare. Better support for nursing leaders results in higher engagement scores among their teams and reduced turnover, both of which are targets of numerous initiatives among health systems.

As an industry, we frequently discuss transformation in healthcare, especially in a post-COVID environment, and how we need to work differently to improve outcomes for our patients and organizations. Yet the people who have the most direct impact in linking C-suite goals with frontline action are often overlooked. Few tools exist today to directly enable frontline nurse leaders to handle increased workloads while maintaining strong connections with their teams, which drives positive outcomes across the board. The same report referenced above noted:

• A strong correlation between the number of purposeful leader engagements (e.g., regular check-ins, recognition, celebrations) with team members and crucial metrics like higher team retention.
• A lack of span-breaking assistant managers with roles that are designed to share administrative burdens and support people processes.
• An absence of deep HR, IT, and nursing department partnerships to enable nurse leaders with the right tools to achieve broad job responsibilities.

To date, innovation in nursing has primarily centered on clinical areas, with novel technologies like virtual nursing and remote monitoring of patients taking priority over investments that enable leaders to propagate broad operational and people-based positive change within their teams. This focus must expand and transition to a holistic approach that is aimed at easing the burden frontline nurses and their leaders face today.

A few examples of how organizations can use new approaches to create a broad positive impact across nursing teams include:

• Use intelligent technology to automate much of the rote people work that frontline leaders perform today to allow them to their time where it matters most – on purposeful engagements with their teams.
• Automate clinical documentation wherever possible to reduce administrative burden through solutions that simplify EHR workflows.
• Introduce innovative leadership models to reduce spans of control and enable leaders to have more humanizing relationships with their team members and the work they do (e.g., dividing large departments into multiple parts, leveraging assistant nurse managers to break spans of control, utilizing nurse educators to lead professional development activities and continuing education around the nursing profession).
• Allow flexibility for team members by implementing new and improved staffing and scheduling practices that center on team member preferences and wellbeing needs versus long-standing industry norms.
• Build the right programs that frontline leaders can use to guide team members through established career paths and advocate for the professional development and skill expansion of team members.

Supporting nurse leaders has a quantifiable impact on organizational outcomes. Senior leadership teams have the opportunity to significantly improve metrics around nursing engagement and retention through purpose-built innovation. Moving the needle at the highest levels requires change that starts at the foundation – supporting, enabling, and empowering nurse leaders with the right processes and resources to drive success. Technology has the ability to redefine work and to scale the impact of leaders on organizational outcomes. Our nurse managers need these solutions now more than ever.

Morning Headlines 7/8/24

UCSF Health and AG Announce Agreement on Saint Francis, St. Mary’s

California’s attorney general approves UCSF Health’s acquisition of Dignity Health’s Saint Francis Memorial Hospital and St. Mary’s Medical Center, with terms that include UCSF Health spending at least $80 million on their EHR.

Florida health department data captured in cyberattack, hackers claim

The RansomHub ransomware group claims to have publicly posted 100 GB of information that it stole from the systems of the Florida Department of Health, which declined to pay the ransom that it demanded in accordance with state policy.

CentroMed Data Breach: basic operations restored after cyberattack

CentroMed, a Texas-based chain of federally funded clinics, restores its computer systems after a ransomware attack forced them offline in early May.

Monday Morning Update 7/8/24

Top News

Oregon Health & Science University shuts down its Connected Care Center, the 16-nurse telehealth nursing unit that it launched at the beginning of the pandemic.

OHSU is eliminating 500 positions as it pursues an acquisition of Legacy Health, which would expand its footprint to 10 hospitals and 32,000 employees.

Reader Comments

From Peds MD: “Re: Epic Care Everywhere. A baby had a very high newborn screen for a condition where confirmatory testing and treatment need to be done urgently. The baby was tested within an hour at a local hospital, using the father’s last name. Not having access to the other hospital’s Epic, I logged into the baby’s birth hospital record (Epic), which still had ‘Baby Girl’ and the mom’s name. I asked Care Everywhere to find the baby’s results. Epic said no match even though the date of birth, sex, address, and phone number were the same. Luckily the ED clinician at the testing hospital sent me the results via text. Just to get the records connected officially, the next day I got the Care Everywhere ID from the testing hospital and plugged it in. Again, no match! Learning lesson for Epic — if you have the Care Everywhere ID, which is an amazingly long set of numbers and letters, you should at least be asked ‘Is this the right person?’ And you shouldn’t even need that if other information is the same. I called it in to IT and got the famous ‘working as designed’ answer.”

HIStalk Announcements and Requests

Poll respondents are evenly divided on whether an oversupply of physician informaticists exists, with those who say yes pointing to the number of doctors who are seeking non-practice roles. 

New poll to your right or here: Who is most responsible for physician dissatisfaction?

Webinars

July 18 (Thursday) noon ET. “New CMS Final Rule: Strategies to Get EHR and IT Vendors Up to Speed.” Sponsor: DrFirst. Presenters: Nick Barger, PharmD, VP of product, DrFirst; Tyler Higgins, senior director of product management, DrFirst. The new final rule that was issued by CMS on June 13, 2024, goes beyond a basic upgrade of SCRIPT standards and improves care connections among doctors, pharmacies, and patients. The presenters will lead EHR and IT vendors through the final rule, provide details on key provisions and compliance deadlines, offer tactics to tackle roadmap development, and provide direction on where and how partners can best leverage the requirements for the benefit of their customers.

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

Acquisitions, Funding, Business, and Stock

Private equity firm New Mountain Capital proposes to buy R1 RCM and take the company private at a valuation of around $5.6 billion. RCM shares are down 38% over the past 12 months, valuing the company at $4.6 billion.

California’s attorney general approves UCSF Health’s acquisition of Dignity Health’s Saint Francis Memorial Hospital and St. Mary’s Medical Center, with terms that include UCSF Health spending at least $80 million on their EHR.

India-based hospital operator Narayana Health launches a Kaiser Permanente-type health plan that covers a family of four starting at $10 per month, which is about 20% of what private insurers charge. Founder, chairman, and cardiac surgeon Devi Shetty, MBBS says that Indian citizens need 70 million surgeries per year but only 20 million are performed due to lack of affordability, which he says causes many times the deaths of malaria, TB, and HIV that are covered by government programs. The policy’s benefits include treatment coverage of $6,000 and surgical expenses of $120,000. The company promises easy claims settlement, coverage of preventive checkups, and discounts on tests that are performed at Narayana’s hospitals. Thanks to the reader who sent this item my way.

Sales

• Shepherd Center will implement Kemtai’s computer vision AI assessments for people with brain injuries.

People

Primary care network Main Line HealthCare (PA) names SVP/CMIO Donald Klingen, MD as interim president.

Announcements and Implementations

Bath Community Hospital (VA) goes live on Meditech Expanse.

Australia-based telemedicine service My Emergency Doctor implements InterSystems HealthShare Health Connect Cloud for interoperability with a major suburban hospital to perform virtual overnight supervision.

Government and Politics

National Coordinator Micky Tripathi, PhD, MPP and FDA Director of Digital Health Center for Excellence Troy Tazbaz resign as non-voting members of the board of Coalition for Health AI to avoid potential conflicts of  interest. Republican lawmakers criticized FDA’s involvement with the group last month, citing concerns about potential conflicts given CHAI’s membership that includes major technology companies and health systems that develop AI businesses.

Privacy and Security

Palomar Health Medical Group (CA) notifies patients that their information may have been compromised in a May 5 cyberattack, but says it doesn’t yet know which patients and which information was involved. PHMG originally hoped to restore most of its systems by July 1, but now is targeting mid-July.

The RansomHub ransomware group claims to have publicly posted 100 GB of information that it stole from the systems of the Florida Department of Health, which declined to pay the ransom that it demanded in accordance with state policy.

An Ascension Saint Agnes Hospital NICU nurse is forced to use a fax machine for the first time when clinicians lost access to the EHR during Ascension’s cyberattack. She says that staff weren’t prepared for a four-week systems outage, when patient medications were tracked on a shared spreadsheet that was faxed to the pharmacy.

Other

The FDA orders North Shore Medical Center (FL) to stop performing mammograms, determining that the facility’s tests failed to meet American College of Radiology image quality standards. The hospital has contacted all patients who had the tests over a two-year period to advise them to have their results re-evaluated and possibly to have the test repeated. The hospital, which is owned by the bankrupt Steward Health Care, will cover the cost if the patient has the rework performed at another Steward facility.

“Jeopardy!” fans debate the decision by host Ken Jennings to accept the answer of contestant and Mary Washington Healthcare IT application coordinator Matt Brooks, who mispronounced “larynx” as “larnyx.” He eventually won the game. Some fans were appalled that Jennings accepted his answer given that it is equivalent to misspelling the word, while others said that the mispronunciation is common in the South and Midwest and noted that former host Alex Trebek had accepted the same mistake in 1997 and 2006 in explaining that a lot of people say it wrong.

Sponsor Updates

• Black Book Research’s latest survey of health plans ranks Surescripts as the top technology solutions provider for payer member safety, PBM, and pharmacy solutions.
• In Belgium, AZ Sint Lucas and AZ Sint Jan hospitals implement Sectra’s One Cloud public cloud service.
• Over 400 Konza-powered sites achieve and/or maintain Validated Data Stream Designations in NCQA’s Data Aggregator Validation Program.
• Meditech customer Humboldt Park Health becomes the first Midwestern hospital to achieve Healthcare Equity Certification from the Joint Commission.
• Nordic releases a new “Designing for Health” podcast, “Interview with Jeff Mounzer, PhD, and Peter Kriss, PhD.”
• Optimum Healthcare IT names Brad Sourwine (Pivot Point Consulting) director of recruiting.
• Sana Kliniken in Germany implements RLDatix’s cloud-based workforce management solutions across the enterprise.
• Waystar will exhibit at the EClinicalWorks Denver Day Show July 10.

Blog Posts

• Inovalon Backs Safer Care: Answering the PCAST Call (Inovalon)
• Maximizing the Value of Your Time: Billing for Linus Health Digital Cognitive Assessments (Linus Health)
• Healthcare CFOs Highlight the Need for End-to-End Digital Solutions (Medhost)
• Unraveling the Financial Ramifications of MSSP ACO Reporting (MRO)
• Physical Therapy Billing Units: A Comprehensive Guide (Net Health)
• The Future of Physical Therapy Documentation Software (Netsmart)
• Nurses of Note 2024: The Clinical Nurse Educator (PerfectServe)
• Optimizing Physician On-Call Schedule Management (QGenda)
• Data intelligence for all: a recap of new solutions and key takeaways from Databricks’ 2024 Data + AI Summit (Redox)
• Attracting Top Tech Talent to Healthcare: Strategies for Success (Revuud)
• Opening the Door to the Patient Cost Conversation – and to Affordable Medications (Surescripts)
• From Vision to Reality: Healthcare Leaders Share Their Vendor Compliance Journeys (Symplr)
• Moving to Meditech Expanse? Five Key Support Considerations for Post-Implementation (Tegria)
• Navigating the Complexities of Outpatient vs. Inpatient Billing (TruBridge)

Contacts

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

Morning Headlines 7/4/24

New Mountain Capital Proposes Buyout of R1 RCM

R1 RCM shareholder New Mountain Capital goes solo in its bid to acquire the healthcare payments vendor in a deal valued at $5.6 billion.

Top Biden administration officials withdraw from Coalition for Health AI

National Coordinator Micky Tripathi and FDA Director of Digital Health Troy Tazbaz withdraw from the relatively new Coalition for Health AI, with Tripathi attributing his departure to potential conflicts of interest.

OHSU Fires Group of Telehealth Nurses It Lauded During COVID-19

Oregon Health & Science University lays off 16 nurses in its Connected Care Center as part of a wider restructuring that will result in the elimination of 500 positions.

Healthcare AI News 7/3/24

News

The American College of Radiology launches an AI quality assurance program for radiology facilities that covers governance, algorithm documentation, security and compliance adherence, documenting use cases, and monitoring algorithm performance.

Mayo Clinic receives a $20 million gift to fund AI projects as well as Mayo Clinic Platform. The donors are Nvidia SVP of Software Engineering Dwight Diercks and his wife Dian.

Business

PicnicHealth, which gives patients and life sciences companies access to medical records, announces an LLM that collects a patient’s medical records from all providers. The company says it product connects to 100% of US care sites, enabling patients to collect all their records and for life sciences companies to conduct observational studies. CEO Noga Leviner had no healthcare background when she co-founded the company in 2014.

Research

An MIT study finds that medical imaging AI models often use demographic shortcuts that cause them to issue biased predictions. The authors say that models may work when first trained (locally optimal), but may not maintain fairness in new environments (globally optimal). They caution that models can predict demographic information from images – such as race, sex, and age – and then use that and other data to make correlations that have no clinical basis.

Other

Anesthesiologist, informaticist, and AMA immediate past president Jesse Ehrenfeld, MD, MPH says that the AI in healthcare hype curve is peaking, but he notes that a recent survey of doctors found that 38% are using AI in their practices, almost all of it for back-end office tasks. He says that it was a mistake to design, develop, and deploy EHRs without enough physician involvement, and that same error could be repeated with AI development. He explains, “I see this with entrepreneurial companies, where there’s a physician who might be involved, but it’s an afterthought. They’re not really driving the development of the solution. That’s a problem.”

Rep. David Schweikert (R-AZ) introduces legislation that would require Medicare to pay for AI-powered remote devices. He previous introduced bills that would allow AI to prescribe as a practitioner and to amend the Social Security act to pay for telehealth consultations such as AI-monitored wearables. 

I read about this Google search error and replicated it: searching for “114/74 blood pressure” brings up an AI Overview that says that this is an elevated reading. I repeated the test on Google Gemini as well as ChatGPT and both correctly indicated that the BP is normal. Interestingly, the AI Overview was correct when searching for 113/73 and 115/74, incorrect for 114/71, but when I searched for 114/75, it correctly said that’s normal but added “along with a pulse of 89 beats per minute” for some reason.

Contacts

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

Morning Headlines 7/3/24

R1 RCM Shares Slide on Reduced Hopes for Buyout Deal

R1 RCM shares drop on the news that its two largest shareholders have failed to reach an agreement on a bid to jointly acquire the company.

Walmart has held talks to sell its shuttered medical clinics

Walmart is reportedly shopping its Walmart Health facilities to potential buyers that include health insurance companies like Humana.

Three Former Executives Sentenced for $1B Corporate Fraud Scheme

The Department of Justice recaps the recent sentences of three former Outcome Health executives who were involved in a $1 billion corporate fraud scheme, and notes that three other executives have pleaded guilty and are awaiting sentencing.

News 7/3/24

Top News

Heritage Valley Health System (PA) will pay $950,000 to settle potential HIPAA security rule violations related to a 2017 ransomware attack that was caused by malware that spread from Nuance to multiple healthcare organizations.

The health system filed a lawsuit against Nuance in 2019 claiming that the vendor failed to prevent the attack, but the suit was dismissed due to contractual technicalities.

Reader Comments

From Angel of AI: “Re: healthcare fraud. What was the largest fraud by number of US patients impacted? Have any that involved medical devices run unto the tens of thousands of patients?” Zeroing in on documented “fraud” rather than just product-related issues narrows the field quite a bit. I was going to say HCA’s various legal and civil challenges over the years, which I believe included performing unnecessary invasive procedures, but I don’t know the extent of that. Theranos might also make the list since while the fraud involved lab testing machines that gave inaccurate results 10% of the time but with unknown effect on outcomes.

HIStalk Announcements and Requests

I’m a new customer, but YouTube Premium is already my most-valued streaming service. Why: it’s ad free, plays in the background, includes YouTube Music, and lets me download videos to play offline. It’s $13.99 for an individual membership and $22.99 per month for families of up to five members with discounts for paying annually. Tips: I play on the big screen through a Roku streaming device, use the Roku app’s remote instead of the physical one so I can type search terms more easily, and turn on good audio like a sound bar. I will acknowledge that 98% of what’s on YouTube is purely intended as time-wasting junk, but the rest is well-made gold and YouTube is better than I expected at suggesting something I’ll like. Mostly I watch videos related to travel destinations, old TV clips, concerts, and how-to fixit help. We still subscribe to Netflix, Hulu, and one of the P-ones (I can never remember if its Paramount+ or Peacock), but I would give up YouTube Premium last.

Webinars

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

Acquisitions, Funding, Business, and Stock

Chronic pain management technology vendor Upside Health shuts down.

Care enablement technology company Fabric acquires virtual care service provider MeMD from the now-shuttered Walmart Health. Walmart bought the business, which was started in 2010, in 2021 for a reported $6 million. Fabric acquired virtual healthcare assistant startup Gyant and announced a $60 million Series A funding round earlier this year.

Telehealth vendor Amwell announces a reverse stock split in order to avoid delisting on the New York Stock Exchange. AMWL shares have lost 87% of their value in the past 12 months to $0.29, valuing the company at $86 million.

Google and TikTok ban ADHD telehealth provider Done Global from advertising on their platforms amidst a federal investigation that has expanded to include five additional people of interest. Done’s CEO and clinical president were arrested last month on charges of distributing Adderall, healthcare fraud, and obstruction of justice.

Virtual primary care company K Health raises a $50 million funding round.

Sales

• Babson Diagnostics will implement Ellkay’s lab-ordering software and LKCareEvolve clinician portal as a part of its BetterWay blood-testing service.
• Adventist Health (CA) selects The Garage’s population health management software.
• Cleveland Clinic will integrate Masimo’s Hospital Automation Platform with its patient monitoring technologies as part of its TeleCritical Care program.

People

Cordea Consulting promotes Thomas Sjostedt to VP of sales.

Greater Houston Healthconnect promotes Junaid Husain, ALM, MBA to CEO.

Ron Wozny, MBA (HealthSmart) joins MyDirectives as SVP of marketing and business development.

CSI Companies hires Douglas Herr (Healthcare IT Leaders) as SVP of client services and strategy.

Carrie Damon, MHA (CommonSpirit Health) joins KPMG as global chief digital officer of KPMG Delivery Network.

Announcements and Implementations

UT Health East Texas implements virtual nursing from Care.ai across its network.

UCHealth (CO) rolls out prior authorization software co-developed with Arrive Health at three of its clinics. It will implement the software across its network next year. UCHealth invested in Arrive’s (fka RxRevu) Series A funding round in 2019 after working with the company for several years through its Care Innovation Center.

The Headwaters High-Value Network clinically integrated network launches with 19 independent rural Minnesota hospitals as members. HVN will consider shared technology solutions in population health management, analytics, and are management.

Government and Politics

NHS London’s medical director says pathology services across its six boroughs are operating at 46% capacity since its pathology services vendor Synnovis was hit with a ransomware attack on June 3.

The Department of Justice recaps the recent sentences of these former Outcome Health executives who were involved in a $1 billion corporate fraud scheme. Three other executives have pleaded guilty and are awaiting sentencing. DOJ summarizes, “faking it until you make it is not an acceptable practice for any business.”

• Co-founder and CEO Rishi Shah: seven years and six months in prison.
• Co-founder and President Shradha Agarwal: three years in a halfway house.
• CEO/CFO Brad Purdy: two years and three months in prison.

Other

UTHealth San Antonio previews the technologies its new Multispecialty and Research Hospital will feature when it opens in December, including virtual nursing, smart beds, and three “Rosey” robots that will deliver items to the 144-bed facility’s nursing units.

Sponsor Updates

• Inovalon joins the Meditech Alliance ecosystem of partner organizations.
• AdvancedMD launches new automation and payment capabilities to help private practices increase productivity and drive more revenue.  
• Augmedix AI Advisory Council member Lisa Rotenstein publishes new research in JAMA Network Open, “Virtual Scribes and Physician Time Spent on Electronic Health Records.”
• AvaSure publishes a new case study, “How UCHealth used Telehealth Technologies to Slash Code Blues up to 70%.”
• Cordea Consulting promotes Michael Tierney to recruiting supervisor.

Blog Posts

• Enhancing Healthcare Practices Through Effective Benefit Verification (AdvancedMD)
• Agfa Insights: UKIO 2024 Key Takeaways (Agfa HealthCare)
• Leveraging Global Resources to Address HIM and Clinical Labor Shortages (AGS Health)
• Analytics in 2024: Making the most sense out of your data (Altera Digital Health)
• Navigating Governance: Build Your Healthcare Analytics Communication Framework (Artera)
• Inaccurate Provider Directories Create Barriers to Care (Availity)
• New York City FC & Capital Rx – More Than a Sleeve Partnership (Capital Rx)
• 7 Ways to Optimize Meditech Expanse for Provider Satisfaction (CereCore)
• Optimizing RCM for Growth Today and Tomorrow (EClinicalWorks)
• Enhance Patient Experience with Continuous Insurance Coverage Search (FinThrive)
• The 6 Logical Steps to Data Migration (Five9)
• Education on Patient Liability Should Occur Every Step of the Way (Impact Advisors)

Contacts

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

Morning Headlines 7/2/24

K Health, The Leading AI Primary Care Platform, Raises $50 Million Equity Funding Round

Virtual primary care company K Health raises $50 million, bringing its total raised to well over $400 million.

HHS Office for Civil Rights Settles HIPAA Security Rule Failures for $950,000

Heritage Valley Health System (PA) will pay $950,000 to settle potential HIPAA Security Rule violations related to a 2017 ransomware attack caused by malware that spread from Nuance to multiple healthcare organizations.

Prescribe Fit Secures $4.8MM in Series A Funding to Revolutionize Musculoskeletal Healthcare with Innovative Remote Patient Monitoring and AI Solutions

Prescribe Fit, which offers remote monitoring, health coaching, and virtual care programs for orthopedic patients, raises $4.8 million in Series A funding.

Curbside Consult with Dr. Jayne 7/1/24

This weekend was all about me fighting technology in its various incarnations and being philosophical about whether we are actually better off with all the bells and whistles that we have come to use in our daily lives.

My first struggle was prompted by the fact that I’m over a certain age and my vision prefers a large monitor compared to my laptop. I have a monitor connected via a docking station, so I really only use the laptop for its camera capabilities, along with being a separate screen for third-party messaging apps and other windows that I don’t want to inadvertently share while on a web meeting. Most of my clients prefer online meetings without video, so that wasn’t really an issue. However, I recently started collaborating with someone on a book (which is an interesting experience in itself) and she prefers on-camera interactions, so I decided to get a separate webcam to put on my primary monitor so I wasn’t always looking sideways on our calls.

After doing my usual comparison shopping and polling friends about their experiences, I narrowed it down to a couple of options that were available locally. One of the three was on sale at a shop a mile from my house, so I jogged over and had it in hand in short order. Everything I read indicated that I should be able to just plug it in to the docking station, tweak a setting or two on the laptop, and be on my way.

This was easier said than done. I struggled to get the camera to mount securely because my monitor has a curved housing on the back. It was downhill from there as I couldn’t get it to work using the docking station regardless of how many settings I tweaked. I resorted to connecting it directly to the laptop, which although functional, created a wiring mess that I was trying to avoid.

From there, I had a battle with some permissions on a client-provided laptop. The agent at the other end of the call was clearly following a script and didn’t fully understand what she was advising. She recommended that I “press and hold the power button for 60 seconds.” I attempted to clarify that she was asking me to restart the computer, therefore I would need to finish some work and get back to her. She advised that no, the computer was not going to restart, we were just “rebooting the power.”

I let her know that I would need to call back at another time and went about my business. I restarted after finishing my work and the problem was resolved so I didn’t need to call back, but it just emphasizes the importance of having people in your call center who actually understand the advice that they are giving and who aren’t just reading from a script.

The issues really hit the proverbial fan when my power had a momentary blip, knocking the internet offline close to midnight. I was half asleep reading a book anyway (“Project Hail Mary” in case you’re interested), so I manually turned off the lamp rather than having Alexa do it, and figured I would address it in the morning. My internet gateway rebooted without a hitch and my hardwired devices were back up, but the wi-fi had renamed itself and reset the password. That required tracking down the magical website where I should have been able to rename the network and change the password back, but I couldn’t figure out how to make my changes save. I’m stuck, in the short term at least, with a goofy 30-character password and a different network name.

Now I need to visit all my internet-enabled devices and get them reconnected, including my thermostat, a couple of Alexa devices, phones, a thermostat, and my smart TV so I can figure out how “Bridgerton” is going to continue to unfold without having to sit at my desk. I didn’t have time for that budgeted on my schedule today, so getting the phone connected was the best I could do for now.

With all that, I was more frustrated by my labor-saving devices than anything, and it was in that mood that I read Mr. H’s mention of the Sunrise EHR error in Australia that incorrectly calculated more than 1,000 pregnancy due dates. Regulators are investigating whether patients were harmed by the incorrect dates, which could have led to premature inductions of labor or mismanagement of patients who spontaneously entered labor well before their due date.

For example, when you’re concerned that a pre-term birth is imminent, there are treatments you administer to try to improve fetal lung function. Those are only indicated between very specific dates as far as fetal age. The issue affected public birthing hospitals in South Australia during the six months prior to June 5. SA Health is performing its own medical records review in parallel to the independent investigation. Approximately 100 patients have yet to deliver, so hopefully their dates are being appropriately updated. Patients have not yet been informed of the issue. 

Details on the incident are slim, with the article noting that due date fields in maternity notes were overridden by a calculation that was based on the last menstrual period. I haven’t used Sunrise since the late 1990s, but I’m guessing the system has a hierarchy for how it populates due dates, which might be determined from a last period, ultrasounds, other medical records such as assisted reproductive technology notes, patient-reported date of conception, or a combination of data available. However it manages those different data points, something went awry.

Back when I was delivering babies as part of full-scope family medicine, we would note all of those data points on this magical fold-out paper form and then document our final estimated date of delivery in a specific place on the form. It wasn’t sexy, but it was accurate, and the only way for it to be overridden involved a strike through and someone’s initials.

My question as a clinical informaticist is this: what happened six months prior to June 5 that caused it to be inaccurate? Was there an upgrade, an update, or some change to a template? What processes were in place (such as two sets of eyes checking on changes to critical patient care content) to prevent such an issue, and what went wrong?

If it is determined that patients were harmed by the issue, I certainly feel for them and for their families, because issues during pregnancy care can lead to a lifetime of “what if” questions that haunt parents. My experience transitioning obstetricians from the paper folding forms to EHR was that they planned to hold onto the paper until the last possible minute because it was a system that just worked. It would be interesting to see whether the benefits of electronic maternity documentation have been shown to provide improved clinical outcomes compared to paper documentation, but I doubt that study has been performed.

I could search for it, but instead I’ll be using my spare time to try to fix my household so that Alexa can once again turn on my bedside lamp.

What’s the technology you miss the most when it stops working? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 7/1/24

Lurie Children’s Hospital cybersecurity breach affected more than 790K people, including patients

Lurie Children’s Hospital of Chicago reports in a data breach filing notice that the information of 791,000 people was exposed to ransomware hackers in its January 31 cyberattack.

Fabric Acquires MeMD, Expanding Virtual Care Services to 30,000 Employers and 5 Million Members

Care enablement technology company Fabric acquires virtual care service provider MeMD from the now shuttered Walmart Health.

Amwell Announces Reverse Stock Split

Telehealth vendor Amwell announces a reverse stock split in order to avoid delisting on the New York Stock Exchange.

Google, TikTok Ban Ads From ADHD Telehealth Company Amid Federal Probe

Google and TikTok bar Done Global from advertising on their platforms amidst a federal investigation that has expanded to include five additional people of interest.

Monday Morning Update 7/1/24

Top News

Lurie Children’s Hospital of Chicago reports in a data breach filing notice that the information of 791,000 people was exposed to ransomware hackers in its January 31 cyberattack.

The Rhysida ransomware group claimed in March that it had stolen the hospital’s data and sold it for $3.4 million.

The hospital finished restoring its systems on May 20.

HIStalk Announcements and Requests

Most poll respondents would like to see government review or approval when private equity firms propose to conduct a provider-related transaction. I’m siding with commenter and industry long-timer Bill Spooner, who suggests that equal attention be paid to not-for-profit transactions since the goal is the same, to eliminate competition and to buy practices as bed-fillers under the guise of integration.

New poll to your right or here, following up on Dr. Jayne’s comments last week and some excellent observations from reader DrM: Does healthcare have an oversupply of physician informaticists? I’m focusing just on the physician part of clinical informatics since that was the subject of Dr. Jayne’s original pondering.

Today I learned – at least I think I did — that my long-time dentist’s practice was acquired years ago by Heartland Dental, which is owned by private equity firm KKR. I’m speculating on the “acquired” part since Heartland labels itself as a DSO (dental services organization) that serves “affiliates,” but it sounds like they either buy practices outright or perhaps take a majority position. Whatever they do, it involves 1,700 practices, 20,000 employees, and the opening of several dozen new practices from scratch each year. I should be relieved that unlike PE-acquired medical practices or hospitals, it doesn’t seem that quality or customer service have slipped.

I don’t watch TV and therefore had never seen Conan O’Brien on anything until YouTube pushed a video at me this weekend from something called “First We Feast Hot Ones” (never heard of it), in which Conan takes over the show as only someone who is smart, funny, and schooled in improv could do (not to mention sticking to the bit while chugging down high-Scoville hot sauce). That led me down the rabbit hole of a Dr. Arroyo follow-up and then a deep dive into old appearances by Jordan Schlansky and savagely funny, Robert Smigel-operated Triumph the Insult Comic Dog, all of which were new to me. I don’t listen to podcasts, but “Conan O’Brien Needs a Friend” might lure me in. Conan sold his Team Coco podcast network for $150 million two years ago to Sirius XM, or as Triumph recently called it, “the abandoned mall of the entertainment industry” and then added, “Why get your milk for free when you could rent the cow for $21.99 a month?”

I nominate “please know” as the most irritating wording in corporate blathering history, given that it’s meaningless, superfluous (just tell us what you want us to know), and also gratingly fawning since companies use it to feign sincerity and humility, usually because of their own misstep or misbehavior. I rank it above even “please don’t hesitate to call” to attempt to sound more professional (sort of like the pompous “utilize” or “leverage” instead of “use.”) I’m more amused than annoyed at out-of-office email replies that claim “I will have limited access to email” as though the person doesn’t own a smartphone instead of just admitting that they at least temporarily have more important things to do.

Webinars

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

Acquisitions, Funding, Business, and Stock

Optum notifies Massachusetts regulators that it won’t follow through on a previously announced agreement to buy Steward Health Care’s physician network.

People

Optum promotes Cara Griffin to SVP of marketing.

Announcements and Implementations

A new KLAS report on digital rounding solutions for nurses finds that Huron, the 2024 Best in KLAS winner, tops the list in customer satisfaction and the ability to drive outcomes and reduce nurse workload.

Other

Australia’s SA health orders an investigation into an error in its Sunrise EHR that miscalculated the estimated due dates of 1,700 pregnant women, raising concerns that the incorrect dates may have caused clinicians to induce labor too early.

Sponsor Updates

• Consensus Cloud Solutions receives the 2024 CSO Award from Foundry’s CSO for demonstrating outstanding business value and thought leadership.
• Black Book Research declares Inovalon the top-ranked vendor in robust data integration and predictive analytics, according to feedback from managed care, health plans, and payer technology users.
• Five9 publishes a new e-book, “AI in Healthcare: How AI Drives Value for Five9 Healthcare Customers.”
• Waystar takes Black Book’s top spot for end-to-end revenue RCM solutions for health systems.
• Surescripts Chief Product Officer Tara Dragert joins the NCPDP Foundation’s Board of Trustees.
• Inovalon announces a partnership with the Meditech Alliance, which will offer the company’s end-to-end RCM to Meditech customers.
• TruBridge publishes a new case study, “How Texas Institute for Surgery Increased Cash Flow and Decreased AR Days.”

Blog Posts

• Can the ONC help drive greater API adoption? (Zen Healthcare IT)
• Enhanced Care Management: Care Coordination for California’s Most Vulnerable (Netsmart)
• The rise of inboxologists in healthcare: Does it really matter who responds? (Nordic)
• 3 Healthcare HR Challenges GenAI Can Help Solve (Optimum Healthcare IT)
• From Aspiration to Achievement: Stacia Fredericks’ Educational Journey with the Assistance of the QGenda /AACN Nursing Scholarship (QGenda)
• 2024 HL7 FHIR DevDays Top 5 takeaways (a newbie’s take) (Redox)
• 5 tips to improve patient health literacy (Sonifi Health)
• How to Provide a Scalable, Flexible, and Seamless Financial Experience (TrustCommerce)
• At Moose Pharmacy the Future of Community Pharmacy is Rooted in the Past (Surescripts)
• How to Combat Key Stressors in Nursing (Symplr)
• Their Words. Not Ours. (Visage Imaging)

Contacts

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

Morning Headlines 6/28/24

Walgreens Boots Alliance Reports Fiscal 2024 Third Quarter Results

Walgreens reports mixed Q3 results and announces that it will reduce its stake in primary care provider VillageMD so that it no longer holds a majority share.

Arcadia acquires CareJourney to enable high-performing networks and value-based care success

Data platform and analytics vendor Arcadia acquires CareJourney, which offers claims-sourced provider cost and quality data.

Hummingbird Healthcare Raises $10M to Address Persistent Barriers to Patient Access

Patient access technology vendor Hummingbird Healthcare closes a $10 million Series A funding round led by UCHealth.

Novant Health lays off 81 IT workers in Winston-Salem

Novant Health (NC) will lay off 81 IT workers in late August and shift some of their tasks to Deloitte Digital as part of a previously announced outsourcing plan.

News 6/28/24

Top News

Walgreens Boots Alliance reports Q3 results: revenue up 2.6%, adjusted EPS $0.63 versus $1.00, beating revenue expectations but falling short on earnings. The company also lowered FY 2024 EPS guidance, citing inconsistent consumer spending. Shares shed 22% of their value following the Thursday morning announcement, dropping their price to 1997 levels.

Walgreens will reduce its stake in primary care provider VillageMD and will no longer hold a majority share. CEO Tim Wentworth, who took the job in October, says that Walgreens will no longer seek majority ownership of primary and specialty care provider businesses and will instead pursue “capital-light services” with a larger range of providers and payers

Walgreens will close a “meaningful percent” of its underperforming stores, which represent about one-fourth of its 8,600 locations. Its review of stores to close will include proximity to other Walgreens and the local crime level in some cities. It says it will work with state Medicaid programs and local law enforcement as the “last company standing” in areas that would be pharmacy deserts otherwise. The company had already closed 625 locations.

Reader Comments

From Steve Shihadeh: “Re: your ‘Death of a Salesman’ response. Pretty good considering your experience and contempt .” Industry long-timer Steve of Get-to-Market Health adds these insights:

• The best salespeople have a great balance of product and service knowledge, relationship skills, and a real appreciation for what drives the buyer.
• AI gives good salespeople the chance to be better prepared and have more compelling presentations and facts.
• While AI is all the rage today, in some ways it is like every big technical evolution. PC, Internet, Search, WiFi, etc. The best sales people will learn about it and find the way to relate it to what the customer needs and how it impacts them in a positive manner.

From Vince Remembered: “Re: ‘Death of a Salesman.’ Your response about salespeople was slightly cynical before turning positive, but not nearly as much so as the late, great Vince Ciotti in your 2019 interview.” I love that interview with industry long-timer Vince and re-read it often. Here are Vince’s thoughts about salespeople, which may or may not remain relevant several decades after his experience:

We hired salesman at SMS and they spent one day walking around all the offices, saying hello, shaking hands. Who are you? What do you do? Oh, OK. Then boom, after one day, they were out there selling. They had no idea what they were selling. It doesn’t matter. Sales is commissions. If you sell a lot of systems, you make a lot of money and you get promoted and you become a big cheese. If you don’t sell any systems, you get fired. You’re going to go to another company and try again. You don’t learn the product. You haven’t been an installer or a customer service rep. You haven’t worked with the system. You have no idea how the system works. What you know how to do is smile, be pleasant, buy lunch, buy dinner, shake hands, be charming, have people trust you, get them to sign the contract, and then run like hell because you’ve got to make some more sales.

HIStalk Announcements and Requests

HIStalk sponsors earn attention from digital health decision-makers, including provider folk, investors, and potential acquisition partners. You’re reading the site already, so imagine the pride of saying, “hey, that’s our name and ad up there.” Contact Lorre, who is motivated by the summer slowdown to offer perks and packages for new signups, and who is likely to offer attractive bundles to startups and former sponsors that rejoin the fold. Thirsty Insta influencers and podcast hosts will perform tricks like an organ grinder’s monkey in desperately seeking views and likes, but we’re talking professional B2B recognition and market influence here.

Webinars

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

Acquisitions, Funding, Business, and Stock

Data platform and analytics vendor Arcadia acquires CareJourney, which offers claims-sourced provider cost and quality data.

Patient access managed services vendor Hummingbird Healthcare closes a $10 million Series A funding round that was led by UCHealth. CEO Jeremy Schwach was formerly CEO Of Bluetree Network, which was acquired by Tegria in 2019.

The Private Equity Stakeholder Project publishes “The Pillaging of Steward Health Care,” which notes that former owner Cerberus Capital Management generated $1.2 billion by selling off the real estate its hospitals sat on, paid fund investors a $484 million dividend from the proceeds, expanded the chain to become the country’s largest private operator of for-profit hospitals, then dumped the investment with the help of its real estate landlord having made $800 million over its 10-year ownership. The report observes that Steward paid its ownership a $111 million dividend, after which Steward CEO Ralph de la Torre bought a $40 million yacht and the company splurged on two private jets. Meanwhile, Steward missed rent payments, racked up patient safety concerns, laid of employees, closed hospitals, and last month filed Chapter 11 bankruptcy with $9 billion in liabilities, most of it due to the real estate company to which Cerebrus sold the real estate. Terms that were part of new financing require the company to close hospitals that it can’t sell in a bidding process that started this week, as officials in the eight states in which Steward operates hospitals worry about loss of services.

New Jersey-based Atlantic Health System will acquire Saint Peter’s Healthcare System.

Amazon renames its 18-month-old Amazon Clinic to Amazon One Medical Pay-per-visit, which will offer pay-per-visit telehealth – $29 for message-based visits, $49 for video — and a membership program for on-demand virtual care and next-day appointments at One Medical offices.

Sales

• Findhelp announces new SDoH network customers Stanford Children’s Health, Virginia Association of Free & Charitable Clinics, and Connxus.
• Community Health Network will implement Microsoft Azure and Nuance Dragon Medical as it increases its use of DAX Copilot and Dragon Medical One.
• Emergency Services Inc. will implement the recently launched Augmedix Go ED ambient AI for emergency medicine at an unnamed large hospital in central Ohio.

People

Healthcare IT Leaders names Jody Buchman, MBA (Clarivate) as SVP of continuous services and David Unger (MedKick) as VP of EHR and RCM.

Government and Politics

Federal authorities will seize the $8 million Chicago mansion of Outcome Health founder Rishi Shah, one of three former company executives who are facing prison time for fraud involving electronic advertising in waiting rooms.Outcome was valued at $5.5 billion before its collapse, with Shah’s net worth estimated at $3.6 billion. The Outcome name was retired in 2021 with the acquisition of its remains by healthcare digital marketing company PatientPoint. Update: 38-year-old Rishi Shah was sentenced to 7.5 years in prison on Wednesday. Co-founder Shradha Agarwal was sentenced to three years in a halfway house on Thursday.

The VA says that it is so far behind on paying contract provider claims due to Change Healthcare’s ransomware downtime that it won’t catch up until February, a year after the original incident. It also expects that its payments from insurers won’t catch up until October.

Privacy and Security

San Diego’s PBS TV station notes that Palomar Health Medical Group’s phones and computer systems remain down from a May 5 cyberattack. Patients report problems getting paper prescriptions filled and nurses relying on the patient to tell them the doctor’s diagnosis.

Sponsor Updates

• Inovalon publishes a new study, “Race/Ethnicity and Socioeconomic Position in Emergency Department Utilization in Patients with Hepatocellular Carcinoma.”
• FinThrive publishes a new case study, “Lawrence General Hospital Successfully Switches to FinThrive After a Cyberattack.”
• Imperial Beach Community Clinic (CA) adds AI, patient engagement, and AI-powered medical scribe capabilities to its implementation of EClinicalWorks.
• First Databank will share information from RxEOB’s prescription pricing transparency application through its FDB Vela prescribing network.
• Healthcare IT Leaders CMO Alex Gramling joins the United Way of Southern Maine’s board.
• Visage Imaging will showcase new enhancements to its Visage 7 Enterprise Imaging Platform at the SIIM annual meeting in National Harbor, MD this week.
• Children’s National Hospital (Washington, DC) expands its use of Laudio’s AI-enhanced workflow platform to include nurse educators.
• Linus Health leaders publish a new peer-reviewed paper, “Towards a lifelong personalized brain health program: empowering individuals to define, pursue, and monitor meaningful outcomes.”
• Loyal achieves TX-RAMP Level 2 Certification for its Chatbot solution from the Texas Department of Information Resources.

Blog Posts

• Pioneering Business Continuity in Healthcare: FinThrive’s Standby Solutions (FinThrive)
• New Five9 Data: AI in CX – It is not replacing humans (Five9)
• How Mature is Your Healthcare SOC? (Fortified Health Security)
• Rising and Falling Tides: The State of Money Supply and Health IT (Healthcare Growth Partners)
• Practice Managers Finding Effective Solutions to Maintain Smooth Clinical Operations Amidst Staff Shortages (Impact Advisors)
• The Promising Convergence of Payer Strategy and Compliance with the CMS Interoperability and Prior Authorization Final Rule (InterSystems)
• AI & Healthcare Marketing. Are You Ready? (Loyal)
• Tips for participating in CHIME’s Digital Health Most Wired program and survey (Meditech)
• Navigating MIPS Compliance: Tips for Medicare Wound Care Providers (Net Health)

Contacts

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

EPtalk by Dr. Jayne 6/27/24

From Jaded CMIO: “Re your recent comments about the Medication Access and Training Expansion Act (MATE) and its 8-hour DEA education requirement being a time waster. I’m in the same boat – I don’t even see patients, but my institution forces me to maintain a DEA regardless. Did you see this commentary on Medscape?” The op-ed from Melissa Walton-Shirley, MD is subtitled “8 Hours of My Life I’d Like Back.” The author calls for reform of DEA regulation, including waiving the requirement for physicians who don’t issue prescriptions for outpatient narcotics (such as intensivists who might be giving controlled substances in the ICU) and issuing a nationwide DEA number instead of forcing providers to have separate ones for individual states. The piece has over 140 comments already and some of them are pretty entertaining. My favorite: “We should get 0.5 hrs just for reading this informative dragging of MATE. And Pharma should be forced to fund the DEA, not provider licensing fees – since when does the taxi driver pay your fare?”

US Surgeon General Vivek Murthy penned a guest essay for the New York Times this week, calling for a “surgeon general’s warning label” on social media platforms and advising users that “social media is associated with significant mental health harms for adolescents.” This would require an act of Congress that I doubt we’ll see anything about soon, however. Murthy issued an advisory last year with specific recommendations to make social media safer, and although there have been some interesting congressional hearings, I haven’t seen a lot of change. I’ve seen in my own community the level of peer pressure for young children to be on social media. I wish we could lure kids and their parents to consciously choose the outdoors and other activities rather than focusing on screens.

From Informatics Doc: “Re: patient portals. I just went to my mom’s Epic portal to see what meds she was currently on since there was some question about whether any of them were making her more confused and sluggish. When she first got her portal, I was impressed that it did a better job than the Cerner portal in terms of usability. It also had an option to print out a wallet card with an easy to read medication list, allergies, and problem list. Fast forward to today. Every option that I tried for getting a medication list showed the same cluttered view in which the info on each drug and its dose and times was interspersed with the pharmacy name, the prescribing doctor, the start date, and a refill button. Hitting the print button gave you the same thing in a PDF with slightly better layout. To get a medication list to send to my siblings meant taking an added 15 minutes to cut and paste into Word and clean out all the extras. Do the EHR vendors have something against a nice clear condensed med list? (I know Joint Commission contributed to the poor med list formats within the EHR by their dislike of Latin abbreviations, but have they caused this problem in the portals as well?)” I test drove this with a couple of organizations and it appears that it might be a setup issue rather than a vendor issue, but I’m not entirely sure. At the first system I logged into, the “current medications” page was cluttered up by information telling me how to request an amendment to my medical records for two of the system’s physician groups. The print version was a little better, but the entire first page was taken up by an inch and a half worth of text about the amendments, pushing the medications to another page. Only the first page had a patient identifier on it, which makes it a little less useful as something that you might take with you to a visit with a physician who uses a different EHR. The second system wasn’t displaying any of my meds, which is definitely unusual.

I’m not ready to blame the EHR vendor because I’ve seen enough client-inflicted setup issues in my career. One of the institutions in question clearly has a setup issue in another part of the system. My recent pathology results had a blank diagnosis (which to me should be a required field before they’re finalized) and also had a tagline at the top of my results that stated “EPIC results best viewed via link to PDF,” which I thought was odd since I had to scroll three times to find the link to the scanned document and it didn’t say anything about it being a PDF. I’m sure there are patients who might not know what they’re looking for or who might not have scrolled. My report was also missing important clinical information that I provided at the time of care (documented as “not provided,” which is simply not true). Sloppiness all around, but not necessarily the vendor’s fault. I think that a concise med list is important for patients to be able to put in a wallet, so if that’s an option, I hope our expert readers will weigh in.

The clinical informatics job market has been a hot topic in recent conversations with colleagues. I have several friends who are highly capable and genuinely nice people, but who have been impacted by sweeping layoffs at their organizations. Most have school-aged children, elderly parents, or both, so they are reluctant to relocate for a new position, which might get cut in a year or two just as easily as their previous one was. In a recent chat, one mentioned that they had made it through multiple interviews, but the companies in question had gone radio silent for a matter of weeks. That’s not only disheartening, but unprofessional. It takes a few seconds of a recruiter’s time to type an email saying, “Thank you for your time, but we will be moving in a different direction” or something similar. Another countered that although that experiencing is depressing, it can be a blessing in disguise when you figure out that the organizational was dysfunctional before joining it.

My favorite quote of the conversation says it all as my colleague described some of the organizational personalities he’s encountered in his job hunt process: “I feel like some of us spend so much time and thought honing our skills and presenting ourselves professionally and some others just Mr. Magoo their way from one executive role to another.” I think most of us have encountered leaders like that in our travels, bouncing from one unsuspecting organization to another. I’m grateful to have had at least a few experiences where I’ve worked with exceptional leaders, but that’s not the case everywhere.

How do you think the hiring process has changed over the last five years? Have things improved or are they only getting worse? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 6/27/24

CHAI Releases Draft Responsible Health AI Framework for Public Comment

The Coalition for Health AI publishes a draft framework for the responsible use of AI in healthcare and solicits public comment.

Form Health, The Leading Provider of Science-Based Obesity Care in the United States, Raises $38 Million Series B Led By Sound Ventures

Online medical weight loss clinic Form Health raises $38 million in a Series B funding round, bringing its total raised to $65 million.

VA still dealing with fallout from Change Healthcare ransomware attack

The VA expects to have backlogs created by the Change Healthcare ransomware attack cleared by next February – a year after the hack originally took place.

CipherHealth Announces Capital Investment by Atalaya Capital Management, Setting Stage for Future Growth in Patient-Centered Communications

Patient engagement software vendor CipherHealth announces an undisclosed amount of new funding from Atalaya Capital Management.

Healthcare AI News 6/26/24

News

The Coalition for Health AI publishes a draft framework for the responsible use of AI in healthcare and solicits public comment. CHAI also posted a draft document of Assurance Reporting Checklists for self-reporting and self-review for assuring that AI solutions meet criteria in five areas: (1) usefulness, usability, and efficacy; (2) fairness, equity, and bias management; (3) safety; (4) transparency and intelligibility; and (5) privacy and security.

In Japan, SoftBank Group founder Masayoshi Son will make a rare public appearance in a Thursday panel discussion on bringing AI to healthcare in his country. The investment group took a significant position in Tempus AI just before its recent IPO and has signed an agreement to set up similar services in Japan.

Business

Wolters Kluwer Health will add AI-powered adaptive learning to its nursing education products.

Oracle announces GA of Clinical Digital Assistant ambient documentation and voice command system for ambulatory clinics that use its EHR.

Solventum, formerly 3M Health Care, announces an AI-driven payment denials prediction solution.

Real-world data vendor Atropos Health expands its Evidence Network to 300 million patients with the addition of two new partners. The company’s products can generate publication-grade, AI-powered observational studies from clinical questions with a two-day turnaround.

Shares in AI-enabled precision medicine vendor Tempus AI have lost one-third of their value since the company’s June 14 IPO. The company’s $8 billion pre-IPO valuation in 2022 is at $4.5 billion. Shares rose Wednesday on news that FDA has cleared sale of its atrial fibrillation detection algorithm for 12-lead ECGs.

Research

NIH awards Cleveland Clinic and other organizations a $2.8 million grant to study the use of AI to analyze MRIs to determine how rectal tumors are responding to therapy. Researchers hope to develop radiomic signatures using radiology and pathology images to identify dying tumors that have responded to therapy, which would allow those patients to avoid unnecessary further surgeries and complications.

Other

Stanford Medicine develops Nuclei.io, which helps pathologists diagnose endometritis and metastatic colon cancer with higher speed and accuracy than pathologists alone. The AI system observes individual pathologist behavior – such as image clicking and enlarging —  to learn what they are looking for and which cells are important.

Contacts

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