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Morning Headlines 12/13/22

December 12, 2022 Headlines No Comments

Oracle Sales Top Estimates on Growth at Cerner Health-Records Unit

Cerner’s $1.5 billion in quarterly sales help parent company Oracle’s sales jump 18% to $12.3 billion.

Commons Clinic clinches $11M for specialty care

Commons Clinic, which is building out a network of specialty physician practices that will offer integrated virtual care programs, raises $11 million in seed funding.

Semler Announces Investment in Monarch Medical Technologies

Semler Scientific will invest up to $5 million in digital diabetes management company Monarch Medical Technologies.

Curbside Consult with Dr. Jayne 12/12/22

December 12, 2022 Dr. Jayne 3 Comments

I was interested to learn about new legislation that was introduced in the US House of Representatives this week. HR 9377, the National Patient Safety Board Act of 2022, establishes an independent federal agency dedicated to the reduction and prevention of healthcare-related harms through use of data-driven solutions. The goal is to create a body similar to the National Transportation Safety Board (NTSB), which looks at transportation-related accidents and issues recommendations aimed at preventing future accidents. The NTSB also takes part in transportation safety research and looks at transportation-related topics, such as worker impairment and equipment failures.

Medical errors have long been a leading cause of death in the US, ranked as high as number three in the pre-COVID years, with numerous organizations leading their own “preventable harm” efforts. However, those processes typically look at events happening within a healthcare organization versus the entire delivery system, and may be skewed by local, regional, or other biases. Honest investigation of certain medical incidents might even be hampered by our patchwork of state and local rules and laws. The proposed National Patient Safety Board (NPSB) would be empowered to look systemically at medical errors, which are estimated at costing upwards of $17 billion each year.

Many experts estimate that patient safety has worsened during the COVID-19 pandemic. I’ve certainly seen firsthand how exhausted clinicians bypass alerts designed to help them and make poor decisions due to mental fatigue. They also sometimes have to choose between multiple non-ideal therapeutic options due to supply chain, financial, and other issues, all of which impact patients. The dramatic rise of interoperability in an effort to de-fragment the healthcare system has also created some potential safety issues that don’t always get the attention they deserve, including patient matching errors, incompatibility of units of measure, erroneous diagnoses, and more.

The proposed NPSB would be designed to be collaborative and non-punitive, empowered to work with other federal agencies and independent patient safety organizations rather than to replace them. It would include a public-private partnership team, the Healthcare Safety Team, designed to achieve consensus on patient safety measures, data collection strategies and solutions, and more. Topics that the Board would be expected to wade into include, but are not limited to, medication errors, wrong-site surgeries, hospital-acquired infections, laboratory errors, and safety issues created during transitions of care.

A coalition of healthcare, business, educational, and technology organizations is rallying in support of the Act. Members run the spectrum of healthcare-related entities, including think tanks, professional organizations, EHR vendors, integrated delivery networks, quality organizations, business consortiums, and more. According to the coalition’s website, “We have seen many valiant efforts to reduce the problem of preventable medical error, but most of these have been focused on the actions of the frontline workforce. This reliance on individuals is part of why efforts to sustain, spread, or standardize progress have been unsuccessful. The healthcare workforce is in crisis, and healthcare safety is suffering.”

The proposed NPSB would have five members, nominated by the President with Senate approval. Members would serve a six-year term. A chair and vice-chair would be designated by the President from among the members and would serve three-year terms in those roles. The Board would be staffed by an organization grouped into various bodies: an Office of the Chair, a Patient Safety Event Monitoring Division, and Study Division, a Patient Safety Solutions Division, an Administrative Division, and regional offices.

The text of the bill goes into further detail about the various divisions and their composition. Other elements that caught my eye included the maintenance of a Patient Safety Reporting System to be used by patients, providers, non-clinical staff, or others wanting to report patient safety events, along with a data access portal to allow state and local entities to submit data. The bill is one of the shorter ones I’ve read, at only 10 pages of standard-formatted text (19 if you read it in the peculiar column formatting found in typical legislation). The bill also includes draft appropriation amounts for setting up the body and its ongoing operation. Although the monetary figures are large, those of us in the healthcare trenches might argue that we can’t afford to not spend money on large-scale analysis and remediation of medical errors.

Not a day goes by that we don’t hear some kind of story about a medical error. If it involves a celebrity, it might even make national headlines, but there are hundreds of stories unfolding every day in the US. As an example, one of my physician colleagues has been reeling this week after being told that nine days after surgery, half of the samples that were taken during a sentinel lymph node biopsy procedure are missing. The pathology department has been supposedly tearing the department apart looking for the sample, but that doesn’t change the patient’s level of anguish, the potential for additional costly and invasive procedures, and the resulting diagnostic uncertainty.

Many patients don’t even know they have experienced a break in protocol unless they know what is supposed to be happening, such as when I was hospitalized and the nurse was scanning the medication barcodes after administration rather than before. Understanding the root causes behind such behaviors is critical to preventing them in the future, and the proposed Board might be uniquely positioned to accelerate the analysis needed to change behavior.

The bill has been referred to the House Committee on Energy and Commerce, and also to the House Committee on Veterans’ Affairs and the House Committee on Education and Labor. I was surprised to see a lack of co-sponsors listed – Representative Nanette Barragan of California appears to be out there on her own on this one. It will be interesting to see if other legislators will help carry this forward or who might introduce a companion bill in the US Senate. It’s been a long time since I’ve been deeply involved in policy work, so I don’t have a good handle on what might be going on behind the scenes with this effort or whether there are forces that are aligning against it. I’ would be interested to hear from readers who are closer to life within the Capital Beltway and who might have tidbits they would be willing to share.

What do you think about the creation of a National Patient Safety Board? Leave a comment or email me.

Email Dr. Jayne.

HIStalk Interviews Jaffer Traish, COO, Findhelp

December 12, 2022 Interviews No Comments

Jaffer Traish is COO of Findhelp of Austin, TX.


Tell me about yourself and the company.

I’m the son of two parents who grew up in poverty. One parent lost two siblings due to food insecurity. At 15, I became a community organizer, working to improve the health of families living near old power plants. Over the years, I’ve worked in government, health IT, and advisory, My focus is on improving the health and wellness of the vulnerable. Our CEO also had many experiences that led him to found Aunt Bertha, now called Findhelp. He worked on streamlining benefit enrollment in state government and became the guardian of a relative who had a rare disease.

The mission of Findhelp has remained the same since founding, to connect all people in need to the programs that serve them with dignity and ease. We are focused on the social drivers of health, such as food, housing, transportation, and other human services. We work every day with communities and government to modernize the social safety net of health and human services by providing open, focused, and contracted social service networks and integrated software for healthcare plans, employers, education, government, and community organizations. We are seeing something interesting happen. Nearly 1 million new adults use the network every few weeks, and that’s humbling and sobering.

Our US healthcare model is an world outlier in being very much driven by profit. What are the challenges in creating a safety net and connecting people to it?

There remains enormous friction in the way people apply for benefits, determine their eligibility, and source post-acute care, social care, and placement. The social service sector and the post-acute care sectors are just catching up to the age of digitization and basic interoperability. It’s interesting to see the first White House Conference on Hunger in 50 years and some new investments, like broadband investments, that are showing some greater federal attention to the safety net. There are more than 240 bills in Congress right now with social care components and over 80 with health equity components, though still today, public policy is slow to address root causes of disparities. With a mostly private-funded safety net, it’s difficult to achieve that scale under our current program.

In terms of the role of government, there are waivers in 23 states with social care reimbursement elements. We believe that government can fund capacity of services, streamline enrollment, require reporting, and accelerate interoperability certification, though they should offer guidance to states on this work and not necessarily suggest paying vendors large sums of money as as solution to social drivers of health.

What is the effort involved in finding hundreds of thousands of programs and maintaining their information?

We call that team our human curation team. It’s hard work. Our team is on the phone every day talking to service providers across the country, validating important information such as the languages they support, eligibility rules, and sliding scale cost structures. We believe that providing individual seekers the dignity of being able to explore their own options is important in this country to empower individuals to find the best services. That information has to be as accurate as possible, as they don’t have the luxury of extra resources, and we want to build the best connections for them to those providers.

That team is our largest investment in the company. We believe that some degree of automation is important and can help us in that curation work, though we receive thousands of signals every day about how programs change and our team is responsible for reviewing, vetting, and processing that feedback. That’s a commitment that we have as a public benefit organization to serve the country and ensure that we make a free service to the nation. 

The network is important. On top of the network, we provide, on the private sector side, the software and tools for care coordination to support connectivity between private industry and the social services sector.

We’ve seen a lot of non-profits engage with us because it helps them with their overall operations. Most folks don’t know, but we provide free case management tools to non-profits, and when they sign up with us for no fee, they have the ability to publish their appointment slots. They can run reports to show their funders how they are serving people. They can see who’s using search terms to find their organization. They can publish an eligibility screener so they can automatically respond to people to let them know whether they qualify for their service or not. They can even integrate referrals into their own non-profit system of record so they can continue working in their own workflows.

What is your business model?

Our business model is relatively simple. We didn’t want to take the approach of traditional health tech companies and charge user licensing or have a PMPM model because that restricts the number of helpers that can engage in this work and the number of people that can self navigate. Early on, we decided that we would have a simple annual subscription model to the software and to the network to integrate and embed into your own navigator workflows. That has been quite appealing to healthcare, government agencies, community colleges, and even large employers who have come to us to help their employees.

Each industry has their own drivers for why they sign up. Some, it’s financial. Some, it’s recidivism. Some, it’s clinical outcomes, student retention, and so forth. The broadness of the network appeal creates a network effect, and that’s why we are seeing somewhere around 50 new large systems join us every quarter right now.

What is the role of the health system that joins?

For our customers that have helpers — and this could be a social worker, a discharge planner, or a navigator of sorts — they are quite interested in assessing individuals for their social needs, generating outbound connections, referrals, or applications to the non-profit sector. Even ordering goods and services, which is something that has emerged in the last couple of years, like diapers or car seats for a new mom to leave the hospital on time. They are interested in building these connections and even funding and supporting some of the service delivery for those connections.

They are interested in tracking the service delivery outcomes and eventually marrying that information with their own clinical or cost information so that they can begin to study the impact of doing this work at scale within their populations. Integration is a key part of their vision. For example, our bi-directional referral integration with Epic’s Compass Rose is a big investment to bring smoother workflows to these tens of thousands of navigators.

What does that integration look like to an Epic user?

We’ve built four integrations with Epic to meet customers where they are in their investment into social care. The first is to give dignity to the population, and that is an integration with MyChart. That is where customers like Trinity Health have embedded their social care network directly into MyChart so people can self-navigate and self-refer to programs at scale. That’s tremendous, by giving people the dignity of access.

The next integration is bringing the network live as a SMART on FHIR application embedded into the care navigator’s workflows. With that integration, navigators can send referrals, process applications, and text and email program information to people who may not be ready for a referral and otherwise navigate the entire network.

There are advanced customers who want to leverage Epic Healthy Planet and Compass Rose to natively have the network living inside of the Epic tools. That’s where the integration is using APIs to allow helpers to directly surface information about programs and send referrals bi-directionally to the non-profits without ever needing to use our software.

How did your work change during the pandemic?

We saw over 100 healthcare organizations join us during the pandemic. We saw major EHR companies reach out to us to accelerate the development of this integration. We added around 4,000 COVID-19-specific support programs to the network during the pandemic. We saw significant volume increases around the country of people looking for help and of navigators using the network. We were up late at night for more than a year working hard to improve the system scaling as well as the software features to support such growth.

How does United Way’s 211 program integrate to support people who lack broadband access?

There are around 240 different 211s around the country. We think the work they have been doing is incredible over the years. Many of them operate call centers, and that’s the first place many people think to call when looking for a service. 

We view them as complementary to the work that we do in many communities. In fact, we collaborate with more than a dozen 211s around the country, and some of them are actually our customers. We see the potential for 211s to not only operate as hubs in communities, helping with care navigation, but also being able to collaborate on the program network and the quality of the program information, as we often both do that curation process in communities. I think there’s an evolution of the 211 model that we are seeing happen around the country.

KLAS has reviewed the small market of social determinants of health networks, in which Findhelp earned top scores. How do you see that market evolving?

We were doing this work 12 years ago, before the term “social determinants of health” was a buzzword. We called it “poverty alleviation.” There were around 15 companies in this space. Over the last 10 years, most of them were either acquired or closed up shop. 

It’s interesting because we see three key issues coming to light. The first is privacy. How do we ensure that individuals can control their private referral information and share it when they are ready and not force an oversharing model? The second issue is interoperability. Are we willing to make the investment as a company and integrate and interoperate with the right systems around the country? Third, how do we work with government? Do we enable government agencies that have helpers to do this same work, or do we depend on government funding to build infrastructure? Our approaches to those three have resonated with many industries, including healthcare. That’s what I would attribute our momentum to, alignment with those that are doing this work to those principles.

What developments do you expect to see over the next few years?

Software is only a small part of building bridges between healthcare and social care providers. Our most successful customers are in the community with us, building trust with the service providers, hiring community liaisons, and organizing coalitions. That is real network building. We are going to see a plethora of funding, and we must be mindful that we direct that funding as much as possible to capacity of these service providers, who are the ones doing the hardest work to serve our communities. That’s where we should keep our focus and attention, serving the service providers and the navigators that do this work every day.

Morning Headlines 12/12/22

December 11, 2022 Headlines No Comments

Epic Launches Connection Hub: Open to All Developers

Epic announces that it will shut down its App Market until sometime next year, and that it will launch Connection Hub on January 9, enabling software vendors that connect to Epic to list their apps and self-report the successful exchange of data.

VA will use Silicon Valley hiring spree to bring fresh talent into EHR program, CIO DelBene says

The VA plans to hire 1,000 new employees to work on its Oracle Cerner implementation as it recruits from Silicon Valley.

Juno Medical Raises $12M Series A Led by Next Ventures and Serena Ventures; Funding Will Fuel Juno’s National Expansion

Tech-enabled healthcare provider Juno Medical raises $12 million in a Series A round, enabling it to expand into Atlanta, Tulsa, and Los Angeles.

Monday Morning Update 12/12/22

December 11, 2022 News No Comments

Top News


Epic will shut down its App Market until “later in 2023”and temporarily replace it with Vendor Services that will provide access to documentation, testing sandboxes, and technical support.

The company will also launch Connection Hub on January 9, where any software vendor that connects to Epic can list their app and self-report if they successfully exchange data.

HIStalk Announcements and Requests


Most poll respondents wouldn’t appreciate a provider charging them personally for answering their questions by email or portal message (I intentionally left insurance out of the question since that introduces all kinds of rabbit hole arguments). Interesting comments:

  • Providers should first recommend booking an appointment instead of charging to answer an inquiry.
  • Does the provider allow patients to ask real questions that generate a situation-specific, useful response?
  • Health insurance premiums have already paid for their time, and charging is a disincentive to getting care.
  • The question is moot since billing codes are already available and other professionals don’t offer free advice.
  • Patients asking questions this way may be a sign of other problems, such as lack of appointment availability.

New poll to your right or here, following up on my interview with Patrice Wolfe: How does industry networking differ between men and women?


Welcome to new HIStalk Platinum Sponsor Findhelp. The public benefit corporation, which was previously known as Aunt Bertha, connects all people in need to programs that serve them with dignity and ease, offering the nation’s leading social care network and integrated software to modernize the social safety net. Over 400 health plans, health systems, governments, and cause organizations use its 600,000-program network, which is #1 in KLAS, to address social determinants of health. Customers can create their own branded platforms to connect their local communities with nearby social care resources. Its social care tools are integrated with Epic, Cerner, Athenahealth, EClinicalWorks, Innovaccer, and CarePort. Thanks to Findhelp for supporting HIStalk.

I’m fascinated that Findhelp has a film division that shares inspiring stories of people who are working to improve their communities, such as this one.

Thanks to the following companies that recently supported HIStalk. Click a logo for more information.



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


  • Great Ormond Street Hospital for Children NHS Foundation Trust will implement Sectra’s enterprise imaging solution and radiology module.


image image

Weill Cornell Medicine promotes Curtis Cole, MD to the newly created position of VP/chief global information officer. Deputy CIO Vipin Kamath, MBA will succeed Cole as CIO.


Meditech confirms that founder and board chair A. Neil Pappalardo has retired from the company that he started 54 years ago.

Announcements and Implementations


Business Insider looks at Medly, a “digital pharmacy” that raised $110 million in funding through mid-2020. The company, which offered a user app and services from its own brick-and-mortar pharmacies, ran out of money in losing $10 million per month. It closed half of its 51 locations, laid off 1,000 of its 1,900 employees, saw its founder and CEO leave without notifying employees, and filed bankruptcy Friday. Employees say the company was so strapped after its most recent layoffs that it ordered its salespeople to fill prescriptions, even as it assured the remaining employees that no more layoffs would be conducted and that profitability was imminent.  

Government and Politics

The VA plans to hire 1,000 new employees to work on its Oracle Cerner implementation as it recruits from Silicon Valley.

Defacto Health summarizes the comments CMS has received to its RFI to create a National Healthcare Directory.

Privacy and Security

A security firm finds that 70,000 websites, including those of hospitals, are using Twitter’s advertising tracker that works like the Meta Pixel in capturing user information. The Twitter advertising pixel can be configured to limit its data collection for advertiser-specific purposes, but 99% of the websites aren’t using that feature.

Baylor College of Medicine reviews the patient privacy and HIPAA aspects of digital photography.

The India-based cybersecurity firm that notified a hospital that its data was being offered for sale on the dark web is itself breached. CloudSEK says that an employee laptop it sent to a computer repair shop was returned with a new copy of Windows installed that also contained stealer log malware. The hacker didn’t get much of anything useful from the data and screenshots that the malware sent, mostly training documents and database schema screenshots.


Three-fourths of surveyed British Medical Association members say that lack of interoperability is a significant barrier to digital transformation, with 30% adding that the software they use is not adequate for their job. Eighty percent of respondents report delays in accessing data from secondary care, while two-thirds say they aren’t confident that instant data sharing will happen within 10 years. BMA recommends that the government upgrade IT hardware and software, improve broadband and wi-fi in healthcare facilities, and develop interoperability standards.

Sponsor Updates


  • Relatient staff honor World Volunteer Day by volunteering at local Rescue Mission homes in Nashville, Cookeville, and Atlanta.
  • Wolters Kluwer Health publishes a new study, “Pharmacy Next: Health Consumer Medication Trends.”
  • Premier announces that its Pinc AI solutions identified $1.5 billion in member-validated savings opportunities, generating an average return on investment of 16:1 between July 2021 and June 2022.
  • TigerConnect publishes a new e-book, “When Every Second Matters: Guide to Speeding Critical Response Workflows.”

Blog Posts


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


Morning Headlines 12/9/22

December 8, 2022 Headlines No Comments

CompuGroup Medical confirms market-leading position with strategic acquisition of Medicus LIS

CompuGroup Medical acquires Medicus, adding a fourth laboratory information system to its roster that includes Labdaq, Schuylab, and AP Easy.

Sonde Health Raises $19.25 Million Series B to Build the Next Generation of Voice-Based Health Monitoring

Voice-based health monitoring company Sonde Health raises $19 million in a Series B round, bringing its total raised to $35 million.

CereCore expands healthcare technology services into the UK

CereCore expands its health IT services to the United Kingdom.

SaVia Health Raises $8.5M in Seed Funding

SaVia Health, which offers software that converts paper-based care pathway information into EHR-friendly clinical decision support content, raises $8.5 million.

News 12/9/22

December 8, 2022 News 1 Comment

Top News


The US Patient and Trademark Office Patent Trial and Appeal Board  rules that three AliveCor heart monitoring patents should not have been issued. The ruling follows a challenge by Apple, which had been found to have infringed on those patents following an AliveCor complaint.

PTAB ruled that the heart monitoring technologies for wearable devices are not patentable.

The International Trade Commission is set to decide by December 12 if importation of Apple Watches should be banned over the dispute.

AliveCor added ECG capabilities to its KardiaBand add-on watchband for the Apple Watch in 2017 and demonstrated the technology to executives of Apple, which rolled out similar built-in technologies the next year. AliveCor retired the band in mid-2019 and introduced new app-powered, non-continuous personal ECG products, including this year’s KardiaMobile Card.

Reader Comments

From Kendra: “Re: HLTH. Had a major data breach right before November’s conference in Las Vegas and registration information is being sold on the dark web.” Unverified. I’ve reached out to HLTH (which does not make it easy to contact them) for confirmation, but haven’t heard back. Personally, I wouldn’t be too worried about it anyway since conferences sell registrant information widely and hackers can’t be any more annoying than vendor spammers. UPDATE: HLTH says no breach occurred.


From Sly Devil: “Re: publicly traded health insurer CEO compensation. Check out this list from S&P Global.” The top-earning health insurance CEOs for 2021 were those of buzzy newcomers Clover Health ($390 million), Bright Health ($181 million), and Oscar Health ($61 million). At least much of that comp was paid as since-tanked company shares — CLOV is down 74% in the past year, BHG is down 79%, and OSCR has slid 72%. Clover Health’s board members include Chelsea Clinton, a former CMS director, a Henry Ford Health System exec, and 7Wire Ventures partner Lee Shapiro, all of whom seem to have consumed Theranos-like Kool-Aid in overseeing this train wreck that went public in 2021 with the help of “SPAC King” Chamath Palihapitiya at a valuation of nearly $4 billion. Billionaire Clover co-founder and CEO Vivek Garipalli previously made a fortune buying three bankrupt New Jersey non-profit hospitals to form CarePoint Health, which took the hospitals out of all insurer networks to become the most expensive health system in the US, earning him an $11 million Hamptons house on Billionaires Lane when he was in his mid-30s. CarePoint then donated the hospitals to form a non-profit, which competing hospitals said was purely to give Garipalli and partners a way to escape huge liabilities and take a tax write-off after pocketing $160 million. I’ll remind myself to blame the game, not the player, but I also note that $300 billion annual revenue UnitedHealth Group compensated its CEO – who actually has a British knighthood for being rich — with “only” $18 million while the failing startups were making it rain for theirs.


From Conflagration: “Re: Neil Pappalardo. I’m hearing that he officially retired from Meditech as of November 30. He’s still board chair and president of the trust, but even as a formality it’s still a noteworthy milestone that he is no longer an employee of the company he founded.” Unverified. I emailed a Meditech press contact but haven’t heard back. Pappalardo co-founded the company in 1968 after he created the MUMPS programming language, and arguably the health IT industry, while at Massachusetts General Hospital as a graduate student.


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

Acquisitions, Funding, Business, and Stock

CompuGroup Medical acquires Medicus, adding a fourth laboratory information system to its roster that includes Labdaq, Schuylab, and AP Easy.


Clinical trials intelligence platform vendor Lokavant raises $21 million in funding. Participating in the round was Roivant Health, which incubated the company as one of its biotech “vants” that includes data integration company Datavant.


  • WebMD Provider Services chooses Artera (formerly Well Health) for patient access and engagement related to patient education materials and medication affordability programs.
  • Ohio Gastroenterology expands its use of Orbita’s conversational AI platform to include interactive virtual assistants for pre- and post-procedure engagement.
  • Sutter Health will use Get Well’s GetWell Loop digital care platform to offer personalized, evidence-based educational content to teens and young adults.
  • LogicStream Health integrates First Databank’s MedKnowledge database into its drug supply system to provide evidence-based alternatives to unavailable drugs.
  • Tampa General Hospital will implement Palantir Foundry as its data platform.



New York -Presbyterian Hospital adds CIO to the responsibilities of Peter Fleischut, MD, who continues as group SVP and chief transformation officer.


Advocate Health, created by last week’s merger of Advocate Aurora Health and Atrium Health, names former Advocate Aurora Health CIO Bobbie Byrne, MD, MBA as EVP/CIO.


Digestive health support vendor Vivante Health hires Hau Liu, MD, MBA, MPH, MS (Teladoc Health) as chief medical officer.


Timothy Wilde (EXL Health) joins UpHealth as CTO.


MSU Health Care promotes Nathan Fitton, DO to CMIO.


Sonifi Health hires Brian Nido, MSEd (Galileo) as VP of customer success.


Azalea Health names Brian Kenah (Sharecare) as its first CTO.


Oncology digital health company OncoHealth hires Susan Hoang, PharmD (McKesson) as chief data and analytics officer.


Jay Adams, MS, MBA (Harris Affinity) joins Altera Digital Health as EVP.

Announcements and Implementations

CereCore expands its health IT services to the United Kingdom.

Amazon ends support for third-party developed HIPAA skills for Alexa. The skill was released as a developer preview in April 2019 with announcement of new consumer voice apps from Express Scripts, Cigna, Boston Children’s Hospital, Providence Health, Atrium Health, and Livongo.

Dominican University New York launches an HHS-funded online public health informatics certificate program for those with a bachelor’s degree, offering a 20% discount of the program’s $11,400 cost for those who enroll by January 10.


A new KLAS report finds that half of the small number of interviewed vendors have migrated their go-forward solutions to the cloud, most commonly choosing Amazon Web Services but with Microsoft Azure gaining traction. The most-reported benefit of cloud is agility (fast scalability, automated provisioning, and automated procurement). Most-mentioned obstacles are support gaps and cost management, with cost models being the top issue that vendors want cloud providers to address.

Government and Politics


Former Theranos COO Sunny Balwani is sentenced to 13 years in prison after being found guilty of 12 fraud charges. He receives a similar sentence to his former boss and lover Elizabeth Holmes, who had asked to be tried separately claiming that Balwani had emotionally and sexually abused her during their long relationship. Key evidence in both trials was the rollout of Theranos lab stations in Walgreens, which spent $140 million in partnership costs only to find that the startup was using old technology instead of its own to perform tests.


The Federal Trade Commission, HHS OCR, and ONC update FTC’s Mobile Health App Interactive Tool that allows health app developers to determine which federal laws and regulations apply to their app.

HHS defers enforcement of the No Surprises Act requirement that providers give uninsured and self-pay patients a Good Faith Estimate starting on January 1. HHS says that providers and facilities need to adopt standard API for exchange GFE data and that HL7 FHIR may be used for that purpose.

Beth Israel Lahey Health will pay $1.9 million to settle federal allegations that it failed to maintain accurate records of control substance use, following a 2018 incident in which a pharmacy technician stole 18,000 doses of controlled substances by removing them from automated dispensing machines indicating that they had expired without returning them to the central pharmacy. Meanwhile, Pikeville Medical Center (KY) will pay a $4.4 million civil penalty for diversion of 60,000 doses of narcotics from its Pyxis MedStations by a pharmacy technician.


A House bill would create an independent federal patient safety agency that would be modeled after the National Transportation Safety Board and Commercial Aviation Safety Team in using a data-driven, scalable approach to preventing and reducing patient safety events.


A Tennessee urgent care center that is owned by publicly traded Healthcare Solutions Management Group remains closed since November 16 following employee complaints that they haven’t been paid since October 1. They say they can’t access the EHR since the corporate office hasn’t paid that bill and that electricity and water have been shut off several times due to non-payment. HSMD shares are down 88% from their 12-month high, valuing the company at $221 million. The company was formed from a merger with a shell company that previously ran a South Dakota fertilizer company that went into receivership, stating as its goal to become “an advanced, national healthcare system.” It has has signed deals with a developer to open ambulatory surgery centers and urgent care centers that will cost at nearly $4 billion. Board chair and interim CEO/CFO Justin Smith is a former stockbroker.

Sponsor Updates

  • Clearsense India promotes Rashmi Bania to head of technology.
  • GHX begins accepting nominations for the 2022 GHXcellence Awards, which will be presented at GHX’s annual summit May 9-12 in Chicago.
  • Healthwise wins seven digital health awards from the Health Information Resource Center for its medical illustrations and health education videos.
  • Forrester recognizes the InterSystems Iris data platform as a Leader in The Forrester Wave: Translytical Data Platforms, Q4 2022.
  • Meditech publishes a customer success story on how “Expanse Genomics supports Frederick Health’s precision medicine program.”

Blog Posts


Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
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Contact us.


EPtalk by Dr. Jayne 12/8/22

December 8, 2022 Dr. Jayne 3 Comments

More stories of absurdity from the patient trenches this week. A few weeks ago, I had the sudden onset of a cluster of itchy blisters on one side of the base of my neck. Being part of the generations that had chicken pox and knowing that if it was shingles it needed to be addressed quickly, I was lucky enough to have a next-day appointment with my dermatologist. She diagnosed it as insect bites and sent me on my merry way (of course after also examining every speck of skin to make sure all was well).

Today, I received a letter from my insurance company informing me that they would not pay for the visit because they need to know if it’s related to an accident or injury. I’ve seen these letters before, especially when there are traumatic injuries and the payer is trying to make sure it’s not due to a motor vehicle accident or a work injury, but I’ve never seen one for an insect bite. It just goes to show the lengths a payer will go to in order to avoid paying for a medically appropriate service.

Just when I thought that was strange enough, I ran into another patient-side issue. I received a notification that I had a new document in my patient portal record, which made sense due to my recent outpatient procedure. On one hand, I like seeing the documents from the patient perspective to make sure they match what I was told during the visit, especially if there was a chance that I was still in a post-anesthesia fog after the procedure. On the other hand, I always like to see how other physicians are documenting, and whether they’re using templates or dictation.

I went to look at the new document and it was indeed a procedure report. Unfortunately, the details of the report simply said, “there is no information for this result.” I think that takes the idea of “no news is good news” way too far. What’s the point of having a result on the chart if there’s no information?

From Jimmy the Greek: “Re: Slack. Did you see the write-up about Slack CEO Stewart Butterfield leaving Salesforce? One of the reasons cited in a Slack message to employees: ‘I fantasize about gardening.’ It’s more like ‘I’m a billionaire many times over, why would I continue to work?’” Why would one continue to work, indeed. I’m sure most of us could come up with a list of fulfilling things to do if we didn’t depend on a steady paycheck. I have a long list of volunteer work that I would become fully immersed in if I had that kind of money, but for now, I’ll have to stick with my current “one hour per week” volunteer responsibilities, which have never been as low as that.


From Holidazed: “Re: holiday gift. Check out what NYU docs received. It’s a collection of speeches and letters from the CEO to students and staff, as delivered over 15 years that he’s held the position. It strikes me as great hubris. It’s a hugely glossy, heavy book. I can’t imagine how much it cost to craft this vanity project and mail it out.” The reader included a copy of the card, signed by Dean and CEO of NYU Langone Health Robert I. Grossman, which states, “In 2007, when I assumed the role of Dean and CEO, my intention was to unify the NYU Langone community around a common goal of fulfilling our true potential for greatness. I began writing In Touch with that in mind, as a way to share the progressive glimpses of what I care about, believe in, and hope for. Fifteen years later, I’m enormously proud of what we’ve achieved together. NYU Langone would never have become the top academic health system in the country without each and every one of you. Now, as we look to the future and seek to hold our position at the top, it’s worth taking time to reflect on the past. I hope this collection of In Touch essays provides an opportunity to take stock of what we’ve been through – both the challenges we’ve overcome and the opportunities we’ve seized – and inspires you to keep striving.”

Holiday gifts have become a hot topic in the virtual physician lounge over the last couple of weeks, as many of my colleagues as for opinions on how to celebrate their staff members. There are also plenty of posts about ridiculous things that hospitals have given employees, including challenge coins, visits from therapy dogs, and endless pizza parties. I polled a couple of colleagues to see what happens in their tech-related firms to see if it’s any different than what we are seeing in health care. Some of the things happening out there include time off for teams to volunteer together, small parties or dinners, and virtual celebrations that include food delivery gift cards for those team members who work remotely. One firm has an “Ugly Sweater Soiree” and I can’t wait to see the pictures of that one.

I’ve been around the block as far as corporate gifting, and what I’ve seen has been all over the map. One employer sent out leather tote bags. but made assumptions on who should have versions for men versus ladies. Although I’ve gotten a lot of use from the one I received, I would have preferred the other option. Last year I received a fruit basket that had decayed by the time it made it to my door. One former boss made a significant charitable donation in honor of our team, which was very touching. Of course, gift certificates are always a hit since they allow for an element of personal choice. By far the gift that has been the most useful was from a health system employer, who gave each worker a set of high-quality jumper cables. The first person I assisted was my EHR vendor’s rep when his truck died in our office parking lot the following January. They have been used at campgrounds, school parking lots, and to teach basic automotive skills to neighborhood kids, so they will always remind me of my decade in that particular workplace.

What do you think about holiday gifting? What are the best and worst corporate gifts you’ve seen? As an employee, what is really on your wish list? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 12/8/22

December 7, 2022 Headlines No Comments

Apple scores victory in dispute over heart monitoring technologies in Apple Watch

AliveCor will appeal a patent court ruling that has found three of its patents covering heart monitoring technologies for wearable devices are unpatentable, negating its allegation that Apple copied those technologies for use in the Apple Watch.

Theranos exec Sunny Balwani sentenced to 13 years in prison for defrauding patients and investors

Former Theranos COO Sunny Balwani is sentenced to 13 years in prison after being found guilty of 12 charges related to defrauding investors and patients and conspiracy to commit fraud.

Blaze Advisors Rebrands as Alera Health

Population health management consulting firm Blaze Advisors rebrands to Alera Health.

ACM medical clinic closed in Clarksville as employees go without pay, lose access to records

Advance Care Medical employees in Clarksville, TN close the clinic after corporate owner Healthcare Solutions Management Group stopped paying them – and the bill for the clinic’s EHR – on October 1.

Readers Write: It’s Time to Make Price Transparency Data Useful

December 7, 2022 Readers Write No Comments

It’s Time to Make Price Transparency Data Useful
By Lewis Parker

Lewis “Lew” Parker, MSIS, MBA is SVP of engineering and CTO of Arrive Health of Denver, CO.


The price transparency movement in healthcare is growing, supported by factors including consumer demand and rules from CMS requiring health plans and hospitals to post pricing information for covered items and services.

It’s good that organizations are complying with these regulations by uploading detailed machine-readable documents to their websites. However, it will only be great when this overwhelming amount of information is digested, personalized, and presented in a way that enables decision-making for all parties involved, at the right time.

These moments include when providers are engaging with patients and making care decisions, when care team members are helping patients manage affordability barriers, and when patients are trying to find lower-cost care options.

How do we get to this future state, when data drives behavior change in a way that impacts affordability, accessibility, and outcomes? Here are three things that must happen to make price transparency data useful.

  • Translate the data. The US healthcare system is highly complex, and multiple data sources are used when completing a medication order: electronic health records (EHRs), drug databases (First Databank, Medispan, etc.), and insurance plan design and patient accumulators (plans, PBMs, and payers). There are rarely consistent fields, and even standards such as those provided by NCPDP may not go far enough to create a seamless prescribing experience. This is why the first step to price transparency must be translation.
  • Make it simple. New tools must be simple and integrated into existing workflows if they are going to be adopted, especially considering growing provider burnout worries. Neither consumers nor providers are accustomed to pharmacy benefit jargon. Real-time cost and coverage tools must go beyond unifying and normalizing content from disparate sources by translating that information into messages that are meaningful to the appropriate audience. For example, providers, care teams, and patients all want to see different pricing information. The provider may want to see lower-cost clinically equivalent alternatives, the care team considers options that avoid a prior authorization (PA), and the patient wants to know how much they will owe at the pharmacy counter. Price transparency solutions need to account for this and deliver useful and actionable information to each individual.
  • Build insights. Price transparency data will become its most powerful the more it is understood. Analytics tools can identify where opportunities exist to maximize price transparency data in clinical decision-making. Robust reporting and user-friendly dashboards show which providers are engaging the most (or least) with cost and coverage data and which are ultimately making decisions — like switching to a lower-cost medication or selecting a clinically relevant option that doesn’t require prior authorization — based on that data. Insights can also highlight which medication classes have available competitive options, and where there are barriers to medication switches.

Achieving price transparency in healthcare is challenging but possible. With all types of costs increasing, not just healthcare costs, now is the time to go beyond the bare minimum and invest in tools that will make price transparency data usable and impactful for all stakeholders involved.

HIStalk Interviews Patrice Wolfe, CEO, AGS Health

December 7, 2022 Interviews No Comments

Patrice Wolfe, MBA is CEO of AGS Health of Washington, DC. This interview was focused on women as health IT executives.


Not to hit you with the hardest question first, but if you see a company whose executives and board members are nearly all white males, how do you convince them that they may have chosen unwisely?

No kidding, you’re asking the hardest question first. Maybe I’m just an optimist, but I like to believe that the best way to convince people is through performance and through results.

I was on the board of a large company recently and it was nine white men, mostly in their 70s, and two women. I had a hard time convincing the rest of the board that when we had open positions, we needed to be a little more open minded in terms of how wide we would set the aperture for the candidates for the roles. 

I’ve noticed that often when we do searches for senior positions — whether it’s a board position or an executive member of an operating team — all the search descriptions end up sounding like the person must have won a Nobel Peace Prize and walks on water, because we are trying to make the job sound as complete and as attractive as possible. Sometimes we create job descriptions where we’re ratcheting down the aperture so much that five people in the entire country can fit this job description.

When you are trying to drive diversity, you have to make sure you open that up a little bit. You have to let in people who might not be traditional candidates, and you have to be willing to take a chance. To me, the thing that has been the hardest is convincing people that the answer isn’t, “We’re going to hire the best person for the job.” Because the best person for the job often looks like a very traditional candidate, and that does not help us gain ground on diversity.

Is that because it’s comfortable to hire candidates who are like us, or is it the perception that those other candidates aren’t as qualified as they actually are? And would you see the same biases toward female candidates if the company leaders were mostly women?

There’s an element in this that we all gravitate towards people who are more like us. That’s human nature.

I don’t have enough experience with all-women leadership teams to know if that bias exists. There’s not enough N’s out there for me to have a good feel for the answer to that. If I look at my own leadership team, we’re about 50/50 in terms of male/female. That puts me in a great position where I don’t have to worry quite as much about gender diversity.

I’ll tell you what I am typically the most focused on — cultural fit. Is the candidate someone who can thrive in the culture that I’m trying to cultivate? That’s definitely not a gender thing.

I don’t think I have a perfect answer to your question. I’d love there to be more examples of women-only leadership teams out there so that we could tell if they suffer from the same bias.

Given the frequent importance of networking in getting hired, how does networking work differently for women than men?

This is such an interesting point. It’s something that I talk a lot about when I speak about gender diversity at the senior executive level.

The good news is that if you are hiring at the executive level, you are most likely at some point, maybe not initially, going to use an executive search firm. For me, that has always been a great way to meet people I don’t know.

But in terms of the networking element, no doubt the more networked you are, the more likely you are to get tapped for a wider range of opportunities from a career perspective. One of the things that women have struggled with is finding themselves in those situations that maximize networking. Are they invited to certain types of meetings? Are they included in a small group of leaders who might be attending what now are incredibly expensive conferences?

What I’ve seen over the years is that you have to almost make a deliberate effort to include women in these types of activities that end up being great networking opportunities. It has to be a deliberate action. It works well when it is tied to things like recognition of high-performance employees. If you do a good talent review in your organization every year, you can pinpoint those members of your employee base who are high potential. You can deliberately do things such as say, we’re going to earmark these people for attendance at a particular conference, or we’re going to earmark them for presentations to the board on a particular topic that they’re focused on. If you don’t do that stuff, those people lose out on the networking that might make them more well known as a candidate for an executive role.

How do men and women apply and interview for leadership jobs differently?

The Harvard Business Review published a study on this many years ago. I may not quote this exactly right, but I believe that the findings were that women would put themselves forward for a role if they fit 90% of the criteria for the job, whereas men would put themselves forward if they felt they met 60% of the criteria. There’s definitely a difference there, obviously in general, but I do think that this is challenging.

When I mentor women, I raise this point a lot. What’s the worst thing that could happen? You could be told no, you’re not qualified enough for the role. Too often, people might build up in their minds an outcome to putting yourself out there that is far more daunting than what really happens. Sometimes I think it helps just to get people to talk through, how could this play out? And are you OK with how this might play out? Why not try?

This is a general challenge that we have to deal with through mentoring women. Also, modeling the behavior that comes from saying, what the heck, I’ll give this a shot. Maybe it won’t work out, but I’ll probably learn something in the process, at least.

Bias sometimes exists against women who have current or future family obligations. Are the trends of remote work and increased work-life balance changing that?

This is a really interesting point, because so much has shifted generationally. I was guest lecturing at a Wharton Business School class a couple weeks ago in the healthcare track, and I had several interesting comments from the students. They were interactive, it was so fun.

One of the students, a woman, raised the point that nowadays men and women are particularly focused on work-life balance. There is more of an acknowledgement, with younger professionals, of the important rule of maintaining both a balance in your personal and professional life, but also maintaining a level of mental health wellness that people my age never really paid attention to. This woman was saying, what about men taking paternity leave and other types of family related time off? Isn’t that part of how we achieve some of this balance in the workplace?

That is exactly right. Younger professionals are more focused on work-life balance in general, and it’s not a gender issue. We are seeing men taking this seriously also. That’s an interesting thing, that some of this gender distinction is going away.

In terms of work from home, I do believe that the trend towards work from home has made it easier for women to take on roles of greater responsibility. I see this in India, where there traditionally has been a big drop-off in women in management roles, because once they start having children, many women have enormous pressure to not go back to work. Work from home in India has helped to shore up the growth of women in management roles in all kinds of industries. I’m fascinated by how the whole workforce dynamic has shifted with work from home.

What career advice would you give to a woman who is in a director or senior manager role and wants to move to VP or the C-suite?

If you want to get to the top echelon of an organization, it’s important that at some point in your career, you get experience managing P&L. Maybe you just manage a cost center, and maybe there’s no revenue attached to it. Too often, you see women working their way up the ranks in support functions, things like marketing or HR, where they don’t get an exposure to enough of the business side of the organization. Having the ability to run some type of operating unit inside a health system or a software company is an extremely important role, because it gives you exposure to a wide range of the key operating metrics for the organization that are important when people are assessing you for the very top of an organization. I don’t often see that as a focus for people’s career paths, and it’s important.

Always be intellectually curious. Raise your hand when something interesting is going on in your organization that you think you could learn from and that you could add value to. Be willing to step out of your comfort zone to show that you can make a difference in a way that’s maybe a little bit different than how you’ve traditionally been spending your time.

Those are great opportunities to expand your understanding of your organization, to expand your networking. You might work with different people than you’ve traditionally worked with. Also, to expand your knowledge of what you personally enjoy, because too often, we find ourselves down a path incrementally that maybe we’re not happy with.

It’s  important for women to find mentors and folks at senior levels who will support them throughout their career,. I’ve been fortunate to have people in my life like that. Actively searching out the men or the women in more senior roles in their organization who they admire or they think they can learn from, and actively build a relationship with those people, because they can be hugely helpful to you.

The last thing I would say  is to believe in yourself. Stand up for and pursue things that you’re interested in, because we are always our own best advocates and we deserve to be good advocates for ourselves. Having a level of confidence to do that is important.

Morning Headlines 12/7/22

December 6, 2022 Headlines 1 Comment

Carle Health Partners with Health Catalyst to Achieve Data-Informed Improvement

Carle Health (IL) will transition its Clinical and Business Intelligence team to employment with Health Catalyst, which will continue to provide it with analytical support through 2028.

Amazon to End Support Next Week for Third Party Healthcare Alexa Skills with HIPAA Requirements

Citing ongoing evaluation of its offerings and less than a month out from layoffs within its Alexa division, Amazon tells third-party developers that it will stop supporting Alexa 3P HIPAA-eligible skills on December 9.

CMS Proposes Rule to Expand Access to Health Information and Improve the Prior Authorization Process

CMS publishes a proposed rule that would require some payers to implement digital prior authorization processes, shorten the time frame to reply to PA requests, and establish payer-to-payer data exchange, among several other requirements.

News 12/7/22

December 6, 2022 News 4 Comments

Top News


Marshfield Clinic Health System (WI) lays off its 18-employee telehealth department and shuts down the service, citing system-wide financial challenges.

The health system launched the telehealth service in 2001.

Primary care staff will take over the team’s duties, with IT absorbing the technology functions that include several telehealth platforms.

The system has been transitioning from its 30 year-old homegrown Cattails EHR to Cerner over the last year. Marshfield Clinic said in its Q2 2022 report that the move to Cerner, in a project called One System EHR, has caused “greater disruption to reporting and revenue cycle billing and collections than anticipated and the realization of expected benefits from the system has been slower to materialize.”


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

Acquisitions, Funding, Business, and Stock

Remote cardiac patient monitoring consulting and management company Rhythm Management Group acquires competitor Equis Consulting Group.

Carle Health (IL) will transition its Clinical and Business Intelligence team to employment with Health Catalyst, which will continue to provide it with analytical support through 2028.

Business Insider looks at the spectacular unraveling of startup health insurer Bright Health, which went public in June 2021 at a $11 billion valuation but now is worth $600 million as it has downsized to selling policies in just one state. Experts say the company priced its Affordable Care Act plans low to attract members in several markets, but couldn’t manage its costs and processed claims manually even though it bragged on being a technology company.

UnitedHealth Group expects to generate $360 billion in revenue in 2023 with EBITDA of $36 billion. The company expects its Optum businesses (Health for patient-centered care, Insight for technology and analytics, and Rx for pharmacy services) to generate $214 billion of the total.


  • Digital health platform developer Better selects Lyniate’s Rhapsody health data integration software.
  • Virtual care company Let’s Talk Interactive selects EHR integration capabilities from Redox.
  • Aesthetics practice software vendor Docovia will leverage Clearwater’s ClearAdvantage managed service for cybersecurity and compliance.



The Guthrie Clinic (NY) promotes Terri Couts, RN, MHA to SVP/chief digital officer.


SolutionHealth (NH) promotes Debra Dulac, RN, MBA to SVP/CIO.


Baker Tilly partner Travis Drouin will also lead its technology industry practice.


Herman Kalra, MBA (Orion Innovation) joins CTG as VP/chief people officer.


Juno Health, the commercial division of Document Storage Systems, hires Michael Bond, MBA (Allscripts) as VP of commercial sales.


NTT Data promotes Douglas Kelly, MBA to VP/federal healthcare practice lead.

Announcements and Implementations

University of California San Francisco Health and UCSF Dentistry announce they have become the first academic health system in the West to merge medical and dental records into one EHR.


Russell Medical Center AL) converts from Meditech Magic to Meditech as a Service with help from CareCloud’s MedSR division.


Mater Private Network in Ireland begins its Meditech Expanse implementation.

QGenda launches a mobile-first solution for nurse and staff workforce management.

Privacy and Security


CommonSpirit Health reports that some patient data, particularly of patients of Franciscan Health (WA), may have been compromised during a ransomware attack that forced its nationwide facilities to downtime procedures for nearly a month.

As AIIMS struggles to restore its IT systems after a November 23 cyberattack, reports begin to surface that the 2,200-bed health system in India hasn’t upgraded its computers and IT systems in 30 years. Government officials investigating the attack have reached out to E&Y to find out if its cybersecurity audit of AIIMS earlier this year found any vulnerabilities.

Sponsor Updates

  • Censinet adds former Mass General Brigham VP/CIO James Noga to its advisory board.
  • Net Health adds new predictive models to its PointRight Radar care management software to better identify patients at high risk for falls, pressure ulcers, mortality, and hospitalization.
  • Access publishes a new patient e-signature case study, “Northern Regional Hospital: Creating a Better Experience for Healthcare Workers and Patients.”
  • Nordic releases a new episode of its DocTalk series.
  • Agfa HealthCare receives the Cybersecurity Transparent Leader award from KLAS and Censinet.
  • Artera receives the 2022 CHIME Collaboration Award for its work with TrueCare to improve no-show rates, create greater access to care, and help patients gain control of when and how they like to communicate.
  • Azara Healthcare becomes an Accelerate Partner with Athenahealth through its Marketplace program.
  • Oracle Cerner customer Hamad Medical Corp. Qatar has built and equipped the dozens of clinics needed for the World Cup.
  • CereCore wins Best of Staffing Client and Best of Staffing Talent Awards from ClearlyRated.
  • ChartSpan names Saylor Zechman sales development representative.
  • CHIME offers support for the Healthcare Cybersecurity Act.
  • Wolters Kluwer Health publishes a new report, “The Path to Open Medicine: Driving Global Health Equity through Medical Research.”
  • Healthcare IT Leaders adds ERP, EHR, and AMS consulting expertise with five new executive director hires and promotions.

Blog Posts


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Morning Headlines 12/6/22

December 5, 2022 Headlines 2 Comments

Rhythm Management Group Announces Acquisition of Equis Consulting Group

Remote patient monitoring consulting and management company Rhythm Management Group acquires competitor Equis Consulting Group.

Medication Intelligence Leader Kit Check Rebrands as Bluesight

Medication supply chain software vendor Kit Check changes its name to Bluesight.

UCSF is First to Integrate Records Across Medical and Dental

University of California San Francisco Health and UCSF Dentistry announce they have become the first academic health system in the West to merge medical and dental records into one EHR.

Curbside Consult with Dr. Jayne 12/5/22

December 5, 2022 Dr. Jayne 2 Comments

This weekend was all about starting some end-of-year organization and making a plan for conferences and travel for 2023.

I’ll be attending many of the same conferences I did this year, but might throw in a couple of new ones if the dates work out. I had mentioned after the HLTH conference that I was disappointed in the lack of COVID precautions, so I was happy to see that HIMSS has an entire Health and Safety section that attendees must agree to. We all know that many people don’t read the details of “terms and conditions” type documentation, and even if they do, there’s no guarantee that they will follow the rules. However, it’s good to see a common sense approach to public health since it addresses not only COVID, but other communicable diseases.

Long story short: If you have symptoms of any communicable illness, including COVID, within five days preceding the conference, you need to stay home. You should also stay home if you’ve tested positive for anything, or if you’ve been in contact with anyone who is confirmed or suspected of having a communicable disease.

These are generally good rules for any gathering. I think that many people want to push back against any kind of health and safety measures because we’re all fatigued from talking about it the last few years. However, we seem to have forgotten the crud that everyone used to catch at HIMSS and bring home with its associated sore throat, runny nose, and fatigue.

HIMSS left the door open for other measures, including the possibility of “vaccination, proof of COVID status, self-monitoring, biometric screening, symptom checkers, contact tracing, use of personal protective equipment and social distancing, or other similar measures.” These will be determined at the time of the conference and will meet or exceed local public health requirements.

My in-person clinical colleagues are absolutely drowning in sick people right now, and the numbers they’re seeing in the emergency department and urgent care settings are commensurate with what they were seeing during the worst COVID surges. Flu is surging in my area and I’m not seeing any public health messaging encouraging people to stay home or to get tested, so I guess we’ve just collectively decided to let it rip.

This time of year, things are generally fairly slow in the realm of healthcare IT. Most of the large healthcare organizations I’ve worked with are out of money by now if they are on a calendar-based fiscal year and are waiting until January rolls around to sign contracts and start new projects. Given the economy, there are a lot of hiring freezes in place, and I don’t see that changing soon. Even in organizations that have fully funded and staffed healthcare IT projects that they were going to complete in December, I’m seeing things placed on hold because the clinical teams that the projects would involve or impact are being absolutely buried. If the flu season curves hold the same shapes they have had in pre-COVID years, it might be several months before these initiatives are pulled off the back burner.

I also spent part of the weekend trying to clean up an ever-ballooning inbox. It seems like when I unsubscribe from a newsletter, two new ones take its place. I was happy, though, to stumble across this article from JAMA Network Open which looked at “Accuracy in Patient Understanding of Common Medical Phrases.” Now that patients have full access to most of the notes and documents generated in the course of their care, it is more important than ever for clinicians to write in a clear manner that patients can understand. The authors surveyed 215 adults outside the medical setting and gauged their understanding of commonly used phrases (in case you are curious, the outside venue was the Minnesota State Fair.) Where 96% of patients knew that “negative” cancer screening means they didn’t have cancer, fewer patients (79%) knew that “your tumor is progressing” wasn’t good news. An even smaller number (67%) knew that having positive lymph nodes meant that cancer had spread.

The authors discussed the possibility of confusion around words such as “negative,” which means something good when it is associated with a screening test, but means the opposite in other contexts, such as “negative reviews” or “negative feedback.” They also spent some time discussing medical jargon and noted a concept which was new to me: that of “jargon oblivion,” which refers to the mismatch between our intent to avoid jargon and the reality of our frequent use of it.

While medical jargon is one thing, acronyms are another entirely. I’ve seen plenty of patient-facing notes that have acronyms that don’t immediately register with me as a clinician, so I can only imagine the confusion that patients have as they are trying to understand it. If I search something and it’s four or five entries down on the Google results, then I would feel safe in suggesting that clinicians probably shouldn’t be using it. “NPO,” which is a Latin-based phrase for “nothing by mouth,” was one of the items tested. Other medical words such as “febrile” were included. The researchers noted that the use of the phrase “occult infection” was interpreted by those surveyed as having something to do with a curse than being associated with a hidden infection.

The authors noted a concern for bias since they selected state fair attendees who were attending a university-sponsored research exhibit. A more generalized sample of the community might produce differing results. Participants who agreed to take part in the survey received a backpack with the University logo. As a visitor to several different state fairs, I think I woud be more motivated to participate if there was the potential for a funnel cake or perhaps a fried Twinkie at the end.

The authors suggest that further studies would be helpful to boost understanding of how patients understand medical jargon, as well as to test recommended alternatives to improve communication with patients. The study involved both audio and written test questions and there was no difference in the results, allowing researchers to conclude that the less time-intensive written approach would be valid for future studies. If anyone is looking for a research assistant who knows how to deep fry things, I might know someone who is available.

What’s your favorite state fair food? Leave a comment or email me.

Email Dr. Jayne.

HIStalk Interviews Matthew Condon, CEO, Bardavon Health Innovations

December 5, 2022 Interviews No Comments

Matthew “Matt” Condon, JD, MBA is founder and CEO of Bardavon Health Innovations of Overland Park, KS.


Tell me about yourself and the company.

I’ve been in employer-driven musculoskeletal health for the  last two decades. I grew up in Iowa, went to grad school and law school, and got passionate about this space. I was fortunate post-law school to relocate to Kansas City, which was the home of Cerner. There’s a Cerner halo here in Kansas City and a lot of people, including the founders, were important to me in the early stages and helped guide me in my career.  

I have been on this journey for a couple of decades, building companies that were specifically aimed at supporting employers in how they optimize the musculoskeletal health of their employees. I’m really fortunate to have built a couple of companies here and I am proud and thankful to call Kansas City my home.

Bardavon was formed in 2014. It is absolute love of mine, intellectually. We partner with employers, or the carriers who represent them in some cases, to optimize the musculoskeletal health of their employees. This ranges from preventative through post-injury solutions that are offered in a hybrid manner at work, in the clinics, and at home. All coordinated, all collaborating, and all aimed specifically at improving the lives of the 60 to 80 million US workers that make up the labor workforce in this country.

Our biggest differentiating factor is that we have seen the spectrum move from all-in clinic to this digital-only focus, and I believe that we are the only people in this space that offer a truly hybrid approach. We have digital solutions that we incorporate, engage, and coordinate, but we also have a nationwide network of over 25,000 physical and occupational therapists that utilize our solutions in an integrated manner aimed at improving the health of the one patient-employee in front of them and the tens of thousands we serve on an annual basis.

How competitive or cooperative are you with the providers that contract with you?

They are partners and we are really proud of that. The first business I had was on the provider side, where I built a company and sold it to a publicly held company. That understanding of the provider realities, the environment that they work in, and what they are aimed at is important to who we are, and maybe why we bring such value to them. We partner with those providers. They get out of their EMR and into our platform for the patients that we send them from the employers that we work with, who want exceptional care for their injured employees.

It is double-sided marketplace, but one that I am proud of on both ends. We feel partner-focused. It is our job to get employers around the country the best healthcare for their injured employees. It is also our job to make that environment for the providers who are treating them efficient, clear and communicative, and collaborative so that they know what success looks like for their employers. They can aim at it and they are rewarded for achieving it.

We’ve seen MSK technology evolve from range-of-motion home exercise coaching that ran on consumer gaming systems and now to technology platforms that include apps and analytics. What is the best use of technology for MSK issues today?

Acuity levels drive the appropriateness of the solution that you put in place. But in the end, the in-person provider relationship experience has never been more important than it is now. Coordinating that with digital solutions that enhance it, especially as you get to a certain level of acuity, just makes sense, and it works. 

The provider community was maybe generally reluctant to engage with digital solutions, but now at least the 25,000 providers we partner with use it because they see that when it is added into their plans of care and added into their care experience for their patients, they are getting better outcomes.That is what those providers want, especially when they are rewarded for it with more referrals from those employers that are looking for that better experience.

All this digital solution application was thrust at the marketplace. Ironically and tragically, though, there weren’t a lot of innovative solutions provided for the American worker, that 60 to 80 million men and women that build our roads, build our buildings, fight our fires, and protect our streets. There’s a unique engagement environment for them. They are unique in that with regard to MSK, their job is the biggest risk factor to their health. No solutions were targeted specifically at them. We think that is a mistake and an opportunity that Bardavon is uniquely fulfilling.

Do employers see workers’ compensation as a problematic expense where providers may take advantage of them or bill for services whose value can’t be proven?

It’s all of that, and there is validity to all the reluctance to enter into this marketplace. Some of it is more structural. Workers’ compensation care — how we address and impact our associates that are hurt on the job — is siloed in a completely different and often disconnected part of the structure. It’s actually property and casualty that your workers’ comp comes under. Your trucks, your equipment, your property, and the workers’ comp injuries are housed in a different silo of the insurance industry. That has created an environment that historically had us treat these individuals as widgets and line items on Excel spreadsheets. 

Today’s reality is that we have this labor shortage and this massive need for these people to be healthy, happy, and productive at work. That has created an environment where the perspectives are evolving. That is tailwinds for us for sure, that employers and carriers are understanding that we have to reevaluate the way that we address this marketplace. They aren’t widgets and they aren’t line items, they are people and they carry with them functional issues that either do or don’t help them do their job effectively. Bardavon is leading in this solution set of providing that group with appropriate, effective tools that they can engage and utilize to improve their lives and improve their productivity and work culture as a result.

A lot of people are trying to solve MSK and workers’ compensation. The MSK health of the American worker has been historically neglected, but we feel that the evolution that needs to happen in the MSK space is best launched from workers’ comp. There’s a number of reasons that make it the most advantageous place to launch it, and we believe that that will happen and are excited about it.

You realized that your previous company, ARC Physical Therapy+, had reached a scale problem where you could only grow so much being tied to bricks-and-mortar operations. You also found that the insights available from data were more valuable than actually delivering the service. How did you apply that experience to Bardavon?

That’s exactly right. We went in with a belief in this unique way of addressing the marketplace, going to employers, building clear value propositions, and clearly aligning the incentives of the provider and the payer around the function of the patient. We believed that was the right thing to do. And as you indicated, we changed a marketplace because of it. We had employers change the way they helped their employees navigate the healthcare system to get access to our clinics for the data.

As I mentioned early on, I was fortunate that we built a great company and I was really proud of it. It was, in part, the founders of Cerner — Cliff and Neal a little, but Cliff in particular – who challenged me that we had a national business that we were choosing to operate locally, and shame on us that we were not thinking bigger. At that time, the world had changed. The cloud had come along, and housing those solutions within the bricks and mortar of the couple of dozen clinics that we owned didn’t change a national marketplace, it only changed a local one. 

We believed that we could evolve the company to no longer be beholden to the bricks and mortar, but to partner across the country with providers and payers that cared. And in so doing, not just change the health and healthcare experience of the employees, but find out which providers in every ZIP code of this country were healing patients in a way that was quantifiable and objective.

That is an exciting part of what we do today. We get stronger every day in knowing who is actually healing patients in a way that we can measure, not based on CPT codes or bills, but whether or not their patients are returning to a level of function. That is, I believe, the most transparent and beautiful reflection of healing in healthcare.

How much of the company’s success and ability to scale was driven by requiring providers to document patient progress in your own proprietary platform?

It is bi-directional. It’s not just that they are documenting and sending us the data. We are telling them at eval what success looks like for that employer, what success looks like for that employee who is injured, and what their functional job demands are. There is no guessing, there is clarity. Then we create this beautiful feedback loop that updates and gets better every second of the day about what providers are doing in other parts of the country with like patients with like return-to-work requirements, that are optimizing their outcomes and doing it efficiently and effectively.

All of that is a dream and a vision. Healthcare providers went to school with the hope that they would be in that environment. Most of them, or maybe all of them, got pushed into an environment that historically and traditionally didn’t facilitate that. We had to ask the providers to do something unique to get there. 

Asking them to get out of their EMR and into our platform is not easy. It’s incumbent upon us to make it as seamless and intuitive as possible, but more than that, it is incumbent upon us to make the providers believe that their dream of why they went to school is our dream. To create a system where good providers get more patients and benefit from that, and bad providers don’t. Creating an environment where providers know what their incentive is, and where employers or payers know that because they are partnering with Bardavon, they are getting access to the best providers in every community that are uniquely focused on the same goal that the employer wants, getting that employee back to work and effectively doing their job.

You used the word “grind” several times in an interview, talking about your college athletics experience where a bigger and more athletically gifted opponent knocks you down and you have to get back up and do it again. How does that personal philosophy translate into a business culture, especially in an environment where employees might not be as willing to sacrifice their lifestyle for company benefit?

I was blessed to not be exceptionally good at anything. It taught me the importance of work and that I could succeed if I would outwork others. My parents and growing up on a farm were surely a part of that, but the fact that I wasn’t blessed with any exceptional talent really was a blessing. It helped me, and that transcended from sports to business. The Midwest is part of that.

In all of the healthcare, and specifically now in every industry like this, I guess there’s always a level of negativity and a level of suspicion about whether people are doing the right thing. This business has been my choice to pursue my entire life, in large part because if you spend time with these patients, they are incredibly inspiring.

My entree into workers’ comp was working with professional athletes who were hurt. I saw all the technology and all the science that was aimed at getting a professional basketball player back to the court or professional football player back on the field. When you are able to take a piece of that and provide it to firefighters, police officers, and laborers who are doing their job very specifically to support their husband, wife, kids, families, friends, whatever … there are always bad actors and characters, but predominantly it is a remarkably inspiring client base and I’m proud of what we can do. It keeps me guided to grind every day.

The other side of that is those providers, specifically the physical and occupational therapy providers who spend so much time with their patients. An hour a day, three or four times a week, for five to six weeks. It’s a very intimate relationship. They put their hands on them and they help them regain the function they once had. They hear about their families and they hear about their personal lives. It is a really beautiful sector of healthcare that has been historically neglected and forgotten. I’m proud of the focus that we can put on it through our own grinding effort.

How will the company change over the next few years?

Cliff and Neal were always clear about having a vivid description of a desired future state. Keep that at the forefront of everything you are doing and why you are doing it. We believe that Bardavon will continue to evolve into a company that represents excellence in the way that employers treat their employees, specifically around MSK health. We will facilitate meaningful and intuitive technologies, services, and when appropriate, exceptional patient care for those associates, so that they know that when choosing an employer, they will assess whether or not that employer works with Bardavon. The providers they work with around the country will see that as a part of brand associated with quality and caring for them as people in their roles and jobs and lives.

I believe that we are on the precipice of that. I believe that as we grow and become the company that we can, that others in this space copy us and take that approach to other parts of the healthcare spectrum and continue to improve their lives as well. That’s probably a bold prediction, but I believe it.

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