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Morning Headlines 11/22/22

November 21, 2022 Headlines No Comments

Gallant Capital Invests in Lightning Step to Support Growth

Behavioral health IT vendor Lightning Step secures an undisclosed amount of funding from Gallant Capital Partners.

Interstate Health Systems Launches with Oversold Pre-Seed Investment Round

Interstate Health Systems launches with pre-seed funding to develop a network of primary care, urgent care, and telemedicine services along the nation’s highway system. Secures $27M from Crescent Cove Advisors to Introduce Ambient Intelligence to Healthcare, which offers AI-powered ambient facility monitoring technology for hospitals, raises $27 million.

Curbside Consult with Dr. Jayne 11/21/22

November 21, 2022 Dr. Jayne 2 Comments

I’m back in the patient trenches again, getting ready for an outpatient medical procedure and loathing the process. I’m an active patient of the physician who will be performing the procedure, with an up-to-date chart at the practice. The ambulatory surgery center where the procedure will be performed is owned by the physicians (although it’s a separate legal entity than the practice) and I’m also considered an active patient there due to a previous procedure.

Even though it would have been perfectly easy for the performing physician to send an appropriate History and Physical document to the surgery center (and for all I know they might have done so), I received an enormous “snail mail” packet to complete that basically treats me like a brand-new patient. Once could claim that it was an artifact of trying to keep the surgery center separate from the practice entity, but all the paperwork has both entities’ logos on it, so that claim doesn’t hold water.

The surgery center called me on Wednesday to pre-register me for the procedure, which is pretty typical. Unfortunately for me, I was still in Las Vegas, so the call came in at 6 a.m. local time and my grogginess was probably entertaining for the registrar. The staffer basically asked me all the information that is already on my chart, although it was from the perspective of confirming existing information rather than being from scratch. I asked about the paper packet, and she indicated that it was mailed from the practice side of the organization rather than the surgery center, and that I should plan to complete it.

I enjoyed answering the COVID screening questions, since I was at a conference with probably 8,500 unmasked people compared to the few of us who might have been masking when we could, and certainly I was exposed to someone with COVID. Another great question was whether I have a Healthcare Power of Attorney, but they didn’t seem interested in knowing who my personal representative is or having me bring a copy. The call took less then five minutes, though, and I was able to get another half hour of sleep before I needed to get ready to head to the airport.

As I went through the paper packet today, I noticed the addition of a new form that might actually be useful to patients, especially those who might not have a lot of experience in our fragmented and messy healthcare system. The page listed out all the different entities that will be involved in my care – including the physicians, the surgery center, the anesthesia group, and the pathology group. Each column had the name of the entity, a description of how they fit into the procedure, the services they provide, and the fact that I will receive a separate bill from each group.

Although it fully illustrates the absurdity of healthcare in the US, I appreciate the fact that they’re trying to educate patients prior to their having a procedure so that there are fewer surprises down the road. I found it interesting that only the surgery center requires payment of my portion of the estimated co-insurance in advance. If I recall correctly, the anesthesia group waited until just shy of the timely filing deadline to submit their claim, so any hopes of wrapping up the procedure and payments will likely be delayed until well into 2023.

I’ve been keeping it low key since I got back from HLTH, partly to avoid having a COVID-related reschedule for the procedure. I’ve heard from two colleagues who brought COVID home from the HLTH conference as an unwanted souvenir, although based on the notifications from the contact tracing app, I suspect there were more cases than we will ever know.

It’s been a good opportunity to catch up on email and some of my virtual water cooler venues. The hottest topic seems to be Amazon’s foray into message-based virtual visits. Most of the physicians I’ve connected with aren’t impressed by the offering, since it’s more of a marketplace than a cohesive service. They’re concerned about the further fragmentation of patient care since these records won’t be making it back to primary care physicians, and the fact that patients may end up receiving care from multiple providers or practices as part of the marketplace arrangement without fully understanding the concept.

There were also some concerns about the business model and how it makes sense for the physicians who are part of the offering. The fees are low, which is good for patient access, but are set at a level which drives physicians toward high-volume processes in order to make it tenable as a major source of income. The virtual visits also include the ability to “message your clinician with follow-up questions at no additional cost for up to 14 days” which further lowers the desire to participate for many physicians, who want to practice telehealth urgent care in a “one and done” type model. Several colleagues guessed that the provider organizations are likely using considerably greater numbers of nurse practitioners rather than physicians.

The main patient-centric concern that was voiced was that of clinical quality, but given the fact that this is Amazon we’re talking about here, I also have concerns about patient privacy. The Amazon Clinic site has a lot of information on how they use Protected Health Information. Things I didn’t like included the fact that patients are asked to accept an authorization for disclosure of contact information, demographic information, account, and payment information, and “my complete patient file” to Services LLC and its affiliates. It notes that “information disclosed pursuant to this Authorization may be re-disclosed by the recipient, and this redisclosure will no longer be protected by HIPAA.” Although I’m not an attorney, it sounds like a bad idea to me. The FAQ page says this authorization is voluntary, but if patients want telehealth services but to not sign the authorization, they will need to reach out to the healthcare providers directly. I’m betting (as I’m sure Amazon is betting also) that patients will just click through the fine print. Patients are exhausted and often just want to get care in the quickest and cheapest way possible, and no one likes to read a wall of text.

What are your thoughts about Amazon Clinic? Will it revolutionize healthcare or just further fragment the patient experience? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 11/21/22

November 20, 2022 News No Comments

Elizabeth Holmes sentenced to more than 11 years in prison for fraud

A federal judge sentences former Theranos CEO Elizabeth Holmes to 11 years in prison on four charges of investor fraud.

Mercy employees in payroll limbo after cyberattack against parent company

CHI Mercy Medical Center (OR) employees say that last month’s cyberattack on parent company CommonSpirit Health continues to impact its payroll system, resulting in missing hours and incorrect payments.

Amazon is gutting its voice-assistant Alexa. Employees describe a division in crisis and huge losses on a ‘wasted opportunity.’

Amazon’s Alexa business division loses $3 billion in the company’s most recent quarter, ranks third in usage behind Google Assistant and Apple Siri, and is being hit hard with layoffs.

More stolen Medibank data released, containing information about mental health and chronic conditions

Hackers continue to publish data stolen from Australian company Medibank, releasing on Sunday the medical records of 1,500 patients with chronic conditions, cancer, dementia, mental health conditions, infections, and injuries.

Monday Morning Update 11/21/22

November 19, 2022 News 12 Comments

Top News


A federal judge sentences former Theranos CEO Elizabeth Holmes to 11 years in prison on four charges of investor fraud.

A law professor concludes, “Fraud cannot masquerade as innovation in Silicon Valley.”

Theranos had raised nearly $1 billion from investors in valuing the company at $9 billion.

Sunny Balwani, former COO and a romantic partner of Holmes, is scheduled for sentencing on December 7 on 10 counts of wire fraud and two counts of conspiracy to commit wire fraud.

Reader Comments

From Les Diables Bleus: “Re: HLTH. I had a full three days of what I felt to be high-value networking — not sales, mind you, which don’t happen at conferences. It’s a good show to see what’s trending (remote point solutions and health equity) and to meet potential partners. Running into a provider was like a unicorn sighting, which is ironic since that is the HLTH mascot. It is like an all-inclusive resort in that food, drinks, and entertainment were easy to find and included. My exhibitor friends said it was easy to have a booth since HLTH manufactures it with your logo and minimal customization, puts it up, and tears it down so you don’t have to deal with shipping, Freeman, or late-night installations. I would definitely attend again purely for the networking.”

From Kitschy Kicks: “Re: HLTH. How appropriate that it was in Las Vegas, where the house always smites players who think their smarts will make them winners.” It’s a pretty good analogy that brash startups were probably emboldened by the heady atmosphere of both the conference and the Strip into thinking that they can beat the house. Companies that don’t provably solve a problem that prospects will pay for in a financially strained environment, that aren’t making money, and that took too much investor cash and have little to show for it probably don’t need to plan much for HLTH 2023.

From Been There: “Re: HLTH. Our company refuses to pay to play for sessions or articles. The challenge is when customers expect us there to support them, and when VC groups are uneducated but still influential (like former CMS execs). It’s worth a 24-hour trip to keep folks honest.” Plus your attendance entitled you to be a guest on an endless number of podcasts and video interviews that nobody will ever consume. And to hear the inspirational story, for his speaking fee of more than $100,000, of how Lance Armstrong overcame adversity (choosing to be the dirtiest doper, cheater, and bullying liar in the history of sports) to start a new and possibly related career in health and wellness investing.

HIStalk Announcements and Requests


Most poll respondents have a LinkedIn profile and 92% of them contain a headshot, more than half of which were taken professionally. Nearly 20% of the headshots are more than seven years old, so couple that with professional retouching and there’s a pretty good chance that you might need to squint to see the resemblance in person.

New poll to your right or here: Will HLTH, ViVE, and the CHIME Fall Forum have a major negative effect on the HIMSS conference? I differentiate my readership from that of other sites by the number of decision-makers who read HIStalk, an advantage that HIMSS has traditionally enjoyed in attracting exhibitors. New conferences may be poaching that desirable audience from HIMSS. The biggest threat to HIMSS is no longer the obvious one, that in-person conferences will be replaced by virtual ones (which were pretty much a complete bust during the pandemic’s darkest days), but rather that the newer conferences offer an alternative that is drawing a response.

I mentioned recently an announcement of two companies that consummated what was labeled as a “merger” even though it was obviously an outright acquisition that wasn’t called that to avoid offending the delicate sensibilities of the acquiree. Legally speaking, a merger occurs when two companies join together to form a new company, and if there’s no new company, then it is an acquisition (there’s very little “M” in “M&A.”) Even “AP Stylebook” warns reporters that true mergers of equals are nearly unknown and should be called that cautiously – PR BS aside, if it will be the same company name, CEO, and headquarters location, they bought the other company.

Mrs. H saw my mention of the Meta Quest 2 virtual reality system and got me one as a special occasion gift. It is crazy immersive and lots of fun even with the limited number of apps I have so far — mini-golf, Beat Saber, and table tennis (those last two are sweat-inducing exercise). I don’t like giving money to Facebook and they could kill off the product line as they run the company into the ground chasing a Metaverse pipe dream, but it’s fun in the mean time. I nearly face-planted when I leaned in for a table tennis shot and tried to catch myself on the realistic yet imaginary table.

I’m looking at the short list of conditions that just-launched Amazon Clinic will treat via text messaging, which includes problems such as dandruff, motion sickness, and birth control. I’m questioning how much value the messaging adds clinically over just making the drugs that are used to treat these conditions non-prescription. You could easily train a pharmacy technician to read the questionnaire results from kiosk or online entry, then hand over the meds if indicated with any appropriate instructions or warnings, which is about all online doctors would do. “Prescribing what patients ask for” is a common business model that adds little value. The new Amazon Clinic is really just Amazon advertising the services of other companies, as it does with its fraud playground of China-based sellers of electronic devices or clothing items whose disposable company names look like a cat wandered across a keyboard. 


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

Acquisitions, Funding, Business, and Stock

Business Insider reports that Amazon’s Alexa business division lost $3 billion in the company’s most recent quarter, ranks third in usage behind Google Assistant and Apple Siri, and is being hit hard with layoffs.


  • Redox will implement terminology solutions from Intelligent Medical Objects



Kaiser Permanente promotes Mark Simon to VP/CIO of Washington and Colorado.


Stephanie Rogers, RN, MBA (Cerner) joins Children’s Mercy Kansas City as CNIO and senior director of nursing, heath informatics, and technology.

Announcements and Implementations

Sanford Health and Fairview Health Services announce plans to merge into a 58-hospital system under the Sanford Health name and CEO.


A report by Providence’s Digital Innovation Group says that health systems should take a retail-like “digital flywheel” approach in using technology to keep in touch with people who otherwise have only infrequent encounters. The authors say the EHR is a big barrier for outreach – it requires clinician involvement, it doesn’t support all lines of business, and it doesn’t address all types of consumer interaction. They recommend an Amazon-type system that applies algorithmic personalization to data to create a digital consumer identity. They say that unlike Amazon, health systems already offer a wide variety of services and have connections to partners that they can recommend to consumers. The report says that such efforts can be profitable to health systems given the $1.2 million lifetime value of a patient and that simply being able to assign a PCP is valued at $3,000. I’m a bit skeptical since Providence and other health systems have profited nicely from selling interventional care and well-intentioned attempts to offer wellness services nearly always fail for several reasons (lack of consumer motivation, ever-changing health plans, and a lack of clinically documented effectiveness). And perhaps the biggest challenge – whether consumers really want an ongoing relationship with their local health system as they might with Amazon or Starbucks. Personally as a “no news is good news” sort, I’m thrilled not to hear from my local medical center.  

Government and Politics

Texas Attorney General Ken Paxton sends a Civil Investigative Demand letter to Epic demanding that the company explain its policies on children’s health information. He says he is following up on complaints from parents that they lost access to the records of their children who were treated at Memorial Hermann Health System once the child reached 13 years of age. The health system, which is also targeted by Paxton’s investigation, says it is not aware of any parent complaints. Paxton said in a comment about his Epic inquiries, “Too many companies are taking marching orders from the radical left, especially when it comes to their all-out assault on family values and parental rights.”

Privacy and Security

First responders in Ontario go back to paper when its IMedic software is taken offline by a cyberattack.


A JAMA Network opinion piece says that patient satisfaction surveys aren’t suitable for evaluating physician performance. The authors reference an interesting previous study in which the patients who rated doctors highest had higher costs and mortality rates. They observe that most patient survey instruments are old and weren’t designed to reward high scorers. They also note that physician panel size and workload means that one disgruntled patient can drag down a clinician’s score unfairly (see: sour Yelp whiners). They urge public and private payers to stop using patient satisfaction scores for quality assessment and payment.

A randomized clinical trial finds that patient portal messages reminding parents that their child is due for a well child visit and COVID-19 vaccinations increased the rates of scheduling both.

Sponsor Updates

  • Meditech Expanse customers in Canada can now integrate directly with digital care journey platform SeamlessMD.
  • Clearsense publishes a new infographic, “Shorten the Runway for Your Data Platform.”
  • PerfectServe announces the full integration of AnesthesiaGo with its Lightning Bold scheduling platform, and new automation capabilities for improved integration between Lightning Bolt and its clinical communication solutions.
  • EClinicalWorks releases a new series of podcasts on “Achieving Success Through Data Capture and Effective Communications.”
  • Wolters Kluwer Health will serve as the exclusive digital distributor of subscriptions to the New England Journal of Medicine, NEJM Evidence, NEJM Catalyst, and NEJM Journal Watch
  • Premier’s PINC AI Applied Sciences team partners with Henry Ford Innovations to host the inaugural Advancing Health Equity Through Innovation and Collaboration event.
  • The Dutch Ministry of Defense expands its use of Sectra’s Tiger mobile encryption system to include secure file distribution.
  • Talkdesk adds Automation Designer and Workspace Designer to its Talkdesk Builder suite of low-code and no-code customization tools for contact center development.
  • West Monroe’s Alanna Discque receives the 2022 Dallas Ft. Worth Admin Award in the Spirit category.
  • Black Book Research names Zen Healthcare IT as the top-rated healthcare IT advisor for interoperability and integration.

Blog Posts

HIStalk sponsors exhibiting at RSNA November 27-30 in Chicago include:

  • Agfa HealthCare
  • Lyniate
  • Nuance
  • Nym Health
  • OneMedNet
  • Sectra
  • Visage Imaging
  • Volpara Health
  • Wolters Kluwer Health


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


Morning Headlines 11/18/22

November 17, 2022 Headlines No Comments

DirectTrust and EHNAC Announce Merger Agreement

EHNAC (Electronic Healthcare Network Accreditation Commission) will merge with DirectTrust on January 4, 2023, giving DirectTrust access to EHNAC’s accreditation programs.

Hospital info hacked at NY-P/Flushing

NewYork-Presbyterian Hospital notifies patients of a recent data breach that occurred when an unauthorized third-party used a cloud-based, remote IT customer support program to access and then copy and delete files from employee laptops.

Cyber incident shuts down paramedic record system

An unspecified cybersecurity incident prompts EMS health IT vendor ESO to shut down the EHR used by paramedics in several counties in Ontario. 

News 11/18/22

November 17, 2022 News 1 Comment

Top News


EHNAC (Electronic Healthcare Network Accreditation Commission) will merge with DirectTrust on January 4, 2023, giving DirectTrust access to EHNAC’s accreditation programs.

Reader Comments

From Dr. X: “Re: NEJM telemedicine article. It is classic that in the US, (a) we figure out that we need to do something — in this case, that further research is advocated — long after we actually implement something, and (b) because of our strange way of paying for healthcare (insurance and Medicare covers most costs), we feel that we need to research something that clearly has huge benefits (and some drawbacks), when in all other industries, market forces provide the answers.” The NEJM article, titled “Informing the Debate about Telemedicine Reimbursement – What Do We Need to Know?” says that we still don’t know whether telemedicine costs are additive to existing costs (some studies say yes) or whether its use improves outcomes. The authors conclude that permanent telehealth payment policies could include (a) higher co-payments for lower-value services to encourage clinicians to limit the use of telehealth; (b) implementation of bundled programs that put the usage controls on payers; and (c) paying for audio-only visits only if the clinician attests that they offer video visits that the patient declined.

From Informatics Daktari: “Re: HLTH. There was very little work being done there. I thought it was one of the most low-value conferences I’ve been to in a long time. Very much ‘see and be seen’ and felt like it was all startups looking for money.” I think the definition of “low value” is the key here. I’m not sure patients, taxpayers, or insurance-paying employers got anything except another set of expenses with HLTH’s promise of “solving the world’s biggest health challenges” (especially the unprofitable ones), but “value” to some is “catching up” (i.e., hanging out in Las Vegas bars) and pretending that the lyrics of featured performer Ludacris’s “Move Bitch” are profound rather than profane.

From Brought the Bug Home: “Re: HLTH. I should have known better than to attend a conference that has no vaccination or testing requirements. I tested positive upon arriving back home.” I’m curious about others, although I acknowledge that much of the exposure would have been in airports and on public transportation.

From CC Charges: “Re: Cleveland Clinic charging for some MyChart message responses. For or against?” I’m cautiously “for” since, like other professionals, clinicians should be paid for their time regardless of the form in which their customer requests it (your lawyer and accountant aren’t likely offering free advice just because they type it into email). On the other hand, I’m curious whether those providers get paid for the extra time spent. And for that matter, why providers who waste the time of patients through their own inefficiency don’t give them a discount for the inconvenience.

HIStalk Announcements and Requests

I excise verbal crutches from my interview transcripts, which I’m certain the interviewee doesn’t realize they are using. Most common are verbal tics that are intended to communicate emphasis or authenticity – a recent 20-minute conversation included 33 uses of “really” and 16 of “very” that I omitted from the final version.

HLTH recaps and photos I’ve seen look like quite the glad-handing party for health IT glitterati. I’ve seen nothing to challenge my assertion that conference attendance is driven mostly by mid-level provider executives – of which there are sufficient number to lure exhibitors – who demand that their employer prove their undying love by underwriting their ROI-free mini-vacation. If HIMSS is a boat show, HLTH a glamper-only, investor-focused Burning Man. Meanwhile, Axios opines that HLTH is “eating the conference world” with 9,000 attendees and the possibility of taking some folks away from JP Morgan and HIMSS, although it also notes that the conference’s wagon is hitched to bull market investor glory days that are rapidly becoming a faint memory. I’m pretty sure that quite a few companies blew the last of their investor-donated wads on a HLTH Hail Mary and won’t exist in a year.

Last chance – new HIStalk sponsors who start before December 31 get their 12 months at pre-increase 2022 rates, the same as existing sponsors pay. Lorre has welcomed several new sponsors in the past few weeks.


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

Acquisitions, Funding, Business, and Stock

FDA and Mitre publish an updated “Medical Device Cybersecurity Regional Incident Preparedness and Response Playbook.”

Genomic testing company Sema4 will exit the reproductive testing business and lay off 500 of its 1,600 employees following a $78 million Q3 loss.


KHN covers private equity’s takeover of the profitable parts of healthcare, which has been sometimes accompanied by patient-endangering profit maximization. Most of the acquisitions – which often involve eye care clinics, dental management chains, physician practices, and hospices – are not subject to regulatory scrutiny since they fall under the $101 million threshold. Another new KHN piece observes that hospitals push vulnerable, confused patients into payment plans, run by big banks and private equity firms, that charge high interest rates. A patient whose hysterectomy forced her to borrow money at 11.5% interest concludes, “Hospitals have found yet another way to monetize our illnesses and our need for medical help,” as many have ended their traditional no-interest payment plans and refer patients to third-party lenders in return for an upfront commission.

My health IT employee advice as a Twitter implosion observer: (a) it’s time look for a new job when richly compensated executives can’t up with a better strategy to fix the problems their strategic misfires caused than to demand that the galley slaves row harder; and (b) no matter how deserving your boss is of correction or criticism, you don’t want to be the person delivering it (“free speech” is like “HIPAA” in that it doesn’t mean what 99% of people think it does, and criticizing the boss or airing company dirty laundry publicly will rightfully get you fired almost everywhere). Imagine asking Elon to pay your way to attend HLTH.


  • Community Bridges, Inc. chooses Netsmart CareFabric.



JTG Consulting Group hires Philip Garrott (WellSky) as VP of sales.

Announcements and Implementations

Hackensack Meridian Health will run Epic on Google Cloud.

Healthcare Growth Partners publishes a white paper titled “Prepare and Prevent Common Due Diligence Issues in Health IT Transactions.”

Bamboo Health launches a care gap solution for its Smart Signals network


A new KLAS report finds that provider burnout leveled in 2022 at 34%, with the main factors being time required to complete bureaucratic tasks, after-hours workload, and efficiency-sapping EHRs and other IT tools.

Government and Politics

A federal grand jury indicts five former employees of Methodist Hospital for selling the names and phone numbers of auto accident victims to a person who then resold them to personal injury attorneys and chiropractors.

Privacy and Security

A review of 12 healthcare websites that focus on substance abuse finds that 11 use tracking cookies, four use session recordings, six use Meta Pixel, and all 12 sent data to advertising companies.

Sponsor Updates


  • GHX hosts its annual Turkey Trot 5K and food drive.
  • Clearsense publishes an infographic on how to shorten the time to building a data platform
  • Nuance publishes a white paper, “Nuance and NVIDIA: Bridging the gap from medical imaging AI development to clinical adoption quickly, safely, and effectively.”
  • AdvancedMD releases its fall update, adding 35 features.
  • Net Health expands its utilization of Kno2’s Communication API to help rehab therapists meet demands for care coordination.
  • Juniper Networks recognizes Sentara Healthcare with an Elevate Award in the early adoption category.
  • Meditech and Google Health advance their search and summarization collaboration to the next phase, with DCH Health System and Mile Bluff Medical Center signing on as early adopters of their integrated solution.
  • Oracle Cerner posts a podcast titled “Evolution of the pager: Creating more effective care team communication.”

Blog Posts


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


EPtalk with Dr. Jayne 11/17/22

November 17, 2022 Dr. Jayne 1 Comment

HLTH Recap

After leaving CHIME last week, I had just enough time to swing by my home base, run a couple of loads of laundry, and repack for a climate that was 20 to 30 degrees cooler than San Antonio. Many of the people in Las Vegas were complaining about the cold, but there wasn’t any snow like I had at home, so I was happy with the temperatures.

This was my first year attending the HLTH conference and I wasn’t sure what to expect. Registration Sunday was crowded, with lines snaking throughout the halls of the conference center. There were plenty of staffers helping people find the end of the line and it moved quickly though.

Sessions on Sunday were standing room only. It felt strange being packed together like sardines given the social distancing of the last couple of years. I was one of the few people masking during the conference, although I wasn’t able to do it as consistently as I would have liked. Still, I figured that if I can reduce the risk of being exposed by even 50%, it was worth a shot. I have a lot of reasons to not bring COVID home, including the fact that next week is Thanksgiving and I have elderly and immune compromised relatives, and also the fact that I’m scheduled for a long-awaited medical procedure and don’t want a COVID-related cancellation. In some of the conversations I had, however, I felt like I had to explain to people why I was masking, which seemed strange.

Walgreens was offering COVID and flu vaccines onsite, but I didn’t see any mention of testing. I did, however, see multiple people buying COVID test kits at the local pharmacy. Several people I spoke with wished that HLTH had encouraged people to be vaccinated and to test prior to departing for the conference. Within the first day, I received four notifications from the local COVID-tracking app letting me know that I had been exposed. Although I’m glad to get the notifications, it was disappointing to receive so many so quickly.

The exhibit hall opened on Monday. I was initially a bit underwhelmed – there wasn’t the kind of energy I’m used to when HIMSS or another big show has its opening day. This improved as the day progressed, and I think perhaps people just took longer to settle into their booths than expected.

I liked the way that HLTH handed meals, with multiple locations serving food that was included in the price of the conference. I also liked having the “grab and go” options available throughout the day, including a bagel box, sushi lunch, breakfast burritos, a protein box, and more. The only downside of the grab and go stations was the lack of beverages, so unless I had a full water bottle in my bag, I had to trek somewhere to find a drink.


The exhibit hall was set up in a hub-and-spoke configuration rather than a grid structure, although there were grids within the various spokes. While standing near the supersized maps of the hall trying to find booths, I heard many comments that people didn’t like the configuration. The center of the hub was a giant HLTH-emblazoned moon suspended from the ceiling, with a darkened space with bean bag chairs inside.

The wi-fi at the conference center went down a couple of times during the week, and the HLTH app advised attendees not to use personal hotspots as they were contributing to the problem. There’s nothing quite like spotty wi-fi at a healthcare tech conference.


I spotted these cute shoes on Monday at a panel on maternal health that featured Jaime Bland, DNP, RN from CyncHealth, Mandira Singh from PointClickCare, and Thomas Novak from the Office of Policy in the Office of the National Coordinator for Health IT. I don’t think people realize that pregnancy in the US is a risky condition. The panelists did a great job reviewing the challenges of interoperability and how to best let people know at the point of care that a patient is or has recently been pregnant. To paraphrase one of the panelists, you can’t just go around asking every woman if they’ve had a baby in the last 90 days. They discussed efforts happening to improve the situation in Nebraska, where many individuals have to travel an hour or more to receive prenatal care or to give birth.


These less-than-cute and decidedly orthopedic-yet-platform shoes were spotted at Zara, across the street in the Fashion Show Mall.

Speaking of shopping, one of the reasons I chose to stay at The Palazzo was its proximity to the meeting, as well as the fact that you can connect through the Grand Canal Shops and avoid walking through the smoky casino. One of the downsides of that path was that the folks working the cosmetic and bath products shops would stand in the doorways and hassle you as you went by. They didn’t seem to understand “no, thank you” and became increasingly aggressive as the week progressed. I have to say I’ve never made a purchase at a shop where people yelled at me from the door, and I’m not about to start.


Also spotted cutting through the shopping area was this person with a rescue-style backboard. She entered the Atomic Saloon Show theater and didn’t seem to be in a hurry, so I hope it was simply an in-service training session.


Solutions for tired feet were available at this handy vending machine at the Venetian.


Only in Las Vegas do people throw paper money in the fountain in addition to coins.


Although the food options in the exhibit hall were solid, finding dinner in the complex without a reservation was tricky. Many of the restaurants were not operating at capacity, presumably due to lack of staff. Others were packed. I successfully dodged being gifted an alcohol-filled guitar at a place where we stopped for a quick burger. On Monday, I would have enjoyed a nice glass of wine with a friend in the late evening, but we were stymied by the combination of restaurants that close at 10 p.m. and bar/lounge areas with a steep per-table minimum.

Cool things spotted on the floor:

  • Caption Health offers Caption Care, which they describe as a “turnkey, end-to-end echo program” for heart failure with the ability to perform exams in the home or office setting. They offer “AI-guided ultrasound” and emphasized the ability to detect disease earlier.
  • Kahun had a presence alongside a number of companies from Israel. Their digital clinical reasoning engine helps identify patient symptoms and connect them with clinical insights, including citations of peer reviewed studies upon which clinicians can rely. Some recent enhancements include the ability to order labs alongside the clinical information being provided.
  • A blood drive was held Tuesday and Wednesday. Thanks to all who participated.


Hinge Health had plenty of giveaways and there was nary a rep in sight.


I spotted these reps in sperm hats several times, but couldn’t figure out which fertility company they were from.


A colleague of mine was on a panel Tuesday that was titled “Sexual Healing.” That should have been a great attention-getter, but I was disappointed to see so few people attending, especially since this is an important topic that more people should know about. It became busier as the session progressed, and most people stayed for the entire session. Sexual health can be an indicator of overall health and is impacted by many conditions, from depression to vascular disease to pelvic floor dysfunction and more. Often these conditions aren’t covered in medical school, residency programs, or physical therapy programs and it was great to hear this dynamic group trying to cut through the “shame and stigma” that they see in their patients and clients.

Carine Carmy, co-founder and CEO of Origin, noted that they are engaging patients through welcoming environments and “using wellness as a veneer for healthcare.” They are positioning their physical therapy services more like a consumer brand than a medical establishment because that’s what gets attention right now in the US. Lyndsey Harper MD, founder and CEO of Rosy Wellness, Inc. talked about their platform, which offers curated materials to help patients along their sexual health journey.


Tuesday night was party night, and I hit a couple of gatherings including one sponsored by SteadyMD (fresh off the announcement of their participation in the new Amazon Clinic telehealth offering) and Zus Health. Jonathan Bush addressed the audience towards the end of the evening, and although it was entertaining, his speech was tame compared to those he delivered at the HIStalkapaloozas of old.

From there it was off to the Ludacris performance, which was packed. I have to admit I left early, partly due to the crowd but partly due to the volume, which could literally be heard across the street at Caesar’s Palace.


After one more trip past the Bellagio fountains, it was off to bed to rest up for the early flight home.

What things did you think were the best and worst of HLTH? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 11/17/22

November 16, 2022 Headlines No Comments

Telehealth Sites Put Addiction Patient Data at Risk

A 16-month analysis of a dozen online addiction and substance use disorder treatment companies finds that each one collects, identifies, and shares information about users with third parties; and engages in ad tracking.

Electronic records issue delaying gynecological referrals on P.E.I.

On Canada’s Prince Edward Island, health officials warn patients that a data entry issue with the island’s newly implemented clinic EHR has caused delays for 700 gynecological referrals.

Cognoa Appoints Pediatric Neurologist and AI in Healthcare Pioneer Dr. Sharief Taraman as CEO to Spearhead the Next Stage of the Company’s Growth

Digital behavioral health vendor Cognoa promotes physician informaticist Sharief Taraman, MD to CEO.

HIStalk Interviews Eric Meier, CEO, Owl

November 16, 2022 Interviews No Comments

Eric Meier, MBA is president and CEO of Owl of Portland, OR.


Tell me about yourself and the company.

I’ve been in the healthcare field for the majority of my career, both on the software side as well as the technology and medical device area. This area is probably lagging other specialties in technology, software, and analytics. This is the realm of behavioral health, which is the largest category spend in healthcare — I think it’s over a quarter trillion dollars spent on services. You can look at the impact from our productivity in our society. I don’t know the current prevalence of behavioral health conditions, but I think that an excess of 16% of the American population has suffered from behavioral health issues. 

We came into the market realizing that unlike other specialties, there was really not a good way to determine and understand if care is working correctly. Behavioral health has been a people-based therapy and involves medication as well as psychotherapy. The ability to assess whether treatment is working has been lagging. Somewhere between 11 and 13% of clinicians are practicing measurement-based care, but it has been shown clinically to be extremely effective way to deliver effective and efficient care.

We were founded at University of Washington, looking to deliver an approach that would allow clinicians to understand or address the fundamental question — is care working, and to what extent? We’ve built upon that over the last five or six years.

What’s encouraging about it is that this methodology of measurement-based care clearly works. The platform was designed by clinicians for clinicians. When you take that type of approach, you can get an understanding of how treatment is being delivered and how effective it is at every step of the journey. 

We are seeing engagement rates well in excess of 90%, which means it is integrated into care effectively and is able to understand what’s the patient’s status at intake from a screening standpoint, but also being able to work alongside the treatment throughout the entire course of treatment. When it’s time to discharge, step down care, or have patients transition away from receiving services, understand the effectiveness from admit to discharge, and then if needed, to see if in fact there is a relapse, being able to detect that early on so care can be administered correctly if needed down the road.

What kind of measurements are used, and how many of them reflect the patient’s perception?

Patient-reported information is a true proxy of the patient’s status, not only for screening, but throughout the course of treatment. It minimizes clinician burden and it has been shown to remove quite a bit of subjectivity or bias. If you look at the early days of capturing assessments for clinical care, a lot of these were physician-reported scales. Over time, what has been increasingly accepted and recognized is that the patient can provide a far better status of their own condition. That also avoids the pitfall of many technologies in burdening clinicians with additional work.

We adopted the approach at the outset of capturing the patient’s status using patient-reported outcomes measurements or what is referred to as PROMs, in addition to looking at social determinants of health information, which in many ways can be key indicators of the patient’s status. Often in many cases, even a leading indicator — one needs to address issues like food insecurity, homelessness, et cetera. We provide this information to clinicians to help understand the condition at the time of screening or intake, then risk stratify populations, then being able to monitor or track treatment effectiveness over time.

Will those measurements became a standard for payers, similar to prior authorization?

I would look at the issue and say, why to date has it not been broadly accepted? I think it’s because of a number of previous solutions were fairly burdensome, relying upon either the clinicians to administer these tools or not fitting into the clinical workflow. We’ve taken a deliberate approach to make it fit into the existing behavioral health practice, whether it’s ambulatory, partial hospitalization or intensive outpatient, inpatient, or residential. You have to look at the clinical workflow and make sure that whatever you’re doing to capture critical information, like what we capture in Owl, fits in the existing environment.

On top of that, I’m pleased to say that there are existing CPT codes to support the capture of information that feeds into measurement- based care. We have customers being reimbursed for this. But you could also look at this information to be critical in the utilization management process, if you want to know that effective care has been delivered or if you need to extend treatment. We have customers using this information to help provide greater transparency around the type of services that have been delivered and how effective they are.

Behavioral health providers have been reluctant to use some technologies because of privacy concerns. Is that an issue?

We really haven’t seen that be an issue. The major questions around adoption are, how does this fit into my existing workflow, or how does this help me institute change management in a way that’s not overly burdensome and can actually make the capture of information easier? 

Around privacy concerns, we have developed a HIPAA-compliant system that is observant and supports conditions around privacy. There are additional requirements as it relates to substance use, but at least from our vantage point, we have not seen that be an issue around adoption of technology. It’s more about just making sure that it fits within the existing treatment model and doesn’t overly burden the clinicians, but actually give them greater information around the kind of care they’re delivering and making sure that using a platform to help improve the overall effectiveness and efficiency of care.

Who makes the decision to implement the concept as well as the technology?

If you look at our customer census — Ascension Health, Oregon Health and Science University, Texas Children’s, Inova Health System, and Carilion Clinic — it starts with leadership that is thinking strategically on how to deal with the basic questions of, how do I deliver the most effective and efficient care? How do I deal with access issues and try to address wait lists that may be occurring? How do I better understand, from a population health standpoint, the type of care that is being delivered within my ecosystem and also support alternate payment schemes, such as value-based care?

All of that hinges upon the understanding of the type of care that’s being delivered, which has been well accepted through the capture of clinical outcomes. With any new technology, getting leadership buy-in up front is crucial to embark upon measurement-based care, but also make sure it’s being utilized by the team on an ongoing basis.

We have been fortunate that our customers tend to think strategically on addressing the fundamental question of how effective is the care, how good a job am I doing? Then making sure that as we look at this from an implementation standpoint, it needs to fit the existing ecosystem, which typically consists of integration with their EHR, whether it’s Epic, Cerner, Athenahealth, or behavioral health EHR such as Netsmart, Streamline, and others. Then secondarily, make sure that information can be used on demand by the clinicians as part of an encounter, but also used by the leadership to assess the effectiveness and efficiency of care across their different clinical programs. 

When you think about the ability to benchmark, let’s take for example eating disorder service lines that may be spread across a health system in different locations. What you would like to understand is, how good a job am I doing? Am I seeing kind of best practices in one location that I can now, based upon the outcomes data that the Owl is generating, replicate and standardize on? 

The other point that needs to be understood is that people delivering behavioral health have probably one of the toughest jobs in healthcare. It is a really challenging job. Well accepted is its ability to not only provide effective care, but get more out of existing resources. For example, we’ve seen about a 56% reduction in time to remission from those folks that implemented the Owl versus those that have not.

Secondarily, given some of the resource constraints that have unfortunately become a consistent problem across the United States, we’re seeing about a 30% improvement in staff efficiency. You take an organization that may have 20 to 25% attrition, there’s a need to backfill those positions, but also make sure the consistency of care is happening across a health system, whether it’s in one geography or multiple. The beauty of the Owl is it provides a systematic way to deliver evidence-based care, and when you think of faster time to remission, I can treat more clients with existing resources.

How are measurement-based outcomes being used in telehealth?

We are an enabler to that. We were designed from inception to support telehealth, long before the pandemic occurred. Virtually 100% of our customers, going back to probably the second quarter of 2020, by necessity pivoted to a virtual healthcare model and, there was no interruption of the use. In fact, one of the things we’re proud of is that our platform has been used to assess the overall effectiveness and efficiency of care in both the on-premise as well as virtual setting. We’re seeing a consistent response. The upside for the patients is you have the ability to receive treatment services in probably a more relaxed setting. You avoid having the transportation and having to go to your appointment. Our platform has been used to give confidence to the providers that the quality of care is not compromised.

When you think about what is happening right now with the fact that there’s been a big focus on access to care and our platform is being used to support improved access to a faster time to remission or whatever your treatment target is, as well as the ability to be able to treat more in patients with existing resources, we’ve been well accepted in providing those values. I would say as you look forward, we think there’s going to be increasing focus on quality. As the access issue begins to abate, we are seeing health plans is saying, that’s great, let’s make sure that the quality of care is not compromised. The payers or the health plans are demanding more data, in the form of clinical outcomes, to document and validate that the treatment services have been administered correctly.

That’s the work we do. Think of us as not only supporting the providers and being able to deliver evidence-based care through the Owl of the measurement-based care platform in a seamless way, but secondarily provide the health plans to better understand the performance of their networks. There’s no better way to do that than to have well-documented, patient-reported clinical outcomes and social determinants of health information to make sure that the best care has been provided at the right level to the patients.

What changes do you expect to see over the next few years with your customers and the company?

In the early days of the company, it was around providing or enabling providers to capture clinical outcomes in a straightforward way. We’ve been able to provide information capture to our customers.

If you look at the evolution of measurement-based care, the next piece of the puzzle is providing detailed reporting and analytics to support internal needs around as a health system. How good a job am I doing relative to where I want to be from a performance standpoint? I think of this as a population health support.

The next area has been in supporting clinical decision support. Not only can I use measurement-based care to determine those clients or patients that may be likely to self-harm or harm others, so looking at suicidal ideation, our platform is designed to provide a safety plan to not only notify the clinicians and staff that immediate attention is warranted, but also say, what do you do? We’re building upon that now to look at different conditions such as depression, anxiety, substance use, et cetera, to provide supportive clinical decision-making so you are administering the right care algorithm.

The fourth area I would speak to is providing greater alignment between providers and plans. Providing visibility, which to date has been opaque, around the overall care that has been delivered by both the behavioral health specialty and primary care. Having an understanding of how a health plan’s network is performing, and once you baseline that information, then it provides the opportunity to be aligned around moving towards alternative payment schemes, such as value-based care.

As we look forward, we see not only continued and growing acceptance of measurement-based care by providers, but health plans using this information to understand the quality of care that has been delivered and making sure there’s alignment around payment schemes and addressing total cost of care.

From a business strategy standpoint, where we are focused is having a balanced portfolio of customers. Not only serving health systems, large community mental health clinics, and health systems supporting both behavioral health specialty and those that move into collaborative care or integrative care model, but also making sure the health plans are able to understand the type of care that’s been delivered. Not only behavioral health, but also recognizing that these behavioral health conditions can adversely impact medical care. This whole concept of whole person care is going to be critical and recognizing you need to address the behavioral health component of it.

We benefited from taking a clean slate five to seven years ago and the ability to develop a measurement-based care platform by clinicians, for clinicians. The area we focused on was number one, making sure we integrate in the clinical workflow in a seamless capacity. This is across different clinical approaches to delivering behavioral health services, everything from ambulatory to partial hospitalization, intensive outpatient, inpatient, as well as residential. We’ve extended that to support when behavioral health is being delivered in a primary care setting as well. Secondarily, once you fit the clinical workflows, to make sure you’ve got a broad enough amount of content that support all the different subspecialties, whether it’s eating disorder, substance use, depression, anxiety, adolescent, or late-life care. 

The upside of this is we’ve got a high engagement level, upwards of 90%. You need those kinds of numbers to fully utilize measurement-based care and capture the benefits of accelerating time to remission and improving effectiveness of care as well as efficiency. Once you accomplish that, you start to address one of the primary issues today, which is access to care. In other words, how do you make sure clients are receiving care in a timely capacity? As I mentioned earlier, we’re seeing compelling and supportive statistics with faster time to remission of 56%, as well as being able to get more out of existing resources.

With that in mind, with this information, then it becomes meaningful not only for providers, but also obviously those that are doing accreditation work, such as the Joint Commission or CARF, as part of their audit process. Lastly is making sure that the health plan has a better sense of the type of care that’s being delivered by their network.

We have been fortunate to have supportive strategic investors in the form of the Ascension Health Network, First Trust, Cardinal Partners, Blue Venture Fund, and the Entrepreneurs Fund.

Morning Headlines 11/16/22

November 15, 2022 Headlines No Comments

Introducing Amazon Clinic, a virtual health service that delivers convenient, affordable care for common conditions

Amazon officially launches Amazon Clinic, a message-based service that connects customers with Amazon-approved, third-party virtual care services for more than 20 common health conditions.

Cleveland Clinic to soon bill for MyChart messages

Cleveland Clinic will begin billing patients for certain messages sent through its MyChart patient portal that take physicians longer than five minutes to answer and require a certain amount of clinical expertise.

Hackensack Meridian Health Aims to Boost Innovation, Increase Efficiencies and Strengthen Security with Plans to Run Epic on Google Cloud

Epic customers can now move their medical records to Google Cloud.

News 11/16/22

November 15, 2022 News 5 Comments

Top News


Amazon officially launches Amazon Clinic, a message-based service that connects customers with Amazon-approved, third-party virtual care services for more than 20 common health conditions.


Amazon Clinic, which doesn’t yet accept insurance, is available in 32 states and offers the option to fulfill prescriptions through Amazon Pharmacy.

Meanwhile, the online retailer plans to lay off 10,000 employees in corporate and technology roles, including those working in its devices (Alexa), human resources, and retail divisions.

HIStalk Announcements and Requests


HLTH is in full swing in Vegas. HIStalk readers who’ve opted for their (hopefully) cozy home offices rather than the bright lights of Sin City may not know what they’re missing. (Perhaps they’re reminiscing about dueling Elvises at HIStalkapaloozas gone by.) Email me with your photos and observations, and I’ll possibly share in an upcoming post.


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

Acquisitions, Funding, Business, and Stock


Digital health integration and remote patient monitoring technology vendor Validic secures $12 million in a financing round led by Kaiser Permanente Ventures.


AngelEye Health, which offers patient and family engagement software for hospital neonatal, pediatric intensive care, and nursery units, raises $20 million in a Series B funding round.


Cleveland Clinic will begin billing patients for certain messages sent through its MyChart patient portal that take physicians longer than five minutes to answer and require a certain amount of clinical expertise. Messaging through the portal has doubled since 2019.


  • TriHealth (OH) selects Andor Health’s ThinkAndor Virtual Patient Monitoring technology.
  • Jasper Health will leverage Particle Health’s FHIR-based integration and API capabilities as part of its digital cancer care coaching and support software.
  • Williamson Medical Center (TN) will implement EvidenceCare’s AdmissionCare and CareGauge decision support products within its Meditech Expanse workflows.
  • Smile Digital Health will use data integration capabilities from Redox to enable customers to migrate data from legacy systems to its digital health platform using the FHIR R4 standard.
  • In Louisiana, Lane Regional Medical Center and Our Lady of the Lake Regional Medical Center will go live on a shared Epic system in 2024.
  • Labcorp will use Oracle Cerner’s laboratory information system to help manage the lab operations of a Catholic health system.



Canvas Medical names JP Patil (Included Health) chief product officer.

image image 

HCTec names Brent Prosser (ROI Healthcare Solutions) VP of sales and promotes Bernard Rush to VP of application support.

Announcements and Implementations


Floyd County Medical Center (IA) goes live on Meditech Expanse with help from Healthcare Triangle.

Net Health develops Missed Visit Prediction Indicator, a predictive analytics tool for hospital-based outpatient rehab therapy clinics.


Summa Health in Ohio transitions from Epic’s Community Care model, courtesy of nearby Bon Secours Mercy Health, to its own Epic system with help from Brightwork Health IT.

Wolters Kluwer Health announces GA of Digital Health Architect Consumer Education Suite, an educational content-as-a-service designed to help virtual care companies build and deliver custom digital health solutions.

Epic customers can now move their medical records to Google Cloud.

Commure introduces CommureOS, a new operating system designed to help providers create and customize organizational workflows.

Bamboo Health develops Rising Risk, new real-time risk stratification and patient engagement capabilities.



The Bermuda Hospitals Board celebrates the arrival of the first baby with an entirely digital health record. Frances Ivy Edwards was born shortly after the King Edward VII Memorial Hospital and the Mid-Atlantic Wellness Institute went live on the Oracle Cerner-based Patient Electronic & Administrative Records Log (PEARL).

Sponsor Updates

  • EClinicalWorks releases a new podcast, “Achieving Success Through Data Capture and Effective Communications.”
  • NTT Data leverages Lumeon’s care orchestration engine in its virtual command center to coordinate delivery of key non-clinical services for hospital-at-home programs.
  • Everest Group recognizes AGS Health as a leader in its Medical Coding Operations PEAK Matrix Assessment 2023.
  • Clearwater publishes a new whitepaper, “Back to the Basics: HIPAA Compliance for B
  • After switching to the EClinicalWorks Cloud, Hyndman Area Health Center reduces its expected five-year costs by over 50% and improves overall practice performance.
  • Wolters Kluwer Health makes its Digital Health Architect Consumer Education Suite and EmmiGuide solutions available via the Microsoft Marketplace.

Blog Posts


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


Morning Headlines 11/15/22

November 14, 2022 Headlines No Comments

Data breach of pediatricians’ computer network ‘may’ have exposed patient data

Pediatric health IT company Connexin Software, parent company of the Office Practicum brand, notifies over 100 customers and their patients of a data breach in late August.

Maven’s Second Act

Tech-enabled women’s and family care company Maven Clinic raises $90 million in a Series E funding round, bringing its total raised to $300 million.

Validic Inc. raises $12 million in its latest funding round

Digital health integration and remote patient monitoring technology vendor Validic secures $12 million in a financing round led by Kaiser Permanente Ventures.

HIStalk Interviews Ben Albert, CEO, Upfront Healthcare

November 14, 2022 Interviews 1 Comment

Ben Albert, MBA is co-founder and CEO of Upfront Healthcare of Chicago, IL.


Tell me about yourself and the company.

I have been in healthcare for my whole career. Prior to starting Upfront, I founded a company called Care Team Connect, which was a care management platform for population health that was acquired by The Advisory Board. We did a lot of care management work through a digital platform that enabled care managers to support the high-risk patients that they were serving and supporting in a shared risk agreement.

That experience it led me to found Upfront, because every patient, not only those who are high-risk in some population health agreement, deserves to be navigated to the care that they need, and technology is required in order to scale that type of navigation for every single patient across a health system. That is the foundation of Upfront Healthcare, to help every patient get the care they need.

How do you differentiate the patient engagement and digital front door technology market?

It’s a confusing market, for sure. The digital front door is mostly tied to patient acquisition. Where Upfront focuses is on how to retain every single patient that you serve. If the digital front door is going to bring in a bunch of new patients, how do you use personalized engagement and access to optimize the experience for that patient so they stay with the system for the long term after the digital front door is activated and you engage that patient initially?

Health systems are starting to understand how to get patients into the system. Do they also study why patients leave the system?

They definitely study why patients leave the system. They look at referral patterns and if patients are leaking out. If they are being used as a retail service and the front door generates only retail visits, how can they convert that patient into an empaneled patient on the primary care side or the system of choice for that patient for the long term?

They definitely look at that conversion and understand how to keep that patient and retain them. Especially in light of all of the specialized services that are coming to market, Amazon and Oak Street Health for example, that are focused on particular types of patients, to help attract those patients to their services. Our clients, the health systems, need to focus on how to differentiate and keep their existing patients.

How do health systems engage with patients whose encounter was one-off, such as in an urgent care center or telehealth visit, and determine how much of a relationship those patients want?

They need to engage those patients through a more personalized experience to help understand the needs of those patients and then guide them to that service proactively. Patients are often left to figure that out on their own. They might get a simple text message thanking them for their visit or preparing them for a visit, but they aren’t really aware of options within the system and how to best use the system to meet their own needs.

We often talk about patients as the most underutilized resource in healthcare. How does the health system look at that initial encounter or initial event as a way to help educate the patient about all the services that are available to them in a personalized way, so that only those services that are going to be the most impactful for that patient are put in front of them?

How is that different from retailers, who are happy to sell you whatever you want to buy and hope you keep buying, when what patients want isn’t always what clinicians think they need?

The patient will make the right choice if they are given the education and the appropriate information to enable them to make that choice. Often the clinician might be communicating what the patient needs, but the patient doesn’t understand it at the time that communication is provided. It’s not as personalized in some ways as it could be.

You can give patient the alternatives in how to get that care. Let’s say it’s a flu shot for example, something very simple. You give them the alternatives of, you don’t have to go to your primary care physician because we have these different options for care for you, including our urgent care, where you can get this flu shot. We are going to help guide you and let you pick what service is most convenient for you to get that care that you need. It flips it around a little bit to give that patient choice to meet the needs that they have by availing them of the information to optimize their own care.

Is there any comparison to dental practices that message their patients effectively, albeit with list of services that is much shorter and predictable than that of a health system?

It will be as simple as that. It’s not the complexity of the system, it’s the communication of what pieces of the system meet the needs of the patient. 

There is a way — we call it care traffic control — to understand all the services that a health system can provide to a patient, and then to personalize that service and the access to those services so that the patient will know exactly where they’re supposed to go and when they’re supposed to go there. They will get that care that they need from the system and it won’t feel so complicated. It won’t feel like there are so many choices because it has been tailored for them and guides them directly to where they need to go.

So yes, it can feel like the dentist. Does it today? No, because it’s a lot of fragmented communication coming through different channels that confuses a patient as opposed to one omnichannel communication that will ultimately all be on the same page to enable that patient to get where they need to go.

How will you apply the consumer science capabilities of PatientBond, which Upfront acquired in August 2022?

We are excited about the acquisition of PatientBond. Psychographics, in combination with the behavioral analytics that we already do at Upfront, will help us understand how to best engage a person. Psychographics are a consumer capability that helps create these personas of individuals, so that we know exactly what communication pathway to take to engage that person so that we can ultimately understand how to best communicate with them.

You use the right imagery, you use the right language, you use the right time of day and super tailor and personalize the experience for that individual. You tie that in with the behavioral knowledge that the Upfront platform has and that really understands that when they go for care, where they need to go. You optimally tie those things together to have a communication pathway, then access that pathway for a patient that is unique to them and scalable. They are getting to that care 40% more than they were before because of that communication pathway.

If value-based care ever becomes significant and maintenance of health becomes more financially important to providers, will the same messaging platform support it?

Yes. From our point of view, whether it’s value-based care or not, every patient should be getting these necessary preventative services. How it gets paid for on the back end, we certainly understand the value of that. But ultimately if you take the patient-first approach, everybody should be getting that annual wellness visit who needs it and everybody should have those care gaps closed who need them, not only if they’re in some value-based care arrangement.

How do you help every single patient, regardless of what the economics are behind their care, get to the most optimal care for them? It’s informed by what type of care they need to receive and what type of model of care they’re in to make it super efficient for the health system while still enabling every patient to get the same level of care across the system. In a value-based care context it’s incredibly important, but it’s equally important in a fee-for-service context where these patients still need that same care.

How do health systems change their philosophy about consumerism and then choose systems to support it?

They all want to be more consumer centric and they’re on this journey to be so. They have built all of these services, retail-type services like urgent care, virtual care, on-demand care services, asynchronous care, and in-person services like traditional office visits. They have built all of these services to be more consumer centric, tried to increase access points, tried to make themselves more convenient.

Ultimately, though, they have not optimized that for the patient. What they are doing now in that next wave is saying, we have all these services and we can compete for access, convenience, and efficiency for the patient. How do we tie it all together and enable the patient to understand which one of those services they should be utilizing within our system to ultimately get the best experience for them and get in for care when they need it?

We see a big effort in tying that all together to make it feel seamless for the patient, even though we know that under the hood, it’s not as seamless as it probably should be in the long term from a health system point of view. You can enable the patient in a way that feels seamless and guides them across those services. That’s how they are digitally transforming right now. The first step is how to enable that consumer even if you can’t fix everything across the system on the back end right now.

Does consolidation into larger health systems change the scale and speed in moving to a more patient-focused direction and the use of technology to support it?

In theory it’s helpful, but ultimately you are now on multiple EMRs. You have to reconcile all of that data and all of those services across the system. Unless you have something that can sit beside the EMR, sit outside of that ecosystem and look across multiple EMRs to understand what services are available and guide patients, it doesn’t actually advance the cause. It can slow it down because of the focus is so heavily on the EMR itself and not on how to activate your patients and help all those patients navigate through the integration of a couple of systems coming together, which is incredibly complex for patients to navigate, but also for the system to execute on as well.

How do you see the consumerism aspect of playing out over the next few years and how will the company change in response to it?

To us, healthcare needs better personalization for every single patient. The more we can delve into truly understanding exactly what service the patient needs and enabling them proactively to get that service, the more efficient we will be at a macro level. For us, it’s continuing to enable patients through personalization, through psychographics, through behavioral data, through the right type of communication and omnichannel communication that is integrated across the system so that access and appointment booking is frictionless and easy to get to. 

I would love to say that it’s a one-year journey to be able to tie all of that together, but those of us who have been in this industry for a long time recognize the complexity of it. We will just stay with it and keep doing more of it over the next few years, and you’ll look back at the body of work and say, wow, we’ve made a big impact. More patients are getting the care they need. They are getting a personalized experience that feels much more consumer centric, and they are actually healthier as a result.

Curbside Consult with Dr. Jayne 11/14/22

November 14, 2022 Dr. Jayne 3 Comments



Since leaving CHIME, I’ve been dodging sketchy airline schedules, some urgent priorities at home, and snow. I finally have a few minutes to reflect on my first CHIME meeting, which overall was successful in my book.

The general conference vibe was laid back. Most of the non-vendor attendees have substantial healthcare IT experience under their belts and didn’t seem to have anything to prove, so that may have been part of it.

Sunday and Monday were the inaugural “Innovation in Clinical Informatics” sessions, which were great for learning about the challenges that other clinical informaticists are facing. A couple of thoughts stuck in my brain:

  • One participant noted that they have concerns about their ability to function during a downtime event, in part because younger staff members don’t read cursive. Several people in my part of the room were unaware that schools stopped teaching cursive more than a decade ago, with the advent of the Common Core State Standards. The concern is real and should be addressed as part of downtime procedures.
  • There was a lot of emphasis on asking “why” when solving informatics problems. Finding the ultimate upstream “why” can often lead to different solutions than just taking a request for change at face value. I’m a huge fan of the Five Whys tool, and if you’re not using it with your team, I would ask yourself why.
  • Behavioral health was a hot topic. Several speakers noted that patients prefer to have these visits at home. Medical outcomes are better when behavioral health issues are treated, and if organizations aren’t offering adequate behavioral health services, they need to work on their strategies.
  • There was good discussion about whether secure chat messages should be considered telehealth.
  • UCHealth’s CT Lin presented the “Swiss cheese model of successful innovation,” explaining that all the holes have to align for projects to deliver maximum value. He used it as an admonition about the importance of clinical informatics, because clinical informaticists can often see the problem through different lenses and see how the holes need to align. They can also recommend how to make the connections and avoid pitfalls.
  • Clinician burnout was a common theme, as was the importance of culture compared to strategy.

One final thing really caught my attention, and that was discussion about the need to deliver “delightful” patient experiences. Based on my recent adventures in healthcare, I’d settle for “decent” or “passable” rather than the “awful” experiences I’ve been having. That imaging result that was supposed to be released within 24 hours actually took six days to release via the patient portal, and when I returned home, I found a paper result waiting for me that had been mailed the day after the study and arrived two business days later. Something is wrong when you get your results via snail mail faster than via the patient portal.


During the conference, participants had the chance to paint a panel that will form a mural to be hung in a multi-assistance care center providing collaborative care and centralized services for individuals with special needs. The painting project was sponsored by CDW.

Tuesday was the opening keynote, with a celebration of CHIME’s 30th anniversary and an early morning champagne toast. Following awards and recognition, the guest speaker was introduced. Sophia is an “advanced humanoid” robot who was advertised as being able to wow audiences with “her superhuman intelligence and advanced ability to read faces, empathize with emotions, understand the nuances of language, and communicate with thousands of facial expressions. Unfortunately, Sophia seemed to encounter a glitch and the audience was asked to take a 15-minute break while they tried to get her back online. One can only presume that while we were out of the room, they tried turning her off and back on again. She wasn’t much better after the break, using mostly what seemed like canned segments of speech. Based on her performance, I don’t think we have to worry about robots taking over the world just yet.

The rest of the day and into Wednesday was a mix of engaging sessions, meet-ups with colleagues, and a couple of focus groups. Although generally the focus groups provided an opportunity for good discussion and learning about what other CIOs and CMIOs are facing in their organizations, one session became challenging. I couldn’t believe I was watching one participant troll another by making snarky comments about an organization’s challenges, knowing that the leader of the struggling organization was sitting right next to him. It just goes to show that it there’s a lot of variety in leadership skills. I hope that particular individual plays nicer with his colleagues at home than he did in the focus group.


The San Antonio spirit was strong as staff worked on the setup for Tuesday night’s reception and dinner.


For those of you looking for wardrobe and shoe reviews, in general the mood was subdued. Lots of jeans and blazers, but since this was my first time attending, I’m not sure if that’s usual for this conference or if it had something to do with the fact that emails were sent telling folks to bring their jeans and boots. The League of Women session had some fine shoe options including sassy espadrilles, kicky boots, strappy sandals, and “trust me, I mean business” pumps. I opted for some low-key loafers, although I did pull out the boots for the Wednesday night event.

The event was held at the Knibbe Ranch, which is about 30 minutes from the conference center. Not only were cowboy hats and western boots out in full force, but there were also several people wearing Woody costumes from “Toy Story.” As guests stepped off the buses, they had the opportunity to have a photo taken with genuine Texas longhorns. Dinner had a distinctly cowboy flair and was served from buffet lines that contained more cast iron than I’ve seen in one place in a long time (and I’ve seen a lot of cast iron). The bars were serving several Texas beers as well as the usual libations, and dessert of course included pecan pie. Attendees had the opportunity to relax with games of horseshoes and cornhole, along with a campfire.


The main event of the evening included an honest-to-goodness Texas-style rodeo, courtesy of the Lester Meier Rodeo Company of Fredericksburg, TX. In talking with some of the attendees from the UK, they’ve never seen anything quite like it. The rodeo opened with the traditional grand entry and flag processional, followed by bull riding, barrel racing, more bull riding, and of course rodeo clowns. Having spent several years in Texas and having attended a variety of professional and amateur rodeos, I have to say this was some of the wildest bull riding I’ve seen. I think only one or two contestants managed to stay on the full eight seconds, and several looked like they needed medical attention after having difficulty releasing their grips after being thrown or dismounting.

Often a rodeo will have an event called a calf scramble, where children compete to try to catch a calf with only a rope and their wits. I strongly suggest a CIO calf scramble for future rodeos, with proceeds to charity. It would definitely add a healthcare IT twist to the festivities. The rodeo concluded with a fireworks display and guests moved back to the dance hall for music, dessert, s’mores kits for the campfire, and plenty of line dancing.


I headed home Thursday morning, missing the final keynote but making it back in time to take care of some afternoon meetings, run a couple of loads of laundry, and begin packing for HLTH. It’s warmer in Las Vegas than it is at home, and I’ll have the opportunity to connect with friends I haven’t seen in years, so I’m looking forward to the bit of travel.

Email Dr. Jayne.

Morning Headlines 11/14/22

November 13, 2022 Headlines No Comments

Controversial £360m NHS England data platform ‘lined up’ for Trump backer’s firm

England’s The Guardian reports that a $425 million contract for a national shared patient data system is likely to be issued soon to Palantir.

AngelEye Health Announces Series B Funding to Support Company’s Rapid Growth

AngelEye Health, which offers patient and family engagement software for hospital neonatal, pediatric intensive care, and nursery units, raises $20 million in a Series B funding round.

SocialClimb Secures $8.5 Million in Growth Funding from Spring Capital and Resolve Growth Partners

Healthcare marketing and patient relationship management software firm SocialClimb secures $8.5 million in growth funding.

Monday Morning Update 11/14/22

November 13, 2022 News 3 Comments

Top News


Telehealth company Wheel acquires GoodRx Care’s back-end virtual care technology, which includes an EHR, clinical management tools, and patient experience software.

Wheel was already providing GoodRx with technology and clinicians. It will license the technology back to GoodRx for use on its GoodRx Care website and app.

GoodRx share price has dropped 87% in the past 12 months, valuing the company at $2 billion versus $23 billion in February 2021.

The company’s share price took a hit in August when grocery chain Kroger stopped accepting GoodRx coupons in its pharmacies, which cost GoodRx 25% of its business.  

Reader Comments

From Not-Football SEC Fan: “Re: Datavant. Other tidbits: (a) Roivant still holds a minority stake; (b) Ciox’s main investor New Mountain Capital seems to be the majority owner; and (c) Datavant has acquired companies such as Mirador and Convenet to expand internationally.” Datavant acquired HIPAA expert determination firm Mirador Analytics in late 2021, then added UK-based Convenet in September 2022 to offer clinical trials tokenization in the UK. Datavant had previously acquired Health Data Link in 2019, which offered health systems linkage to researchers, and de-identification services vendor Universal Patient Key in 2018, both before Datavant merged in 2021 with Ciox Health, which New Mountain Capital formed in 2016 by rolling up four of its acquisitions. Datavant has raised $81 million in funding through a Series B round.

HIStalk Announcements and Requests


Poll respondents may not love the fact that conferences sell their registration lists to facilitate vendor spamming, but it’s apparently a pretty minor inconvenience since only a few folks would be willing to pay to eliminate the practice.

New poll to your right or here: What kind of headshot do you use on your LinkedIn profile? A reader told me that she has seen pictures that are more than 10 years old, which must be as awkward as creating an “optimized” online dating profile that leads to an awkward in-person moment. I trawl LinkedIn regularly for People updates and have seen awful headshots that are unusable – tiny or low-resolution ones and shots that include adjacent body parts from people who were amateurishly cropped out of a group photo. Most puzzling to me is why someone would bother to create a LinkedIn profile without adding a headshot unless they are technically challenged, struggling with appearance issues, or hiding from the mob. 


Lorre has published a children’s book and will send a copy to anyone who donates $20 or more to the non-profit animal sanctuary where she volunteers. She is personally covering the printing and shipping costs, so the entire tax-deductible donation goes toward taking care of the animals.

Serving in the military involves sacrifices – career, family, and sometimes life and limb. Thanks to those who made them.

I’m pondering the takeaways from rich CEOs who are grandstanding their sorrow about laying off their employees. Many of these are wunderkinds who seem shocked by the concept of business cycles. My second reaction is more cynical — investors rewarded them for irrational growth, questionable strategies, and overpriced acquisitions and probably will do so again down the economic road, so their handwringing over dumping human ballast overboard reeks more of all-about-me embarrassment than personal remorse. It was inevitable that the “talent wars” power that was begrudgingly granted to galley-rowers was temporary and that the Great Resignation would eventually toggle to the second definition of that word  — unhappily accepting something that you can’t change, like taking a job because you need the money and realizing that “work from anywhere” and “take all the vacation you want” policies can disappear faster than crypto billions.


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

Acquisitions, Funding, Business, and Stock

An article by Andreessen Horowitz, a tech-heavy venture capital firm that manages $35 billion in assets, says that the biggest company in the world will be in consumer health technology. Snips:

  • Healthcare is a $4 trillion industry in the US alone that consumes 20% of GDP, five times the size of the entire world’s advertising industry.
  • The consumer health giant won’t be a big tech firm or an healthcare incumbent. It will be “a consumer-obsessed, healthcare-native tech company that reimagines what care can look like.”
  • The company’s core competency will be the ability to engage and retain patients, which healthcare companies have done poorly.
  • The vertical path to creating that largest company in the world would be to create a payvider firm that can demonstrate value, such as if “UnitedHealth Group and Apple had a baby.” The challenge is that consumers don’t pay directly for healthcare and the system is optimized for insurers and self-insured employers, so companies have little incentive to care about the consumer experience.
  • The horizontal path would be for a company to become the Amazon or Visa of healthcare, offering a marketplace of healthcare reviews, quality metrics, and price transparency or simplified bill-paying in return for a tiny percentage of the revenue, which given massive healthcare spending could still make that company one of the world’s largest.
  • Companies must plug into the health industry to succeed, using health systems and providers as channel partners who can help drive transactions.


  • William Osler Health System chooses Sectra’s enterprise imaging, including radiology imaging, breast imaging, and vendor-neutral archive.
  • Pivot Point Consulting deploys OCHIN’s Epic EHR at San Francisco Community Health Center.



Tower Health names surgeon Eugene Reilly, MD, MHCI as VP/CMIO.


Andrew Burchett, DO (Avera) joins Meditech as executive director of medical informatics.

Announcements and Implementations


Finland announces Radical Health Festival, a pan-European digital health conference that will be held in Helsinki June 12-15, 2023. It will offer a speed-dating platform, a Solution Match service, a hosted buyer program, and conference app. CHIME will offer its Boot Camp there. Early bird registration opens on December 1 and starts at $200.

Two new KLAS reports look at home-based care technology. Facilities – which name as their top three challenges staffing, regulatory requirements, and COVID-19 – most commonly choose MatrixCare, PointClickCare, and Indeed. Home-based acute care organizations name staffing,regulatory requirements, and reimbursement changes as their top concerns and most commonly deploy MatrixCare, SHP, Netsmart, and WellSky to address them.

Government and Politics

South Africa’s deputy health director says that the country’s universal healthcare system will add a central patient information system within 4-5 years ,

England’s The Guardian reports that a $425 million contract for a national shared patient data system is likely to be issued soon to Palantir. Patients will not be required to provide consent for using their data, which will be used by integrated care boards and then de-identified for use by researchers. 

Privacy and Security

The ransomware hackers behind the breach of Australia-based insurer Medibank post a list of customers who have been treated for mental health and alcohol issues, following its earlier list of those who have had abortions. They are demanding payment of $1 AUD per customer, nearly $10 million USD.



The VA and DoD fund a 12-month surgical fellowship at Virginia Commonwealth School of Medicine that trains surgeons to perform pre-surgical preparation using a patient’s 3D-modeled organs or tumors.

A JAMA Health Form research letter notes that the EHRs of the six vendors that have settled HHS/DOJ charges are being used by 77,000 clinicians, recommending that (a) ONC’s certification process be changed so that vendors don’t know in advance which functions will be tested; and (b) post-market surveillance of EHRs be initiated.

A Gonzaga law professor who studies antitrust, health law, and inequity says that a federal judge should not have approved last month’s $13 billion merger of UnitedHealth Group and Change Healthcare because the insurer can use Change’s EDI clearinghouse data to cherry-pick the most profitable consumer groups to insure, reducing access and allowing the company to unfairly compete with insurers that don’t have access to that data. She says that insurers want to acquire companies that capture health data so they can create a unique digital ID for each person insured, which on the positive side would allow them to apply healthy nudges, but would also allow them to move sicker people to plans that require higher cost-sharing,. She notes a 2014 complaint that insurers in Florida placed all HIV drugs, even cheap generics, in their highest cost-sharing tier to discourage HIV patients from signing up and that UHG could remove specific providers from their network if their claims data shows that they see a lot of expensive patients, such as diabetics. 


The Internet has resurfaced years-old survey data from the US Bureau of Labor Statistics that shows who people spend time with by age, as visualized by Our World in Data. It isn’t pandemic-adjusted current, but still interesting since I hadn’t seen it until folks starting sending it my way. Tidbits, from which your life-planning takeaways may vary:

  • People spend more time with co-workers than family members from ages 21 through 65.
  • Time spent alone hums along at fours hour per day until the mid-30s, when it steadily increases to nearly eight hours per day for those in their 70s.
  • Time spent with children peaks at 4.5 hours in the mid-30s, then tapers down hard to one hour per day by 60.
  • Time spent with friends peaks at more than two hours per day at 18, then trends down do a fairly steady half hour per day at around 40 through 80.
  • People spend more time with their partners as they age, increasing from three hours per day with a big jump starting in their late 50s, then tapering until 77 (I assume due to death or a change in living situations).

Sponsor Updates

  • Gozio Health and Artera expand their partnership, following their initial launch at UNC Health, to add smart links to Artera patient communications and to launch text messages to providers from the mobile app.
  • The Inspiring Women Podcast features Kim McKay, MD PeriGen CMO and clinical VP of OB/GYN at Avera Health (SD).
  • The Executive Leaders Radio Podcast features Quil Health CEO Carina Edwards.
  • Oracle Cerner releases a new podcast, “Increasing interoperability to connect care for Veterans and service members.”
  • Spok publishes a new report, “The state of healthcare communications.”
  • Upfront Healthcare CEO and co-founder Ben Albert joins the Day Zero Podcast to share his entrepreneurial journey.
  • Wolters Kluwer Health expands its Sentri7 suite of clinical surveillance tools to include Sentri7 Sepsis Monitor.

Blog Posts


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


Morning Headlines 11/11/22

November 10, 2022 Headlines No Comments

Amazon’s leaked ‘Clinic’ would connect patients to telemedicine

Amazon posts and then quickly unpublishes a video on its YouTube page describing Amazon Clinic, an online care program for common conditions.

Northwell Holdings and Aegis Ventures Sign Strategic Collaboration Agreement to Launch Upliv, a Comprehensive Digital Health Company for Menopause

Northwell Holdings and Aegis Ventures launch Upliv, which will offer video consults and care for managing the symptoms of menopause.

CommonSpirit Update

CommonSpirit Health says that access to its EHR and patient portal has been restored for most users following an October 4 ransomware attack.

Virtual care startup Wheel buys GoodRx tech for $20M

Virtual care company Wheel will acquire prescription savings company GoodRx’s virtual care technology for $20 million.

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