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Monday Morning Update 6/12/23

June 11, 2023 News 9 Comments

Top News

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Madison, WI-based news site Isthmus questions whether Epic’s non-compete agreements limit Dane County’s entrepreneurial growth as compared to Microsoft’s startup influence in the Seattle area.

A former Epic employee says that it’s nearly impossible for people like him to launch a startup given the two-year non-compete that involves the 4,500 banned companies that Epic lists as competitors and its “all efforts” pledge that prohibits part-time, professional, or teaching work while working for Epic.

The article also notes that Epic requires independent consulting firms, vendors that are listed in its app marketplace, and its customers to incorporate the same two-year non-compete terms.

Some of the former employees who were interviewed say they took jobs that seemed unrelated to Epic, but were terminated by their new employers when Epic inquired.

The FTC is reviewing its proposed ban on non-compete agreements, which is almost certain to be legally challenged.


HIStalk Announcements and Requests

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A surprising number of poll respondents say their phone has driven life-changing improvements, with some examples being Pokémon Go leading to exercise, Reframe for sobriety, Apple Watch’s three-ring activity tracker, Strava for exercise, exercise trackers and monitoring, and calorie tracking.

New poll to your right or here: Has a non-compete agreement that you previously signed ever had a negative impact on your search for a new job?

My fascination with ChatGPT has been replaced by annoyance at the hucksters who are carpet-bombing LinkedIn and Twitter with dull, formulaic, and probably ChatGPT-generated drivel that practically begs for followers and newsletter sign-ups. They will disappear in a few months as they fight each other to be top-of-mind for short attention span crumbs, but meanwhile it’s getting tedious being swamped with repetitive content from self-proclaimed experts:

  • Pithy “ChatGPT for business” editorializing from people who have never held a real job beyond self-promotion and who have no documented education, experience in AI, or success in running a company.
  • Soulless, pointless one-sentence-per-paragraph eye-rolling insight haikus on LinkedIn.
  • Recirculating low-value lists of ChatGPT tools, prompts, and screenshots.
  • Making lists of predictions of companies or industries will be rendered obsolete by ChatGPT.
  • Posting the non-clever results of the “I asked ChatGPT and here’s what it said” type.
  • Folks, many of them in marketing and writing, who don’t realize that any leverage they get from ChatGPT will be quickly adopted by everyone else, erasing any temporary competitive advantage.

Webinars

June 22 (Thursday) 2 ET. “The End of COVID Public Health Emergency is Here. Is Your Rev Cycle Ready?” Sponsor: Waystar. Presenter: Vanessa L. Moldovan, commercial enablement + insights program manager, Waystar. This webinar will describe the proactive steps that are needed to avoid increased rejections and denials. It will cover regulatory waivers and flexibilities, major shifts in telehealth, changes to reimbursement, and the impact of the end of the PHE on Medicaid coverage.

July 12 (Wednesday) 2 ET. “101: National Network Data Exchanges.” Sponsor: Particle Health. Presenter: Troy Bannister, founder and CEO, Particle Health. It’s highly likely that your most recent medical records were indexed by a national Health Information Network (HIN). Network participants can submit basic demographic information into an API and receive full, longitudinal medical records sourced from HINs. Records come in a parsed, standardized format, on demand, with a success rate above 90%. There’s so much more to learn and discover, which is why Troy Bannister is going to provide a 101 on all things HIN. You will learn what HINs are, see how the major HINS compare, and learn how networks will evolve due to TEFCA.

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


Acquisitions, Funding, Business, and Stock

A Business Insider article predicts a startup “mass extinction event” for startups in late 2023 through 2024 that may have already started, although with low visibility since “most startups die quietly and slowly” since they aren’t publicly traded. The result could be asset sales, recapitalization at lower valuation, acqui-hires in which companies are bought simply to poach their employees, and low-visibility shutdowns.

A researcher in Australia says that employees value work-from-home options because of – in addition to time spent commuting — poorly designed corporate offices that stifle inspiration and creativity with cookie-cutter furnishings, high noise levels, and interruptions, also noting that companies tout serendipitous conversations and collaboration that usually doesn’t happen just because employees are forced to sit in a room together. She says the return-to-office push is being driven by Theory X managers who think lazy employees need to be observed and controlled as well as economic concerns about commercial property values.


Sales

  • The New York State Office of Mental Health chooses NTT Data to provide Independent Verification and Validation (IV&V) services for the Child Support Workstream of the Integrated Eligibility System (IES) Program.

People

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Cedars-Sinai hires James Jones, MHA, MSN, RN (UW Medicine) as its first CNIO.

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Bridget Bell (Nordic Consulting Partners) joins Cardamom Health as VP of business development.

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CommonSpirit Health promotes Karen Hunter, DNP, RN to system VP of clinical informatics.

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Industry long-timer Michael Kendzierski died May 26 at 61. He retired a few months ago from DrFirst and had held executive sales jobs with Spok, Vocera, CareFusion, Initiate Systems, Eclipsys, and Spacelabs.


Announcements and Implementations

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Orbita launches CallDeflectAI, a conversational virtual assistant for provider websites that answers common patient questions using only provider-approved documents and web pages. The company offers a 30-day free trial and promises a one-day launch.

Medhost will offer its partners the Sentri7 antimicrobial and sepsis surveillance suite of Wolters Kluwer Health.


Sponsor Updates

  • EClinicalWorks releases a new podcast, “Prisma: Enhancements & Benefits for Clinicians.”
  • Tegria will host a LinkedIn Live discussion June 21, “Demystifying Cloud Misconceptions for Healthcare.”
  • AdvancedMD publishes a new e-book, “The Private Equity M&A Playbook: A Guide for Private Practices.”
  • Meditech publishes a new whitepaper, “Insights on the evolution and implications of healthcare workforce challenges.”
  • NeuroFlow releases a new Bridging the Gap Podcast featuring Stephen Klasko, MD of General Catalyst.
  • Nuance will present at AHIP 2023 June 14 in Portland, OR.
  • Netsmart will present at the I2I Center for Integrative Health Spring Conference June 12 in Raleigh, NC.
  • A new KLAS report highlights the success PerfectServe’s customers have experienced with its clinical communication solutions.
  • Sectra will exhibit at SIIM 2023 June 14-16 in Austin, TX.
  • Volpara Health issues a statement on the new USPSTF breast cancer screening recommendations.
  • Waystar will exhibit at the FL AAHAM Annual Conference June 21-23 in Daytona Beach Shores.
  • Optum, Availity, Bamboo Health, Surescripts, West Monroe, Ellkay, First Databank, Intelligent Medical Objects, InterSystems, Trualta, and Wolters Kluwer Health will exhibit at AHIP 2023 June 13-15 in Portland, OR.
  • Medhost offers customers access to Wolter Kluwer Health’s Sentri7 surveillance suite with turnkey regulatory reporting.
  • Zen Healthcare IT’s Stargate IHE Gateway achieves EHealth Exchange Validated Product designation.

Blog Posts


Contacts

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

Morning Headlines 6/9/23

June 8, 2023 Headlines No Comments

Carta Healthcare Secures $25 Million in Series B Funding with Additional Investments from Memorial Hermann Health System and UnityPoint Health

Carta Healthcare, which offers registry data abstraction and analytics, closes a $25 million Series B funding round.

Loopback Analytics Announces Strategic Growth Investment by PSG

Specialty pharmacy analytics vendor Loopback Analytics secures funding from PSG Equity.

US medi-tech firm plans ‘major UK campus’ on edge of Bristol

Epic will build a campus in Bristol, England to house its 350 employees there along with others in the UK.

No staff cuts at Spokane VA due to budget deficit, regional director says after visiting Mann-Grandstaff

Mann-Grandstaff VA Medical Center will not be required to reduce staffing or services to address its expected $35 million budget shortfall that was mostly caused by its problematic implementation of Oracle Cerner.

Laudio Announces $13 Million Series B for its AI Solution that Drives Productivity and Reduces Burnout in Health Systems

Healthcare workforce software vendor Laudio raises $13 million in Series B funding, brining its total raised to $25 million.

News 6/9/23

June 8, 2023 News 3 Comments

Top News

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Primary and urgent care chain Carbon Health launches hands-free, AI-powered EHR charting across all of its clinics and providers.

Audio recordings of patient visits are analyzed with AWS Medical Transcribe, then processed with GPT-4 to generate an EHR-ready notes document. The company say that chart completion time is reduced from 16 minutes to four.

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Carbon Health  is reviewing options to license the technology. It cut 200 jobs and ended several key initiatives in January 2023, shortly after opening conversations about licensing its EHR and days before announcing a $100 million Series D funding round led by CVS Health Ventures.


Reader Comments

From CTDeveloper: “Re: [company name omitted]. Fired 450 employees over the last three weeks. Was acquired by a private equity firm last year.” I’ve left off the company’s name while waiting on a response to my inquiry. The company and most of its employees are based in India.


Webinars

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


Acquisitions, Funding, Business, and Stock

Wolters Kluwer Health acquires Invistics, which offers AI-enabled software to detect drug diversion in hospitals and ambulatory surgery centers.

Carta Healthcare, which offers registry data abstraction and analytics, closes a $25 million Series B funding round.


Sales

  • Curana Health, which offers primary and post-acute care to senior living communities, chooses Netsmart’s CareFabric for consumer engagement, value-based care, and management of high-risk populations.

People

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William Crawford, MS, MBA (Medically Home) joins Newfire Global Partners as CTO.


Announcements and Implementations

HIMSS will move its global headquarters to Rotterdam, Netherlands this summer, after which its Chicago facility will be known as its Americas headquarters. HIMSS first announced the opening in September 2022.

A new KLAS report on clinical communication platform adoption finds that PerfectServe Telmediq and Stryker Vocera are closest to having comprehensive deployments that address customer strategies.

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Epic will build a campus in Bristol, England to house its 350 employees there along with others in the UK.

University of Pennsylvania receives a $10 million gift to establish a fund for student healthcare entrepreneurship.

Bankrupt weight loss center operator Jenny Craig will sell its Australia and New Zealand online business to Eucalyptus, which sells medical products online for weight and hair loss, erective dysfunction, menopause, fertility, and skincare. The Royal Australian College of General Practitioners has raised concerns that Eucalyptus may be illegally advertising drugs directly to consumers and allowing its doctors issue prescriptions from questionnaires rather than real-time consultations as the law requires.

Mayo Clinic will use Google’s low-code Enterprise Search in Generative AI App Builder to combine Google search with generative AI to provide information to clinicians and employees.


Government and Politics

The VA’s Northwest regional director says that Mann-Grandstaff VA Medical Center won’t be required to reduce staffing or services to address its expected $35 million budget shortfall that was mostly caused by its problematic implementation of Oracle Cerner.


Sponsor Updates

  • Lumeon publishes an infographic titled “Healthcare Is in Crisis: Is It About to Get Much Worse?”
  • HFMA awards Premier’s Pinc AI InflowHealth solution its Peer Reviewed by HFMA designation.
  • Care.ai’s Smart Care Facility platform integrates with Samsung’s healthcare-grade display.
  • Divurgent releases a new episode of The Vurge Podcast, “Using Data in HIT.”
  • Nordic publishes a new episode of DocTalk titled “An asset-based approach to health IT.”

Blog Posts

The following HIStalk Sponsors achieve top user ratings in Black Book’s analysis of financial and RCM solutions:

  • Optum – chargemaster and price transparency solutions.
  • AdvancedMD – end-to-end RCM outsourcing, small physician practices.
  • AGS Health – end-to-end RCM outsourcing, hospitals under 100 beds.
  • Rhapsody – enterprise master patient identifier solution.
  • Meditech – patient accounting, community hospital.
  • Upfront Healthcare – patient communications and financial RCM satisfaction solutions.
  • VisiQuate – revenue analytics solutions.
  • Waystar – inpatient claims management systems; end-to-end RCM software and technology, large hospitals and medical centers 250+ beds; end-to-end RCM software, large hospital chains, systems, corporations, IDNs; end-to-end RCM software, small to mid-size hospital chains, systems, corporations, IDNs; patient payment technology.

Contacts

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

EPtalk by Dr. Jayne 6/8/23

June 8, 2023 Dr. Jayne 3 Comments

When I certified, one of the major components of the clinical informatics board exam curriculum was public health informatics. As a family physician, I understand the value of public health, and especially after the pandemic, most of us understand how underfunded it is in the US.

Various studies show that a dollar spent on public health has the power to reduce future healthcare spending by anywhere from $11 to $80 depending on the nature of the intervention, yet it’s still not where we prioritize our spending. The reality is that prevention isn’t sexy and doesn’t make money for the people who pay for lobbying, but a girl can hope that eventually policies will shift in a way that makes better funding a reality. A recent article in the American Journal of Public Health looked at the US life expectancy compared to that of other nations over the better part of the last century.

The author found that the US life expectancy began falling in the 1950s and continued to worsen over the last four decades. He also noted regional variation across different parts of the US, finding that the Midwest and south-central states fared worse than other regions. Almost a third of the US states have 60% or fewer of their children vaccinated, and that’s a basic public health intervention that is proven to save lives and reduce days missed at work and school. When people don’t see the value in that, it’s hard to get them on board with funding more “exotic” interventions like community gardens, food pantries, nutrition and cooking classes, and healthy environments for exercise and community activities.

As a clinician, it’s difficult to watch the decisions that health systems continue to make as they prioritize high-earning surgical subspecialties and cutting-edge interventions while they refuse to fund staff expansions in primary care. I’d love to see more research looking at the long-term cost savings and quality of life improvements when preventive care is prioritized.

I had that on my mind when I came across an article about how Regenstrief Institute is working with the National Association for Chronic Disease Directors on a project that will use EHR data to estimate chronic disease burdens at the national and local levels. I wasn’t aware that there was a project in the works for a Multi-State EHR-Based Network for Disease Surveillance (MENDS) or that local public health organizations will be able to tap into it.

The goal is for the EHR-derived data to replace more manual efforts, such as health department workers having to canvas at the community level. There are barriers to the data sharing, however, including the lack of a mandate for hospitals and provider organizations to share their data with public health agencies. Other potential issues include lack of accuracy in diagnosis coding and lack of staffing at public health agencies.

The Office of the National Coordinator for Health IT is looking for feedback on expanding the US Core Data for Interoperability classes and elements. The list of data elements was expanded to better reflect the clinical quality measures that are in use with Centers for Medicare & Medicaid Services quality reporting programs and also to incorporate greater use of FHIR-based reporting. The draft list of data elements for USCDI Version 4 will be open for public comment until June 30.

I had the chance to help a colleague out today when they were working on a specific formatting issue for a scholarly work. It’s been a long time since I’ve published anything, and as I was digging into the details, I was impressed by the number of resources available on the internet. Back in the day when I was a regular on the presentation circuit, you had to have a stack of reference manuals to make sure you got everything right before submitting your paper, which had to be sent in a box since it was typed, double spaced, and printed with multiple copies. As we think about standards in healthcare and standards in the digital universe, it’s intriguing to remember that some of the first usability standards were set for written scholarly works. When papers were all written with the same stylistic features, it made it easier to understand the content and less likely for the reader to have to wade through a confusing format. Usability principles have evolved over time, but still adhere to a common core of thinking, and it was nice to be pulled in as an “expert” on the topic.

I’ve been back on the road recently and summer travel is in full swing. Unfortunately, I started today’s leg of the trip at an airport that decided it would be good to shut down 50% of the women’s restrooms for maintenance at a time when they had 20 arrivals and departures in the hour surrounding my flight. Needless to say, it created some bottlenecks.

I always wonder if people exhibit the behaviors that I see in the airport during their “regular” lives. At least where I live, I never see people ordering hard liquor with their breakfast, but you see it a lot at the airport. In the boarding line today, I had two guys behind me chugging beers after they had been told they couldn’t take them down the jetway. There was also a group of high schoolers, the majority of whom had full-size bed blankets for their trip and were juggling all their gear while trying to figure out how to repack to try to get it all on board. I felt bad for their chaperone, who had largely lost control of the group. I’ve chaperoned groups of teens before and we always had strict rules about what they could bring or not bring so that we could avoid issues at the gate like I saw today.

On the plane, one of the students in front of me spent the majority of the flight kneeling backwards in her seat, talking to the person in the row next to me. Their chaperone, who was in the same row, just ignored it. Although it was annoying, I remember what it was like to be a teenager, so I decided to just tune it out. There have been so many changes to the typical US teen experience during the last couple of years that this might the only trip these kids have taken (or might ever take), and it’s good to see schools who are encouraging their students to see the world. I also learned today that you can’t take a bowling ball through the TSA checkpoint at this particular airport even though the TSA app says it’s permitted.

What’s the most interesting thing you’ve seen during travel this year? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 6/8/23

June 7, 2023 Headlines No Comments

Wolters Kluwer acquires U.S. AI-enabled drug diversion detection software

Wolters Kluwer Health acquires Invistics Corporation, which offers AI-enabled software for drug diversion detection.

Karoo Health seeds $3M for value-based heart care

Tech-enabled, value-based cardiac care startup Karoo Health raises $3 million in seed funding.

Healthcare Triangle Receives Nasdaq Delisting Notice; Appeals Determination

Healthcare Triangle appeals Nasdaq’s decision to de-list the company after its failure to comply with listing requirements by the May 30 deadline.

Yuvo Health Raises $20.2 Million Series A Financing To Advance Innovation in Value-Based Care for Federally Qualified Health Centers

Yuvo Health, which offers FQHCs technology-based operational and administrative expertise for value-based care, raises $20 million in a Series A round of financing.

Significo Secures 12 Million USD Series A Funding to Revolutionize Personalized Health Recommendations and Strengthens Leadership Team

Significo will use $12 million in new funding to further scale its personalized health recommendation API for employee wellbeing companies.

Healthcare AI News 6/7/23

News

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Mayo Clinic will use Google’s low-code Enterprise Search in Generative AI App Builder to combine Google search with generative AI to provide information to clinicians and employees.

Boston Children’s Hospital, which drew recent attention for posting a job for a ChatGPT prompt engineer, tells Mashable how it may use the technology to solve real-world problems such as helping patients navigate its buildings or to create patient-specific discharge and rehabilitation instructions using their EHR data.

Wolters Kluwer Health acquires Invistics Corporation, which offers AI-enabled software for drug diversion detection.

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Primary and urgent care chain Carbon Health launches hands-free AI charting across all of its clinics and providers. Appointment audio is analyzed with AWS Medical Transcribe, then processed with GPT-4 to generate an EHR-ready notes document. Early studies show that unedited accuracy is 88%, charts are 2.5 times more detailed than with manual entry, and chart completion time was reduced from 16 minutes to four. The company says it may sell the software to other provider groups.

AvaSure adds AI-powered enhancements to its TeleSitter virtual care platform in which the virtual safety attendants will be alerted when a patient who is at risk for a fall or elopement tries to sit up or leave the room. The company is partnering with Kinometrix, which applies AI predictive analytics to EHR data to identify patients with fall risk.

FDA issues 510(k) clearance for Ezra’s AI-enhanced MR images for early cancer detection, which the company says would reduce full-body MRI screening cost by 30%. The company says it hopes to offer a 15-minute, $500 full body scan versus today’s one-hour scan that costs $1,950.


Business

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LeanTaas announces a generative AI solution that gives leaders insights about patient flow, scheduling, block management, and other capacity management measures.

Clarify Health is beta testing a generative AI solution called Clara, which analyzes claims data to recommend care opportunities.

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ObjectiveHealth launches an AI-powered clinical trials feasibility and recruitment platform that identifies the most qualified study candidates using risk factors and biomarkers from their EHR data, then keeps participants engaged by streamlining appointments and communications.

SafelyYou, which offers AI video and remote monitoring support for dementia care in senior living communities, including fall detection, raises $30 million in funding.


Research

University of Colorado medical school researchers are studying patient experiences with AI that simulates conversation, raising questions about potential bias created by the appearance of the chatbot’s avatar and the ethics of nudging people into healthcare behaviors without restricting their choices.

Researchers find that ChatGPT provides evidence-based answers to public health questions with 91% recognition versus a cumulative 5% recognition among Alexa, Siri, Google Assistant, Cortana, and Bixby. However, ChatGPT, along with the other tools, rarely offers referrals and instead gives advice. The authors conclude that public health agencies should publish a database of recommended resources that AI could use in fine-tuning its responses to refer people to vetted resources.

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NYU medical school researchers describe NYUTron, a large language model they trained to on EHR notes to forecast clinical and operational event in real time with better accuracy compared to traditional methods. They tested the system at NYU Langone Health System on five predictive tasks: 30-day readmission, in-hospital mortality, co-morbidity index, length of stay, and insurance denial. The authors say that models trained on highly tailored data are more useful than using larger, less-specific datasets, but they still require a lot of computational horsepower.


Other

Kenya-based “contract cheaters” who ghost write essays and complete assignments for students in wealthy countries worry that ChatGPT could replace them. One of them says that most of his customers are studying nursing and healthcare. A January study found that 89% of the surveyed students are using ChatGPT to help them with homework and 53% used it to write an entire essay.

South Korea is using AI-powered image analysis to assess the health of North Korea’s leaders, determining that Kim Jong Un weighs over 300 pounds, has dark circles under his eyes, and may suffer from a sleep disorder.


Contacts

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

Morning Headlines 6/7/23

June 6, 2023 Headlines No Comments

RxLightning Closes $17.5M Series A to Accelerate Growth and Remove Barriers to Essential Specialty Medications

RxLightning, which specializes in digital specialty medication enrollment solutions, raises $17.5 million in a Series A funding round.

Digital Technologies in Cardiac Rehabilitation: A Science Advisory From the American Heart Association

An American Heart Association science advisory group says that digital technology can address many of the challenges faced by center-based cardiac rehabilitation and care programs.

Codex IT Acquires Professional Services Company

Eye care-focused health IT firm Codex IT acquires EyeDeal Consulting, marking its third acquisition of 2023.

Cardinal Health announces the merger of its Outcomes business into Transaction Data Systems and related partnership

Cardinal Health sells its Outcomes business to pharmacy software vendor Transaction Data Systems.

News 6/7/23

June 6, 2023 News 1 Comment

Top News

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A science advisory group of the American Heart Association says that digital technology can address many of the challenges that are faced by center-based cardiac rehabilitation and care programs.

The authors list available technologies for patient assessment, nutritional counseling, risk factor management, exercise training, and digital  monitoring tools.

They predict that data from digital technology systems will be merged with clinical data to support integrate biomarker-directed risk identification, medication adherence, risk factor modification, and fully virtual cardiac rehab programs and AI-powered training plans.


Reader Comments

From Pilsner: “Re: HIStalk’s 20th birthday. How about the tenure of the rest of the crew?” I’m winging it from memory, but I think Dr. Jayne started 12 years ago, Lorre 10, and Jenn nine.


Webinars

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


Acquisitions, Funding, Business, and Stock

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Fuse Oncology, a Cone Health spin-off specializing in radiation oncology software, closes a $9 million Series A funding round.

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RxLightning, which specializes in digital specialty medication enrollment solutions, raises $17.5 million in a Series A funding round.

UnitedHealth Group makes an unsolicited cash offer of $3.3 billion to acquire home care provider Amedisys, which has already agreed to be acquired by Option Care Health for a slightly lower sum, for its Optum business.  UnitedHealth acquired home health and hospice provider LHC Group for $5.4 billion in February 2023, which is also operating under Optum.

Cardinal Health sells its Outcomes business to pharmacy software vendor Transaction Data Systems. Cardinal launched the business in April 2021 by combining its medication therapy management, patient engagement, telepharmacy, and vaccine administration scheduling products.


Sales

  • Renovis Health (MI) selects Innovaccer’s ACO REACH Solution Suite.

People

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LSU Health Shreveport (LA) names Viola Sprague, MBA (Kettering University) CIO.

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Reperio Health hires Nicole Brooks (Innsena Communications) as VP of marketing and communications.

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Tom Gregorio (Tufts Medicine) joins Care New England as SVP/CIO.

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University of South Alabama Health names Tyler Whetstine (Adventist Health) CIO.

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Newfire Global Partners hires Sonali Damle, MS, MBA (Innovaccer) as chief people and transformation officer.

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Sam Zebarjadi (Amazon) joins Moderna as VP of strategy and go-to-market innovation.


Announcements and Implementations

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Startup Remission Medical will work with the Mayo Clinic (MN) to further develop its virtual rheumatology clinic software, incorporating AI and machine learning to reduce time between diagnosis and treatment, and to predict flare-ups.

Emerus Holdings implements Orchard Software’s Point-of-Care LIS software at its eight hospitals in the Dallas-Forth Worth area.

In California, Seneca Healthcare District, Plumas District Hospital, and Eastern Plumas Health Care go live on Oracle Cerner through its CommunityWorks model.

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Bellevue Hospital in Ohio implements Meditech Expanse.

CloudWave rolls out a fully managed patching service.


Government and Politics

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Politico reports that HHS is accepting proposals from organizations that are interested in managing its TEFCA data-sharing initiative. The non-profit Sequoia Project has managed the framework since 2019 through a four-year contract and has applied to continue that work. Proposals are due June 27 and ONC expects to name the coordinating entity by September.

KFF Health News questions whether a federally created, independent National Patient Safety Board, similar to the National Transportation Safety Board, can succeed in helping hospitals learn from medical errors. The hospital industry’s influence will be hard to overcome given the $220 million it spent lobbying Congress last year and its role as the leading employer in 47 states. Proposed bills would allow the proposed group to investigate only when invited by the organization involved and would prohibit it from naming organizations or individuals, making it likely that it will be able to use only de-identified, voluntarily submitted data that is protected from public view.


Other

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Dartmouth Hitchcock Medical Center (NH) uses $2 million in initial funding to launch the Center for Precision Health and Artificial Intelligence, which will offer researchers and developers the means to evaluate new AI-powered digital tools in clinical settings.

Australia’s general practitioner professional group wants doctors to be paid for the time they spend referring patients to hospitals, a process that it calls “exporting hospital bureaucracy into general practice.” RACGP urges adoption of standardized digital referral forms, observing that while general practices have progressed past PDF forms and faxes, “hospitals are using not just unique forms, but archaic systems.”


Sponsor Updates

  • Horizon Health Care (SD) expands its use of EClinicalWorks to include the company’s behavioral health module.
  • Biofourmis, Current Health, and Volpara Health join The White House’s CancerX national accelerator.
  • Nordic publishes an episode of its Designing for Health podcast that features an interview with Allison McCoy, PhD.
  • Bamboo Health completes its SOC 2 examination, validating its commitment to critical security standards.
  • Remedi Health Solutions sponsors the CHIME Innovation in Clinical Informatics Summit in San Diego.
  • CloudWave will exhibit at the New England Spring HIMSS Annual Conference June 8 in Norwood, MA.
  • CTG publishes a new case study, “CTG Improves Healthcare System’s Patient Portal Support with Amazon Connect.”
  • Netsmart will integrate NVoq’s speech recognition software with its MyUnity EHR for post-acute care.

Blog Posts


Contacts

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

Morning Headlines 6/6/23

June 5, 2023 News No Comments

General Electric to sell over $2 bln stake in GE HealthCare

General Electric plans to divest $2 billion worth of common stock in GE Healthcare Technologies, which spun off from GE earlier this year.

HHS Office for Civil Rights Reaches Agreement with Health Care Provider in New Jersey That Disclosed Patient Information in Response to Negative Online Reviews

New Jersey-based Manasa Health Center will pay $30,000 to settle HIPAA violations stemming from a response it posted to a patient’s negative online review.

New Dartmouth Center Applies AI to Improve Health Outcomes

Dartmouth Hitchcock Medical Center (NH) uses $2 million in initial funding to launch the Center for Precision Health and Artificial Intelligence, which will offer researchers and developers the means to evaluate new digital tools in clinical settings.

HIStalk Interviews Chakri Toleti, CEO, Care.ai

June 5, 2023 Interviews 9 Comments

Chakri Toleti is founder and CEO of Care.ai of Orlando, FL.

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Tell me about yourself and the company.

This is my fourth gig in the healthcare space. My brother Raj and I have done business together, and this is my own project. I started the business three and a half years ago to bring ambient intelligence to healthcare.

I don’t have a pure technology background or healthcare background. I worked for Disney Ideas, then went to film school. That has nothing to do with any of this stuff, but I always was intrigued with other industries and how they adopt technology to bring process automation and efficiencies to deliver consistent, better solutions. That is my background and my passion.

Looking at healthcare, many processes can be efficiently automated to impact the care delivery process itself. I looked at ambient intelligence and felt that there is a significant gap in healthcare. I saw the transformation that was happening even in your home, like a smart home, the ability to get control of what’s going on in real time. That was the genesis of Care ai.

How will your business change as new types of health-related sensors are developed?

The technology has evolved dramatically. We can deploy high compute engines like GPUs in a smaller form factor with less power consumption. We have several provisional patents in terms of how to scale and do edge computing in a much more efficient way in the healthcare setting. We can roll out across tens of thousands of rooms without bringing the network down. We are really good at being able to get the appropriate data, clean data, to run these AI models on the edge.

If you want to draw parallels, look at Nuance’s 10- or 15-year-old technology with Dragon. When you have enterprises like Google, Microsoft, and Amazon spending billions of dollars on NLP-based workflows, that has become commoditized dramatically. Amazing large language models are being deployed in enterprise settings to be able to deliver the same kind of results, and much better results, for a fraction of the cost. That’s the transformation that is happening.

What we’ve built is bringing these operational clinical workflows together, building a scalable command center, and shifting the paradigm of what clinical data capture or operational data capture will look like in healthcare.

A lot of the old-school monitoring in the ICU went beyond sensor-based instrument alarms and instead involved an experienced clinician asking questions or observing the patient. Can value be added by analyzing audio and visual information?

That’s exactly what we do. Imagine a Tesla car sitting in a room. That’s what we’ve built — inferencing, audio-visual, three-dimensional volumetric data to give you a lot more information of what’s going on, how many people are in the room, how long did they stay there, did the patient eat food, how long have they been sleeping in the same position. All the environmental data, coupled with the data capture of every action that’s happening, is the fundamental difference that we are enabling to truly build a smart patient room.

I wake up every day from the dream that I’m going to kill the EMR. EMRs are the most antiquated way of data capture. They are required, but were built for a specific purpose 10, 15, or 20 years ago with an archaic way of data capture. It would be unthinkable if workers in an Amazon warehouse had to stop and input information about everything that they are doing. Yet we take the most talented and expensive resources in healthcare and make them do data entry in a crappy interface with all these clicks, forms, and flows in a complex form of data capture. All it is doing is generating a bill.

Obviously the clinical data is important, but we all know that every unit in every health system has skewed dark data. If you look at the respiratory rate, it is magically the same, 14 or something, in every unit. It’s like muscle memory. It gets worsen as you go through the ecosystem. Post-acute reimbursement is completely based on data capture. They have something called ADLs, activities of daily living. They have to capture all of that, and it’s a manual process.

Some hospitals have created command centers and are interested in remote patient monitoring. What will the hospital of the future look like given the opportunity to separate the services from the hardware capabilities of the room or having people enter the room regularly?

An accelerator for us is that the staffing shortage and the staffing crisis is elevating the need for solutions like these that can give the bedside care teams the scale that they need. Also, they have to think outside the box. The EMR cannot be the universe of every way of capturing information. Every health system recognizes that, and that’s why we are getting traction.

Also, the technology has become democratized, in that the cost to deploy these solutions is fractional. If you go to most of these organizations, they are still moving computers-on-wheels from older companies from one room to another, paying $10,000 or $30,000 per cart. For a fraction of that cost, we can wire up a true smart patient room that gives you real-time visibility into operational and clinical workflows with the ability to analyze audio, video, three-dimensional volumetric data visualization and capture of that information with super high accuracy.

How will AI change the way we think about healthcare software and how technology is developed or deployed?

It will be a once in a generation change in terms of how you look at delivering care. There are two sides to it. One is innovation, drug discovery and all the other aspects of AI. But when it comes to the four walls of operations of a hospital or post-acute facility itself, real-time AI will fundamentally change how we monitor and how we deliver care in an efficient way and at higher standards of quality. If you look at generative AI and all the innovation that is happening at an accelerated rate, healthcare will have a huge impact on that.

When we talk about AI in a healthcare setting, people talk about taking a few algorithms and applying them to the dataset that we have. That is good, and you need it. But a lot of the data is dark data. It’s skewed. How did we capture that information? Is it accurate? You have to go back and look at how you bring true, clean data into the system. 

Imagine a self-driving car. They send out these cars, capture real-time information about the roads, then teach the neural nets to look for the most efficient way of driving. More and more you will see those kind of implementations and adoption of AI into healthcare in a different way. It could be a radiology or a CT scan that’s happening in real time. The ability for it to recalibrate itself using AI to get more accurate scans will also be a part of the entire ecosystem. Rather than just, hey, I’ve scanned, so let’s apply AI to identify abnormalities. There are different aspects of AI that have not fully been leveraged in healthcare settings.

How should a mid-sized healthcare technology company look at incorporating large language models that are changing so quickly?

We should be looking at a problem and then seeing if applying AI to that problem will solve it. Does it even require AI? Once you have identified a problem like nursing shortages — we have a virtual nursing infrastructure — but then how do you look at AI being more integrated into the platform? Understanding the workflows within healthcare and using the frameworks with the right set of data to impact that workflow. That work will be a key way for these organizations to succeed. 

Cerner or Epic were designed before a lot of these innovations happened. For example, for controlled substances, two people have to sign off in the room, logged into the EHR on the same computer. That was designed like 10 years ago. There’s no way for one person to be virtually beaming in and one person in the room. EMRs don’t have the ability to do it. They would have to re-architect everything in the new way of doing things. That would be a big lift for them. 

Newer companies have an advantage to look at a clean slate and say, what’s the most effective way in today’s technology landscape to implement the most effective solution for that problem? If they truly understand what real-time AI can do, then the sky’s the limit to transform healthcare.

You started the company right before the pandemic began. What is different now about starting, running, and selling a digital health company?

I would strike out the last one. If someone is building something with the objective of selling it, then that’s the wrong way of going about it. You have to solve a problem, and whatever the outcome is, it will be good, whether you sell the company or stay with it. 

The landscape has dramatically changed. For us, we had an advantage in that we started the business when the pandemic hit, which propelled and accelerated our growth. I don’t think I could repeat the same kind of growth again in my career. We were at that inflection point.

Also, health systems have changed their thought process. The pandemic exposed the weaknesses that are inherent in the care delivery system and processes. That is in the forefront of the leaders in these health systems for them to solve. They are much more open to new, innovative companies, so it’s a great time to bring innovative technologies to these institutions that are more open to newer ideas and newer companies to innovate for them. They know that the status quo has a lot of weaknesses that are built into their systems today. It’s a great time if you have the right solution to help them be more efficient and deliver the same or higher standards of care.

What will be key to the company’s strategy in the next three or four years?

It will be extremely important to understand the impact of AI and how it will change the client’s businesses. If companies don’t look at new ways to solve problems, be nimble about it, and adapt aggressively, it will be tough in a dynamic environment. The technology landscape is changing at a much faster pace than we’ve ever seen in our careers. They have to be at the same speed as what the technology is changing. ChatGPT 3.5 versus ChatGPT 4 or Bard are coming up at lightning speed, and startups and new companies that are trying to go to market need to have the same agility.

Readers Write: Cutting Through the Hype: Navigating AI in Healthcare

June 5, 2023 Readers Write No Comments

Cutting Through the Hype: Navigating AI in Healthcare
By Michael Burke

Michael Burke, MBA is founder and CEO of Copient Health of Atlanta, GA.

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First, a confession. Our company leverages machine learning in our operating room utilization software solution. As such, we stand to benefit from the AI hype machine that is running at full speed. But I promise you, the intent of this paper is not self-promotion; it’s to help you distinguish true AI value from mere marketing hype.

Understanding the categories of AI, and a little about how each tool set works, is essential. However, wading into the weeds a bit is an unfortunate requirement of doing this.


The Basics of AI: What Healthcare Executives Should Know

Before delving into the nuances of true versus misleading AI claims, let’s first understand some fundamental AI categories relevant to healthcare. The items below aren’t a comprehensive list, but they do capture some of the most common and important categories you’ll see:

Machine Learning (ML)

Machine learning is a branch of AI that uses specific algorithms to analyze and learn from large amounts of data. This “training” process, and subsequent testing, results in a model that can make predictions or decisions without being explicitly programmed to perform the task.

Training methods of different ML algorithms include:

  • Supervised learning. Supervised learning is like teaching a child with the help of a teacher. The teacher knows the correct answers and provides guidance, and the child learns from this guidance. An example of supervised learning in healthcare could be predicting whether a tumor is malignant or benign based on a set of labeled tumor data. In this case, the “teacher” is a labeled dataset where each tumor is classified as either malignant or benign. The ML model is trained on this data and can then predict whether a new, unlabeled tumor is malignant or benign based on what it has learned.
  • Unsupervised learning. Unsupervised learning is like a child learning through exploration without guidance from a teacher. The child learns about the world by observing and interacting with their environment. An example of unsupervised learning in healthcare could be patient segmentation, where healthcare providers group patients into different categories based on their health data. There are no pre-labeled categories here; the ML model must learn to identify patterns and structure in the patient data to determine how best to group the patients. For instance, an unsupervised learning algorithm could analyze patient data to identify clusters of patients with similar health characteristics, which might correspond to different risk groups or disease subtypes.
  • Semi-supervised learning. Semi-supervised learning is a combination of supervised and unsupervised learning. The model learns from a combination of labeled and unlabeled data. A semi-supervised learning example could be if a hospital had a large amount of patient data, but only a small portion of the data is labeled. Perhaps only a small set of the patients’ records include a diagnosis for a certain disease. The ML model can use the small amount of labeled data to learn about the characteristics of patients with that disease and then apply this learning to the large amount of unlabeled data to predict which of those patients might have the disease.
  • Reinforcement learning. Reinforcement learning is more like teaching a dog to perform a new trick. You don’t tell the dog explicitly what to do. Instead, the dog tries different actions, and you give it a treat (a reward) when it performs the action you want, like sitting or rolling over. Over time, the dog learns which actions will earn it a treat and starts performing those actions more frequently. In a healthcare context, consider a machine learning model that is trying to optimize treatment plans for patients with chronic conditions. To compare to our dog training explanation, the ML model is the dog, the different treatment plans are the actions the dog tries, and the patient health outcomes are the rewards. The model tries different treatment plans (actions) and observes improvements in patient health (the reward). Over time, the ML model learns which treatment plans lead to better patient health outcomes, much like the dog learns which actions earn it treats.

ML excels at tasks where patterns and structures can be discerned from data, such as prediction (predicting hospital readmission rates based on patient data), classification (classifying skin lesions as benign or malignant based on image data), and clustering (segmenting patients into different risk groups based on their health data).

Deep Learning (DL)

Think of deep learning as a team of detectives working on a case. Each detective looks at a part of the evidence and makes their own observations. They pass their findings to a senior detective, who then makes more complex observations based on the initial detectives’ findings. This goes on until the chief detective (the final layer of the network) makes a decision based on all these observations.

In the world of AI, each ‘detective’ is a layer in an artificial neural network. Each layer looks at some aspect of the data and passes on its findings to the next layer. This allows the network to learn from simple features at lower layers to more complex features at higher layers.

Let’s translate this into a healthcare example. Consider a deep learning model analyzing an MRI scan to detect a tumor. The initial layers might look for basic features like edges or colors. The next layers might recognize more complex patterns like shapes or textures. And the higher layers might identify the specific features of a tumor. Just like our detective team, each layer contributes to the final decision, allowing the model to accurately identify whether a tumor is present.

Deep learning excels at tasks involving unstructured data such as images, audio, and text. For instance, deep learning algorithms can analyze MRI images to detect tumors, listen to a patient’s speech to diagnose mental health conditions or analyze electronic health records to predict patient outcomes.

Natural Language Processing (NLP)

Natural language processing (NLP) involves the interaction between computers and human (natural) languages. This technology allows computers to understand, interpret, and generate human language in a valuable way. At its core, NLP involves machine learning to automatically learn rules by analyzing a set of examples and making a decision based on them. This decision could be understanding sentiment, translating languages, or converting speech to text.

In the healthcare sector, NLP can be used to interpret clinical documentation, analyze patient feedback, or enable natural language user interfaces (e.g., chatbots for patient engagement).

Generative AI

Generative AI involves creating new, previously unseen content. Think of it like an AI artist that creates new works based on styles it has learned from. Generative AI is not limited to any particular type of content and can generate images, text, music, and other types of data.

In healthcare, generative AI could be used to create synthetic patient data that can be used for research or training purposes without compromising patient privacy. For instance, a generative model could be trained on real patient data and then generate new data that maintains the statistical properties of the original data (like the distribution of different diseases or the average patient age) but does not correspond to any real individual patient. This synthetic data can then be freely used without worrying about privacy violations.

Computer Vision

Computer vision is like teaching a computer to ‘see’ and interpret visual data in the way humans do. This technology is extremely versatile, being used in everything from self-driving cars to facial recognition software.

In healthcare, computer vision is often used in medical imaging to detect diseases and conditions. For example, computer vision algorithms can be used to analyze X-rays, MRIs, or CT scans to detect tumors, fractures, or other abnormalities. It’s also used in telemedicine solutions, where computer vision algorithms can help monitor patients and detect abnormalities or changes in their condition. Computer vision is also used in robotics.

Knowledge Representation and Reasoning

Imagine AI as a detective solving a complex case. To do this, it needs  a vast amount of knowledge about the world, along with the ability to reason with this knowledge to draw conclusions. That’s what knowledge representation and reasoning AI do.

In the healthcare domain, such AI can be used in clinical decision support systems to aid physicians in diagnosing diseases. The AI system has access to a vast amount of medical knowledge and can reason with this knowledge to provide suggestions to physicians.

It’s hard to decide where to draw the lines when categorizing types of AI. For instance, that the problem of tumor detection often involves computer vision as part of a series of machine learning models that feed together into a deep learning network. Additionally, a field like robotics is sometimes considered its own AI category and other times considered an application that uses specific categories of AI. I’m confident that people smarter than me will sometimes disagree with my categorization choices.


Identifying Genuine AI: A Guide to Avoiding the Hype

While understanding AI categories is a good starting point, the key to discerning genuine AI applications in healthcare software lies in recognizing when these technologies add real value to a process or outcome. And remember: AI, at its core, should aid decision-making, not replace it.

It’s easy for marketing campaigns to dress up their solutions with the AI label, but there are several ways in which the reality may fall short of the hype.

The AI Imposter: Recognizing Automation Dressed Up as AI

AI, including ML, DL, and NLP, learns and improves from data over time, enabling complex decision-making that is generalizable and extends beyond predefined rules. In contrast, rules-based automation, though beneficial in certain contexts, lacks this level of complexity and adaptability.

Consider, for example, a software solution that sends alerts when patient vitals reach certain thresholds. This represents a rules-based automation system, not AI. A genuine AI solution might continuously analyze patient data, learn from it, predict potential health risks before they become critical, and even suggest personalized treatment plans. This shouldn’t imply that a solution that leverages AI is necessarily better than a rules-based automation solution. However, beware of vendors dressing up automation as AI to take advantage of the hype as a rationale to increase price.

The Overkill: Unnecessary AI Implementations

Some solutions may incorporate AI where it’s unnecessary, serving more as a marketing tool than a feature that adds value to the end user. An example could be an element of a software solution that matches tasks to individuals based on skills. It might use an unnecessarily complex ML categorization algorithm where a simple lookup table would have sufficed.

The Overstatement: Claiming Unrealistic AI Capabilities

Some vendors may oversell what their AI can achieve. While AI can indeed help predict patient outcomes, claiming perfect accuracy is unrealistic and potentially misleading. Also, prediction accuracy in machine learning is a moving target as training data sets change over time, sometimes in response to the ML-based intervention itself.

Downplaying the need for quality data can lead to overstating anticipated results. AI systems are only as good as the data they’re trained on. If a solution downplays the importance of data quality, quantity, or diversity, be skeptical.

The Overlook: Ignoring the Need for Human Oversight

True AI applications in healthcare are designed to support and enhance human decision-making, not replace it. If a solution suggests that its AI can replace human judgment entirely, it’s likely overhyped. It could also be dangerous.


Conclusion

While Copient Health indeed benefits from the AI boom, we urge discernment when it comes to AI in healthcare. Understanding the basics and recognizing when AI genuinely adds value is critical. The future of healthcare is undeniably intertwined with AI. With a robust grasp of the subject, you’ll be primed to guide your organization into a more efficient, patient-focused era.

Curbside Consult with Dr. Jayne 6/5/23

June 5, 2023 Dr. Jayne No Comments

I spent the weekend largely unplugged, catching up on some household projects and indulging my need for quality time in the kitchen. My last-minute run for pickling and baking supplies created an interesting assortment of items at the grocery checkout, but when you like to do things old school, sometimes you really do need three kinds of vinegar and a jar of bay leaves.

My pickling efforts were slightly more successful than the baking one, which resulted in the first time I’ve ever had to admit that it’s possible to have too much sugar in a cake. When I finally reconnected this weekend, my inbox seemed to be forming a theme around the topic of healthcare IT gone bad.

First, there was the story of the National Eating Disorder Association chatbot being decommissioned after it recommended harmful behaviors, including dieting and calorie restriction. The organization at least owned the problem, stating that the advice being given was “against our policies and core beliefs.” Apparently the chatbot, called Tessa, was created around proven cognitive behavioral tools that have been shown to reduce eating disorders. However, it appears that programmers may have tried to make it work more like ChatGPT and ended up running off the rails. The original tool used pre-programmed responses and was not intended to be adaptive or to use AI features.

It’s been interesting to watch chatbots evolve over the last couple of years. Quite a few vendors claim to have created AI-enabled chatbots, but when you look behind the scenes, they end up being sophisticated (or sometimes not so sophisticated) decision trees. I’ve seen some alleged healthcare chatbots that are constructed by teams that don’t even have clinicians on them, which is truly worrisome. It’s always surprising to see the logos of organizations who have bought into the hype and probably never asked to speak to the clinical person behind the proverbial curtain.

When ChatGPT came to the forefront in recent months, I saw several companies try to leapfrog good design and development principles in an effort to be able to say that their product was using the technology. I’ve worked with enough technology organizations and on enough different projects to know that trying to cut steps out of the software development lifecycle is never a good idea.

The steps that organizations typically try to cut are the ones that are the most critical in my book: planning, analysis, and testing. They forget that the whole point of the process is to be efficient from both time and cost perspectives. When you rush to market, you usually end up paying for it on the back end with broken functionality and unhappy users. The piece that it feels like people forget though is that when you’re in healthcare IT, that can translate to patient harm. Developers always need to remember that regardless of whether you call them users, consumers, or patients, the person on the other side of the code is someone’s parent, child, friend, or loved one.

The next story wasn’t about AI run amok, but was about more than 400 Grail patients receiving notices that they may have cancer. The company immediately pointed fingers at its third-party telemedicine vendor, PWNHealth. In digging into the details of the issue, more than half of those receiving the erroneous letters hadn’t even had their blood drawn.

The test in question is Galleri, which can screen for 50 kinds of cancer through a single blood draw. Large healthcare organizations like Mercy have jumped on board with it, offering the tests on a cash-pay basis even though they aren’t part of guidelines-based recommendations. The test costs $950, and if I had paid that kind of money, I would be doubly aggravated to receive an erroneous letter before I even had my sample collected. I had heard of the test when Mercy first started advertising it, but didn’t realize until I read the articles this weekend that it has not completed human clinical trials. There’s a study in the UK that’s at the halfway point, though. Despite that, more than 85,000 patients have spent the money to have the test performed, with only a handful of insurers providing coverage.

I’ve been on the other side of an erroneous medical testing result and it’s a horrific experience, leading you to wonder even if your corrected result is valid. In my case I had my pathology slides re-read by an outside pathologist because I didn’t know which reading to trust. Not every patient has the knowledge to ask for that or the resources to pay for it. Also in my case, the test orders were placed by a local physician who knew me well and with whom I had a relationship, which was a great support as we worked through the issue. Grail, whose owner is DNA-sequencing equipment Illumina is already under fire from regulators in both the US and Europe due to monopoly concerns. It will be interesting to see how this unfolds.

The third story wasn’t about healthcare IT as much as about AI in general, looking at specifically how AI would compare to humans on judging whether rules have been broken. A study done by Massachusetts Institute of Technology examined how AI would handle such things as a post violating a site’s rules or a dog being in violation of apartment rules. Researchers concluded that since AI can be trained on data sets that don’t include human validation, results may skew more harshly. A researcher in the field, Professor Marzyeh Ghassemi, is quoted as saying, “Humans would label the features of images and text differently if they knew those features would be used for a judgment. This has huge ramifications for machine learning systems in human processes.” Definitely something to think about when it feels like everyone is clamoring for more AI.

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I would be remiss if I didn’t say happy birthday to the HIStalk team as the healthcare IT universe celebrates its 20th anniversary. One of my vendor executive friends recommended it to me when I first started my healthcare IT journey, and I never dreamed I would be part of the team. It’s been quite a ride with a lot of ups and downs in the industry, and I still remember sending my application to join the team by way of my trusty BlackBerry. Looking through old posts and revisiting what we thought was wild and crazy at the time, some of those news items pale in comparison to the issues of today. Here’s to the future of HIStalk as it continues to chronicle our topsy-turvy industry and to be everyone’s favorite source of healthcare news, opinion, rumors, and gossip.

Email Dr. Jayne.

Morning Headlines 6/5/23

June 4, 2023 Headlines No Comments

Eating disorder group pulls chatbot sharing diet advice

The National Eating Disorder Association shuts down its chatbot after users report that it gave them inappropriate advice for managing eating disorders, such as advising them to diet.

Fuse Oncology Closes Funding Round with Support from Leading Health Systems in the Southern US

Fuse Oncology, a Cone Health spin-off specializing in radiation oncology software, closes a $9 million Series A funding round led by Cone Health Ventures and Northeast Georgia Health Ventures.

Software snafu leads to 400 Grail patients getting bogus letters saying they might have cancer

Cancer screening company Grail blames third-party telemedicine vendor PWNHealth for sending 400 people letters inappropriately warning them that they may have cancer.

HHS’ big data-sharing decision

Politico reports that HHS is accepting proposals from organizations interested in taking over management of the TEFCA data-sharing initiative, which is currently overseen by the nonprofit Sequoia Project.

Monday Morning Update 6/5/23

June 4, 2023 News 8 Comments

Top News

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The National Eating Disorder Association shuts down its chatbot after users report that it gave them inappropriate advice for managing eating disorders, such as advising them to diet.

The association closed its human-staffed help line in May 2023, a few days after its employees unionized. Help line employees and volunteers fielded 70,000 calls per year.

The medical school team that created the chabot says it was never intended to be a replacement for the help line. They also suspect that the organization introduced bugs in trying to make the chatbot look like ChatGPT even though it is a rules-bases system that can’t generate unique responses. 


Reader Comments

From Smidge: “Re: HIE. I saw a new doctor who downloaded my health and demographic information from an HIE and some of it was outdated or truncated. I’m wondering if others have seen this. It may have been caused by another provider’s system merge.”

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From Another Dave: “Re: Scanadu Scout. Remember that? Mine still works on those occasions where I find it in my drawer of broken dreams. This one might make it to the marketplace.” Scanadu’s so-called Tricorder system died in a big cloud of hype dust when it gave up on bringing the Scout to market in mid-2017. Meanwhile, smartphones are slowly adding Scout-like technologies, and UCSD engineers have developed a 10-cent phone clip that allows measuring blood pressure using the phone’s camera and flash.


HIStalk Announcements and Requests

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Most readers aren’t making big money via side jobs.

New poll to your right or here: Has your cell phone ever been a key driver of a life-changing improvement to your health? Feel free to click the Comment link after voting to provide details.


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

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Webinars

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


Acquisitions, Funding, Business, and Stock

India-based Apollo Hospitals will sell a 6% stake in its online platform for $200 million, valuing the business at up to $3 billion. Apollo HealthCo was launched in June 2021, merging the company’s digital health and telehealth products with the intention of raising investor capital to expand.


Sales

  • Belgian hospitals AZ Sint Jan and AZ Sint Lucas select Sectra One Cloud for enterprise imaging.

Privacy and Security

Molecular diagnostic company Enso Biochem announces via an SEC filing that the clinical test information of 2.5 million people was exposed in an April 2023 ransomware attack.


Other

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Microsoft researchers train a GPT-4 model using a PubMed Central dataset extract of diagnostic images and their captions to inexpensively create a conversational assistant for biomedicine in one day.

Cancer screening company Grail blames third-party telemedicine vendor PWNHealth for sending 400 people letters inappropriately warning them that they may have cancer.

South Australia Health has failed to deliver on its promise of implementing a crucial result tracking and notification feature within its Altera Digital Health Sunrise EHR system, three years after the death of a patient whose adenocarcinoma diagnosis was delayed by three months. SA Health says a Sunrise upgrade later this year is required before introducing Compass, a task tracking function that reminds doctors when they don’t review test results promptly.

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Where would you start if you were CEO of this major ambulatory EHR vendor as profiled in a new KLAS report?


Sponsor Updates

  • Be Well Primary Care (TX) transitions to EClinicalWorks V12.
  • Azara Health publishes a new resource and strategy guide, “Leveraging Social Drivers of Health Data to Promote Health Equity Advancement.”
  • AvaSure adds AI enhancements to its TeleSitter virtual care platform, including augmented alerts for patient falls and elopement, and predictive fall risk identification.
  • NeuroFlow publishes a new whitepaper, “Navigating the Integrated Behavioral Health Landscape: A Roadmap for Providers and Organizations.”
  • Orbita will present at the Healthcare Contact Center Conference taking place June 7-9 in Atlanta.
  • Nuance publishes a new case study, “DAX expands access to care at WellSpan Health.”
  • Wolters Kluwer Health partners with Ariadne Labs and its Better Evidence program to donate over 100,000 UpToDate subscriptions.

Blog Posts


Contacts

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

Morning Headlines 6/2/23

June 1, 2023 Headlines No Comments

FDA-approved Alzheimer’s drugs will be covered by Medicare, with some limitations, CMS says

CMS announces that Medicare Part B will cover the use of FDA-approved monoclonal antibodies to slow the progression of Alzheimer’s disease, but will require doctors to populate patient registries for real-world tracking of the performance of those treatments.

Biden plans to pick physician Mandy Cohen to lead CDC

President Biden will reportedly choose Aledade executive and former North Carolina health secretary Mandy Cohen, MD, MPH as director of the CDC.

Lightning Step Divests AVA Billing & Consulting, Reinforcing Focus on Core Behavioral Health Software Solutions

Behavioral healthcare software vendor Lightning Step sells its Ava Billing & Consulting subsidiary to RCM company Medusind.

News 6/2/23

June 1, 2023 News 4 Comments

Top News

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CMS announces that Medicare Part B will cover the use of FDA-approved monoclonal antibodies to slow the progression of Alzheimer’s disease, but will require doctors to populate patient registries for real-world tracking of the performance of those treatments.

The Alzheimer’s Association says that requiring patient registries for coverage should be reconsidered because of the clinician data entry workload that is required. The association wants to know more about how data will be submitted, how the CMS-facilitated portal or other registries will work, and how patients and physicians can enroll.


Reader Comments

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From Zippydoodle: “Re: non-existent HIPAA certifications. HIPAA compliance is a process, not an event, and there is no single body that certifies a company as being HIPAA compliant. Startups in particular that should be saying ‘we will sign BAAs’ instead declare that they are HIPAA compliant or HIPAA certified.” Companies need to be HIPAA compliant, not HIPAA certified,  and HHS has been clear that it requires the former and doesn’t recognize the latter. 

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From Austin Keeping Weird: “Re: Founder Wellness and Blood Draw Party. Some influencer who isn’t affiliated with healthcare is promoting a digital health startup event. So many things wrong: the free blood draw panel for folks who are likely amply insured while much of Texas isn’t, the IV bar that has nothing to do with wellness, and the ice baths that create images of attendees in Speedos. Digital health companies who attend will soon discover that their sustainability is associated with payers or prescribers, not vanity faux medicine.” Maybe the unnamed company should launch a TikTok challenge.

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From Laff Riot: “Re: Florida patient data law. I’m surprised that few comments have been made given the number of health IT companies that use offshore resources for support, development, or billing services. Florida providers and their vendors have little time to review or modify contracts to ensure that offshore resources do not have access to PHI.” The newly modified Florida Electronic Health Records Exchange Act, which takes effect July 1, prohibits providers from storing patient records offshore or allowing access to US-stored data to anyone who is outside the US or Canada. Providers must also ensure that patient data that is stored in the cloud is physically housed in the US.  A couple of websites mentioned of the law a few days after reading about it on HIStalk, but otherwise it has drawn little attention. Given that compliance will be far from universal by the due date, it’s all about enforcement and penalties.

From Billie Gene: “Re: gene editing to reverse/stop a hereditary condition. Laudable R&D to advance precision medicine or another over-reach by pharma?” Genetic telehealth provider Genome Medical will offer genetic counseling to participants in a company’s clinical trial of a gene editing process for treating sickle cell disease. Much of medical research isn’t laudable since profit is the intention and the reward, but I would have good feelings about the company if their treatment alleviated my SCD symptoms.


HIStalk Announcements and Requests

Are you Rockies-bound next week for MUSE Inspire? Some of my sponsors are, and here’s what they will be doing there.

I have some very slightly overlapping background with someone I was interviewing today and they asked if I knew Brad Dodge. I instantly said yes, recalling that his company back in the day, Dodge Communications and specifically Brian Parrish, designed the HIStalk logo you see at the top of this page that has served me well for more than 10 years (I am obviously from the “ain’t broke” school of rebranding). Thanks to Brad and Brian for volunteering to create what turned out to be a long-lasting graphic.

Listening: WITCH (We Intend To Cause Havoc), a Zamrock band from 1970s Zambia, where bands emulated the psychedelic sounds they heard from the US. The band’s (and the country’s) rough history left it with just one surviving member, 72-year-old Emmanuel “Jagari” Chanda, whose day job is gemstone miner. They are releasing a new album this week and are on a long US tour.

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HIStalk turns 20 years old this week. I was bored over the Memorial Day weekend of 2003 and decided to jot down a few temporary thoughts about my health system IT job to help me keep things straight in my head. I didn’t expect or necessarily even want anyone to read it, and given my limited attention span and lack of interest in hobbies in general, I definitely didn’t plan to still be doing it 20 years later.


Webinars

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


Acquisitions, Funding, Business, and Stock

BJC HealthCare and Saint Luke’s Health System will merge to form a 28-hospital system with $10 billion in annual revenue.


Sales

  • Ardent Health Services will deploy Loyal’s consumer engagement solutions.

People

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Leadership Development Worldwide hires Shane Danaher, MBA (Divurgent) as COO.


Government and Politics

President Biden will reportedly choose Aledade executive and former North Carolina health secretary Mandy Cohen, MD, MPH as director of the CDC.


Other

UnitedHealth cancels its plan to require prior authorizations for colonoscopies, instead requiring physicians to submit patient information before performing a procedure to quality for a “gold card” expedited approval process that will be rolled out next year. Three provider groups say the new plan is just as laborious for practices as the PA process would have been.

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A New York Times report says that doctors at the “wealth nonprofit” Allina Health System aren’t allowed to see patients who have unpaid medical bills. Reporters found a document in which employees were told to cancel appointments for patients who own $4,500 or more and to lock their EHR records so that appointments can’t be scheduled. Doctors say they are used to seeing EHR messages that a patient “will no longer be eligible to receive care because of unpaid medical balances.” Patients with unpaid bills can continue to be seen only if they obtain a loan from the hospital or file bankruptcy.


Sponsor Updates

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  • Careport Health staff volunteer with Cradles to Crayon, which provides children with the resources they need to thrive.
  • University Health (TX) upgrades to Agfa Healthcare’s Enterprise Imaging 8.2, and adds Enterprise Imaging for Cardiology.
  • Arrive Health publishes a new whitepaper, “The Terrifying Truth About America’s Healthcare Affordability Crisis.”
  • Baker Tilly releases a new Healthy Outcomes Podcast, “Key insights for not-for-profit leaders in behavioral health.”
  • ChartSpan partners with HAPevolve, a subsidiary of The Hospital and Healthsystem Association of Pennsylvania, to offer preventative care programs to Medicare patients.
  • CHIME launches its Trailblazers Podcast, with the first episode focused on “Developing the HIT Leaders of Tomorrow.”
  • Divurgent releases a new episode of The Vurge Podcast, “Tips for Managing Cyber Risks in Healthcare.”
  • Azara Healthcare releases a resource and strategy guide titled “Leveraging Social Drivers of Health Data to Promote Health Equity Advancement.”
  • Ellkay will exhibit at AHIP June 13-15 in Portland, OR.
  • The VA’s Veterans Data Integration and Federation Enterprise Platform, which supports longitudinal patient records using InterSystems HealthShare, wins a 2023 Forum Innovation Award.
  • Rhapsody publishes a new case study, “From data ingestion to production in less than 30 days: How Zephyr AI uses Rhapsody Semantic to create precise AI models at scale.”

Blog Posts


Contacts

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

EPtalk by Dr. Jayne 6/1/23

June 1, 2023 Dr. Jayne 1 Comment

Midwestern health systems BJC Healthcare and Saint Luke’s (Kansas City) have announced plans to join through a $10 billion merger. They have been previously connected through participation in the BJC Collaborative, which Saint Luke’s joined in 2012 as the organizations sought to share resources and cut costs.

Announcements from the organizations note plans to operate under their existing brands and operate from headquarters in both St. Louis and Kansas City. Detailed plans for the merger are slated to unfold through the rest of the year, with a goal of closing the deal by the end of the year. I reached out to some Midwestern friends who know both organizations well and it sounds like there may be some significant cultural differences that come into play. It should be an interesting one to watch.

I receive dozens of cold call emails every day despite my best efforts to filter them into junk mail or spam folders. My favorite of the week was one that gave three different stylistic treatments to the healthcare entitlement program for seniors: MediCare, MediCARE, and ultimately Medicare. Maybe their marketing team will eventually create a style guide so that they can remain consistent, but since I made use of the block sender functionality, I hopefully won’t be seeing it again.

I don’t practice as often as I used to, but when I do, there’s always a patient who asks about something they saw on the internet and how it might relate to their reason for seeking medical care. A recent Forbes article discusses data that more than a third of members of Generation Z trust TikTok more than doctors. It’s not the only player in the equation – another 44% of adults surveyed visit YouTube before contacting their physician. One in five respondents trust health influencers more than they trust medical professionals, citing access, cost, and avoiding judgment from medical professionals.

The article goes on to emphasize the need for care providers to meet patients where they are. I agree with that approach. I’ve not seen many mainstream health organizations fine tuning their social media sites to go after that demographic, but I’ll keep an eye out. There is plenty of medical misinformation out there that needs to be countered, but competing against influencers might be an uphill battle.

For health systems and other organizations that are trying to build their brands (and often renaming themselves in the process), they might want to target older demographics. A recent article notes that members of Generation X and Baby Boomers are twice as likely to trust brands than members of Generation Z. Topping that brand list and possibly providing inspiration for marketers: Band-Aid, UPS, Amazon, Lysol, and Kleenex followed by Cheerios, Visa, Dove, The Weather Channel, and FedEx. The survey noted that Generation Z doesn’t trust many brands to do the right thing – non-profit brands were the only category to which it responded well. I tried to poll a couple of the members of Generation Z about the topic, but hit a dead end because they were heads-down on their phones.

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I have a visit later this week with a new physician who is part of the medical group where I’m already established. I was relieved to receive an electronic check-in notice through the patient portal. My previous physician left the practice for health reasons, but I’ve been a patient in both the practice and its database since 2019 (and in its precursor, which was converted, for a decade prior) so it should have been smooth sailing.

I completed the electronic check-in and was met with a notice that “you might be asked to complete additional paperwork in the office,” which jogged my memory that indeed they had mailed me a packet six months prior. I found it in the file sorter on my desk and was dismayed to find that it contained four pages of materials that are redundant to my existing chart, including the pharmacy information and medication list that I just confirmed during the electronic check-in process. When I scheduled the appointment, I made it clear that I was transferring from her former partner. Since I’ve been seen within the past three years by a physician of the same subspecialty who bills under the same tax ID, I’m technically an established patient even though I’m new to her. I assume they send the “new patient” paperwork to everyone, but it’s still disheartening.

No one wants to arrive at the office and be turned away because they don’t have the (totally unnecessary) paperwork, so here I sit filling out information when I’m 100% confident that it’s all in the chart already, because I’ve seen it in my past visit notes. The real kicker was when I arrived at page four and found the “physical examination do not write below this line” section, where presumably the physician (who has a multi-million-dollar EHR) will not be documenting my exam because her contract requires her to use said EHR if she wants to get her annual bonus. I helped institute those contracts in a past life, and according to my former colleagues, they are still in place, so that should make for a fun conversation when I get to my appointment. The photocopies themselves are no longer crisp and are marked by smears from repeated copying, which is just sad.

Getting to the end of the paperwork, I realized that it didn’t even ask for some of the key elements of my history that are important to the topic of the upcoming visit, as well as being critically important for a physician in that subspecialty regardless of whether they’re a topic of this specific visit or not. As a physician, I know this is a big deal, but many patients might not volunteer that information if the physician doesn’t specifically ask for it.

Based on the paperwork and the pre-visit experience, I’m not confident of what to expect from this visit. For an organization that is worried about patient experience and their patient satisfaction ratings, I’ll be sure to give appropriate feedback when the inevitable survey arrives in my inbox. If they’re interested in some management consulting and EHR optimization, I might just know someone.

What’s the most frustrating healthcare IT-related issue you encounter as a patient? Leave a comment or email me.

Email Dr. Jayne.

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