Readers Write: Unlocking Hidden Gems: Leveraging RCMTAM for Revenue Cycle Excellence

Unlocking Hidden Gems: Leveraging RCMTAM for Revenue Cycle Excellence
By Kim Waters

Kim Waters, MBA is principal consultant, advisory services with CereCore.

Revenue cycle management (RCM) has become more challenging than ever. With increasing denials, evolving payer policies, and growing patient financial responsibility, healthcare organizations need innovative solutions to optimize their revenue cycles. Enter the Revenue Cycle Management Technology Adoption Model (RCMTAM), a game-changing framework that’s revolutionizing how we approach RCM technology.

As a leader in healthcare IT solutions, I’ve seen first hand how RCMTAM can transform revenue cycle operations. Let’s dive into the hidden gems this model offers and explore how it can drive operational efficiency, improve financial outcomes, and uncover cost-saving opportunities.

The RCMTAM Advantage: A Data-Driven Approach to RCM Excellence

RCMTAM is more than just another acronym in the healthcare alphabet soup. It’s a peer-reviewed, five-stage framework endorsed by Healthcare Financial Management Association (HFMA) that assesses operational performance and the maturity of revenue cycle technology within healthcare organizations. What sets RCMTAM apart is its data-driven approach, linking technology adoption with financial outcomes to create customizable roadmaps for RCM optimization.

Key features of RCMTAM include:

• A five-stage model for assessing RCM technology maturity.
• Financial benchmarks for performance comparison.
• Correlation of RCM technology adoption to financial performance.
• Personalized organizational roadmaps.

Uncovering Hidden Gems: RCMTAM in Action

Let’s explore some specific examples of how RCMTAM can enhance operational efficiency and improve financial outcomes:

• Streamlining eligibility checks. Experian’s recent state of claims survey revealed that 43% of respondents spend 10 to 20+ minutes on secondary eligibility checks. By leveraging RCMTAM to assess and optimize eligibility verification technology, organizations can significantly reduce this time, improving staff productivity and accelerating the revenue cycle.
• Tackling denials head-on. With 38% of respondents reporting claim denial rates of 10% or higher, denials management is a critical area for improvement. RCMTAM can help organizations identify and implement advanced denial prevention and management technologies, potentially saving millions in denied claims.
• Automating manual processes. Nearly 50% of providers still review denials manually. RCMTAM can guide the adoption of AI and automation technologies in the denial management process, freeing up staff for more complex tasks and reducing errors.
• Enhancing data accuracy. Bad data is a leading cause of denials, with 46% of respondents citing missing or inaccurate data as a top reason. RCMTAM can help organizations assess and improve their data management technologies, reducing errors and improving clean claim rates.

The Path Forward: Embracing RCMTAM for Continuous Improvement

As the 2024 State of Claims survey shows, the healthcare landscape is constantly evolving. Payer policy changes are occurring with more frequency (77% agree), and 66% of respondents find submitting “clean” claims more challenging now than before the pandemic. In this dynamic environment, RCMTAM provides a structured approach to continuous improvement.

By regularly reassessing your organization’s position on the RCMTAM scale, you can:

• Identify emerging technologies that address your specific pain points.
• Benchmark your performance against industry leaders.
• Create data-driven strategies for ongoing RCM optimization,

Navigating the complexities of revenue cycle management can be tough. An RCMTAM assessment can provide the performance readout that your organization may need to help uncover the hidden gems in your revenue cycle so you can drive meaningful improvements in your financial performance.

As you embark on your RCMTAM journey, remember that technology is just one piece of the puzzle. Success lies in the seamless integration of people, processes, and technology. By taking a holistic approach and leveraging the insights provided by RCMTAM, you can transform your revenue cycle from a source of frustration to a driver of organizational success.

Morning Headlines 2/24/25

Blue Orca is Short Teladoc Health, Inc.

A short-selling investment firm claims that mental health therapists in Teladoc Health’s BetterHelp business are using ChatGPT to respond to patients during therapy sessions without the patient’s knowledge.

Waystar Reports Fourth Quarter and Fiscal Year 2024 Results

Waystar reports Q4 results: revenue up 19%, EPS $0.11 versus –$0.12, beating analyst expectations for both.

AI health-care startup OpenEvidence raises funding from Sequoia at $1 billion valuation

OpenEvidence, which has developed a clinical decision support chatbot for providers, announces $75 million in funding.

Arizona advances bill to keep AI from rejecting medical claims

Following several other states, lawmakers in Arizona advance a bill that will, if passed, require a provider to review a claim or prior authorization before it can be denied.

Monday Morning Update 2/24/25

Top News

A short-selling investment firm claims that mental health therapists in Teladoc Health’s BetterHelp business are using ChatGPT to respond to patients during therapy sessions without the patient’s knowledge.

Some BetterHelp therapists who were confronted by their patients admitted that they use AI tools because of heavy workloads and company bonuses that are tied to the number of words that a therapist types.

TDOC shares dropped 9% on Friday. They have lost 24% in the past 12 months, valuing the company at $2 billion.

Teladoc Health paid $4.5 million in 2015 to acquire BetterHelp, which generates $1 billion in annual revenue, representing up to 40% of Teladoc Health’s total revenue. However, declining BetterHealth revenue caused Teladoc to take a $790 million impairment charge in mid-2024.

Reader Comments

From Placater: “Re: agentic AI. What does that even mean and why should I care?” AI began as a simple chatbot that answered user questions, sometimes even correctly. Over time, it improved by learning to analyze, correct its mistakes, and respond based on context to please its master. We’re now at agentic AI, which can take keyboard actions like placing an Amazon order or prescribing medication. This is the step that will start killing jobs, although software developers were already ripe for reduction by the last phase. The next short step is AI-powered robots performing human-like tasks, which is really just another output of agentic AI that is limited more by robotics maturity than AI itself. Self-driving cars already showcase AI’s ability to make better decisions than distracted human drivers. With each leap, fewer people benefit — while tools like ChatGPT help the masses, only industry titans and their investors will gain when robots replace human workers.

From Monetary Magnet: “Re: health tech conferences. I’m thinking about attending HIMSS next year as a frustrated patient. Will software vendors listen, or am I wasting my time? Didn’t you sponsor several patient advocates to attend HIMSS years ago?” I did, but that experience didn’t encourage me to repeat it. Reasons:

• Health tech vendors create products that the market wants, and that market isn’t patients. Consumers don’t see 99% of the available software and their complaints usually relate to how it is used, not how it was designed.
• Software vendors can’t fix the problems that are inherent with our dysfunctional US healthcare system. I eat at restaurants occasionally, but I would add zero value by attending a restaurant software convention. That’s a cleaned up version of my initial cynical healthcare thought, which is that having patients at health tech conferences would be like inviting livestock to attend a slaughterhouse software convention (that came to mind because I have a friend who is an executive in exactly that business).
• Healthcare is not a retail market. Patients aren’t the ones paying and often don’t have a say in major decisions that affect them as a result.
• Conferences like HIMSS and ViVE are designed for industry experts, and any patient representation is likely symbolic at best or tokenistic at worst. Their emotional keynote anecdotes get us all worked up, but we walk out of the conference room with nothing actionable.
• It’s easy for patient advocates to become overwhelmed by conference parties and booth giveaways. A lack of relevant education sessions would probably leave them to wander the exhibit hall.
• Healthcare is fragmented by geography, demographics, provider choices, and medical needs. A single patient’s experience and viewpoint don’t necessarily represent that diversity.
• Vendor input on patient needs is more effectively gathered from their provider customers who write the checks. Those providers should be talking with their patients / customers and choosing software that supports whatever strategies the providers choose. Blame providers for bad patient experience.
• The bottom line is that we’re all patients, just not at the same time, but what we think as patients doesn’t necessarily move markets. Change would need to come from providers, politicians, insurers, and life sciences firms that are pretty happy with the profitable status quo. Patients might better invest their time by engaging with people from those organizations.

HIStalk Announcements and Requests

Three-fourths of poll respondents don’t believe that their job performance can be entirely measured by objective metrics. Question: if that’s the case, what is your boss using instead, especially if you work remotely? I assume subjective criteria such as peer feedback, customer satisfaction, and the maddeningly vague areas of responsiveness, collaboration, problem-solving, and worth ethic, all of which might be heavily influenced by likeability or brown-nosability.

New poll to your right or here: Who is most responsible when a telehealth company regularly prescribes drugs that patients want in the absence of clear medical need? I admit that I don’t understand why companies are punished for fraud, opioid overuse, and prescribing without adequate clinical due diligence, but the clinicians who actually generated those prescriptions for cash aren’t even named, much less punished. Would you as a patient want to know that your doctor has willingly agreed to rent their license to the highest bidder? The concept probably extends to health systems – aren’t doctors supposed to represent the best interest of the patient rather than of their corporate bosses?

I’m testing a weekly, 60-second LinkedIn carousel that lists my picks of the week’s most important health tech news stories for the TL;DR types. I’ll post a new one each Wednesday morning to see how it goes.

Sponsored Events and Resources

Live Webinar: March 20 (Thursday) noon ET. “Enhancing Patient Experience: Digital Accessibility Legal Requirements in Healthcare.” Sponsor: TPGi. Presenters: Mark Miller, director of sales, TPGi; David Sloan, PhD, MSc, chief accessibility officer, TPGi; Kristina Launey, JD, labor and employment litigation and counseling partner, Seyfarth Shaw LLP. For patients with disabilities, inaccessible technology can mean the difference between timely, effective care and unmet healthcare needs. This could include accessible patient portals, telehealth services, and payment platforms. Despite a new presidential administration, requirements for Section 1557 of the Affordable Care Act (ACA) have not changed. While enforcement may unclear moving forward, healthcare organizations still have an obligation to their patients for digital accessibility. In our webinar session, TPGi’s accessibility experts and Seyfarth Shaw’s legal professionals will help you understand ACA Section 1557 requirements, its future under the Trump administration, and offer strategies to help you create inclusive experiences.

HIMSS25 Guide: HIStalk sponsors can provide conference participation details by February 24 to be included in my guide.

Survey Opportunity: Healthcare AI Purchasing. Responses from health system and imaging center readers to this short survey will trigger a Donors Choose donation from Volpara Health plus matching funds.  

Contact Lorre to have your resource listed.

Acquisitions, Funding, Business, and Stock

Waystar reports Q4 results: revenue up 19%, EPS $0.11 versus –$0.12, beating analyst expectations for both. WAY shares have gained 104% since the company’s June 2024 IPO, valuing the company at $7 billion.

Sales

• Akron Children’s will implement Abridge for ambient documentation.
• Blessing Health System (IL) will implement Epic, replacing Altera Digital Health’s Sunrise.

Announcements and Implementations

Mass General Brigham researchers develop an Epic tool that identifies frail patients who are at risk for higher rates of hospital readmission and death. The tool works even when primary care visit data is not available.

Government and Politics

Website operator Gregory Schreck pleads guilty to federal charges that accused him of tricking Medicare patients into giving up their personal information so they could be sent “free” medically unnecessary items like braces and pain creams that were then billed to federal insurance programs. The scheme led to $1 billion in false Medicare claims, with Medicare and insurers paying out more than $360 million. Schreck was a VP at DMERx, the Internet platform that was used to generate the false prescriptions. He was also VP of HealthSplash, which advertised its service as helping payers, providers, and suppliers share data.

Other

The UK’s medical exam administrator admits to sending incorrect scores to September 2023 test-takers. It mistakenly told 222 internal medicine doctors they had passed when they had actually failed, while 61 who passed were told they had failed. The British Medical Association warns that those who were wrongly told that they passed now face an uncertain future, while some of the 61 who were incorrectly failed may have already left the profession as a result.

Sponsor Updates

• Black Book Research publishes a free report, “2025 Black Book of Rural and Critical Access Healthcare IT Solutions.”
• Nordic releases a new “Designing for Health” podcast featuring Doug Turner, MBA.
• Nym names Yaara Libai and Bella Sirota clinical data annotators, Ariela Krumgals VP of HR, Yiftah Sasson product manager, Shiraz Tov junior backend engineer, and Hadar Yehezkeli NLP research engineer.

Blog Posts

• Meditech customers create efficiencies to address emergency department utilization (Meditech)
• IDD Workforce Empowerment: 3 Takeaways from the IDD Summit Expert Panel Discussion (Netsmart)
• Same-day visits: Will you be the leader to make it happen in your organization? (Nordic)
• The New Patient Priority: Why Healthcare Payment Flexibility is No Longer Optional (TrustCommerce, a Sphere Company)
• The role of AI in modern healthcare: Striking the balance between progress and accountability (Wolters Kluwer Health)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
Follow on X, Bluesky, and LinkedIn.
Contact us.

Readers Write: ViVE 2025 Recap

ViVE 2025 Nashville – The Tale of AI and the Snowpocalypse!
By Mike Silverstein

Mike Silverstein is managing partner of healthcare IT and life sciences at Direct Recruiters, Inc.

Tell me about your agents! No, not one from the CIA, FBI, or your record label. Tell me about your AI agents!

That was the theme of ViVE 2025 in Nashville. Music City was frigid outside, but inside the Nashville Convention Center, the agentic AI blaze was on. 

Two weeks ago, I gave up and finally asked a client on a Zoom call, ”Can you tell me what the heck agentic AI is?” My head is still spinning from large language models (LLMs), GPTs, and generative AI (still not entirely sure what this is). Now if you don’t have AI agents, you are an HIT artifact.

Big tech is coming to healthcare and this time I think it is REALLY here to stay. With the labor crunch and margin pressures being ubiquitous and in full force, an AI agent that can make a phone call to a patient / member / health plan and converse like a real person with whatever tone and accent you prefer might just be a game changer.

The tools are really getting smart, borderline scary smart. I had several people demo products for me that I literally couldn’t tell with certainty if I was listening to a real person or an AI agent. Even more, these agents are being trained on serious healthcare data and workflows, and I believe the dominoes are going to start falling.

At HLTH 2024 in Las Vegas, AI co-pilots were all the rage. Now those firms are racing to stay up the value stream and provide even higher value clinical impact as AI note-taking feels like it will be table stakes very soon. Call centers and one-way SMS texts both seem like they could be on the chopping block, and it feels like we could be on the precipice of patients actually having a real consumer experience like in every other industry.

On the investment front, deal activity seems to be up. The firms I talked to are living less hand to mouth (as opposed to only focused on sales in the next six months) and are back investing in products and technology out of fear of being left in the dust. However, what stood out as interesting to me is that access to this cutting-edge technology seems to be far wider than various technological breakthroughs of the past.

Most of the vendors I talked to are layering their healthcare workflows on top of off-the shelf AI agent tools and platforms, so the speed-to-market has been pretty blinding. New healthcare tools are being developed using publicly available foundational tech and low code development. ViVE 2025 felt a bit like healthcare’s version of a big-time arms race. Everyone is working diligently to stay out in front of, or totally away from, Epic’s roadmap. It feels like this could be the start of a major leap in how we experience healthcare as consumers.

Unfortunately, the other major thing I learned this week is that Nashville is woefully unprepared for snowstorms. At the end of every conversation I had in the past 48 hours, everyone told me, “You had better move up your flight. It’s going to snow on Wednesday and this whole place is going to shut down.” As a result, there was a mass exodus from Nashville Tuesday evening, and the airlines cashed in big on change fees.

Even so, Music City was a great host, and 2025 feels like it’s going to be a pivotal year in the adoption of AI in healthcare.

Morning Headlines 2/21/25

Hims & Hers Acquires At-Home Lab Testing Facility, Expanding Capabilities to Ultimately Include Affordable Whole Body Testing for Subscribers

Vanity prescription vendor Hims & Hers acquires Trybe Labs, an at-home lab testing provider that processes customer self-collected blood samples.

Hummingbird Healthcare Closes $20M Funding Round in Support of Mission to Elevate Patient Access

Patient access software and services company Hummingbird Healthcare raises $20 million in a Series B funding round.

Millie Secures $12M Series A to Continue Closing Gaps in Maternal Healthcare

Tech-enabled maternity clinic Millie will use $12 million in new funding to open new clinics in California and expand its IT capabilities and services.

HHS Office for Civil Rights Imposes a $1,500,000 Civil Money Penalty Against Warby Parker in HIPAA Cybersecurity Hacking Investigation

Hybrid eyeglasses prescription and retailer company Warby Parker will pay a $1.5 million HIPAA violations penalty related to a 2018 data breach that wound up exposing the PHI of 200,000 people.

News 2/21/25

Top News

Vanity prescription vendor Hims & Hers acquires Trybe Labs, an at-home lab testing provider that process customer self-collected blood samples.

The company says the acquisition will allow it to offer whole-body testing and give it de-identified health data for AI training.

HIMS shares rose on the news are are up 350% in the past 12 months, valuing the company at $15 billion.

Reader Comments

From Hal2k: “Re: HIMSS25. Federal employees, including those from ONC / ASTP, have had to drop out. What will be the downstream impact? I heard lower turnout overall – they had to cancel a couple of hotels.” Unverified. I gave the conference website a quick look, with the only surprise being that Hal Wolf will be doing a fireside chat with Oracle Health EVP/GM Seema Verma on improving patient-centered care, which seems questionable for several reasons.

From Tired Sales Gal: “Re: ViVE. My perspective is that its attendance was down from previous years. Not sure if the weather played a part or not. Attached is an attendee list. The majority were vendors versus providers and payer representatives. Fewer investors attended. I question whether the list might not have included those attendees who registered through CHIME, but that might only be another 500 folks.” The list has about 4,000 vendors versus 900 providers, and some of those provider folk don’t have a title that suggests purchasing influence (podcast host, professor, administrative fellow, etc.) I’ve never heard of quite a few of the companies on the list. Maybe if I decide that I care enough I’ll compare the ViVE and HIMSS exhibitor lists.

ViVE Conference Day 3 and 4 Observations from an Attendee

• Tuesday felt like the busiest day; lots of activity across the floor as folks tried to wrap up before the snow.
• Simply based on my perceptions from walking around, it felt like sessions on the four primary stages were sparsely attended. One-on-one and small group meetings seemed to be the dominant activities throughout the conference.
• Nashville got about 1.5″ of snow, so on the low side of expectations. On Wednesday there were lots of flight delays but relatively few cancellations, and major roads were in decent shape.
• I’d estimate only ~2,000 folks were around on Wednesday. Probably one-third of booths had no one, and many started packing up early.
• ViVE should’ve had a scavenger hunt to find all the booths that don’t have AI mentioned somewhere in their display or marketing materials. Practically every company is trying to say they have or use AI, but how real it is is unclear to me.
• I want to give a shout-out to Streamline Flow. They were demoing until the very end, and in an industry of bad software, their product seems attractive, intuitive, clinician-friendly, and easy to use. It’s early, but looking forward to seeing how they progress.
• Now the hard work begins. Companies that had a good conference and generated valuable leads are only on first base; there is a lot remaining to do to get to home plate. We feel good about how ViVE was for us but how we execute in the coming weeks and months will determine whether it was worthwhile.

Sponsored Events and Resources

HIMSS25 Guide: HIStalk sponsors can provide conference participation details by February 24 to be included in my guide.

Survey Opportunity: Healthcare AI Purchasing. Responses from health system and imaging center readers to this short survey will trigger a Donors Choose donation from Volpara Health plus matching funds.  

Contact Lorre to have your resource listed.

Acquisitions, Funding, Business, and Stock

A remarkably fine MedCity News investigative piece (it’s well worth clicking over) by Arundhati Parmar looks at Transcarent:

• Founder Glen Tullman had said previously that care navigation companies are as obsolete as travel agents. Transcarent then acquired care navigation company Accolade for $621 million last month at what was seen as a fire sale price.
• Insiders say that Transcarent wildly missed its 2024 sales targets, booking $60 million instead of the expected $175 million, and earned most of its big clients via its acquisitions or from Tullman’s executive connections.
• Another insider says that 70 employer navigation RFPs were issued last year and Transcarent not only failed to win any of them, it wasn’t even considered in any.
• Accolade’s prospects were fading after being dropped by big customers, trading as a penny stock, and being shopped to potential buyers.
• A CEO who has known Tullman for years criticizes the strategy of Transcarent selling directly to executives who tend to perform less due diligence than benefits consultants: “I think Glen preys on the benefits buyers who do not have a ton of resources to understand that there is nothing under the veneer that he is presenting. There is no Transcarent model. They have no NCQA designation, no URAC designation. They have no hard standard accreditation for care management. He invests a lot of money in political connections and in being part of CEO clubs that give him access to board members that don’t know much about benefits.”
• A healthcare CEO who passed on acquiring telemedicine vendor 98point6 after reviewing its financials said of Transcarent’s $100 million acquisition of the company: “They were losing 60 cents for every dollar of revenue they made. Glen has a pattern of taking distressed, low-quality assets and then slapping a bunch of tech together.”

Therapy Brands, which offers EHR/PM software for mental health and therapy providers, expands its Fusion rehab therapy product to the adult market.

Venture capital and private equity firm Insight Partners merges two of its population health management technology companies, Azara Healthcare and I2i Population Health. The announcement is coy about what name the combined businesses will use.

Hummingbird Healthcare raises $20 million in a Series B funding round.

Walgreens shares jump Tuesday following a report that its potential acquisition by private equity firm Sycamore Partners could be back on the table.

IRhythm Technologies announces Q4 results: revenue up 24%, EPS –$0.04 versus -$1.26. IRTC shares are down 1% over the past 12 months, valuing the ambulatory ECG solution vendor at $3.5 billion.

Sales

• Cleveland Clinic will roll out ambient documentation from Ambience Healthcare.
• Inspira Health announces that it will replace Oracle Health with Epic, as a reader reported here last September.

Announcements and Implementations

WellSky launches a patient scheduling and workforce management solution for home care agencies. 

Availity launches Rapid Recovery, a solution that is designed to swiftly restore critical healthcare operations after large-scale catastrophic events, including cyberattacks. Key features include a five-day recovery objective, an air-gapped recovery environment, comprehensive backups, and third-party certification.

Epic will expand its 11,400-seat Deep Space underground conference center by 23,000 square feet with a new 750-seat auditorium and a dining facility. The expansion is intended to accommodate the company’s user group meeting and is scheduled to open before UGM 2026 next August.

Government and Politics

Sen. Patty Murray (D-WA) presses Paul Lawrence, PhD at his confirmation hearing for VA deputy secretary:

EHR started in 2018 under President Trump and in 2020, it deployed to two Washington state VA hospitals. Instead of helping to improve our veterans’ health care, the rollout ending up being a complete disaster, and it endangered veteran patients. Unfortunately, the system still is not working the way that the VA doctors and nurses need, and veterans are continuing  to suffer. Last month, the VA announced that it would be moving forward with pre-deployment activities at the next four sites for this Electronic Health Record. You will oversee the EHR program, so if confirmed, I want to know what you are going to do differently to hold Oracle accountable and to make sure we get this system right for our veterans?” Lawrence responded that he will figure out an accountability plan, to which Murray said, “We have heard that answer from every VA person that’s come before this committee for a number of years now. Everybody’s looked at it, everybody’s considered it, everybody’s talked about it, everybody’s convened panels. It is not working.”

Other

I saw this after reading Dr. Jayne’s piece on tech for seniors and thought it looked interesting. The free version turns an old tablet into a companion device that serves as a smart picture frame, text and photo messaging tool, and task manager. A $10 per month subscription adds auto-answer video calls, auto-join of Zoom meetings, AI activities and check-in, and connection of multiple family members. Onscreen Joy was announced last month at CES.

In the Netherlands, a man buys five 500GB hard drives for $5 each at a flea market and discovers that they contain patient medical records, apparently from the defunct healthcare software vendor Nortade ICT Solutions.

Sponsor Updates

• Capital Rx releases a new episode of “The Astonishing Healthcare Podcast” titled “Judi Health: Going Beyond Pharmacy and into Medical Claims, with AJ Loiacono and Dr. Sunil Budhrani.”
• BNH Hospital in Thailand implements the TrakCare EHR from InterSystems.
• A Surescripts analysis projects more than $3.76 billion in healthcare savings could be realized if care managers leverage Surescripts Medication History for Populations technology.
• First Databank publishes a new white paper, “Empowering Consumer Choice with EPrescribing.”
• Findhelp welcomes new customers Cone Health (NC), Help at Home (IL), and Marion County Commission on Youth (IL).
• FinThrive will present at the Idaho HFMA Spring Conference March 3 in Boise.
• Five9 announces its global availability on Google Cloud Marketplace.
• Healthcare Growth Partners advises Insight Partners on its investment in Azara Healthcare and I2I Population Health.
• Inbox Health partners with Lighthouse Lab Services.
• MRO achieves HITRUST CSF certification for its Exchange Services platform.

Blog Posts

• Signs it is time to change your PBM vendor, and how to overcome common hesitations (Capital Rx)
• 5 Healthcare IT Trends Shaping the Industry (Healthcare IT Leaders)
• AI in Enterprise Clinical Imaging: Capitalizing on the Value Proposition (Impact Advisors)
• HEDIS MY 2026 Public Comments: Highlights for Quality Teams (Inovalon)
• Full speed ahead: Interoperability at MEDITECH enters a new era (Meditech)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
Follow on X, Bluesky, and LinkedIn.
Contact us.

EPtalk by Dr. Jayne 2/20/25

As someone who has been practicing medicine via telehealth since pre-pandemic days, sometimes I am placed in the wise elder role and asked to explain how things started and how they came to be the way they are. It can be a bit of a journey down memory lane, but then again, everything changed when COVID arrived and telehealth will never be the same.

Although large healthcare delivery organizations see telehealth as an extension of what they are doing in brick and mortar facilities, players in the direct-to-consumer space have dramatically shifted the options that patients can choose from in their quest for prescriptions and other services. In my own practice, I’ve seen it shift from being a partnership between physician and patient to being a transactional consumer activity where an outcome is expected and the patient/consumer becomes irate if they don’t get exactly what they think they need.

This is often frustrating to physicians who are new to third-party telehealth and thought it would be an easy way to pick up some extra money while making use of the medical license they spent hundreds of thousands of dollars in tuition payments to acquire.

I was in an online physician forum the other day and this topic came up. A physician was asking what it’s like to work for one of the direct-to-consumer companies that is well known for prescribing medications for erectile dysfunction. The company has added pre-visit questionnaires to gather information, often with somewhat leading questions that coach for patient answers that will generate a prescription. It’s a win-win for profits since the company is selling the medications as well as the professional services.

In some states, clinicians don’t even have to interact with patients in real time. They can treat them based on the equivalent of a one-way message. The medical board of a neighboring state has disciplined dozens of physicians for this since it’s not allowed in their state, but that doesn’t seem to have dissuaded people from doing it.

It always amazes me to see physicians who have no idea what is going on in their own industry and have little visibility beyond their personal practices. I found a recent article about the phenomenon and shared it to the forum. It was clear based on the comments section that people were having their minds blown.

One of the facts from the piece that drew quite a bit of attention was that together, three well-known telehealth companies spent more than $1.5 billion on advertising, sales, and marketing in 2023. Physicians in the forum also had no idea that direct-to-consumer telehealth companies were getting into clinical conditions that involve more complexity, such as mental health or obesity.

One of the physicians in the forum is the chief medical officer at an online weight management program. It works strictly through payer-based contracts and provides a multidisciplinary care team to address patients’ varying needs. She shared horror stories about patients who came to them after being seen at more commercial enterprises, where patients were basically told to use the medications that were shipped to their doorsteps but weren’t given any other counseling or support.

She made some great points. It’s not just that the treatments are ineffective, but that in some situations, they introduce side effects, including metabolic abnormalities that could have been avoided if a more thorough evaluation were performed prior to treatment.

Patients don’t always understand the knowledge and experience that is behind why physicians do or do not recommend a treatment. That’s especially true when they have seen dozens of influencers and paid spokespersons tell them exactly what they “need.” They don’t know the difference between one obesity management telehealth company that only hires physicians who have extensive formal training and years of experience in weight management versus another that is willing to onboard any licensed provider who willing to sign on the dotted line and accept $20-$30 for writing a prescription and a brief chart note.

The article has some great comments from Ateev Mehotra, MD, MPH, a public health professor who focuses on telehealth. He describes the transition from patients who work with their physician to make a treatment plan to a situation where the patient makes their own diagnosis and consults a transactional service whose clinician is a screener who is paid only to make sure that the medication is safe for the patient. That’s the lowest possible expectation for healthcare.

Not to mention that “safe” is a relative term. Is it safe because it probably won’t kill you? Or is it safe because you aren’t likely to have complications that dramatically impair your quality of life, whether briefly or for a longer period of time?

The article mentions situations where a screening-type approach might make more sense, with one of them being the provision of reproductive health services. Especially in states where it might be difficult to obtain reversible contraception, those services can be popular.

For medications that are over the counter in many other nations but remain prescription-only in the US, it’s easier to see that the risk/benefit equation for certain drugs might tip in favor of more streamlined access. I don’t have the statistics in front of me, but would bet that for many healthy non-smoking females in their 20s, the risk of morbidity and mortality from oral contraceptives is likely less than that of pregnancy, given the current state of maternal and infant health in the US.

I’m looking forward to seeing how the conversation unfolds over the next couple of days, which is about the typical length of time one of these threads survives. I’ll certainly make note and share if there are any particularly thought-provoking comments.

I enjoyed reading Mr. H’s recap of one of the Donors Choose grants in which reader donations provided microphones and speakers for a classroom in North Carolina. In addition to students being able to hear their teacher and peers clearly, learning how to use a microphone properly is a life skill that everyone should have.

Conferences that I’ve attended usually have microphones distributed throughout the audience to ensure that people can be heard when they ask questions. Invariably, at least one or two people will declare, “I don’t need the microphone.” They try to talk loudly, but don’t succeed, or they inadvertently sabotage the recording or broadcast for attendees who are not in the room. Some hold the microphone too far away from themselves or place it right up against their lips, both of which are never great for the audience or others who actually would like to hear what the speaker is saying. Hopefully incorporating those skills into the school setting will pay dividends for those students down the road.

If your organization expects you to confidently approach the microphone, do they provide any instruction in how to effectively do so or to avoid the dreaded screechy feedback? Or do they just hope you were a member of the A/V club in high school or that you channel your inner rock star? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 2/20/25

Azara Healthcare and i2i Population Health Unite to Supercharge Safety Net Population Health Management

Population health and value-based care company Azara Healthcare acquires I2I Population Health Management.

URAC Launches Development of Health Care AI Accreditation

Healthcare accreditor URAC announces plans to release a healthcare AI accreditation program later this year.

Walgreens Gains After CNBC Says Sycamore Takeout Is ‘Alive’

Walgreens shares jump on the news that private equity firm Sycamore Partners has revitalized its interest in acquiring the retail pharmacy chain.

Valsoft Enters the Managed Care Space with the Acquisition of Chordline Health

Canadian software business acquisition company Valsoft acquires North Carolina-based Chordline Health, which specializes in managed care software.

Readers Write: Solving Healthcare’s $125 Billion Fax Problem

Solving Healthcare’s $125 Billion Fax Problem
By Thomas Thatapudi

Thomas Thatapudi, MBA is CIO of AGS Health.

In the six years since Centers for Medicare and Medicaid Services called for an end to faxing in healthcare, the industry remains stubbornly attached to fax communications. Fax-led communications solutions are prevalent today, as organizations continue exchanging more than 9 billion fax pages each year, representing about $125 billion in annual costs to the healthcare system.

It is a problematic practice in terms of data integrity, productivity, and efficiency. According to information compiled by DirectTrust, 30% of tests must be re-ordered due to lost faxes and 25% of faxes fail to arrive before a patient’s first visit. Faxes also often require manual indexing for integration into the EHR and other health information systems, a time-consuming process that requires human and financial resources that are hard to come by for many healthcare organizations.

Luckily, fax indexing lends itself to automation. In particular, generative AI (GenAI) and agentic AI excel at automating mundane and repetitive tasks. However, it is unrealistic to expect digital workers, such as AI agents that mimic human actions, to accurately index 100% of the faxes from the outset. Thus the best outcomes are realized when digital workers are paired with human counterparts who manage exceptions and handle specialized information and requests, at least until the digital workers have accrued enough on-the-job training via machine learning and deep learning models to take over higher complexity tasks.

Implementing a hybrid fax indexing model accelerates processing and eliminates the care delays that are caused by improperly managed faxes. It also alleviates the strain on increasingly scarce resources, reducing costs and freeing internal staff to focus on higher-value tasks.

However, achieving these outcomes requires careful orchestration of a workflow that seamlessly integrates digital workers (AI agents) and their human counterparts delivering on quality, timeliness, and accuracy.

Designing the Digital Workforce

The heart of a successful hybrid fax indexing strategy is a well-designed digital workflow model that helps orchestrate workflows between humans and digital workers. It starts with mapping the necessary technologies, a step that is best informed by shadowing human indexers to fully understand the process and map any unique needs. This information is also used to plan the implementation and conduct feasibility testing.

Like their human counterparts, digital workers are armed with an array of intelligence and automation tools, including optical character recognition (OCR), to analyze faxed documents and convert them into machine-readable text. They use natural language processing (NLP) models to interpret and manipulate the data contained within. GenAI is then leveraged to classify faxes based on the sender’s documentation format, determine its confidence threshold, and either index it into a documentation management system or EHR or divert it to the validation workflow for manual processing.

Machine learning allows digital workers to adapt to new document formats and categorize data according to providers’ templates and styles. Further, each processed fax enhances accuracy, efficiency, and capabilities while reducing exceptions.

Monitoring effectiveness is crucial to success. Establish clear KPIs, such as the volume of faxes indexed per day, indexing accuracy, turnaround times, and productivity levels to assess progress over time.

AI Grounded in Reality

While automated fax indexing is a relatively new entry into the burgeoning field of healthcare AI, it is quickly making an impact. One health system’s implementation of automated fax indexing has put it on track to save approximately $2 million in annual expenses. Automation has reduced the number of manual indexers that are required to process the health system’s fax volume, which allows key team members to focus on higher-value tasks while achieving a near-perfect accuracy rate and 24-hour turnaround time. As digital workers “learn” over time, the automation rate will increase, while the need for human intervention decreases, adding to the anticipated cost savings.

While it is unlikely that we will see a fax-free healthcare system in the near-term future, leveraging readily available automation and AI tools makes it possible to digitize the process and alleviate its associated cost, productivity, and patient safety burdens.

Automated fax indexing is yet another example of a thoughtful AI application that solves an age-old problem that, until now, has been stubbornly resistant to change.

Readers Write: Are Your Patient Access Metrics Ready for Healthcare Consolidation?

Are Your Patient Access Metrics Ready for Healthcare Consolidation?
By Emily Tyson

Emily Tyson, MBA is COO of Relatient.

The healthcare industry witnessed a surge in merger and acquisition (M&A) activity in 2024, a trend that is expected to gain momentum in 2025. While organizational growth can unlock new potential for patient care and financial performance, it often brings operational inefficiencies that, if left unchecked, can strain staff, frustrate patients, and hinder sustainable success.

One of the biggest hurdles is managing the influx of data from fragmented sources. Adding new providers and locations introduces complexity, making it difficult to maintain consistency in scheduling, patient flow, and care delivery. Without the right tools to consolidate and standardize this data, organizations risk creating bottlenecks that impact the patient experience, disrupt operations, and negatively affect financial outcomes.

To ensure sustainable growth, healthcare organizations need proactive, data-driven strategies that are focused on four key aspects of patient access — provider scheduling performance, call center efficiency, patient experience, and financial outcomes — to not only identify inefficiencies, but also address them before they escalate.

Provider scheduling performance

During periods of growth, whether through acquisition or organic expansion, the last thing healthcare organizations need are scheduling disruptions. Scheduling is a cornerstone of operational success, directly impacting patient acquisition, physician satisfaction, and financial performance.

Accurate data insight is key to identifying gaps and uncovering opportunities for improvement. For example, high patient no-show rates might signal ineffective communication about appointment details, leading to missed visits. Another critical metric is appointment wait time, as patients overwhelmingly identified this as a top frustration in a 2024 survey.

Other essential metrics such as provider utilization rates, rule optimization, and scheduling accuracy reveal how effectively an organization accommodates provider preferences while balancing patient demand. Monitoring these indicators helps prevent overbooking, supports efficient patient throughput, and ensures that providers’ schedules are sustainable.

Metrics like the third next available appointment and waitlist conversion further illuminate the balance between patient access and appointment availability. These insights empower organizations to fill open slots more efficiently, expanding patient access while maximizing financial performance.

Contact center efficiency

During periods of growth and M&A activity, ensuring a seamless transition at the first touchpoint of the patient journey, the contact center, is critical. As new organizations integrate, call volumes naturally increase and require careful management to maintain care quality and consistency.

Proactively measuring and analyzing key performance indicators (KPIs) for both efficiency and patient satisfaction allows healthcare organizations to identify potential gaps. For instance, tracking peak call times allows administrators to allocate resources strategically, ensuring that patients receive timely support during high demand periods. The right metrics provide insights to reduce bottlenecks, streamline scheduling, and lower operational costs. Other KPIs like appointment booking efficiency, minutes per call, and staff training time offer a comprehensive view of contact center performance and areas for improvement.

Patient experience

Today’s healthcare consumers demand convenience, and if scheduling processes are complicated or time-consuming, particularly during periods of growth or consolidation, patients are likely to seek care elsewhere. To meet these expectations and enhance both patient experience and contact center efficiency, organizations must monitor patient experience metrics that reflect engagement and satisfaction.

Given that research consistently shows that patients prefer self-scheduling options, empowering patients to take more control of the scheduling process can lead to better outcomes for both patients and staff.

With the right systems in place, providers can track self-scheduling rates and after-hours scheduling activity to gain deeper insights into patient behavior. Other essential patient experience metrics include patient acquisition, referral conversation rates, and appointment abandonment rates, all of which provide a clearer picture of how well the organization is meeting patient needs.

Financial outcomes

Effective scheduling and data management play a vital role in driving financial performance. During periods of rapid growth, healthcare organizations should closely monitor key financial metrics that are tied to scheduling and payment processes. Doing so enables them to identify opportunities to streamline operations, reduce costs, and maximize revenue.

Crucial metrics that provide insight into a practice’s financial health include payment collection percentages, reductions in accounts receivable, balances collected through payment plans, and the speed of patient balance collection. By tracking these indicators, organizations can pinpoint inefficiencies, implement targeted improvements, and ensure financial stability during times of expansion.

Setting the state for growth

Tracking the right metrics enables teams to address inefficiencies and achieve sustainable growth by focusing on four critical areas:

• Optimizing scheduling workflows. Track scheduling KPIs like no-show rates, wait times, and provider utilization to balance patient demand and provider efficiency.
• Boost contact center performance. Analyze KPIs such as peak call times, appointment booking efficiency, and staff training to improve operations and care quality.
• Enhance patient engagement. Offer self-scheduling options, track patient satisfaction metrics, and resolve issues like appointment abandonment to align with consumer expectations.
• Improve financial health. Focus on payment collection rates, accounts receivable reductions, and patient payment speed to drive revenue stability.

Intelligent patient access tools such as multi-channel appointment scheduling, provider preference management, and automated appointment reminders allow organizations to accurately track the most relevant KPIs, enhancing operations and improving the patient experience. Combined with robust analytics, these tools enable data-driven strategies, optimize performance, and support sustainable growth.

Healthcare AI News 2/19/25

News

Google launches Co-Scientist, a Gemini 2.0-powered research LLM that researchers say is like having an expert collaborator. Users provide a plain language research goal, after which the tool provides a summary of published literature and cited suggestions for new hypotheses and possible experiments.

Healthcare accreditor URAC announces plans to release a healthcare AI accreditation program later this year.

CVS Health redesigns its app with AI-driven features to provide a personalized health concierge experience. The app allows users to manage prescriptions for their entire family across CVS Pharmacy, CVS Caremark mail order, and CVS Specialty pharmacies. It also allows them to open locked display cabinets and pick up prescriptions using a barcode. Future enhancements include conversational AI for checking refill status and tailored recommendations for chronic condition management.

Business

Innovaccer launches telephone-based AI voice agents for patient scheduling, protocol intake, referral, authorization, care gap closure, HCC coding, and patient access.

HP acquires wearable device maker Humane AI for $116 million, gaining its employees and software while discontinuing the device. The widely hyped product, criticized as a solution in search of a problem, will be retired. The year-old, $699 Humane AI Pin  — which also required a $24 monthly subscription – will become dysfunctional next week when its cloud service shuts down. The startup had raised $230 million and sought a $1 billion buyout.

Ambient documentation vendor Abridge raises $250 million an a Series D funding round. The company was previously valued at $2.5 billion.

Crunchbase lists five healthcare-related companies whose new fundraising rounds suggest a Unicorn Club valuation of at least $1 billion:

• Neko Health (body scanner), $1.8 billion.
• Hippocratic AI (AI agents), $1.6 billion.
• Aragen Life Sciences (drug discovery), $1.4 billion.
• Truveta (healthcare data from its provider owners), $1 billion.
• Cera (digital-first home health), $1 billion.

Research

A UK-based company develops an AI-powered “super test” for prostate cancer screening that offers greater accuracy and sensitivity than traditional tests like PSA. The multi-omics test uses AI to analyze blood and urine samples for the presence of specific genes and proteins that have been clinically associated with the disease.

University of Michigan and other organizations are using a federal grant of up to $25 million to develop an AI-equipped van that can help medical generalists deliver hospital-level services in rural areas.

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
Follow on X, Bluesky, and LinkedIn.
Contact us.

Morning Headlines 2/19/25

FDA cuts hit AI division, even as Trump invests in the technology

Report says that FDA has laid off many AI and digital health employees who were involved in healthcare AI regulation.

Ex-Palantir Veteran to Run Data, IT Security for RFK Jr.’s Health Department

HHS appoints Clark Minor, a Palantir software executive, as CIO.

MultiPlan Enters New Era and Unveils New Brand, Claritev, Reflecting Company’s Transformation and Mission to Support the Healthcare Continuum

Out-of-network price platform vendor MultiPlan changes its name to Claritev.

Ohio Becomes First State to Require Hospitals to Publish Prices

A new Ohio law prohibits hospitals that don’t post their prices publicly, as required by the federal government, from collecting medical debt and filing negative credit reports against patients.

News 2/19/25

Top News

Abridge raises $250 million in a Series D funding round.

The company says that its ambient documentation product is being used by 100 health systems.

Abridge’s valuation has been reported as $2.5 billion.

Reader Comments

From Dr. Anon: “Re: Oracle Health. We keep hearing about the ‘excitement’ of Oracle shifting ‘to the cloud,’ but I’ve still not been able to get a straight answer on what will happen to all of our custom build when that occurs. And we have tons of custom build based on the old PowerForm / PowerNotes features that supports all of our regulatory reporting requirements. Unfortunately the workflow mPages and dynamic documentation features, on which the cloud implementation will be based, has yet to include key features despite a decade of Cerner / Oracle knowing what is needed.”

From Aca-Doc: “Re: work metrics for physician productivity. My prior chairman was big on metrics for bonuses. As the CMIO, I had to develop reports to show who was at 75th percentile or above on RVUs. Because we’d had problems with people submitting charges without writing a note, the metrics also incorporated a requirement that 95% of notes had to be completed within seven days of the visit. People figured out workarounds. They would sign a blank note on the day of the visit and then go back later and fill in the details. On the other hand, patient satisfaction and outcomes are not necessarily a good indicator of work effort or quality, so it’s not really fair to hold clinicians accountable for these variables over which they have no control.” 

From ViveRant: “Re: ViVE. Now there’s wristband for ‘additional security.’ This is required wear in addition to the badges that now include a picture of the attendee. As when airlines started requiring picture ID, the point was to remove the thriving secondhand market for unused plane tickets. Like CES, ViVE realized that badge pictures are suboptimal since scanning thousands of people is impossible. Adding a wristband that cannot be removed without breaking is possibly easier to spot, but for most, it remains invisible and adds the frustration of unnecessary lines each morning to get a new wristband unless you like wearing a post-shower, now-sodden cloth wristband.” Being cynical, I would wonder what kind of attendee tracking the badge enables, like the RFID that HIMSS planned to use at HIMS11 (also RSNA) so that exhibitors could “derive a more accurate score of a visitor’s buying potential and send a booth alert when a key prospect approaches.” As if that wasn’t creepy enough, the tech company that HIMSS hired for that attendee tracking later incorporated facial recognition and also added a feature that HIMSS didn’t use — value-based booth pricing, so getting stuck in exhibit hall Siberia at least cost less. Also, did the ViVE wristbands have ads?

ViVE Conference Day 1 and 2 Observations from an Attendee

• 10,000 attendees (2,500 more than ViVE 2023 in Nashville), 30% are C-Suite-level. 725 provider and payer organizations represented. 5,000 scheduled meetings over the course of the conference.
• Nashville has not been spared from the latest Arctic blast. There were snow flurries falling during the (partially outdoor) opening night reception.
• The show floor feels both active and quiet; there’s definitely a lot of people and a lot of activity, yet nothing feels frenetic or chaotic. It feels like everything flows and runs smoothly.
• The layout of the show floor is different in notable ways from two years ago. There is less empty space. Every inch is used in a way that’s compact but doesn’t feel cramped.
• It feels like there are a lot more vendor booths, and they’ve cut back on some of the free space as a result. Also, the primary stages at each corner of the show floor have much less seating compared to two years ago.
• 99% of the booths seem to be taken. I’ve only seen three booths and one meeting cube on the floor plan showing as unfilled.
• AI is definitely a core focus and some of the biggest booths are heavily AI-oriented.
• Vendors I’ve noticed who have a diminished or no presence (smaller booth, much fewer attendees): Health Gorilla, Graphite Health, Moxe, eClinicalWorks, Interfaceware, Quest Diagnostics. I’m sure there are others.
• I continue to question how valuable a booth is. If you have a catchy brand or offering that’s likely to attract the attention of a wanderer, I can see it helping. If you’re meeting- and one-on-one-focused, I feel like a meeting area is a better investment.
• The Provider and Payer Connect Lounge, where vendors have scheduled meetings with provider and payer orgs, is huge this time around, with at least 170 small tables for meetings. The Investor Connect Lounge feels smaller and anecdotally, I haven’t run into nearly as many investors.
• Being a repeat ViVE attendee, I feel my organization has a much better game plan for the conference. I’m clearer on who to meet with and how to make connections happen. I’m more realistic about who actually attends and how to find them. I think vendors coming to ViVE need to understand that it is focused on doing business with investors and health system/health plan prospects. The days are heavily structured around meetings and more curated interactions with providers, payer, and investors. Some folks are here to learn or explore, but many are on a mission and will treat everything tangential to that mission as a distraction. If you are a B2B company, like a professional services org, you need to hit every aisle of booths and seek out partnerships or prospects. You have to have the right strategy to make the conference worthwhile, and for some it probably isn’t the right fit.
• Nashville is expecting one to four inches of snow starting late Tuesday night, so there is a lot of chatter about folks changing flights and abandoning town. I’m expecting Wednesday to be dead, and I’m surprised the ViVE organizers haven’t addressed the elephant in the room and given guidance on whether they’ll even keep Day 4. I feel bad for those slated to hold key meetings or to present on the final day. Though the weather’s unusual, it isn’t unheard of in Nashville in February. ViVE should really stick to March.

Sponsored Events and Resources

Instant Access Webinar: “How AI Addresses Resource Constraints Within Identity Data Management.” Sponsor: Rhapsody. Presenters: Lynn Stoltz, MS, director of product management, Rhapsody; Drew Ivan, MS, chief architect, Rhapsody; Michelle Blackmer, chief marketing officer, Rhapsody. Discover how to overcome the toughest challenge in identity data management: resource constraints.  The presenters will cover how Rhapsody EMPI with Autopilot solves resource challenges like limitations in time, talent, and budget; Reduces costs and risks associated with inaccurate data; and boosts identity data accuracy through 98% decision-making precision.

HIMSS25 Guide: HIStalk sponsors can provide conference participation details by February 24 to be included in my guide.

Contact Lorre to have your resource listed.

Acquisitions, Funding, Business, and Stock

Keebler Health raises $6 million in seed funding. The Durham, NC-based company’s software performs medical records review to help providers assess and adjust risk under value-based care contracts.

I missed this from mid-January. A private equity firm acquires ComplexCare Solutions, a carve-out from Inovalon. The company offers an independent health assessment and member engagement platform.

Avandra, which operates a medical imaging data network, raises $17.75 million in funding.

Sales

• Community Hospital Corporation will deploy CarePilot’s AI scribe solution. Founder and CEO Joseph Tutera, Jr. ran unsuccessfully for governor of Kansas in 2017 at age 16, then started a business early in the pandemic buying respirator masks and COVID tests from Asia and reselling them to US customers.
• MultiCare Connected Care will use Tuva Health’s open-source technology to manage and analyze data for 375,000 patients and has taken an ownership stake in the company through its investment arm.
• Montefiore Health System selects Amazon Web Services as its cloud provider and will transition Epic to AWS.

People

Germany-based medical inhaler digital therapy vendor VisionHealth promotes Peter Shadday to CEO. He replaces founder Sabine Häussermann, PhD, who will move to chief scientific officer.

Oncology software vendor OncoHealth hires Jon Maack, MBA (Definitive Healthcare) as CEO.

Announcements and Implementations

Innovaccer launches telephone-based AI voice agents for patient scheduling, protocol intake, referral, authorization, care gap closure, HCC coding, and patient access.

DrFirst enhances its IPrescribe electronic prescribing app with a feature that lets providers call patients from their personal phones while displaying their practice’s name as the caller ID.

Healthcare accreditor URAC announces plans to release a healthcare AI accreditation program later this year and seeks advisory committee members to help develop standards.

DirectTrust opens a 60-day public comment period for draft criteria for its new Identity Provider and UDAP Identity Provider programs.

Arcadia launches new solutions for modeling care networks, managing value-based care contracts, identifying care gaps, and developing AI models to identify disease progression and risk.

Symplr announces an AWS-powered platform that integrates 28 applications in a unified user experience.

MultiPlan changes it name to Claritev and announces its intentions to broaden its product lines beyond reducing payments for out-of-network provider claims.

Clarigent Health, a Cincinnati Children’s startup that developed an AI-driven tool for schools to analyze counseling session recordings for suicide risk, shuts down. The company had received $1 million in NIH funding, but a 2023 newspaper investigation found no evidence supporting its claims and raised accuracy concerns due to the AI being trained on recordings from a majority-white population.

Government and Politics

HHS appoints Clark Minor, a software executive at Palantir, as CIO. The intelligence data firm won a contested $415 million NHS contract in 2023, drawing criticism over sole-source awarding and full NHS data access. HHS, a Palantir client, has paid the company $300 million over four years.

Stat reports that FDA has laid off many AI and digital health employees who were involved in AI regulation.

A new Ohio law forces hospitals to comply with the widely ignored federal price transparency rule by prohibiting non-compliant hospitals from collecting patient medical debt.

Sponsor Updates

• Cordea Consulting introduces its Innovation Lab video series.
• Clinical Architecture joins the CHIME Foundation to collaborate on healthcare IT innovation.
• Optimum Healthcare IT achieves Amazon Web Services Healthcare Competency status.
• CloudWave will present at the North Carolina Healthcare Association Winter Meeting February 20 in Raleigh.

Blog Posts

• AI and healthcare: What clinicians need to know (Wolters Kluwer Health)
• How Cybersecurity Ambassador Programs Strengthen Your First Line of Defense (CereCore)
• Navigating the Current State of AI and Automation in Revenue Cycle Management (AGS Health)
• Looking toward the future of healthcare: Altera leaders’ predictions for 2025 and beyond (Altera Digital Health)
• Seven Habits of Client-Focused Companies (Clearsense)
• Powering Pharmacogenomics: Clinical Architecture’s Role in Advancing Personalized Medicine in the NHS (Clinical Architecture)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
Follow on X, Bluesky, and LinkedIn.
Contact us.

Morning Headlines 2/18/25

Abridge Announces $250M Series D Investment and New Contextual Reasoning Engine to Streamline Clinical and Financial Workflows at the Point of Care

Ambient documentation company Abridge confirms reports of a $250 million Series D funding round, bringing its total raised to over $450 million.

Carecierge Revolutionizes Healthcare Delivery with Cutting-Edge Tools for Care Teams

Carecierge launches to offer physician practices workflow optimization software.

Innovaccer Launches ‘Agents of Care’ to Transform Healthcare Operations, Enhance Care Delivery

Innovaccer develops AI agents to help providers automate tasks related to patient scheduling and intake, referrals, prior authorizations, care gap identification and coordination, coding review, and patient access.

Curbside Consult with Dr. Jayne 2/17/25

I spent some time this weekend doing something that I’m sure many techie readers have done at least once. I supported an elderly relative who was having technology issues.

My particular relative is in her late 90s and still lives fairly independently, which is impressive in itself. Even more impressive is the fact that she understands the value of the internet in helping her stay connected with the rest of the world, especially as she describes it, “now that my friends who actually used the telephone are all dead.”

We’ve seen plenty of data on the fact that older people do indeed use technology, and we know that utilization numbers are growing as the population ages. Still, actually spending time with someone who is nearly 100 years old and watching them interact with technology was particularly educational.

She called me initially to say that she thought she had a virus on the tablet she uses for internet access, Based on her description, I knew it would be easier to just go see what was happening myself rather than trying to figure it out over the phone. For some of my other older relatives who primarily use PCs and laptops, we’ve installed remote access solutions so we can troubleshoot when they have issues, but I have exactly zero experience doing remote access on tablets.

I had a couple of thoughts about how I could help her, including doing a factory reset on her device versus buying a newer tablet versus replacing it with something else like a touch screen laptop. I’m not a fan of tablets because I think the user interface is clunkier than what you get on a Windows interface, plus the ability to install remote access software would be a plus. Like many older people, she’s significantly hard of hearing and also has a tremor, which can make it interesting when the user interface requires fine motor control. I packed a bag of different devices and headed out.

The first thing I identified was the fact that she actually has two tablets, although it was initially unclear why she needs two or how she decides which one to use. Seeing them jogged my memory, as I remembered hearing about this from another relative who had  helped her manage two email accounts and two Facebook accounts. She didn’t understand then that accounts can be accessed across different devices, so she had just made new accounts when she got the second device.

I asked her to show me how she uses each one and what kinds of sites she accesses with them so that I could see it for myself and not make any assumptions about her technology needs. As I watched her, we had some good conversations about how Facebook actually works and the fact that it primarily exists to make money off of people’s viewing habits, by way of explaining why her feed was entirely clogged with junk and not things she actually wanted to see.

In addition to social media, she’s a fairly heavy user of MyChart, which always impresses me. She gave me access to her account many years ago so I could help explain some of her lab results. Although Epic has proxy functionality, she prefers that I use her login and password.

That made sense once I saw her password management system in person. She uses an old Rolodex to keep track of her passwords, with a card for each website or app. Thank goodness she doesn’t write down her usernames right next to the passwords, but still it was enough to make me cringe. She writes down new passwords when she changes them, but doesn’t always cross out the old ones, which added to the adventure as I was trying to gather all of her important information in case we had to do a factory reset on her devices.

It was interesting to see the password choices of someone in their 90s, especially for sites that require some degree of complexity. I laughed when I came across a password of “OldLady” plus her age to satisfy the numeric requirement of her last password reset. There were plenty of passwords with names of people who I’ve never heard of and also words in another language. I was glad that I didn’t see “Password123,” the name of her late spouse, or other easily guessed options. We talked a little about how the Rolodex probably isn’t a great idea unless she’s willing to keep it in her lockbox, but I made a note to myself to explore password manager solutions for tablets.

One of the issues that she was having with the tablet interface was not being able to unsubscribe to emails or easily mark them as spam. As a Windows user, I can see clear links in the different email clients I use. For her, she would need to press and hold on the screen to get a dialogue that would allow her to do this, which was difficult given her motor abilities even though she is using a stylus.

She agreed to let me access her email from my laptop so I could rapidly clean up her inbox and take care of a lot of junk mail. As we began that process, I discovered how difficult it is when you don’t have a smart phone and systems want to text you a code to confirm that you are logging in on a new device. Although some of these platforms also allow you to receive a phone call for a verbal code, you can imagine the comedy of errors that ensues when the person is using a landline and a telecommunication device for the deaf to receive her phone calls.

After clearing up her primary problem — which was annoying popup ads that were being generated by a solitaire game that she didn’t remember installing — and working to clean up her tablets, we decided to send the older one to the next electronics recycling event to reduce any future confusion. Now that we had her back in action with a device she knew well, I decided to forego auditioning new devices since I have good hopes that we can probably get another six months of use out of this one. No need to upset the proverbial apple cart if we have something that meets her needs. I know from experience that the future value of a problem can sometimes be worse than the current value of a problem, but I’m willing to play the odds on this one.

The experience was a good one to remind me that although many of the elderly have access to technology, they may not understand how it works or how to stay out of trouble when they’re online. It also gave me a new appreciation for people with mobility and sensory challenges who are trying to access technology platforms. That will give me some things to think about the next time I have to write scripts for end user testing. I’m glad I could help her and she treated me to an ice cream at the end, so you can’t go wrong with that.

If you work for a technology vendor, do you consider the needs of the elderly or those who have additional needs as you design your solutions? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 2/17/25

Agentic AI Startup, VoiceCare AI, Launches to Automate Healthcare Back Office and Super-Staff Workforce

Mayo Clinic will pilot voice AI agent technology from VoiceCare AI, which recently launched with $3.85 million in funding, in three areas for pre-authorization and benefit confirmation.

Donate Life America and Epic Bring Organ Donor Registration to MyChart

Epic integrates organ donation registration capabilities into MyChart in collaboration with the non-profit Donate Life America.

Trusting Health Care Systems to Use Artificial Intelligence

A JAMA commentary piece notes that patients don’t trust how health systems will use AI, leading author Jessica Ancker, MD, MPH to recommend that health systems clearly disclose AI interactions, specify who can access AI-generated data, and inform patients when AI is used to influence clinical decisions.

Monday Morning Update 2/17/25

Top News

A JAMA commentary piece notes that patients don’t trust how health systems will use AI, but then again, they don’t trust health systems in general.

A cited study found a mean health system overall trust score of 5.23 on a 12-point scale. Only 40% of respondents expressed high trust, down from 72% pre-pandemic.

The author, Vanderbilt informatics professor Jessica Ancker, MD, MPH, recommends that health systems clearly disclose AI interactions, specify who can access AI-generated data, and inform patients when AI is used to influence clinical decisions.

She also notes that people tend to be wary of technology they haven’t personally experienced, such as self-driving cars, but usually warm up to it once they see it for themselves.

Reader Comments

From Peds MD: “Re: Epic’s Care Everywhere. Responding to the HIStalk post last fall where Care Everywhere failed to match a critical newborn, Epic relaxed its requirements to make matches if you have the patient’s Care Everywhere number (from the place you are querying) and two other matching demographics. Today we had a patient who had “some kind of heart surgery” as a child in 2001, and it was medically important to know exactly what was done. Because they had moved across the country, I couldn’t match the patient using regular demographics — everything had changed except their name, sex, and date of birth — but when I obtained and entered the Care Everywhere number from the other hospital’s HIM department, the match came back immediately. We are still working with Epic on improving matching, but I think it’s important to recognize progress, as it made a big difference in this patient’s care. Kudos to HIStalk for helping in this.” I posted the reader’s original problem description last year. Thanks for the update and thanks to Epic, which I can say always responds quickly and personally to address issues that readers have reported here.

From Silken: “Re: Epic and SaaS. I’ve seen online commentary about the benefit of Epic moving to SaaS model. What do you and your readers think?” For me, I see the possible customer advantages of running a SaaS versus on-premise and cloud-hosted products. However, technical punditry and wishful thinking aside, you have to assume that Epic is like all companies in being most likely to take whatever path benefits it most. Thoughts:

• Big, Epic-using health systems aren’t visibly demanding a SaaS model, at least when it comes to voting with their dollars, which is the only vote that counts. They have already invested in Epic-driven infrastructure, IT expertise, and long-term budgets. These are sunk costs that shouldn’t influence future decisions, but hospitals are generally risk-averse and don’t relish major disruptions like retraining and workflow changes, especially in the absence of a clear business benefit.
• Even though Epic’s maintenance costs are high, SaaS wouldn’t necessarily be cheaper over time since it’s still up to Epic to set prices.
• Many health systems already operate a de facto SaaS model by hosting Epic for affiliated hospitals and clinics. This may be more cost-effective than Epic offering SaaS directly to an ever-decreasing number of unaffiliated small hospitals and practices.
• SaaS benefits include scalability and faster onboarding of acquisitions, but drawbacks include a reduced ability for customization, forced upgrades on Epic’s schedule, and tighter vendor lock-in.
• The Change Healthcare breach heightened concerns about reliance on a single vendor, possibly making CIOs skeptical that Epic SaaS would be more secure or resilient than their own IT capabilities.
• SaaS would increase health system dependence on Epic, with unknowns about what a post-Judy Epic looks like.
• Oracle Health talks up cloud-native ambitions but lacks market momentum, industry focus, and credibility to provide much of a medium-term threat. Health systems care less about technology compared to business results, proven ROI, and vendor responsiveness and stability. Oracle’s commitment, performance, and retention of internal healthcare expertise remains unproven, and customers have been historically burned by big tech outsiders who barged into (and then out of) healthcare. 
• A full Epic rewrite is unlikely unless the reward to Epic clearly outweighs the risk. Few vendors have pulled this off. Meditech did it seemingly effortlessly with Expanse and Cerner (as a publicly traded company) sweated through many bad years until Millennium was fully baked. Otherwise a lot of vendor-touted technology improvement is pig lipstickery, and sometimes that’s all customers care about anyway.
• Epic dominates the market and will eventually run out of deep-pockets health systems to sell to. It doesn’t need to chase new customers by teasing their CTOs into an advanced state of technical arousal.
• Potential drivers for change are Oracle Health rebounding as a serious competitor; a demand for cloud-native AI and analytics; and regulatory pressures around interoperability and cybersecurity (which seem to be lessening by the day).

HIStalk Announcements and Requests

Most poll respondents book their medical appointments by telephone or patient portal. Some say they do it at the check-out desk at the end of their visit, which I’ve seen almost universally with dentists but commonly with doctors, although that experience probably involves routine chronic condition management.

New poll to your right or here: How much of your job performance can be measured using objective metrics?This came to mind while reading an article about how much of a pay cut office employees would take to work fully remotely. The article noted that managers who oppose WFH often oversee employees whose performance isn’t easily quantified by output metrics, which forces them to rely on in-office proxies such as hours worked, enthusiasm, and the perceptions of colleagues and customers. Another question might be that if your job performance isn’t being mostly measured by metrics, then why not? Is your work inherently unquantifiable, or is it that managers haven’t created the right metrics and instead rely on direct observation?

HIStalk sponsors: fill out this form to tell me about your HIMSS25 plans by February 24 and I will include you in my guide, which will look like the one above from last year..

Readers provided microphones and speakers for students in Ms. B’s elementary school classes in Kinston, NC. She reports:

You would not believe how student engagement has changed in our classroom!!! We faithfully use the devices during our math lessons. Students love when they are able to clearly share their thinking, using the microphone, as they give explanations while solving rigorous word problems. Being in the spotlight, they aren’t shy to speak out for all to hear. The Bluetooth speaker sits stationary in the center of the room so all voices are projected throughout. I love the range and how I’m able to walk around freely without even realizing that it’s still on. The students are able to hear me no matter if I’m in the front of the room or in the back of the room.

Sponsored Events and Resources

Instant Access Webinar: “How AI Addresses Resource Constraints Within Identity Data Management.” Sponsor: Rhapsody. Presenters: Lynn Stoltz, MS, director of product management, Rhapsody; Drew Ivan, MS, chief architect, Rhapsody; Michelle Blackmer, chief marketing officer, Rhapsody. Discover how to overcome the toughest challenge in identity data management: resource constraints.  The presenters will cover how Rhapsody EMPI with Autopilot solves resource challenges like limitations in time, talent, and budget; Reduces costs and risks associated with inaccurate data; and boosts identity data accuracy through 98% decision-making precision.

Contact Lorre to have your resource listed

Acquisitions, Funding, Business, and Stock

ProPublica examines the history of Zolgensma, a taxpayer- and charity-funded gene therapy for a rare nerve disease in infants whose rights were acquired by a startup. The chief scientist gained partial ownership, the startup went public, and Novartis later bought it for $8.7 billion, netting the scientist $400 million, an investor $315 million, and the CEO $190 million. Novartis then priced the drug at a record $2 million per dose. Medicaid spent $309 million on it over four years, while Novartis made $6.4 billion. The article notes that 10 gene therapy products now cost more than $2 million per dose once Novartis set the price bar so high.

People

WellSpan Health SVP/CIO Hal Baker, MD announces that he will retire in July. He encourages those who might want to succeed him to apply for the York, PA-based job, telling me that “We have a fantastic team, are doing some very cool cutting edge stuff in AI, and I think my 30 years working for a single employer says about as much as one can about how good the opportunity is.”

Announcements and Implementations

Meditech signs its 100th Meditech as a Service client.

Epic integrates organ donation registration capabilities into MyChart in collaboration with the non-profit Donate Life America.

Mayo Clinic will pilot VoiceCare AI’s voice AI agent in three areas for pre-authorization and benefit confirmation.

Ukraine’s Ministry of Defence deploys the first batch of 200 tablets to Air Assault Forces medics, who will use them to document frontline care in the military’s self-developed Electronic Primary Medical Records system. The tablets were donated by the Come Back Alive foundation, which supports members of the Armed Forces of Ukraine.

Other

In England, a trade union raises concerns about a hospital’s plan to use license plate recognition software to impose fees and fines. The website of technology provider ParkingEye says that the advantages are to “increase parking revenue, reduce car park abuse, and improve customer satisfaction,” also noting that 30 NHS trusts already use its systems. Complaints abound, mostly about being erroneously told by someone on site that it was free to park or to get validated, having their credit card hit with a huge charge with no response to appeals, and angry excuses of the “I was only a little over the time limit and it wasn’t my fault” variety.

Sponsor Updates

• Health Data Movers hires Andrew O’Hara as a health IT recruiter.
• TruBridge announces its selection as a preferred partner to healthcare services company Cibolo Health.
• Visage Imaging General Manager, North America Brad Levin recaps the first Sharp HealthCare Spatial Computing Health Care Summit in San Diego.
• Contessa Health (TN) works with Netsmart to develop and configure the first application in a suite of tools that is its new population health management platform for palliative care at home.
• Nym publishes a new case study, “Transforming Medical Coding at Inova.”
• Optimum Healthcare IT publishes a new white paper, “Improving Efficiency & Meeting User Demand with ITSM Practices in Healthcare.”
• Praia Health announces it has been granted a second patent for its account and experience orchestration technology.
• QGenda offers a new case study, “North American Partners in Anesthesia Achieves Faster, More Accurate Payroll with QGenda’s Schedule-Driven Time and Attendance Solution.”
• Waystar earns top rankings for its payment solutions in eight categories, according to Black Book Research’s latest analysis of AI-powered RCM software platforms.
• WellSky publishes an EHR checklist for behavioral health facilities.

Blog Posts

• Best Practices for Collaborating with Payers (FinThrive)
• CMS TEAM is coming: Why CIOs must act now on EHR optimization (Nordic)
• Top Physician Communication Frustrations (PerfectServe)
• The Cost of Doing Nothing (Praia Health)
• How Redox and Databricks are transforming prior authorization through interoperability (Redox)
• Powering the Prior Authorization Transformation (Surescripts)
• How a Healthcare Platform Transforms Patient Care & Operations (Symplr)
• How to Align Operations + Technology to Improve Patient Access (Tegria)
• Value-based care requires creativity and technology partnerships (Wolters Kluwer Health)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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