News 10/25/23

Top News

Digital consulting firm Perficient acquires San Diego-based healthcare software development company Smedix.

Webinars

October 25 (Wednesday) 2 ET. “Q&A: What’s new with the NSA? A No Surprises Act update.” Sponsor: Waystar. Presenters: Joseph Mercer, JD, managing director, Marwood Group; Heather Kawamoto, VP of product strategy, Waystar. The No Surprises Act created a lot of change,  and those changes are still coming. A panel of revenue cycle experts answer frequently asked questions and offer a concise update on the NSA, including legislative developments, FAQs, and tips for navigating changes.

October 25 (Wednesday) 2 ET. “AMA: The Power of Data Completeness.” Sponsor: Particle Health. Presenters: Jason Prestinario, MSME, CEO, Particle Health; Carolyn Ward, MD, director of clinical strategy, Particle Health. Is your healthcare organization looking to drive profitability and scale quickly? Our experts will explore how comprehensive clinical data can revolutionize the health tech landscape. This engaging discussion will cover trending topics such as leveraging AI and data innovation to enhance patient care and outcomes, real-world examples of organizations leading the charge in data-driven healthcare, overcoming challenges in data completeness and interoperability, and visionary perspectives on the future of care delivery.

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

Acquisitions, Funding, Business, and Stock

PicnicHealth, which uses patient-reported data to build datasets for research, acquires rare disease data aggregator and research firm AllStripes.

Akumin, a national outpatient radiology and oncology care services provider, announces a financial restructuring plan that includes filing for Chapter 11 bankruptcy protection and reverting to a privately-held company. Akumin experienced a ransomware attack in late September that is still impacting its ability to see patients at numerous locations.

HealthStream announces Q3 results: revenue up 5%, EPS $0.13 versus $0.12, beating earnings expectations but falling short on revenue.

Sales

• Delaware’s Division of Substance Abuse and Mental Health will work with Bamboo Health to develop and implement behavioral healthcare coordination software.
• East Suffolk and North Essex NHS Foundation Trust in England will implement Epic.

People

Eskenazi Health promotes Randall Grout, MD to chief health informatics officer.

HealthEC names Chris Caramanico (JJCAL) CEO.

Karen Mellin (DrFirst) joins CTS Connected Technology Solutions as VP of sales and business development.

Announcements and Implementations

Northern Health in Melbourne, Australia, goes live on Agfa HealthCare’s enterprise imaging through its new Northern Imaging Victoria service.

Netsmart develops an AI Data Lab that is built on Amazon Web Services, which will allow the company to develop new technologies for its CareFabric platform. Missouri Behavioral Health Council will contribute predictive analytics for population health and provision of care functions.

Privacy and Security

MultiCare recovers from a service outage that caused it to suspend surgeries and procedures at several facilities within its system. The Washington-based provider has attributed the outage, which affected multiple systems including its EHR, to an interruption in service from one of its vendors.

In Canada, the IT systems of five hospitals that formed their own IT provider organization go offline due to a cyberattack.

Other

Increased enrollment in Medicare Advantage plans has hurt critical access hospitals, which are paid lower, negotiated rates than those of traditional Medicare. Hospital executives say insurers are “slow pay or no pay” with their Medicare Advantage contracts. They also report that patients must drive long distances to find nursing homes and rehabilitation facilities that accept MA plans versus nearly universal acceptance of Medicare.

Sponsor Updates

• ConnectiveRx employees assemble several bikes for children in need as part of the company’s Customer Service Week events.
• Frost & Sullivan recognizes Wolters Kluwer Health with the 2023 Global Competitive Strategy Leadership Award for its work with conversational AI in healthcare.
• EClinicalWorks integrates with Sunoh.ai, an AI-powered ambient listening technology that generates clinical documentation during appointments.
• Dimensional Insight and Health Matrix partner to offer an intelligence and data analytics platform to the Middle East healthcare market.
• Baker Tilly releases a new Healthy Outcomes Podcast, “Empowering healthcare leaders with data-driven decision-making.”
• Nordic publishes a new episode of its In Network podcast, “Making Rounds: Lab information, at your service.”
• Black Book Research recognizes vendors exhibiting at MGMA’s Leaders Conference who’ve received its 2023 awards for highest customer experience and user satisfaction in practice management, including HIStalk sponsors Availity, Dimensional Insight, EClinicalWorks, and Nuance.
• Bamboo Health will exhibit at the TAHP Conference November 6-8 in Houston.
• Censinet releases a new Risk Never Sleeps Podcast, “In the Trenches of Healthcare Cybersecurity.”
• Consensus Cloud Solutions sponsors the annual Cognosante Charity Golf Tournament benefiting Final Salute.

Blog Posts

• Navigating the Challenges of Transcription: Finding a Solution That is Accurate, Timely & Secure (AdvancedMD)
• How Machine Learning Can Enhance the Healthcare Revenue Cycle (AGS Health)
• Make a good first impression: Keys to achieve long-term success in healthcare data analytics (Arcadia)
• HLTH 2023 Takeaways (Arrive Health)
• Meet Alexandra Ricciardiello – OCP Analyst (Optimum Healthcare IT)
• Unlocking Patient Engagement: The Power of Advanced Communication Approaches (Artera)
• Securing healthcare data: The critical need for cyber resilience. (Nordic)
• Meet the Clinician – Julia Greer, VP, Clinical Strategy, Ascom Americas (Ascom)
• Fuel Your FHIR with Better-Quality Data (Availity)
• The Bardavon Index: How Does it Inform Better Treatment Decisions? (Bardavon)
• What CIOs Want ITSM Providers to Know (Clearsense)
• How Geek Squad Supports Care at Home (Current Health)
• Crafting Effective Job Postings (Direct Recruiters)

Contacts

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

Morning Headlines 10/24/23

Perficient Reaches Definitive Agreement to Acquire SMEDIX, INC.

Digital consulting firm Perficient acquires San Diego-based Smedix, which offers cloud-based interface solutions for medical equipment and remote device management.

Ovation Healthcare Expands Portfolio with Launch of Tempo Technology Services

Ovation Healthcare launches Tempo Technology Services, a managed and IT services and procurement firm.

PicnicHealth Acquires AllStripes, Fortifying its Role as the Leader in Patient-Centered Healthcare Evidence Generation

PicnicHealth, which uses patient-reported data to build datasets for research, acquires rare disease data aggregator and research firm AllStripes for an undisclosed sum.

Curbside Consult with Dr. Jayne 10/23/23

I traveled this weekend to attend a celebration of life, marking the passing of a longstanding healthcare IT colleague. Many of those in attendance had known each other for decades, from the early days when electronic billing systems began to spawn clinical systems.

It was great to hear so many memories and to reminisce about how the industry used to be. Many of the companies that people worked for are no longer in existence, having either become part of another organization or sold for parts after an acquisition. Most of us were in agreement that the industry continues to be topsy-turvy and that it’s unclear how much or how fast new technologies like artificial intelligence will really have an impact. Hopefully, the next time we get together will be for a less solemn occasion.

I also recently had the chance to meet up with another former colleague, who was passing through my city on the way to a consulting engagement. He’s one of the super-techy types who took me under his wing when I was at the beginning of my clinical informatics career. I’ll always be grateful that he was willing to spend the time making sure I really understood the options that were being discussed versus just trying to get me to make a decision so the tech team could move on.

I’m pretty sure our conversation picked up where we left off the last time we saw each other, as if we saw each other every day, and I’m so grateful for those professional relationships that have turned into genuine friendships. In many of the informatics roles I’ve filled since the beginning of the pandemic, it seems like there’s so much understaffing there really isn’t time for those friendships to develop because everyone’s just scrambling to get the work done.

Once in a while, I see a scholarly article with a title that can only be described as clinical informatics clickbait. This time, the article in JAMIA not only caught my attention, but also delivered. As a clinical informaticist who has spent a good chunk of her career in emergency departments, how could I not be drawn to an article looking at how disaster hazards are represented in SNOMED CT? After all, I used to teach a class called “Things that can get you in the great outdoors,” so this was right up my alley.

Electronic health records are well positioned to gather data about the impact of various disasters on populations and sophisticated analytics platforms can help health systems and governmental agencies understand the respective responses to such happenings. In crafting the study, the authors looked to “determine the extent of clinical terminologies available to capture disaster-related events” as well as to map the United Nations Hazard Information Profiles to the SNOMED CT terminology.

I settled down with a nice cup of tea and dug in. Through the mapping process, the authors identified more than 200 disaster hazard concepts that had the potential to negatively impact health. These included not only things like chemical or biological disasters, but also those related to weather, flooding, earthquakes, or extraterrestrial factors. They noted that “geographically unique” hazards such as heat wave, cold wave, smoke, and drought were not found in the SNOMED CT data, coming to the conclusion that such concepts need to be added in order to improve clinical reporting. As someone who dealt with a variety of heat-related and smoke-related complaints during the long summer of 2023, I can attest to the impact that extreme heat can have on a population, especially when they don’t have access to air conditioning, fans, or transportation to cooling centers.

The authors highlighted the frequency of disasters by listing some of the events of 2023 that happened prior to publication. These included major earthquakes in Turkey and Syria; floods in South America, Indonesia, and Australia; multiple cyclones, wildfires, and more. Technological disasters included a coal mine collapse and shipwrecks. Along with other less major disasters, these events impacted 100 million people and cost $190 billion in economic losses. They also made the point that it’s not only the injuries and loss of life, but the impact of these disasters on healthcare facilities, the healthcare workforce, and the greater healthcare delivery system. They call on organizations to create strategies to make healthcare systems more resilient to disasters whether natural or human caused.

In reading the article, I thought about the current state of “resilience” in healthcare in the US. Prior to the COVID-19 pandemic, we didn’t have a lot of reserves to draw from at baseline. There was already a nursing shortage, a primary care shortage, and intermittent supply shortages when factories were hit by natural disasters or there were minor supply chain disruptions. Along came the pandemic, which exposed problems with strategic national stockpiles in the US and a rapid outstripping of global production for medical supplies. Those of us who were on the front lines vividly remember telling us we could wear bandanas to work to try to protect us from airborne pathogens and saw the pictures of our colleagues wearing trash bags when they couldn’t source barrier gowns. Although most of us have returned to relatively normal lives, the horror was real and continues to hit some of us, sometimes daily.

It doesn’t feel like healthcare delivery organizations (or policy makers for that matter) have risen to the challenge of addressing these issues for the future. As a nation, we’re not doing a great job of assessing risk, setting health priorities, or building workforce capacity, all of which the authors deem as essential for meeting future health needs. We already have a tremendous amount of data that we’re not acting on, so although I agree with the authors that more data might be better in planning for the future, I’m skeptical that it will be as useful as it might otherwise be. Certainly, there are more progressive nations out there who might actually make use of the data, and then in a decade or two the US will follow along.

I recently visited a country that has embarked on a half-century plan to eliminate certain invasive species and to return the environment to its natural state. If only we could translate that kind of initiative to the US and use it to promote public health and reduce the burden of chronic disease. Especially over a long-haul study horizon, we’ll need good data to evaluate whether interventions are working and whether we’re achieving the desired objectives.

Although the authors state that the risk of natural disasters is higher due to climate change, they acknowledge that “real-time data demonstrating the adverse impact of climate-change related events on populations, healthcare workforce, and healthcare systems, including natural disasters at the point of care, is lacking.” They attribute this in part to the absence of appropriate concepts in the clinical tools used in electronic health record documentation.

I would go further to add that there need to be additional abilities for clinicians to have easy access to this data, including access to patient-generated health information and pulling data from patient histories or linked geographical information. As an example, I spent a number of years living in a community that was directly impacted by chemical contamination. The federal government has identified particular ZIP codes in their efforts to track the downstream impacts of that contamination; if I could provide that in my patient history, which could serve as a proxy to prevent physicians from having to search for the appropriate codes for soil contamination.

The authors also acknowledge that many areas of the world don’t have health information system infrastructures that support the capture of such codes, and those areas are more focused on “the challenges of providing basic care for vulnerable populations in resource-limited settings.” They also note that there are gaps in the contact infrastructure for some countries to participate with SNOMED International in requesting additions or updates to the terminology and expressed concerns that many of the nations at highest risk for natural disasters are not members of SNOMED International. Although some may see this as a bit of a niche area in clinical informatics, I thought it was a thought-provoking article. I’ll have to reach out to my colleagues who are more closely involved in terminology to see what their thoughts might be.

What do you think about the data infrastructure for tracking disaster-related health outcomes? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 10/23/23

HealthAlliance Hospital in Kingston transferring, discharging all inpatients after confirming cyberattack; system expected to shut down through weekend

HealthAlliance Hospital (NY) discharges or transfers all of its inpatients and diverts ambulances following a cyberattack.

U.S. Defense Health Agency selects Amwell and Leidos to power the Digital First initiative for the U.S. Military Health System

The US Defense Health Agency awards Amwell and Leidos a contract valued at up to $180 million to provide a hybrid care platform that will replace MHS Video Connect.

EClinicalWorks and Healow Announce $900 Million in Projected Revenue and Significant Investment in AI

EClinicalWorks announces that it expects to generate $900 million in revenue in 2023, up from the previous year’s $800 million.

Monday Morning Update 10/23/23

Top News

Medication management company Cureatr shuts down without notice, blaming a lack of financing and a failed acquisition.

The company acquired SinfoniaRx in March.

Reader Comments

From Tolstoy: “Re: startups. The wave of shutdowns and fire sales is just starting as former stars run out of cash.” Agreed. Companies that ran big early-round raises in a go-go market are just now seeing the invisible investor strings that were attached – the moneyed folk are demanding profitability, growth, and proof that the company’s moat exists and is not drying up. Inexperienced operators, especially first-time founders, are new to a market that values being cash-stingy to ride out the storm. Some will attempt to pivot, which rarely works. The lowest-quality startups will shut down, but most will come hat-in-hand to established companies hoping to sell the business, its IP, or its office furniture at a dismal fraction of now-laughable historic valuation. Meanwhile, the valuation premium for startups versus publicly traded companies is narrowing and founders are packing up their rosy pitch decks being forcefully relocated from the CEO chair to the boardroom. The upside is that the cream floats to the top when irrational exuberance meets reality, so winners will emerge stronger.

From Belzer: “Re: Waystar IPO. Good timing?” It’s hard to say given the long IPO drought and SPAC distraction. The PE-owned company’s string of acquisitions has piled up quite a bit of debt, with the S-1 showing interest payments of $149 million in 2022 on $704 million in revenue, resulting in a $66 million pretax loss. The company was valued at around $3 billion in 2019 when a majority stake was sold. Rumors of an $8 billion valuation floated around last summer when the IPO plans leaked.

From Plowboy: “Re: Henry Schein. We are placing orders by phone while the company keeps its site offline.” The medical and dental supply vendor took its systems offline on October 14 due to a cybersecurity incident, although its practice management software was not affected.

HIStalk Announcements and Requests

Poll respondents who quit because of non-job issues cite management ethics by far as their most common issue.

New poll to your right or here: Looking back five years, which aspects of healthcare have been significantly improved by technology? I ran this a few years ago, so let’s see how the responses differ.

Webinars

October 25 (Wednesday) 2 ET. “Q&A: What’s new with the NSA? A No Surprises Act update.” Sponsor: Waystar. Presenters: Joseph Mercer, JD, managing director, Marwood Group; Heather Kawamoto, VP of product strategy, Waystar. The No Surprises Act created a lot of change,  and those changes are still coming. A panel of revenue cycle experts answer frequently asked questions and offer a concise update on the NSA, including legislative developments, FAQs, and tips for navigating changes.

October 25 (Wednesday) 2 ET. “AMA: The Power of Data Completeness.” Sponsor: Particle Health. Presenters: Jason Prestinario, MSME, CEO, Particle Health; Carolyn Ward, MD, director of clinical strategy, Particle Health. Is your healthcare organization looking to drive profitability and scale quickly? Our experts will explore how comprehensive clinical data can revolutionize the health tech landscape. This engaging discussion will cover trending topics such as leveraging AI and data innovation to enhance patient care and outcomes, real-world examples of organizations leading the charge in data-driven healthcare, overcoming challenges in data completeness and interoperability, and visionary perspectives on the future of care delivery.

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

Acquisitions, Funding, Business, and Stock

EClinicalWorks announces that it expects to generate $900 million in revenue in 2023, up from the previous year’s $800 million. The company will continue to invest in AI, including ChatGPT integration, an AI-based image model for document management, and RCM improvement.

Weight loss drug startup Calibrate will sell itself to a private equity firm and restructure the business, which recently pivoted from selling prescriptions directly to consumers to having employers offer its services as an employee benefit. The company has struggled with refund-demanding customers who couldn’t get their prescriptions filled due to short supplies, as well as those who found that their insurance wouldn’t cover the high cost of GLP-1 drugs.

Nomad, whose app connects travel nurses with hospitals, lays off employees for the second time this year as budget-challenged health systems reduce their use of expensive travel nurses. 

Sales

• The US Defense Health Agency awards Amwell and Leidos a contract valued at up to $180 million to provide a hybrid care platform that will replace MHS Video Connect.

People

Tony Ambrozie, MBA, MIM (Baptist Health South Florida) joins CVS Health as chief digital and technology officer, pharmacy and consumer wellness.

Net Health hires Ron Books (ECI Software Solutions) as CEO.

Matter Communications promotes Paul Berthiaume to SVP.

Privacy and Security

HealthAlliance Hospital (NY) discharges or transfers all of its inpatients and diverts ambulances following a cyberattack. Owner Westchester Medical Health Network says the incident also affected Margaretville Hospital and Mountainside Residential Care Center.

Other

Cedars-Sinai researchers develop an AI tool that can detect atrial fibrillation in people who don’t have symptoms, including in diverse settings and patient populations.

Sponsor Updates

• Inovalon partners with HealthVerity as part of its new Preferred Data Partner Program to advance the use of real-world evidence in research.
• NeuroFlow publishes a new case study, “Prudential Helps High-Risk Disability Claimants Access Support Through Population-Wide Suicide Risk Assessment & Prevention.”
• Surescripts shares a new podcast, “A Recap of NACDS Total Store Expo 2023.”
• Wolters Kluwer announces that its Emmi patient engagement and education solution has received a 2023 Black Book award for highest client/user satisfaction from managed care providers.
• InterSystems partners with Indonesian EHR vendor Zi.Care to provide expert services via the InterSystems Iris for Health – Indonesia Edition data platform.

Blog Posts

• What’s top of mind for healthcare executives now? (Notable)
• Intelligent patient experiences, part 1: How easy it is to use your patient portal? (Nuance)
• Healthcare workforce: Burnout, compensation, and strikes with Elizabeth Ojo on Diagnosing Healthtech (Redox)
• Supporting Med Access by Collecting Digital Patient Consent (RxLightning)
• 4 Reasons to Skip Paper and Switch to Online Incident Reporting Software (Symplr)
• Rev cycle 101 – Healthcare revenue cycle terminology: Denial prevention glossary (Waystar)
• A Provider’s POV: Can Technology Help Us Be Better Patient Advocates? (CereCore

Contacts

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

Morning Headlines 10/20/23

Uniguest expands presence and capabilities in healthcare through acquisition of PCare

Audience engagement platform vendor Uniquest acquires PCare, which offers interactive patient systems.

Pair Team Raises $9 Million Series A to Expand Access to Health Care Services for Medicaid’s Most Vulnerable Patients

Tech-enabled primary and social care management company Pair Team raises $9 million in a Series A funding round.

Telehealth Privacy and Security Tips for Patients

HHS OCR publishes a checklist covering “Telehealth Privacy and Security Tips for Patients.”

News 10/20/23

Top News

OptumInsight CEO Neil de Crescenzo leaves the company a year after it acquired Change Healthcare in a $13 billion deal, according to a LinkedIn post. He had been CEO of Change since 2013.

OptumInsight’s new CEO is Roger Connor, who will also continue his role as EVP of enterprise operations and services for parent company UnitedHealth Group.

A reader tipped me off to de Crescenzo’s s departure in mid-September, but the company did not respond to my inquiries.

OptumInsight offers transaction processing, technology, analytics, and revenue cycle management. Its annual revenue is nearly $5 billion.

HIStalk Announcements and Requests

Welcome to new HIStalk Platinum Sponsor FinThrive. The Plano, TX-based company helps 3,200 healthcare organizations increase revenue, reduce costs, improve patients financial experience, and ensure regulatory compliance across their entire revenue cycle continuum. Its SaaS-based RCM Platform delivers the industry’s widest breadth of capabilities, including integrated workflows supporting patient access, revenue integrity, claims management, contract management, and collections management teams within a centralized work environment. The company helps its customers bring modern digital experiences to their patients, including self-scheduling, virtual check-in, price estimations, patient payments and payment plans, and ongoing SMS-based secure communications – with no app downloads required. Its platform also leverages machine learning, robotic process automation, end-to-end RCM analytics, and billing and coding education resources to increase efficiency and drive sustained ROI. Thanks to FinThrive for supporting HIStalk.

Here’s a FinThrive explainer that I found on YouTube.

Webinars

October 25 (Wednesday) 2 ET. “Q&A: What’s new with the NSA? A No Surprises Act update.” Sponsor: Waystar. Presenters: Joseph Mercer, JD, managing director, Marwood Group; Heather Kawamoto, VP of product strategy, Waystar. The No Surprises Act created a lot of change,  and those changes are still coming. A panel of revenue cycle experts answer frequently asked questions and offer a concise update on the NSA, including legislative developments, FAQs, and tips for navigating changes.

October 25 (Wednesday) 2 ET. “AMA: The Power of Data Completeness.” Sponsor: Particle Health. Presenters: Jason Prestinario, MSME, CEO, Particle Health; Carolyn Ward, MD, director of clinical strategy, Particle Health. Is your healthcare organization looking to drive profitability and scale quickly? Our experts will explore how comprehensive clinical data can revolutionize the health tech landscape. This engaging discussion will cover trending topics such as leveraging AI and data innovation to enhance patient care and outcomes, real-world examples of organizations leading the charge in data-driven healthcare, overcoming challenges in data completeness and interoperability, and visionary perspectives on the future of care delivery.

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

Acquisitions, Funding, Business, and Stock

Audience engagement platform vendor Uniquest acquires PCare, which offers interactive patient systems.

Henry Ford Health and Ascension Michigan form a joint venture to combine their Detroit-area operations, with the combined $10.5 billion business giving them 44% of the Detroit area hospital market by revenue. 

Private equity firm Ardian will increase its stake in Europe-focused healthcare software vendor Dedalus to 92%. Board member Albert Calcagno, who has no healthcare or software experience, has been appointed CEO, with Andrea Fiumicelli moved to board chair.

Sales

• Medicare Advantage insurer EternalHealth will implement Inovalon’s Converged suite for quality measurement and risk scoring.
• USA Health Children’s and Women’s Hospital goes live on AdaptX’s Obstetric Advisor to improve maternal health equity.
• Culbertson Memorial Hospital will go live on Oracle Health CommunityWorks next month.
• Virtua Health will allow its doctors to prescribe Woebot Health’s mental health support app to people who are waiting for behavioral health provider appointments.

People

Bamboo Health hires Jeff Smith, MBA (Lumeris) as CEO. He replaces interim CEO Jay Desai, MBA, who will continue as executive board chair. Former CEO Rob Cohen, MBA left the company in July 2023 to join Livara as CEO.

Adrian Agostini (Booster) joins Experity as chief revenue officer.

Industry long-timer Rob Titemore, most recently with Sonifi Health, died August 13 in a motorcycle accident. He was 52. Visitation will be November 18 in Burlington, MA.

Announcements and Implementations

Insurer Oscar Health describes in an excellent “Continuous Hackathon” website how it is using large language models in pursuit of three goals: creating better client experiences, impacting behavior to generate better outcomes, and automating processes to reduce cost. Some of its ideas for using AI to move care delivery outside of the medical office:

• Assign members to virtual primary care doctors.
• Use AI to interpret EHR lab results as an initial draft for the virtual care provider. Co-founder and CTO Mario Schlosser says in an X post that the response of providers is binary – either they delete the summary immediately or they accept it with minimal changes.
• Automate the creation of care summaries. Schlosser says that providers modify the AI-written summary often, adding their own personal style or adding context.
• Collect patient information before starting a virtual patient visit.

In Japan, Fujitsu and Toppan Holdings will collaborate to create research databases from de-identified EHR data and apply analytics to improve the efficiency of drug development and care delivery.

Ronin and MD Anderson experts describe the development of an AI-powered digital tool that identifies cancer patients who are likely to require an unscheduled ED visit within 30 days due to treatment side effects, concluding that 50% of those visits as well as 19% of hospitalizations are avoidable.

Prudential’s implementation of NeuroFlow’s technology for conducting remote clinical assessments of disability claimants triggered 4,200 self-harm or suicide alerts from 24% of the monitored population, enabling the insurer to promptly connect them with mental wellness resources and resulting in a 34% reduction in their symptoms of depression.

Government and Politics

HHS OCR publishes a checklist covering “Telehealth Privacy and Security Tips for Patients.”

Other

A survey of employers finds that health insurance premiums increased 7% in 2023, outpacing worker wage increases and inflation as family coverage averaged $23,968 per year. Employers paid an average of 71% of the cost, although 65% of workers were enrolled in self-funded plans in which the employer pays for health services directly. Employers say that the key health benefits concerns of their employees involve the high cost-sharing that they bear, their ability to schedule timely appointments, and the complexity of prior authorization. More than half of employers think that telemedicine will be important or very important for providing access to behavioral health services and primary care.

An interesting series of tweets from Science.io co-founder and CEO Will Manidis makes these observations in predicting healthcare’s “top deck of the Titanic” moment as consumers abandon the existing system and create their own:

• The status quo is that costs have increased constantly and clinic waitlists remained full because: (a) clinicians are in limited supply; (b) insurers pay rather than patients; (c) demand is inelastic and trust is high; and (d) regulatory capture.
• He says that all four factors are shifting as (a) LLM-assisted doctors will gain technology leverage; (b) the payer-PCP model will shift to online services that treat individual conditions; (c) patients who are disillusioned by the opioid epidemic and by poor treatment at physician offices will exit the system instead of calling for it to be improved; and (d) FDA’s healthcare regulation doesn’t reflect patient desires and instead rewards incumbents.
• Technology will allow new companies to be more efficient than incumbents as vendor overpromising fades.
• Amazon, Walmart, and CVS are building a cash-pay, free-market parallel care system.
• Margins on low-acuity care will increase due to telemedicine and consumerization, which will also offer cross-selling opportunities for high-margin lifestyle management plans.

A fascinating and potentially HIT-adjacent article in The Atlantic ponders the “failed experiment” of retail self-checkout, which mentions but does not primarily blame customer dishonesty as its main challenge. The initial promise of quick checkout and the ability to deploy freed-up cashiers to offer more customer assistance never materialized, as finicky technology, purchases such as alcohol that require employee review, and assigning a single staff member to oversee the enter kiosk area have diminished the technology’s potential. Snips:

• Self-checkout allows cutting back on low-wage cashiers, but the problem-prone technology requires a lot of expensive IT resources to keep running.
• It hasn’t been proven to be faster or more convenient, but customers are fooled because instead of just waiting in line, they fumble through the scanning and bagging process in doing the cashier’s job with a small fraction of their efficiency.
• Retail store owners used self-checkout as a reason to cut staff in general, resulting in messier stores, poorly stocked shelves, and lack of employees to assist customers.
• Retailers aren’t likely to abandon the concept because they spent fortunes installing the technology, but they will likely need to provide more human assistance.
• The article concludes, “A familiar limitation of many grand tech-industry promises endures: At the bottom of all the supposed convenience, you do actually just need a lot of people to operate a store.”

Sponsor Updates

• Divurgent releases a new The Vurge Podcast, “From Operations to IT: An Inside Look.”
• Ellkay will present at the CommonWell Health Alliance 2023 Annual Meeting and Fall Summit November 6-8 in Kansas City, MO.
• HealthMark Group employees volunteer at Operation Kindness.
• Optimum Healthcare IT posts a case study titled “Sentara: Strategic Portfolio Management with ServiceNow.”
• Censinet and First Health Advisory will partner to offer cybersecurity risk assurance solutions, including the Censinet RiskOps platform for managing and mitigating third-party and enterprise risk.
• Nordic releases a video titled “The Download | Restart, refuel, or hang tight: The EHR dilemma.”
• Inovalon collaborates with Amazon Web Services to develop software to support better healthcare outcomes and economics.
• MRO will exhibit at the NCQA Health Innovation Summit October 23-25 in Orlando.
• Heart of Florida Health Center realizes a 21% increase in payment collections with EHR and Healow Payment Services software from EClinicalWorks.
• Redox partners with healthcare-focused digital transformation consultancy Productive Edge to offer the Healthcare Data Strategy Accelerator and Healthcare Data Integration Accelerator programs.

Blog Posts

• Using Data to Champion Hospital Workers and Prevent Strikes (Dimensional Insight)
• The Role of Emotional Intelligence in the Hiring Process (Direct Recruiters)
• How Healow Self-Scheduling Helped a New Practice Fill 400 Appointment Slots (EClinicalWorks)
• Creating Effective Warnings for All (Everbridge)
• Supporting Colorado’s Drug User Health Hub (Findhelp)
• Navigating the Future with Contact Center AI Solutions (Five9)
• How to make cybersecurity training part of your healthcare culture (Fortified Health Security)
• The future is now: Healthcare IT needs a rapid evolution (HCTec)
• 4 time-saving features of an integrated RCM solution (Inovalon)
• Bridging a Legacy LIS to Epic Beaker: JTG Consulting Group’s Collaborative Effort with Atrium Health (JTG Consulting Group)
• Healthcare Orchestration Needs a Conductor (Lumeon)
• How to Deal with Angry Patients in Urgent Care (Experity)
• 3 Ways Hospitals Can Foster Exceptional Patient Experiences in the ED (Medhost)
• How an EHR partnership can improve efficiency, person-centered care and outcomes (Meditech)

Contacts

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

EPtalk by Dr. Jayne 10/19/23

Clinical informaticists are often asked to help their organizations with strategies to combat health misinformation, whether it’s through implementing patient education solutions, providing input for patient-facing websites, consulting on social media campaigns, or creating content for distribution through mixed channels.

The Kaiser Family Foundation recently released results of a health misinformation tracking poll pilot with the goal of following health-related misinformation in the US, especially in communities where misinformation can gave the greatest negative impact. This round of tracking looked at important topics: COVID-19/vaccines, reproductive health, and firearm violence. Plans are in place to investigate other health topics in coming months. A Health Misinformation Monitor report will be distributed to those who are working to fight health-related misinformation.

Those of us seeing patients on the frontlines spend a good chunk of our time counseling against misinformation. It’s challenging because we would often rather use that time to talk about other important topics like dietary changes, lifestyle adjustments, and cancer screenings. We’re still seeing patients that are falsely convinced that COVID vaccines are killing healthy patients, that sex ed causes promiscuity, and the increased rates of firearms deaths “aren’t a thing.” In addition to taking time away from other health topics, having these conversations over and over is exhausting, so I’m excited to see what this new resource makes available for clinicians.

I’m onboarding a new consulting client and a significant amount of time is slated to help the organization improve productivity. We’re going to work to streamline its meetings, improve communication, and get some process guardrails in place. As I met with several high-ranking members of the company this week, it was obvious that one of them was multitasking on his phone the entire time we were meeting. I’m no stranger to the fact that conflicts come up, but what I experienced was not only rude, but also wasted the resources of the others who were on the call. I’m still figuring out all the dynamics in this organization, but at least one person who wasn’t on that particular call also mentioned the behavior as “habitual” for this leader. True leadership is being willing to reschedule meetings, to step out when you have a conflict or distraction, or to delegate meetings to others who can cover them.

In the worst case when one has to field text messages during a call, can I offer a pro tip: install the relevant texting app on your laptop so that you can manage your phone’s messages without actually having to touch your phone (let alone have it visible to others on the call). The solution won’t necessarily help with inattentiveness, but it will reduce the obviousness of undesired behavior.

Speaking of communications and productivity, one of the biggest time wasters I see among the large organizations I work with is trying to use too many “pull” communications and not enough “push” communications. Pull refers to materials that someone has to go to in order to get information, such as visiting a page on the company intranet or going to a reporting dashboard. They require effort on the part of the end user, who may need to remember that they need the information and also may need to remember where they need to go to get it. Push communications put the information in the hands of the user without a hunt. This method can be great for distribution of data that’s episodic, like a weekly census report.

I just had a conversation with one of my clients this week about using the right method for the right data. They were using a compound push/pull method. They pushed a link out to the audience on a daily basis, but then the users had to click the link, log in to a dashboard, and reset a filter to today’s date to see the daily data. A simple stopwatch exercise showed that this took about 30 seconds for the recipient to get to the right data, assuming they didn’t get distracted by another task along the way.

I asked the sender what the purpose of the email was and was told that it was to distribute end-of-day metrics that are finalized during a 2 a.m. reporting package. That sounded reasonable, but the need for users to log in and adjust filters to see the data didn’t. I talked to a couple of data consumers, who agreed the process was annoying. They are required to look at the data daily, but said that greater than 95% of the time they don’t need to do any further digging, so a snapshot would be fine.

I multiplied the daily review of data times the number of people looking at it times the average hourly rate of the end users. The company is spending $7,500 annually for employees to click links and adjust filters. In comparison, automated distribution of each day’s static data can be added to the reporting package for about $120 in work effort. I’m not surprised that no one thought of this before. It’s magic moments like this that make consulting fun as well as beneficial to the client. I’m hoping that they take this as an a-ha moment and look at some of their other communications to see what kind of savings they can generate.

It’s also a good exercise for organizations to examine how well their communications are reaching the target audience. If you’re maintaining a website for people to visit to get information, how many unique visitors is it getting and at what frequency? If you’re sending emails, what is your open rate? If you’re throwing things out in a Teams or Slack channel, are you measuring whether the materials actually make it to the audience? It’s important to understand too that different people consume information differently, and for some really important notifications, you may need to send them through multiple channels – email, messaging, intranet/web sites, and more.

People also need reminders when there are deadlines. Simply sending it once and then claiming “well, it was on the Slack channel” doesn’t help with knowledge distribution for most organizations.

From a patient advocacy standpoint, I’m excited for plans to eliminate the reporting of medical debt for consumer credit scoring. The initiative is being handled under the Consumer Financial Protection Bureau, which has rulemaking authority for the Fair Credit Reporting Act. The process involves convening a Small Business Review Panel to identify next steps. Medical debt impacts millions of patients and it can negatively impact their employment prospects, ability to obtain housing, or purchase a vehicle. The rulemaking process doesn’t move at the speed of light, so it will be 2024 before we see how this is going to shape up. Some credit agencies are already excluding paid-off debts and small debts from reporting, but the new initiative will expand consumer protections.

I’m finally able to say “that’s a wrap” to my recent travels. I’ve also caught up with some old friends, made some new friends, and got to learn about both mining and particle physics at the same place, so how can one top that? Now that I’ve been bitten by the travel bug, it’s only a matter of time before I decide where I’m heading next.

If you could go anywhere in the US for vacation, where would you visit? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 10/19/23

Waymark Announces $42M in New Funding

Waymark, which offers tech-enabled care support services to primary care teams and their Medicaid patients, announces $42 million in funding.

Ventricle Health secures $8M in seed financing led by RA Capital Management, along with Waterline Ventures and others to accelerate national delivery of its value-based home care model for heart failure patients

Ventricle Health, a virtual and at-home cardiology care provider, raises $8 million in seed funding.

Allara, a telehealth platform for women with chronic hormonal conditions, raises $10M Series A

Membership-based virtual care startup Allara raises $10 million in a Series A funding round.

Healthcare AI News 10/18/23

News

OpenAI adds voice capabilities to the ChatGPT mobile app, which can carry on a conversation with the user through one of several available natural-sounding voices. Existing voice assistants such as Alexa, Siri, Google Assistant, and Cortana will need to follow quickly or risk becoming instantly obsolete. 

Rumors suggest that OpenAI will soon launch AI-powered autonomous agents, which can interact with other software such as email or calendars to complete tasks without supervision.

Vanderbilt University Medical Center develops an EHR-embedded AI tool to identify pediatric patients who are at risk for blood clots. Outcomes were no better than for patients in the control group, however, which the researchers say may be due to physicians rejecting the tool’s recommendation to start blood-thinning therapy only 25% of the time due to fears of causing a major bleed. Yale medical school dean F. Perry Wilson, MD, MSCE observes that the VUMC study illustrates a key point that making accurate predictions is table stakes that vendors shouldn’t launch an “accuracy arms race” since “even perfect prediction is useless if no one believes you or if they don’t change their behavior.”

Business

UAE-based M42 launches Med42, a clinical large language model that answers medical questions using synthesized knowledge. The company claims it outperforms ChatGPT 3.5. It’s free for non-commercial use and research and can be downloaded from Hugging Face.

Research

ChatGPT performs at least as well as primary care physicians in choosing treatment options for newly diagnosed depression, and unlike doctors, it does not exhibit gender or socioeconomic bias. ChatGPT nearly always recommends psychotherapy for mild cases versus the 4% of PCPs who do so. It also favors using antidepressants alone for severe cases, while doctors usually add anxiolytics or hypnotics.

A Klick Labs study finds that AI analysis of a 10-second recording of a person’s voice can determine if they have Type 2 diabetes with nearly 90% accuracy. The company says that the non-intrusive, accessible approach will allow screening large numbers of people for Type 2 diabetes and potentially other chronic conditions.

Researchers are surprised to find that ChatGPT does a poor job of reviewing urology residency application letters.

Other

Experts predict that AI will play an outsized healthcare role in Canada because of clinician shortages in rural areas, with initial use in creating clinician documentation, providing easier access to patient records, helping with staff scheduling, and reviewing digital images.

Healthcare AI experts list ways that AI can help in healthcare, which include providing patient-friendly explanations, performing back office functions, predicting next events in a patient’s journey, analyzing images, keeping patient data private, and training itself. On the downside, it can create disinformation that sounds plausible, introduce bias in agreeing with what the user says, provide a false sense of security, and cause professionals to question whether their knowledge or careers are obsolete.

Contacts

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

Morning Headlines 10/18/23

Aspirus and St. Luke’s Move Closer to Affiliation

Aspirus Health (WI) will acquire St. Luke’s (MN), pending the signing of a definitive agreement that calls for Aspirus to implement Epic and its other standard systems at St. Luke’s within 24 months of closing.

Reimagine Care Announces Investment from Memorial Hermann to Help Transform the Cancer Care and Recovery Experience

Reimagine Care, a provider of virtual and at-home cancer care, secures funding from Houston-based Memorial Hermann Health System.

Sharecare confirms receipt of unsolicited proposal from Claritas Capital

Atlanta-based digital health and wellness company Sharecare considers an acquisition proposal from private equity firm Claritas Capital.

News 10/18/23

Top News

Waystar announces that it filed IPO documents in August that reportedly value the company at up to $8 billion.

Waystar says it booked $196 million in sales for the quarter ending June 30 versus $173 million for the same quarter last year.

The revenue cycle management company was formed in 2017 with the merger of Navicure and ZirMed. Waystar has since acquired Connance, HealthPay24, Patientco, PARO, Digitize,AI, and ESolutions. 

Webinars

October 25 (Wednesday) 2 ET. “Q&A: What’s new with the NSA? A No Surprises Act update.” Sponsor: Waystar. Presenters: Joseph Mercer, JD, managing director, Marwood Group; Heather Kawamoto, VP of product strategy, Waystar. The No Surprises Act created a lot of change,  and those changes are still coming. A panel of revenue cycle experts answer frequently asked questions and offer a concise update on the NSA, including legislative developments, FAQs, and tips for navigating changes.

October 25 (Wednesday) 2 ET. “AMA: The Power of Data Completeness.” Sponsor: Particle Health. Presenters: Jason Prestinario, MSME, CEO, Particle Health; Carolyn Ward, MD, director of clinical strategy, Particle Health. Is your healthcare organization looking to drive profitability and scale quickly? Our experts will explore how comprehensive clinical data can revolutionize the health tech landscape. This engaging discussion will cover trending topics such as leveraging AI and data innovation to enhance patient care and outcomes, real-world examples of organizations leading the charge in data-driven healthcare, overcoming challenges in data completeness and interoperability, and visionary perspectives on the future of care delivery.

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

Acquisitions, Funding, Business, and Stock

The loss of a legacy customer and associated $4.5 million in annual revenue prompts RCM vendor Streamline Health Solutions to move forward with a corporate restructuring plan that includes a 24% reduction in its workforce and the promotion of Benjamin Stilwill to CEO. Former CEO Wyche “Tee” Green will transition to executive chairman. STRM shares have lost 40% of their value in the past 12 months versus the Nasdaq’s 31% gain, closing Tuesday at $0.30 and valuing the company at $18 million.

Aspirus Health will acquire St. Luke’s in signing a definitive agreement that has been unanimously approved by the boards of both health systems. The agreement calls for Aspirus to implement Epic and its other standard systems at St. Luke’s within 24 months of closing, which is expected in the spring of 2024. St. Luke’s went live on Meditech Expanse in mid-2019. The combined organization will operate 19 hospitals and 130 outpatient locations with 14,000 employees.

Drug chain Rite Aid files for Chapter 11 bankruptcy and hires a new CEO as it struggles with slowing sales, debt, and a Department of Justice opioid lawsuit.

Sales

• AdventHealth will use tech-enabled clinical support from Wellvana to improve access and outcomes within its network of primary care clinics in Florida.

People

Samir Shah, MD (Envision Healthcare) joins Qure.ai as chief medical officer.

Cordea Consulting names Travis Earlywine (Lowes) regional VP of sales.

Announcements and Implementations

Highmark Health (PA) will implement Google’s new Vertex AI Search technology across its enterprise. It is initially using the generative AI tool as a part of an automated, post-visit medical documentation workflow pilot project.

King’s Daughters Medical Center (MS) implements BridgeHead Software’s HealthStore clinical data repository as a part of decommissioning its legacy Meditech Magic EHR. KDMC went live on Meditech Expanse last December.

Guelph General Hospital in Ontario goes live with Sectra’s cloud-based enterprise imaging technology.

Government and Politics

The VA will establish four AI centers to test and apply new AI solutions at partner VA medical centers. The centers support the VA’s recently announced AI strategy, which includes using AI to improve care outcomes and experiences for veterans.

Privacy and Security

Mt. Graham Regional Medical Center (AZ) works to restore computer systems after a September 27 ransomware attack.

University of Vermont Medical Center President and COO Stephen Leffler, MD tells lawmakers at a joint subcommittee hearing in Washington, DC that more federal grants should be made available to help health systems purchase stronger cybersecurity software. Leffler also shared the details of the hospital’s recovery from a 2020 ransomware attack, which led to 28 days of downtime and $65 million in costs.

Other

Epic employees complain on Reddit that the company has announced that it will no longer allow them to work from home during heavy snow days. Some of them note that Epic’s new hires often have never driven in snow and therefore are prone to creating automotive mayhem.

Sponsor Updates

• Healthwise posts a case study of how Duke Health used its health education to increase the success rate of its smoking cessation program.
• Availity offers RevSpring’s staff-assisted payment and merchant services as part of its Availity Essentials multi-payer platform.
• AvaSure will host its 2023 Symposium October 25-26 in Grand Rapids, MI.
• Inovalon’s Claims Management Pro solution is offered on the PointClickCare Marketplace.
• Baker Tilly publishes a new case study, “Handled with care: UT Health San Antonio’s Oracle HCM journey towards one cloud.”
• Nordic publishes another episode of its In Network podcast, “Designing for Health: Bre Loughlin.”
• Bamboo Health publishes a new case study, “Revolutionizing Nevada’s Behavioral Health Referrals: A Leap Forward for 988 Suicide Prevention and Crisis Lifeline Services.”
• Censinet releases a new Risk Never Sleeps Podcast featuring cybersecurity expert Frank Riccardi.

Blog Posts

• Navigating the Challenges of Transcription: Finding a Solution that is Accurate, Timely & Secure (AdvancedMD)
• From Pain to Progress: Streamlining LIS Upgrades with JTG Consulting Group (JTG Consulting Group)
• Coding and Documentation Synergies: The Power of CAC and CDI Integration (AGS Health)
• How to create a trusted and consistent data foundation for healthcare (Arcadia)
• Building a Pan-European Paediatric Data Collaboration Network (Aridhia)
• Leveraging High-Quality Clinical Data to Safeguard HEDIS Quality Bonus (Availity)
• Why Injury Prevention Technology Used by Athletes is so Effective in the Workplace (Bardavon)
• Copay Adjustment Programs: What Brand and Hub Teams Need to Know (ConnectiveRx)

Contacts

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

Morning Headlines 10/17/23

Streamline Health Executes Strategic Restructuring, Provides Corporate Update

RCM vendor Streamline Health Solutions announces layoffs, the loss of a legacy customer, and management changes including a new CEO.

Rite Aid Takes Steps to Accelerate Transformation and Position Company for Long-Term Success

Rite Aid files for Chapter 11 bankruptcy protection and names a new CEO as part of its corporate restructuring strategy.

Healthcare payments startup Waystar makes IPO filing public

Waystar goes public with its IPO filing, announcing plans to list its shares on the Nasdaq alongside a bump in quarterly sales.

Curbside Consult with Dr. Jayne 10/16/23

Generative AI continues to be a hot topic around the virtual physician water cooler. My colleagues have come to expect me to have my finger on the pulse of innovation, even though interacting with these solutions is a small part of my current work in clinical informatics.

OpenAI recently announced that “ChatGPT can now see, hear, and speak,” heralding an opportunity for a “more intuitive type of interface” that allows the user “to have a voice conversation or show ChatGPT what you’re talking about.” The blog details the potential of the technology to impact daily life.

As an aspiring amateur chef, I’m intrigued about the potential to “snap pictures of your fridge and pantry to figure out what’s for dinner (and ask follow up questions for a step by step recipe).” At any given time, my kitchen has a stack of recipes that I find intriguing. It would be great if artificial intelligence could parse them and determine which ones I might be more likely to make, and what ingredients I need to make their creation a reality.

Plus and Enterprise users get first crack at the new features, with voice coming on mobile platforms and images being available on all platforms. As for voice, the goal is for users to be able to have a conversation with the virtual assistant after choosing one of five voice options.

As an early adopter of the Garmin Nuvi back in the dark ages before Google Maps, I miss my former trusty companion “Ken the Aussie” and was hoping that there would be a similarly engaging option available with the new solution, especially since the company states they worked with professional voice actors to create the options. Alas, I didn’t find an internationally-accented voice – the options are named Juniper, Sky, Cove, Ember, and Breeze.

I can’t wait to explore the image options. One of the use cases that OpenAI lists includes “analyze a complex graph for work-related data.” I have some absolutely crazy pictures of whiteboard drawings that I’ve collected over the years and can’t wait to unleash AI technology on those and see what sense it can make of them, if any. New York Times reporter Kevin Roose got a sneak peek at a beta version of the technology recently and shared his results. He noted some issues:

• Taking a picture of the front page of the newspaper, he asked ChatGPT to summarize it. The AI hallucinated, “inventing a statistic about fentanyl-related deaths that wasn’t in the original article.”
• The technology “flopped” when asked to assist with a crossword puzzle.
• It referred to a stuffed dinosaur as a whale.

It was also unable to assist with deciphering a diagram for assembling a piece of IKEA-esque furniture, although I’m less surprised by that than the other issues mentioned. He also noted limitations in how the technology processes images of human faces, although he mentions this is functioning as designed. Developers wanted to avoid it being used for facial recognition or critiquing people’s appearance. As someone who has cared for teens who have been cyberbullied, I’m grateful for the latter.

The New York Times reporter found the voice capabilities to be particularly powerful, referring to it as “Siri on steroids” with a “fluid and natural” voice that has “slight variations in tone and cadence that make it feel less robotic.” He notes that his request to hear the story of the Three Little Pigs “in the character of a total frat bro” was “a sleeper hit.” (The example is available in the article, if you’d like to give it a listen – I agree it was pretty funny.)

Honestly, I can’t wait to ask it to tell me a story about healthcare IT from the perspectives of some of the archetypal personas we see in the industry: the exuberant CEO, the frustrated project manager, the surly end user, and the burned-out clinician. It would probably be more entertaining than some of the talks we saw at conferences like HLTH, hands down.

Earlier in the month, OpenAI had also announced that its Dall-E image generator was being incorporated into ChatGPT. When AI-generated images first came on the scene, there were a lot of concerns about copyright issues, competition with human artists, and the role of AI in the creative process. Now that the technology is becoming more accessible, some of my physician colleagues have also been concerned about the potential for using generative AI to create images that can be passed off as medical records in order to manipulate a physician into providing treatments or medications for which a patient might otherwise be inappropriate.

There was a big discussion among our group about the potential for diversion of controlled substances if patients presented with AI-generated x-rays, CTs scans, or MRIs. I’m seeing an increasing number of physicians paying attention to political happenings, so of course there was concern with the potential to use AI to manipulate upcoming elections. Of course, there are plenty of bad human actors that already have the technology to do those sorts of things, but somehow things just seem scarier to some when automation is involved.

OpenAI isn’t the only company that’s doubling down on chatbot investments. Google recently released improvements that allow Bard to access information from Gmail, Google Docs, and Google Drive accounts through a feature called Bard Extensions. It can also draw from YouTube and Google maps for information. Although those enhancements potentially represent a substantial increase in generative power for sophisticated applications, I’m more interested in straightforward but potentially complex tasks, like helping me parse through the hundreds of emails I receive each day across both my personal and HIStalk accounts and helping me identify which ones might be most intriguing.

Given my consulting work helping organizations streamline their meeting calendars, I’d also love to unleash a chatbot to parse calendar data to help me figure out which meetings should be moved to maximize attendance, which should be kept where they are, and which might be able to be eliminated. Of course, most of the organizations I work with are still devotees of Office 365, so Bard isn’t going to be much help there.

What do you see as the areas with the greatest potential for generative AI, and what do you see as the biggest potential pitfalls? Leave a comment or email me.

Email Dr. Jayne.

Readers Write: Easing HCC Coding Adoption by Using Insights and Assessment for More Accurate Data

Easing HCC Coding Adoption by Using Insights and Assessment for More Accurate Data
By Shahyan Currimbhoy

Shahyan Currimbhoy, MS is vice president of product of Edifecs of Bellevue, WA.

Healthcare provider organizations that are participating in Medicare Advantage plans are acutely focused on the adoption and execution of Hierarchical Condition Category (HCC) coding. HCC is a healthcare risk adjustment model that is used to predict the healthcare costs of individuals or populations based on medical conditions. Adoption requires disciplined and accurate documentation and coding of all relevant medical conditions to properly reflect the health status of patients. Accuracy is critical. Even the slightest inconsistency or error can impact risk scores and subsequent reimbursements to providers.

HCC coding is an important model for healthcare reimbursement risk adjustment because it offers the benefit of accurately predicting healthcare costs. Unfortunately, as it has been put into practice, it has elevated some operational challenges. It’s no secret that coding has long-been an administrative burden on the healthcare system. Over time, we’ve learned that automated, integrated, and system-wide technology can help reduce these burdens. In the present evolution of our healthcare system, we also know the viability of value-based care (VBC) desperately depends on alignment between documentation, provider engagement, and claims coding.

The implementation of HCC coding requires a thoughtful approach. If done right, organizations could quickly see opportunities to refine and improve the encounter documentation process and care delivery.

Your HCC Coding Approach: Collaborate with Clinicians

As care teams recognize HHC coding as a critical component of an organization’s business model, identifying the right deployment approach is an important early step. Each health system will take a different approach, but change must be met with ease and collaboration. Organizations that attempt to move into alternative payment models (APM) by flipping the switch overnight on new processes or technologies will encounter pushback from care teams and coding staff. Value-based payment participants will have a better outcome if they ease into the transition, including starting with tools that are made for VBC, and weaving them into the existing team structure and processes.

Care teams and coding staff will have questions. Will HCC coding be addressed before, during, or after the visit? Will coders and clinicians collaborate in person or electronically? Consult your clinicians before determining the best approach. Excluding them will undoubtedly result in a missed opportunity to best understand how strategy could impact their day-to-day workflows, which can lead to a more challenging implementation process.

A collaborative approach will result in more accurate coding in the long run, playing a huge role in reducing the time providers are spending confirming or rejecting a suspected condition.

Coding Insights and Provider Education Support Entering High-Risk Sharing Arrangements with Confidence

Even with automation and collaboration tools, care teams that have incorporated HCC can still find themselves coding inconsistently. For leadership to understand where education and resources are needed, there needs to be provider-level visibility of coding efficacy. Without data-driven insights into provider quality risk operations, this can prove challenging.

With the proper sources, providers can build patient registries, identify where the patients are, and build standard care pathways to ensure that patients are getting proper care. Leadership can gather the clinicians to share knowledge and identify variations in care. Treating HCC coding as a discipline, rather than as an administrative or financial function, helps ensure alignment between providers and the coding team, which drives improved patient outcomes.

Organizations with confidence to move into high-risk sharing arrangements can use automation and natural language processing (NLP) to drive scalability, collaborative tools that allow care teams to work in unison, and performance analytics to help the whole care team continue to improve.

Using “MEAT” to Fully Assess New Conditions Against Patient History

VBC payment models often require a comprehensive understanding of a patient’s medical history, always culled from various sources and locations. Consolidating diagnostic codes linked to HCCs becomes difficult when a patient is treated at multiple departments within a clinically integrated network (CIN) with separate EMRs. In today’s state of financial resources, the right integrations and automation tools are key.

Organizations are empowering clinical review specialists by giving them a comprehensive view of each patient’s medical history, as well as the tools needed to help identify the gaps in care. If medical history is reviewed prior to an encounter, it can reduce some of the burden on clinicians during the patient visit. With the comprehensive view and additional time, providers can better assess new potential conditions using the acronym “MEAT” as suggested by the AAPC (monitoring, evaluating, assessing/addressing, and treating).

MEAT serves as the connective tissue between documentation, provider intervention, and claims coding, and is essential for any reliable risk adjustment program. VBC relies on this alignment, confirming that money is flowing to organizations that are most at risk, and ensuring that patients with chronic conditions are served efficiently. Combined with tools that simplify HCC recapture, such as artificial intelligence and machine learning, these approaches can save time across the care team and ensure care continuity and revenue capture for chronic disease management.

Stop Using Old Solutions for New Practices

Automation tools and assessments like MEAT help care teams, providers, and coders ensure that HCC coding accurately reflects the true burden of patient populations. Without the necessary systems and technology infrastructure in place, following the guidelines in practice can be challenging. Health systems that are incorporating VBC arrangements often expect to solve new problems with old solutions, and that is just simply not realistic. Organizational efficiencies leading to increased clinician satisfaction, improved financial performance, and better clinical outcomes can be realized with the right operational components to support automation, visibility, and collaboration for both provider organizations and health plans.

Morning Headlines 10/16/23

Sphere Announces Agreement to Divest Commercial Division

Sphere will sell its Commercial Division to commerce enablement company NMI, allowing it to sharpen its focus on core business such as its TrustCommerce healthcare gateway, Health IPass patient engagement solutions. and Qgiv digital fundraising platform for non-profits.

VA’s new artificial intelligence centers will focus on iteration in AI testing process, agency official says

The VA will establish four new AI centers to test and apply new AI solutions at partner VA medical centers.

Walgreens plans to close some 60 VillageMd clinics

Walgreens will close 60 of its drugstore-attached VillageMD clinics as it pursues $1 billion in cost reductions following a Q4 loss that is the first in its 122-year history.

Monday Morning Update 10/16/23

Top News

Walgreens will close 60 of its drugstore-attached VillageMD clinics as it pursues $1 billion in cost reductions following a Q4 loss that is the first in its 122-year history.

Walgreens paid $5.2 billion in late 2021 to increase its stake in VillageMD. The Walgreens interim CFO insisted in Thursday’s earnings call that the company will “unlock the embedded profits at Village” by cutting costs, improving execution, and “right-sizing the footprint” in focusing on the highest-opportunity markets and expanding integration of the company’s digital assets.

Walgreens also says it will reduce retail inventory and optimize product mix, which might make one wonder why the highly-compensated executives waited for a crappy quarterly earnings report to do so. Actually, maybe the company agrees since they have already canned the CEO, CFO, and CIO.

Worth a read is the analysis by AI company founder Sergei Polevikov, who says half of the company’s 2023 loss of $3 billion is due to money-losing VillageMD while the remainder is because of “kitchen sinking,” where all of the company’s problems are blamed on previous management in an opportunity to clean up the ugly books. He previously wrote a brilliant piece titled “Why did I say No to 100 SPAC offers? Because SPACs are Ponzi schemes” in which SPAC salespeople pushed him to take his AI company public, but didn’t bother to ask questions about profits or ROI since their interest was pumping and dumping, fueled by insiders hyping the company to unload shares to retail investors who shortly after took it in the shorts.

Reader Comments

From Boyd Blender: “Re: PE firm acquiring a health system. That would be an unwelcome intrusion.” The intrusion has already occurred, as private equity firms already own health systems, physician practices, clinics, ambulance services, hospices, insurers, drug companies, ED staffing firms, health IT software vendors, pharmacy chains, dental and vision offices, and funeral homes. Meanwhile, ever-larger health systems are exhibiting PE-like behavior in closing less-profitable sites, running investment firms, and strong-arming patients to pay balances due while generously enriching their executives. Patient expectations of empathy, customer focus, and an emphasis of quality over revenue – even when the patient is an executive of the same health system — usually lead to disillusionment.

HIStalk Announcements and Requests

Many poll attendees wouldn’t attend any conferences if they had to pay their own way, but some say they would self-fund trips to a vendor’s user group meeting, HIMSS, or ViVE. I’ve long held that at least on the provider side, conferences are bestowed as paid vacations for executives with little expectation of ROI. I say that from experience, having enjoyed the budget and paid time off to traipse off to conferences about which my health system employer asked little and for which I held minimal expectation of benefit to my employer.

New poll to your right or here: Which of the following non-job issues were the main reason you left an employer? Everybody understands quitting over better opportunities, boss conflicts, or lack of challenge or inspiration, so I’m looking for broader, company-wide issues.

I’m never going to trust Google to lead AI innovation until it improves Gmail. I use it in the most basic ways possible, but still marvel that (a) selecting all items in Promotions and then clicking Delete All runs what looks like a primitive macro that leaves many emails undeleted; and (b) deleting emails on mobile brings up a pointless and unmovable “Conversation moved to trash” message that hides the next email. Only a UI-indifferent engineer could find Gmail easy to love. I’ve used it since mid-2005 and its appearance and sometimes frustrating behavior hasn’t changed much, like Google is reluctant to mess with it.

Sign up as a new HIStalk sponsor and Lorre will give you the rest of this year for free, a deal that rewards action rather than indecision.

Webinars

October 25 (Wednesday) 2 ET. “Q&A: What’s new with the NSA? A No Surprises Act update.” Sponsor: Waystar. Presenters: Joseph Mercer, JD, managing director, Marwood Group; Heather Kawamoto, VP of product strategy, Waystar. The No Surprises Act created a lot of change,  and those changes are still coming. A panel of revenue cycle experts answer frequently asked questions and offer a concise update on the NSA, including legislative developments, FAQs, and tips for navigating changes.

October 25 (Wednesday) 2 ET. “AMA: The Power of Data Completeness.” Sponsor: Particle Health. Presenters: Jason Prestinario, MSME, CEO, Particle Health; Carolyn Ward, MD, director of clinical strategy, Particle Health. Is your healthcare organization looking to drive profitability and scale quickly? Our experts will explore how comprehensive clinical data can revolutionize the health tech landscape. This engaging discussion will cover trending topics such as leveraging AI and data innovation to enhance patient care and outcomes, real-world examples of organizations leading the charge in data-driven healthcare, overcoming challenges in data completeness and interoperability, and visionary perspectives on the future of care delivery.

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

Acquisitions, Funding, Business, and Stock

Sphere will sell its Commercial Division to commercial enablement company NMI as a non-core business. UPDATE and correcting an earlier version of this item: the company is retaining the healthcare offerings as part of its specialized integrated verticals, selling only the Commercial Division that serves non-integrated SMB retail customers. Sphere says the sale will allow it to focus on fully integrated payment and software experiences, which in healthcare includes its TrustCommerce healthcare gateway and Health IPass patient engagement solutions.

UnityPoint Health and Presbyterian Healthcare Services end their plans to merge.

Venture capital firm Andreessen Horowitz provides vendor advice from health system digital health leaders on selling AI products:

• Frame the problem instead of assuming that buyers seek AI for AI’s sake.
• Identify the person who is charged with fixing the problem, not the one who is most excited about AI.
• Understand the buyer’s roadmap to solving problems, their buy versus build framework, and their value proposition for choosing a startup versus an incumbent vendor.
• Define the ROI case and KPIs to avoid “death by pilot.”
• Focus on user workflow since organizations aren’t interested in standalone solutions and those that add steps the clinician’s work.
• Be transparent about why you need data and how it will be managed.
• Pricing methods include mirroring the cost of an existing solution that will be replaced, API-based pricing that allow customers to build their own applications, a straight SaaS subscription, and charging based on what employees would be paid to achieve similar results.
• Raise investor funds based on the high cost of compute resources that are needed to develop products. Those funds are one form of product moat, along with hiring skilled AI people, gaining access to proprietary data, and achieving market lock-in where health system customers are reluctant to replace incumbent vendors.

Announcements and Implementations

A Kerala, India-based startup creates user-friendly scheduling software that updates the assigned appointment time with a prediction of when the visit will actually begin based on the doctor’s real-time schedule. The system also allows doctors to transfer their appointments.

Financial Times-backed European startup publication Sifted asks investors which digital health companies they like, although the investors don’t indicate any financial interest in the companies they name:

• Abtrace (UK) – preventive care monitoring.
• Floy (Germany) – radiology image analysis.
• Lighthearted.AI (UK) – wearables for heart condition detection.
• Lindus Health (UK) – clinical trial platform.
• Nabla (France) – ambient documentation.
• Nebu-Flow (UK) – smart nebulizers.
• Nelly Solutions (Germany)  – digital signatures and credit.
• Nyra Health (Austria) – digital stroke rehabilitation.
• Phare Health (UK) – medical coding.
• Sohar Health (UK) – insurance eligibility.
• Tortus.ai (UK) – EHR task automation for physicians.
• Upheal (Czech Republic) – note-taking for mental health professionals.
• Verisian (UK) – clinical data analysis.

Atrium Health surveys primary care users of Nuance’s DAX Copilot. Almost all report ease of use and an improved documentation experience, while two-thirds think it has improved their care delivery experience.

A LinkedIn post describes Northwestern Medicine’s pilot project for IT Locker, in which employees who forget their laptops at home can submit a quick form to receive a PIN that allows them to withdraw a loader.

Other

Doctors, nurse practitioners, and physician assistants at Allina Health System’s clinics vote to unionize and will be represented by Service Employees International Union. Physicians who were involved in the organizing campaign complained that understaffing at the clinics is swamping them with managing refill requests, patient messages, and lab results.

The parents of 28-year-old Ohio hospital ED nurse Tristin Kate Smith, who died by suicide in August, discover and publish “A Letter to My Abuser,” which they found on her laptop. The abuser she references is profit-driven health systems, which she said compromise patient care by laying off staff, ignoring nurse input, and failing to supply security to protect workers, all while providing gratuitous pizza parties and “healthcare heroes” pens. She blames health systems for exploiting nurses who are constantly being asked to do more with less while lining their pockets delivering overpriced healthcare. She concludes, “If I stay, I will lose my sanity – and possibly my life – forever.”

Sponsor Updates

• NTT Data sponsors the US Marshals Golf Classic, supporting the families of fallen officers.
• The 2023 Surescripts White Coat Award recognizes 11 healthcare industry leaders in performance, innovation, and accuracy.
• Aga Khan University Hospital in Nairobi, Kenya implements Meditech Expanse.
• Spok releases the 2023 State of Healthcare Communications Report.
• The Dermatology Specialists realizes a 50% reduction in claim submission lab and a 33% reduction in payer rejections after implement RCM optimization services from EClinicalWorks.
• Atrium Health reports that Nuance’s DAX Copilot solution has improved the documentation experience for almost 85% of physicians.
• Netsmart will exhibit at the National Association for Home Care and Hospice Conference and Expo October 15-17 in Washington, DC.
• PerfectServe will exhibit at the American Association of Physician Leadership Fall Institute October 26-29 in Scottsdale, AZ.
• Sectra releases a new podcast, “The power of remote reading – why radiologists should never settle for less.”
• Symplr partners with the Daisy Foundation to celebrate nursing excellence with the Moments that Matter video series.
• Artera, Availity, Consensus Cloud Solutions, Dimensional Insight, EClinicalWorks, HealthMark Group, Linus Health, Meditech, MRO, and Nuance will exhibit at MGMA’s Leaders Conference October 22-25 in Nashville.

Blog Posts

• What Meditech’s top podcasts reveal about healthcare drivers (Meditech)
• The 5 Biggest Takeaways from ‘Bridging the Gap,’ Our First Ever user Summit (NeuroFlow)
• Burnout’s triple threat: Compromising care, clinicians, and cash flow (Nordic)
• Top 3 Considerations for an EHR Upgrade (Optimum Healthcare IT)
• Highly Trained, Under-Utilized: Advocating for a Shift in Pharmacy Care (OmniSys)
• The healthcare executive’s guide to AI (Redox)
• NASP Recap: How Tech is Closing Info Gaps in Specialty Medication Fulfillment (Surescripts)
• For Epic Implementations the Right Project Manager is Crucial (CereCore)
• Revenue cycle 101: Referral status, authorizations vs. referrals + more (Waystar)
• The $150K Email (VisiQuate)

Contacts

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