News 1/19/24

Top News

Venture capital firm General Catalyst signs a letter of intent to acquire Akron-based non-profit health system Summa Health.

GC formed Health Assurance Transformation Corporation, HATCo, in October 2023 to lead a technology-driven transformation from “sick care” to health assurance, which focuses on helping people stay well, reducing cost, and increasing accessibility. General Catalyst said at that time that it planned to acquire a health system to demonstrate the value of its approach, which includes the involvement of some of its healthcare technology companies.

General Catalyst’s health assurance portfolio includes more than 100 companies.

The company says that the acquisition should not be considered as “another private equity deal” because it will not focus on cost reductions or a quick flip.

Summa Health has three hospitals, 1,027 licensed beds, and 8,500 employees. Its most recent financial report shows a loss of $57 million on revenue of $1.5 billion. It will convert to a for-profit system under its new owner.

Beaumont Health signed an agreement to acquire Summa in December 2019, but the organizations backed out in May 2020.

Summa executives expect the acquisition to close by mid-summer.

Webinars

January 19 (Friday) 1 ET. “Unlocking Reliable Clinical Data: Real-World Success Stories.” Sponsor: DrFirst. Presenters: Alistair Erskine, MD, MBA, CIO/CDO, Emory Healthcare; Jason Hill, MD, MMM, associate CMIO, Ochsner Health; Colin Banas, MD, MHA, chief medical officer, DrFirst. Health system leaders will describe how they are empowering clinicians with reliable patient data while minimizing workflow friction within Epic. They will offer real-world experience and tips on how to deliver the best possible medication history data to clinicians at the point of care, use clinical-grade AI to infer and normalize prescription instructions in Epic, and encourage patient adherence to medication therapies for optimal outcomes.

January 24 (Wednesday) noon ET. “Medication Management Redefined.” Sponsor: DrFirst. Presenters: Nick Barger, PharmD, VP of product, DrFirst; Caleb Dunn, PharmD, MS, senior product manager, DrFirst. Clinical workflow experts will paint a reimagined vision for e-prescribing that offers enhanced patient adherence, customizable clinical support, intelligent pharmacy logic, and data integrity and safety. Join this first chapter of an ongoing conversation about what medication management should be, how to deliver greater benefits today, and how to prepare for the future. Elevating your solution and customer benefits isn’t as hard, scary, or economically challenging as you may think.

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

Acquisitions, Funding, Business, and Stock

Reuters reports that the private equity owners of Netsmart Technologies are planning to offer the company for sale, hoping to attract offers of more than $5 billion.

PointClickCare acquires CPSI subsidiary American HealthTech, which offers long-term care management software. CPSI had stopped development of the product after deciding to divest the business.

Online vision testing company Visibly acquires EyecareLive, which offers a similar test along with video visits with optometrists.

Health data interoperability platform vendor Hart will move its headquarters from California to Kansas City, MO.

SeamlessMD co-founder and CEO Joshua Liu, MD raises interesting points (and creates a fun graphic) about General Catalyst’s planned acquisition of Summa Health and its use of the health system as an incubator for its many health tech businesses:

• Will they try to build an EHR? (leading to my corollary question – how does Epic feel about one of its customers, which the CIO says spent $850 million to move from a shared instance of Epic to its own Epic system in 2022, being bought by a VC firm that has ownership in healthcare software vendors?)
• Will Summa make its own technology decisions or will GC force them to use products that its portfolio companies sell?
• How will staff react to having the health system’s goals set by a financial firm?
• Will startups that aren’t part of General Catalyst avoid working with Summa out of intellectual property concerns?
• Will GC bring in entrepreneurs in residence and incubate new companies?
• Will Summa develop innovation fatigue given the focus of its new owners?

Sales

• The Association of Community Mental Health Centers of Kansas will implement Netsmart Population Health Platform across 26 members that are transitioning to the Certified Community Behavioral Health Clinic model.

People

Roswell Park Comprehensive Cancer Center hires George ”Buddy” Hickman, MS (First Health Advisory) as chief digital and information officer.

Vasanth Balu (Excela Health) joins Bozeman Health as CIO.

Kevin Shiotelis (CorTech) joins Healthcare IT Leaders as CFO.

Consensus Cloud Solutions promotes Johnny Hecker to chief revenue officer and EVP of operations.

Announcements and Implementations

Hospital-at-home technology vendor Biofourmis adds in-home services to its platform, allowing providers to order, schedule, confirm, and track in-home services and diagnostics.

Epic launches Showroom, which lists products and services that can be used with Epic.

Nuance announces GA of DAX Copilot embedded in Epic, which it says has a 150-hospital waitlist.

NYC Health + Hospitals adds Findhelp’s social services referral platform to Epic. Completing Epic’s SDoH screening tool will trigger resource recommendations from Findhelp, which staff can also search directly for community-based resources and create closed-loop referrals.

UCLA Health creates Medical Informatics Operating Room Vitals and Events Repository (MOVER), a de-identified database of 83,000 surgical outcomes from UCI Medical Center’s Epic and former SIS system that approved researchers can use at no cost to test AI algorithms.

A University of Michigan survey finds that 7.5% of people aged 50 to 80 have used an online-only provider and 60% of those received a prescription, but two-thirds of them didn’t tell their regular provider. The authors express concern that online providers don’t have access to the patient’s health history and medical records, making it challenging to screen for drug interactions. Respondents said they used online services because of convenience or lack of access to a regular provider, with only 10% saying they used an online service because of discomfort talking to their regular provider about topics such as mental health or sexual issues.

Privacy and Security

Bluewater Health, which is part of a five-hospital shared services group that remains down from an October 23 ransomware attack, will replace its 25-year-old Meditech system with Oracle Cerner by the end of 2024. The hospital has cancelled 8,000 diagnostic imaging appointments. It planned to move to Cerner in 2013, but delayed the project.

Other

Patent troll SynKloud Technologies sues Epic, claiming that MyChart violates a 2005 patent that it bought in 2019 that describes a personal alarm system for seniors.

Sponsor Updates

• EClinicalWorks customer DePaul Community Health Centers (LA) adds Sunoh.ai ambient listening technology from ECW to its V12 EHR.
• CereCore offers revenue optimization assessments to help health systems maximize financial performance despite increased denials.
• Meditech signs its 100th Expanse MaaS customer, with 37 hospitals signing on in 2023 alone.\
• Experity will host its third annual Urgent Care Connect Conference February 13-14 in Austin.
• Black Book Research survey-takers rank Verisma as the leading vendor for release of information, audit management, and revenue integrity solutions for the fourth consecutive year.
• Fortified Health Security names Joan Edens (Vaco) documentation and quality assurance specialist.
• ThoroughCare integrates Healthwise’s educational healthcare content with its care coordination software.
• Inovalon releases a new podcast, “Data Insights and Impact Across Healthcare.”
• Linus Health publishes the results of a new study, “Digital Clock and Recall is superior to the Mini-Mental State Examination for the detection of mild cognitive impairment and mild dementia,” in Alzheimer’s Research & Therapy.

Blog Posts

• 7 Patient Engagement Solutions to Help Patients and Practices in 2024 (EClinicalWorks)
• 4 Ways to Maximize Government Reimbursements (FinThrive)
• AI in Contact Centers: What Makes it a Game-Changer? (Five9)
• The 5 Stages of Adopting Intelligent Virtual Care (AvaSure)
• Improving Clinician Workflows and Data Insights (InterSystems)
• Identifying Advanced Adenomas Helps to Prevent Colon Cancer (Lucem Health)
• Healthcare Trends 2024: Three Topics to Keep on Your Radar (Medhost)
• Responding to disaster at Brockton Hospital (Meditech)

Contacts

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

EPtalk by Dr. Jayne 1/18/24

The Lown Institute has released its 2023 Shkreli Awards, highlighting “the worst in healthcare profiteering and dysfunction.” The selection panel includes clinicians, journalists, patient advocates, and health policy experts.

In case anyone doesn’t recognize the name, the award is named after so-called “pharma bro” Martin Shkreli, who earned notoriety and scorn by purchasing the rights to manufacture a well-known antiparasitic medication and jacking up its price by 5,000%. Full descriptions along with the judges’ comments can be found on the Lown Institute website, but the winners are below. Given the nature of the activities, I can only imagine what was going on in those that didn’t make the cut.

1. Columbia University interferes with patients filing sexual assault complaints against one of its physicians.
2. Stunning CEO salaries at nonprofit hospitals (CommonSpirit Health is specifically called out, but they’re far from alone).
3. Pharmaceutical companies claim that price negotiations for Medicare drugs are unconstitutional.
4. Hospitals partner with private equity-backed companies to offer high-interest medical credit cards with rates up to 26%.
5. Vascular specialist allowed to continue to practice despite discipline in numerous states and failing to be able to write the essay needed to pass an ethics course.
6. GlaxoSmithKline hides evidence that its heartburn medication Zantac may cause cancer.
7. Indiana cardiologist accused of implanting unnecessary cardiac stents, including 80+ stents in a single patient.
8. Hospitals “dump” homeless patients who are unable to fully care for themselves.
9. Device manufacturer Medtronic incentivizes surgeons to implant devices in patients that may not benefit, all in the name of education.
10. Lehigh Valley Health – Cedar Crest Hospital threatens to medically deport a comatose patient receiving expensive care

From BlackBerry Forever, iOS Never: “Re: BlackBerry. I appreciated the picture of your old-school device. I also had the Torch and it was the best of both worlds – touch screen with a keyboard. Did you see the buzz about add-on keyboards at the Consumer Electronics Show?” Clicks Technology is offering the keyboard, which comes in either “Bumblebee yellow” or “London Sky,” which is decidedly grey. The accessory connects via the standard charging port and will start shipping on February 1. I haven’t met anyone who is remotely interested in buying one, so if you like the idea, feel free to weigh in. Personally, I loved the tactile BlackBerry keyboards and could type on them way faster than a touchscreen model. The roller ball mouse thing, not so much. There have to be others out there like me, so we’ll see if this results in an appreciable number of sales.

Another reader clued me in that BlackBerry is exhibiting at CES 2024, accompanied by a Monty Python-esque “I’m not dead yet” meme. Indeed, the company even has a website highlighting its participation, and it looks like it’s mostly tied to automotive technology. I have to admit I haven’t followed the company since my former employer killed off its BlackBerry server back in the day.

Other interesting items coming out of CES include the Withings BeamO multiscope device. Although it reminds me a bit of an early generation Wii remote, it’s designed to quickly produce vital signs data for use during non-office healthcare encounters. It can deliver temperature, oxygen saturation, heart rate, and electrocardiogram data that can be sent to healthcare providers using an app. Withings has an application in for FDA approval of certain features, such as detection of atrial fibrillation. The device is expected to hit the shelves in July and will retail for $250.

Speaking of cool devices, I see all kinds of wearables out on the trail and at the local YMCA. A recent Stat opinion piece calls for a “data diet” to help curb the growing obsession with data. I’m sure there’s a boom in sales during the early part of the year as people seek digital help tracking their progress towards various New Year’s resolutions and annual goals. The article confirms this, noting that fitness app downloads are more than a third higher in January than at other times. It also notes that the fitness tracking industry rakes in $45 billion annually and that there are 400 personalized nutrition companies out there. The article questions the role of fitness trackers in trying to curb the obesity epidemic and the increase in chronic diseases. It suggests that we’re tracking the wrong data, and that in order to harness technologies like AI to better use our data, we need higher-quality data in the first place. The author shares vignettes of several patients gaming their fitness trackers, one sitting in a meeting but waving his arm trying to clear an alert telling him to move. It will be interesting to see how the fitness tracking movement evolves and whether we start getting better data or just more mediocre data.

I’m always looking for interesting new companies and was excited to run across CareLuminate. Their premise is straightforward: if one understands how nurses feel about the care being delivered in their workplaces, one can better understand clinical quality and help reduce healthcare costs. CareLuminate can help those who are paying for healthcare (such as employers) steer their workers towards facilities with higher quality. The company’s founders have background in clinical outcomes and industry research, coming from the nursing world and from KLAS Research and specifically its Arch Collaborative. By interviewing nurses directly, the company generates independent and current data that they note hasn’t been “gamed” by health systems. Some of the measures captured in interviews and through available data include nurse perceptions of care safety, patient satisfaction, infection rates, and readmission rates. I’ll be watching them closely to see how they gain traction in the industry. They’re worth checking out.

Speaking of checking companies out, I was happy to book my first celebrity Booth Crawl for HIMSS24. Since I’ll be the only member of the HIStalk team in attendance at the show, I feel particularly responsible to capture the glitz, glamour, and exhaustion of the event. It’s my first time to schedule a booth crawl on the opening day of the exhibit hall when people are fresh and should be eager to chat.

What are your hopes for the HIMSS24 conference? Is there anything you’d recommend as can’t miss opportunities? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 1/18/24

Netsmart’s owners explore a sale valuing it at $5 bln

The owners of Netsmart reportedly prepare to put the company up for sale, eyeing a valuation of over $5 billion.

PointClickCare Acquires CPSI Subsidiary, American HealthTech

Post-acute care technology company PointClickCare acquires post-acute care EHR vendor American HealthTech from CPSI.

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

CMS publishes the Interoperability and Prior Authorization Final Rule, which enacts firm timelines for select payers to issue prior authorizations, and mandates the implementation by certain payers of HL7 FHIR APIs to improve data exchange between providers and payers.

Healthcare AI News 1/17/24

News

Nvidia founder and CEO Jensen Huang tells attendees of the J.P. Morgan Healthcare Conference that he expects drug design to move nearly completely to AI systems. He also predicts that medical devices such as ultrasound and CT scanners will be “a device plus a whole bunch of AIs” and that will create incredible value and opportunities.

A UC Berkeley public health professor and psychiatrist warns that using AI to offset a shortage of mental health providers and to address growing problems such as loneliness raises concerns. Jodi Halpern, MD, PhD  worries about the effect of companies marketing AI conversational bots as therapists and trusted companions to people who are depressed or vulnerable. She says that unlike therapists, app vendors are not regulated, companies may be motivated to use the “addictive engineering” of social media companies, and app users may rely on the app the point of withdrawing from human engagement.

A Georgia lawmaker introduces a bill that would make it illegal to use AI to discriminate against people or for making health insurance and public services decisions without human review.

Family-powered autism therapy AI platform provider Forta raises $55 million in a Series A funding round.

A Google-created AI system called AMIE that was optimized for diagnostic dialog outperforms primary care doctors in synchronous text chat with patient actors. The authors warn that while synchronous text chatting is not a common practice, their work is a milestone in developing conversational diagnostic AI to take patient histories, provide diagnostic support, and communicate with skill and empathy.

Business

Investor Mark Cuban predicts that AI will transform healthcare, but will involve millions of models that are created by individual companies and providers instead of a handful of big-name models. He says that the biggest issue is intellectual property protection, and expects health systems to limit access to the models they develop.

Workers’ compensation insurer MEMIC will use AI technology from Clara Analytics to automate medical records transcription and data extraction for claims reviews.

The CEO of medical device maker Medtronic says that the company will transform its products with AI, giving recent examples of its solutions for intelligent endoscopy, digital surgery, and remote surgery assistance.

Research

Mass General Brigham researchers show that large language models can be trained to automatically extract social determinants of health from clinician notes. The finely tuned model identified 94% of patients who have adverse SDoH versus the 2% that could be identified using diagnostic codes. The model was trained to identify sentences that refer to employment status, housing, transportation, relationships, the availability of social support, and parental status. Bias was less likely than with GPT-4. The model was much smaller than ChatGPT models and results were better even thought the model was trained on just a few hundred patient records.

Switzerland-based cardiologists and researchers use AI to improve the usefulness of the atrial fibrillation detection capabilities of consumer wearables that are made by AliveCor, Apple, Fitbit, and Samsung. The study authors say that the single-lead ECG functionality alone is not clinically useful because of high numbers of inconclusive tracings, but the model reduced the percentage of those from 16% to 1.2%. They caution that opportunities for further studies will be limited as those manufacturers enhance their algorithms in undisclosed ways and may restrict access to their raw data. The study used cardiac diagnostics AI products from PulseAI.

A Michigan Medicine team uses AI to review physician notes for signs of risky drinking, which identified three times the number of patients than would have been flagged by diagnosis codes alone.

ChatGPT failed to make an accurate diagnosis in journal-published pediatric case challenges 83% of the time. The authors note that systems such as Google’s Med-PaLM 2 that were trained on medical data would likely perform better.

Pharmacy professors find that ChatGPT performs well in answering questions that patients might ask a pharmacist who is working remotely. It also did a good job of answering general patient questions, offering dietary suggestions, encouraging patient adherence, and clarifying medical terms.

Other

UCSF Health is developing AI tools for nurses, which include patient deterioration detection, patient placement, and matching patients with specialized nurse expertise. A representative of UCSF Health’s nursing union isn’t convinced, declaring that AI has created a “disaster-capitalism moment” in being used to improve efficiency with an end result of reducing access to skilled care.

Contacts

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

HIStalk Interviews Mark Burgess, President of North America, Agfa HealthCare

Mark Burgess is president of North America of Agfa HealthCare of Carlstadt, NJ.

Tell me about yourself and the company.

I’ve spent the majority of my career in electronic health records. I have worked with a startup and have done tours with Cerner, Allscripts, and NextGen Healthcare, with roles that included strategy, product and solutions management, and business unit leadership. I have enjoyed seeing the progression from the introduction of the EHR into interoperability, and now I’m on the imaging record side.

Agfa HealthCare is a global imaging software business that has been in the market for 25-plus years. We were an early mover in PACS. probably one of the first to bring that to market. The company started the transition into enterprise imaging, which is more of what we do today. We’ve gone from a single system to the enterprise system. That has contributed to the evolution of the image to the image health record.

We have 1,200 employees across the globe. We work with some world -class organizations. We have a talent base that is second to none because we’ve been doing it for so long. We provide diagnostic imaging software solutions to thousands of client sites who read millions of image studies each year.

What are the similarities and differences between the EHR application business and the imaging business?

Imaging software is a medical device that is governed by specific regulatory requirements, agencies, and rules. That’s not true of the EHR side.

With imaging, there’s a lot of work and thought that is put into the design of the technology and the way that the technology needs to show up, because you’re using it as an instrument to diagnose. You can obviously use the EHR to get to a diagnosis, but it’s even more intense with imaging, where you are putting it into the hands of a radiologist who forms a diagnosis with it. There are more regulatory components involved with managing a medical device and maintaining it from version to version. 

The EHR side is more governed by achieving regulatory guidelines or regulatory thresholds. The EHR side has to deal with things that surround the EHR, which we don’t see as much of on the imaging side, although that is changing with things like AI. As the imaging side starts to mature and reach deeper across the enterprise, it is getting more involved with those things, including the EHR itself.

What is the demand for accessing and exchanging the actual images versus the reports that are created to describe them, and how does that align with EHR interoperability?

You want all of that to show up in the EHR. You don’t want to have two systems. You are seeing the convergence of that in the industry. We work with all the major EHRs. The radiologists who use our system produce reports and studies that show up in the EHR for the for the physician and the clinical team to see, or in the patient portal for the patient to see, depending on how the organization makes that available.

The image health record and the clinical record are becoming fused. That fits the direction that we are going in healthcare with regards to IT and how patient records are being managed, which is more of the whole-patient care model.

The enterprise imaging decision is relatively new. It reminds me of the days before people started buying enterprise EHRs instead of those that were specialty based. The EHR  grew up in front of everybody, and then the goal was to create a single patient record across an organization. Organizations want to know how they can get a single imaging record across their organization. We’re spending a lot of time ensuring that organizations know how to go about making this decision.

How has the work of radiologists and radiology staff evolved as imaging volume and expectations have increased?

Diagnostic confidence is above all else. Performance and workflow are fast followers, meaning that radiologists prioritize a high-performing system with intelligent and integrated workflows that presents information when and where they expect it. We’re still in a world where performance is key. Radiologists are still focused on safe productivity where they make no mistakes. They want high-performing systems, so by definition, that includes workflow that gives them what they need, when they need it. That means point-of-care capabilities and the ability to pull a prior or to do a report.

Third is coordinated care and integrated care, the ability to see relevant clinical data when they are reading images as well as having access to care team members to share and collaborate.

Finally, we need little to no barrier to system access, bringing the data and information to the radiologist and not the other way around. Streaming data is the future.

Is it hard to develop a company strategy for incorporating AI when it changes every day?

The idea of formulating an AI strategy is accelerating among the radiology base, especially radiologists in the US. An extraordinary number of algorithms have been FDA cleared. Radiologists are starting look at where they can put those to work. It’s a partnership between their ability to operate at the top of their license in a high-performing way, but leveraging the goodness of those AI algorithms. Clients are 100% prioritizing AI and seeking the initial phase of production use, moving from the proof-of-concept stage to focusing on production clinical use.

We want our clients to have choice, so we are staying nimble. It reminds me of the early EHR days, when we started looking at patient portals, scheduling systems, and other applications that were hanging off the EHR. You wanted your clients to have choice and you started to build an ecosystem.  We are focused on the AI side with building an ecosystem, and that ecosystem will be able to go to the point of care or the point of need.

We make sure that as we bring more AI partners into our ecosystem, we hold them to a standard so that what we put in front of our clients has been pressure tested. But it’s fast and furious. The FDA has cleared more than 500 algorithms, with the vast majority of them targeted to radiologists. We have a team that’s in charge of that. But the most important thing for us is to stay aligned with our clients on where they want to put time and energy relative to AI. We are doing our best to curate those opportunities for them.

Do radiologists question how algorithms were developed or do they evaluate them on their level of transparency?

They are curious and have asked many questions about it. I don’t know that we are seeing as much of that healthy skepticism as before, now that we are starting to see some of these organizations gain track records of success. That is lending more clarity and confidence to the radiologist. They are starting to look at, how do I get a better experience with an AI algorithm? How can I improve it in another part of the body?

While we work with a lot of scientists who are always interested in how something was built, what it was based on, and how it was tested, we are seeing more curiosity around how it can be applied to a particular workflow or to a particular part of the body than we saw two years ago.

What is the company’s vision of a enterprise imaging solution?

As I mentioned,  this organization was an early mover on the PACS side. As organizations started digitizing images, they also started standing up multiple PACS. Health systems are coming together and finding that they have three, four, or five of these different systems, and they don’t really don’t talk to one another. It’s not very efficient.

We want to be that single imaging platform. We want to be able to serve not only the needs of the core radiologist user, but start to expand out into all of the different service lines that have imaging needs and imaging demands. We absolutely want it to be treated as a platform. We want to be able to put more capabilities into the hands of these different medical professionals to enhance what they do with medical imaging, and that’s starting to get into the reaches of analytics, research and teaching and how that incorporates into the medical record.

We want to be all things from an imaging software standpoint on this single platform, much like the way the EHR has developed. And then of course the fusion of those two things, so that medical professionals can look at an image with clinical data, or look at clinical data with an image. We don’t want limitations to that.

One of the final frontiers of imaging is digital pathology. What trends are you seeing?

This is one of the most complex parts of the hospital that is moving to becoming digitized. We are certainly seeing more and more of our clients that are moving in this direction. We have been tracking this with some of the largest organizations in the in the world, and certainly in the US, there’s a great appetite to start moving pathology into a digital state. They are hungry for more efficiency, the ability to do more with the slide samples and unlocking more of what they can do with that. Whether it’s data insights, driving better outcomes, or better synthesizing that data into the medical record, they are hungry to unlock more opportunity with what they are doing today.

I see it as maximizing the use of the data to increase efficiency and improving turnaround times, enhance clinical collaboration with the care team, increase access to care, and streamline workflow. Like radiology, pathology is seeing an accelerated
demand for services and a shrinking base of pathologists. Maximizing pathology resources through digital modernization enables the pathologist to better force multiply their expertise to accelerate and advance specialty care like oncology, decrease surgical time that includes reading samples during the procedure, plus comprehensive clinical collaboration through networking with specialists and subspecialists.

How much imaging volume has shifted to non-hospital locations, and how has that affected interoperability requirements?

As patients, we demand more. We want a better experience. We want more options. We don’t want to be tied down to going to one one place at a certain time. The idea of imaging becoming more pervasive in the community is popular and well documented.

The demand for medical imaging continues to go up year over year. In the US, we are hovering around a billion imaging studies annually. The aging population contributes to that. As you capture images, store them, and move them around, you want to make it convenient for the patient. You don’t want patients carrying images on a CD. I had scoliosis as a child and  my parents carried around a jacket of x -rays to different doctors. Those days are gone. It’s like the fax machine in the medical practice, where you just want to be done with that and build the network.

We think about it as an image health network. We want to connect all the different places that are using our platform, and other platforms to some degree, so that these images can be moved in an intelligent, safe, and a effective way. Physicians should not be seeing a patient without having access to the image that will help get the best outcome for them. The image health network is the key to that.

What will be important to the company’s strategy over the next few years?

In addition to our ongoing client success activities such as continuous engagement and collaboration, meeting the accelerated demand to replace PACS with enterprise imaging, and continuing to innovate and expand the utility of our platform and eco-system, we want to make a dent in addressing burnout. Burnout among radiologists is higher than in most specialties. That drives our work around curating high-performing workflows, leveraging AI, and building the next-generation imaging health network.

We are in a high-growth situation. We want to cover the market properly, continuing to serve those who have an interest in what we do and how we do it. There’s a lot of activity in this market, with a lot of interest in moving to an enterprise imaging solution. First and foremost, we want to be able to accommodate everybody who has an interest.

We are on this journey to cloud, which is essential for us. We recently struck up a partnership with Amazon Web Services and we are pretty excited about working with them. We are starting to move clients into our own AWS private cloud model. The level of interest in that is growing exponentially faster than even the upper reaches of the model we created a couple of years ago. We are excited about what that means from a modernization standpoint, getting organizations away from legacy worries about storage and compute power. We can neutralize that through our cloud offerings.

As we continue to build the ecosystem, we will continue to curate the ability to give our clients the most options that we can give them. AI will have a part. It’s all about continuing to serve across the enterprise, helping all the medical specialties that are in need of medical imaging, where it lives inside our platform that sits on top of this image health network and is connected to the EHR.

Morning Headlines 1/17/24

Apple to Remove Blood-Oxygen Sensor From Watch to Avoid US Ban

Apple will remove pulse oximetry technology from its Watch to avoid the possibility of having the product banned from importation into the US if Apple loses a pending patent appeal.

Care enabler 98point6 buys telehealth Bright.md

98point6 acquires Bright.md’s 17 telehealth customers and hires six of its employees.

HCAP Partners Leads Investment in Apprio

RCM and patient eligibility and enrollment software vendor Apprio secures an unspecified amount of funding from private equity firm HCAP Partners.

Innovaccer Acquires Cured, Accelerating Growth of the Intelligent Healthcare Experience Platform

Healthcare analytics vendor Innovaccer acquires Cured, which offers healthcare digital marketing software.

Mayo Clinic Diet Announces the Beta Launch of Mayo Clinic Diet Medical Weight Loss Rx Program

Mayo Clinic adds an Amwell-powered telehealth component to its Mayo Clinic Diet weight loss program so that select participants can access prescription weight-loss drugs.

News 1/17/24

Top News

Apple will remove pulse oximetry technology from its Watch to avoid the possibility of having the product banned from importation into the US if Apple loses a pending patent appeal.

The US International Trade Commission ruled in late December that the technology, which is included in the Series 9 and Ultra 2 models, infringes on the patents of medical device manufacturer Masimo. The ban was temporarily paused when Apple appealed the ruling, allowing sales of the Watch to be restarted.

Bloomberg says that Apple has already shipped modified watches to the company’s retail stores, but has yet to approve their sale. Apple has not announced any plans about previously sold Watches that contain the pulse oximetry feature or whether it will be disabled via an update.

Reader Comments

From RIP Cerner: “Re: Oracle Health. Rumor is that former CMS Administrator Seema Verma will replace the departing Travis Dalton as GM/SVP of Oracle Health. She joined Oracle last year as head of Life Sciences and will reportedly add Oracle Health to her responsibilities, reporting to EVP Mike Sicilia.” Unverified, but rumored internally. She raised a lot of controversy during her CMS years, especially related to her taxpayer-funded personal self-promotion.

HIStalk Announcements and Requests

Listening: Jimmy Fallon, who I can’t stand to watch in his late-night hosting job, but who is amazing beyond belief in his dead-on (no pun intended) impersonation of Jim Morrison and the Doors doing “Reading Rainbow.” I’ve listened to a lot of Doors and he is spot on in capturing style and stage mannerisms of Mr. Mojo Risin’ (minus the indecent exposure). The faux Densmore, Manzarek, and Krieger aren’t actually playing – The Roots are skillfully channeling 1967. I’m sure that Fallon’s celebrity fawning and self-aware attempts at cleverness pay better than fronting a Doors tribute band, but I would vastly prefer watching the latter.

Webinars

January 19 (Friday) 1 ET. “Unlocking Reliable Clinical Data: Real-World Success Stories.” Sponsor: DrFirst. Presenters: Alistair Erskine, MD, MBA, CIO/CDO, Emory Healthcare; Jason Hill, MD, MMM, associate CMIO, Ochsner Health; Colin Banas, MD, MHA, chief medical officer, DrFirst. Health system leaders will describe how they are empowering clinicians with reliable patient data while minimizing workflow friction within Epic. They will offer real-world experience and tips on how to deliver the best possible medication history data to clinicians at the point of care, use clinical-grade AI to infer and normalize prescription instructions in Epic, and encourage patient adherence to medication therapies for optimal outcomes.

January 24 (Wednesday) noon ET. “Medication Management Redefined.” Sponsor: DrFirst. Presenters: Nick Barger, PharmD, VP of product, DrFirst; Caleb Dunn, PharmD, MS, senior product manager, DrFirst. Clinical workflow experts will paint a reimagined vision for e-prescribing that offers enhanced patient adherence, customizable clinical support, intelligent pharmacy logic, and data integrity and safety. Join this first chapter of an ongoing conversation about what medication management should be, how to deliver greater benefits today, and how to prepare for the future. Elevating your solution and customer benefits isn’t as hard, scary, or economically challenging as you may think.

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

Acquisitions, Funding, Business, and Stock

98point6 acquires Bright.md’s 17 telehealth customers and hires six of its employees. 98point6 announced last year that it would pivot from being a virtual care provider to offering technology, after which it sold off its chatbot, self-insured employer business, and physician group to Transcarent for $100 million. Bright.md, meanwhile, sold its asynchronous virtual care technology to Cigna’s Evernorth Health Services subsidiary last October.

Healthcare analytics vendor Innovaccer acquires Cured, which offers healthcare digital marketing software. Cured’s three co-founders started their careers with Epic.

Per diem staffing provider Aya Healthcare acquires UK-based workforce solutions provider ID Medical, which will make Aya’s platform available to NHS and UK-based clinicians.

Sales

• Bluewater Health in Ontario will replace its Meditech system with Oracle Health by the end of this year. The health system made a similar announcement in 2019, along with several other local hospitals that went on to adopt the then-Cerner software.

People

Sarah Bennight (Carenet Health) joins IKS Health as SVP of marketing.

NCQA names Tricia Elliott, DHA, MBA (Northwestern Medicine) VP of quality implementation within its quality measurement and research group.

Announcements and Implementations

Capital Region Medical Center (MO) will adopt Oracle Health as a part of its now-finalized integration with MU Health Care.

Midwest Cardiovascular Institute (IL) will implement real-time monitoring, AI-powered diagnostics, and other digital health technologies from Livemed Telehealth.

Baptist Memorial Health Care (MS) finalizes its acquisition of Anderson Regional Health System, which will share Baptist’s Epic system.

Luminis Health (MD) rolls out Teladoc Health virtual nursing technology across its acute care hospitals.

Essentia Health-Mid Dakota Clinics in North Dakota will go live on Epic this month.

Hackensack Meridian Health (NJ) implements Volpara Health’s breast cancer risk assessment and clinical decision support software.

In Canada, Quebec’s implementation of Epic will cost $1.1 billion USD if it is approved for full implementations, with the first go-live expected at the end of 2025. Epic would replace the Quebec Health Record, whose completion ran 10 years late and triple the original budget at $1.3 billion USD. Quebec chose Epic over the other finalist Cerner in September 2023, estimating the project’s cost at up to $2.2 billion.

In vitro diagnostics vendor BioMérieux will acquire Lumed, which offers antibiotic and infection monitoring software to hospitals.

Privacy and Security

A radiology practice in Sydney, Australia, tells patients that a November data breach was caused by an unspecified IT issue, all the while dealing with harassing phone calls and texts from the breach’s perpetrators.

Liberty Hospital in Missouri declares it has “significantly recovered” from a December 19 cyberattack that forced it to temporarily divert ambulances and revert to downtime procedures for several weeks.

Other

South Dakota Governor Kristi Noem presents Avel ECare physician Katie DeJong, DO and Casie Hunter, RN along with EMT Ed Konechne with the Governor’s Award for Heroism for their roles in saving the life of a rancher who was critically injured in a bison attack. Konechne used the state-funded ambulance telehealth system to get ED physician instructions from DeJong, who was 140 miles away, and to then alert the hospital that they were en route.

Sponsor Updates

• Bamboo Health will exhibit at the Massachusetts Health & Hospital Association Annual Meeting January 25-26 in Boston.
• CereCore honors innovation and collaboration amongst its employees at its annual Connection event.
• Nordic publishes a new episode of its “Designing for Health” podcast titled “Interview with David Butler, MD.”
• Divurgent releases a new episode of The Vurge Podcast, “Change Champions with Amy Horner: Strategies, Leadership, and Personal Growth.”

Blog Posts

• How healthcare will evolve in the next decade (Arcadia)
• Enablement of hospital-based precision dosing with the DRE (Aridhia)
• Meet the Clinician – Calvin Janney (Ascom)
• The Future of Healthcare: AI in Prior Authorizations (Availity)
• The Privacy Impact Assessment: Identifying and Minimizing Risks of PII Exposure (Clearwater)
• CloudWave’s 2024 Predictions Part 2: How AI Will Transform Healthcare in 2024 (And What CIOs Must Do to Prepare) (CloudWave)
• Hospital Finance Predictions for 2024 (Dimensional Insight)
• How Clinical-Grade AI Streamlines Healthcare Workflows (DrFirst)
• Start the Year Off Right: Strategies for Enhancing Revenue Cycle Performance (Vyne Medical)

Contacts

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

Morning Headlines 1/16/24

Harbor Health Secures $95.5 Million in New Funding to Expand and Enhance Primary & Specialty Care Services in Central Texas

Texas-based hybrid healthcare provider Harbor Health raises $95.5 million, bringing its total raised to more than $218 million.

IT failure caused weekend chaos at Sussex hospitals

University Hospitals Sussex NHS Foundation Trust in England recovers from a power outage-induced IT and phone systems failure over the weekend that forced its facilities to divert ambulances and revert to downtime procedures.

Quantum Radiology cyber attack: Former and current employees data targeted

A radiology practice in Sydney, Australia, tells patients a November data breach was caused by an unspecified IT issue, all the while dealing with harassing phone calls and texts from the breach’s perpetrators.

Curbside Consult with Dr. Jayne 1/15/24

I’ve been practicing in the telehealth space since before the pandemic. We deal with a lot of situations that other physicians don’t want to deal with – patients calling for antibiotics, patients with questions about lab results they received through their patient portal after most physician offices are closed, and requests for refills on chronic medications for patients who haven’t been seen by their physicians in a long time period.

Most of the primary care physicians I talk to are grateful that we are out there as a buffer, allowing their patients to receive care without having to be on call 24×7 themselves. However, this week I discovered that apparently a subset of physicians thinks that those of us who practice telehealth exclusively are less than “real” physicians. A newly formed physician education program refused to let me join because I didn’t have an ID badge that has a hospital-style “PHYSICIAN” designation on it. In fact, I don’t have an ID badge at all, which was also an issue.

I submitted a copy of a different photo ID along with a copy of my state medical license, thinking that would suffice. Instead, they asked me for my National Provider Identifier number, which was particularly silly since that can be found via a web search. Once I provided that, they wanted copies of my medical school diploma and residency completion certificate. I’m not sure why a state license wasn’t sufficient, and I hope they had fun trying to read the Latin on my diploma. I had to go digging for those documents since I’m not one of those folks that has them hanging on my office wall. Next time I’ll just use the magic of computers to make a simulated ID badge and be on my way.

The entire experience was annoying, though, and impacts not only telehealth physicians, but any physician who isn’t working in a clinical setting. One doesn’t stop being a physician because they’re not seeing patients. I am definitely going to address this once I am established in the program.

Speaking of annoyances, I had to deal with some annoyances from CMS this week. I received an email from the CMS Identity Management System telling me that my account was going to be deleted due to inactivity. I attempted to log on but couldn’t, and the password recovery system presented a security question that I swear I’ve never seen in my life, because I would have said it was ridiculous if I had. It asked me to provide a telephone number for a relative that was not my own number. I tried to guess when it was that I had set up the account and tried some numbers, which of course were not correct, and the account was locked. The system unhelpfully told me that I needed to call the help desk associated with the application I was trying to access, which was also silly because I have access to multiple applications through the CMS Enterprise Portal. Each of them has their own help desk.

Of course, I was trying to do this at 10 p.m., so I waited until the next business day when I had a gap in my schedule and started calling help desks. The first one was closed because their office hours are only until 4 p.m., and the second one allowed me to hold for 11 minutes and then disconnected me. I called right back and went directly to an agent, so I can only assume their phone system was having a momentary malfunction. The agent clearly had no idea how to help me and was reading from a help desk manual and couldn’t even pronounce some of the application names. He provided another phone number to call. That agent asked me for a bunch of personal data. I finally interrupted and asked whether she’d like to know why I was calling. She seemed surprised that I would want to tell her that. I told her my story, and she said, “Oh, so you just need a password reset?” Bingo! She switched gears and did the reset, giving me a 15-character complex password that I had to write down.

Fortunately, she stayed on the line while I did the reset. The process requires two-factor authentication. I chuckled when I got to the screen that recommended Google Authenticator because it’s supported for “iPhone, Android Phone, and Blackberry.” I wonder how many Blackberry devices they get accessing their system these days. Finally, I was able to set a new password and was on my way. The agent disconnected and I went to set a new security question, since I still had no idea what the answer was for the one with a relative’s phone number.

The list of security questions had some interesting choices. Not only were they strange, but they’re also things that change over time for many people, which doesn’t make them a good security question. The highlight reel:

• What did you earn your first medal or award for? Hmmm, was it swim team or horseback riding in elementary school? I have no idea.
• What is your favorite movie quote? I’m at a point in my life where I can barely remember the things I’m supposed to remember, let alone the specific grammar and syntax of a movie quote.
• What music album or song did you first purchase? I seriously have no clue since it was more than 40 years ago.
• What was the first computer game you played? Truly have no idea here either, although I was tempted to put Oregon Trail due to the lack of good questions.
• What was your grandmother’s favorite dessert? I can’t wait until I’m old enough to have a grandchild call and ask me this.
• Where were you on New Year’s Eve in the year 2000? I think the better question for healthcare workers was where we were on New Year’s Eve in 1999, since many of us were in Y2K hell.
• Who is your favorite book/movie character? I read more than 50 books a year, so I wasn’t touching this one.
• Who is your favorite speaker/orator? I can’t remember the last time I saw the word “orator” and was tempted to put Abraham Lincoln, but I knew I wouldn’t remember that down the line either.
• What is your favorite security question?

I couldn’t believe it when I got to that last one. Again, how would I ever remember the syntax if I selected that one? Maybe “what is the answer to your favorite security question” would have been a better option, since it wouldn’t involve more than a word or two. Still, the entire experience was bizarre and fortunately I was quick enough to grab a screenshot of the list of crazy questions. I sent it to one of my favorite online security experts who replied with four different kinds of eye-roll emojis and GIFs. You can’t make this up, folks. Thanks to CMS for keeping it real.

What’s the weirdest security question you’ve seen? Leave a comment or email me.

Email Dr. Jayne.

HIStalk Interviews G. Cameron Deemer, CEO, DrFirst

G. Cameron “Cam” Deemer is CEO of DrFirst of Rockville, MD.

Tell me about yourself and the company.

I was a latecomer to healthcare IT. I started my career in the ministry and didn’t get into this side of the industry until the early 1990s. I started working with PCS Health Systems in Scottsdale, Arizona. I did about a decade with PBMs, worked with NDC Health for a couple of years building what became Surescripts later, and then joined DrFirst in 2004.

When I joined DrFirst, I would have called it an e -prescribing company, which would have been easy to understand. But since then, we’ve developed a much broader vision. Today, the company is about making sure that patients have their best outcomes through their medication therapy. We do that through offering technology platforms that help providers work with patients around things like electronic prescribing, medication reconciliation, and population health. Our fastest-growing platform addresses patient adherence to therapy.

How has the original vision of e-prescribing expanded?

I had a front-row seat in the early days of e -prescribing. We did some seminal piloting of e -prescribing when I was with PCS. It has gone from essentially a record of what would have been written on a piece of paper to being a more fully informed decision support system.

As an example, we connect to all of the state PDMPs, the controlled substance registries, so that a doctor can consider that information at the same time they are writing the script. They have a much better idea of whether someone is drug seeking or legitimately coming onto therapy. Similarly, a real -time benefit check allows them to understand exactly how much the patient is going to pay. Then, bringing other information in from outside, such as formulary status and electronic prior authorization. Essentially e -prescribing has become an ecosystem as opposed to just a replacement for the prescription pad like it was originally started.

How does seeing cost and insurance coverage at the time of prescribing improve patient outcomes as well as patient satisfaction?

We view it as two parts. There’s what happens in the doctor’s office when they are  prescribing therapy, and then what happens after the patient is released back into the wild to act on the prescription.

In the physician’s office, we think that real -time benefit improves compliance with therapy, because it finally gives the physician a real idea about the impact of what they are prescribing. How much is this drug going to cost versus that drug? Or is therapy going to be delayed because you have to go through a prior authorization if you choose this therapy versus that therapy? It is giving the physician real insight. They already know what they want to write, so now they get insight into what the outcome will be from the patient’s perspective.

The reason that we started working downstream from there, on what happens to the patient after they walk out of the office, is that we often found that the providers maybe didn’t have time, or maybe they weren’t focused enough on the extra information, and weren’t necessarily helping the patient make a decision that would be ideal for the patient to then go fulfill the therapy. 

We try to hit the patient immediately after they leave the doctor’s office with more information. What prescriptions were written? Where are they going to get them filled? We have a call to action to pick up the prescriptions. We provide financial assistance information if the physician has chosen a drug that is extraordinarily expensive for the patient. We give the patient the tools to make up for what may have been missed when they were in the provider office, or to reinforce the decision the provider made.

Have coupon-type programs, such as manufacturer assistance programs or GoodRx, made displaying patient prices more complicated?

Systems have come a long way in being able to present all that at once. From a provider perspective, they wouldn’t be perceived as a set of different decisions. At least for our system, it’s all combined into one decision point, so the physician can consider them all at once. From a patient perspective, it would only really be one thing, because their therapy has already been decided at that point. Now they just have the one decision to either pick it up or don’t pick it up. The financial incentives can help them with the “pick it up” decision if they are available.

Has the prior authorization process, which everyone seems to agree is burdensome, improved?

Boy, I agree that it needs to be fixed, so I’m on that page. Prior authorization is widely recognized as a coping mechanism, a way to stem the flow of products that the payers feel are expensive. They don’t necessarily want to cover the therapy unless they are pushed to do so.

I’m not sure how much incentive exists to truly fix it. Truly fixing would look like the barriers make sense and they are readily overcome. What’s going on in the industry right now to fix it is that when the physician is confronted with a screen they have to fill out for the prior authorization, can we just grab that information out of the EHR, fill in the form, and let the physician have very little work to do to send that PA?

The whole thing is counterintuitive. They are intended as a barrier. Making it easy makes the barrier less effective. It’s an interesting problem that I’m not sure we are really solving yet.

If the prior authorization is a prescribing speed bump that payers hope will discourage the prescription, what interest would payers have in solving the problem? Why couldn’t they look at a prescriber’s history, even with AI if needed, and bypass the front-end work unless that provider is an outlier in deviating from accepted norms?

That would be a fascinating way to handle it. I’ve actually not thought about that before, but with machine learning and AI, you should be able to analyze, give the doctors some kind of performance score, and put a lower set of barriers in front of those who are good actors. There would be a lot of discussion about what equals a good actor from a provider perspective. I imagine there’s a wide range of thought on that.

An interesting development is Lilly’s program, where they are to some degree working around these kinds of restrictions with some of their new drugs for weight control and diabetes management. They appear to be sidestepping the process and maintaining pricing control rather than throwing rebates at formulary status. 

Rather than being told that your drug will go off formulary unless you can bring this price way down from a PBM perspective and that you will be faced with a prior authorization hurdle that will be a giant pain to get people on, they are essentially setting up a parallel system. Patients can have relatively simple access to the drug and they can help manage the cost for the patient without causing the kind of disruption to everybody that a massive rebate program causes. Good or bad, I think it’s a really interesting approach that was creative on Lilly’s part.

It’s also interesting that they are working with third-party companies for telehealth prescriptions and pharmacy fulfillment. Will other drug companies follow suit?

I want to reinforce that what they have effectively done with those third parties is sidestepped the plan design. Patients are being asked to go outside of the health plan that they are paying for, and instead participate in this other parallel program that’s been set up for these drugs.

That will make it a little more difficult for other drugs. Not many drugs have the demand profile of the weight loss drugs. If your expensive drug is less in demand, there’s probably less incentive for the patient to step out of their plan design. I’m paying for this insurance, I should use it, that kind of psychology, so I wouldn’t think that everybody will be in a position to follow suit. But it’s a creative model when the drugs fit the profile that would make this work. It’s brand new, so we don’t know yet.

Lilly is also potentially keeping some of the revenue that would have otherwise gone to PBMs or pharmacies while gaining control over pricing. Is there a DrFirst technology implication for manufacturers that sell drugs directly with patient discounts?

One of the things we are excited about is our ability to engage patients, let’s say five minutes after they leave the doctor’s office. Because of our position in workflow on the prescriber side, we actually know when the electronic prescription has been sent. At that point, we can reach out and engage a patient. We are four and a half million patients a week touching about one out of every four new prescriptions. Our scale has  gotten fairly large because of the number of EHRs that we work with.

As a result of that, we are in a position to work with somebody like Lilly to be an entry point for patients into their program who might not know about their program. In the event that the physician bypasses whatever opportunities Lilly has provided for them, we have an opportunity to talk to both the provider and the patient because we sit squarely in that workflow. So yes, I hope we can be a part of that. I really enjoy these creative solutions to persistent problems around cost in healthcare.

What is the state of medication history and its delivery directly into the clinician’s EHR workflow?

I would say not greatly improved. There may be broader access to records now, a more complete patient record. But not much has happened to clean up the dirtiness of the data, this kind of shady underbelly of the whole data space. We spend a lot of time on data optimization because we find that the data feeds still are not semantically usable by the people who receive them.

As an example, somebody who creates a record might be using Latin abbreviations, and somebody who is receiving it might use English abbreviations. No matter what abbreviations they use, they can still write the sigs [abbreviations for instructions] differently and you can make millions of different combinations out of any given sig, depending on how the one system prepared it and how the other system wants to receive it. A big part of our business remains matching those data feeds up. How do you massage the incoming feed to make sure that all the fields are discrete and all the data elements are ready to be imported into the receiving system so that somebody doesn’t have to manually retype it?

That kind of data optimization is still missing from the industry and still needs to be handled independently before a system can receive the records. The bottom line is that I would say that there’s availability of a lot of records now, more than there’s ever been, but they are still just as dirty as they were years ago and still need that cleanup.

What role do you see for AI in your business and the industry in general?

We’ve been all over AI for data optimization for at least six years now, and it makes a huge difference. Machine learning and AI provides a much more elegant and complete solution than, say, a table of substitutions. You can only anticipate so many errors that a person might make, and the ability of the AI to sort that out automatically is huge. We end up with much higher rates of cleanliness of the data than are available through traditional methods.

We call that augmented intelligence, meaning that we do the cleanup, but then we provide the clinician with both the original and the cleaned up version. If they’re good with it, they can just say, “That’s good.” Otherwise, they can tweak it if it’s incorrect in some way. We put most of our focus on trying to find practical problems in the workflow and provide an efficient solution so that providers can get more work done and get away from that burned out feeling of having to retype everything.

What are the company’s near-term priorities?

One of our major business lines is providing e-prescribing platforms for EHRs. We serve over 300 EHRs in that way. A major change is coming in 2027, when Surescripts is going to implement the 2023 version of the SCRIPT standard. We expect other changes to come along with that. That will make everybody stop and do major development in their systems again. A big part of what we’re going to do over the next few years is work on helping people with that conversion. Some will decide that this is the last straw and that it’s not worth maintaining their own e-prescribing channel any more and we’ll be able to do integrations with additional companies. It will be a major focus to make sure that the industry is ready for this big change in coming in 2027 around prescribing standards.

Another major focus for the company is to continue to drive our adherence programs. We believe that we will eventually get to one out of every two new scripts, and when we have that level of aggregation, we will be meaningfully able to address things like access to specialty scripts. The industry is moving towards specialty drugs at this point, and those have all kinds of access challenges. We’re going to be spending a lot of time cleaning up those processes for the industry and making sure that patients can get on therapy quicker and stay on therapy for specialty.

The last thing is perhaps a little controversial, but we believe that it’s time to take a hard look at what happens after a script leaves the doctor’s office before it gets to the pharmacy. We’ve been working since the 2000s under a 50-year-old technology, the switching network that we use to move scripts between doctors and pharmacists. It’s a lowest common denominator solution that lets everybody have a level playing field, but doesn’t give anybody an opportunity to innovate and try new models.

We’re going to be breaking out of that mold over the next few years. We are standing up a capability to provide real innovation in this space with a broader set of data exchange between providers and pharmacies to enable better business flows on both sides of the equation. Just think about when you write a script, knowing that the drug is in stock at the pharmacy you are writing it to. Or if you’re on the pharmacy side trying to do some primary care type functions, think about what it would mean to get a patient record at the same time the script comes to you. That kind of innovation isn’t available today. We’re going to make that a part of how the industry works going forward.

I got into this industry in 1992 and have been talking to pharmacists this whole time. They are always trying to find that a breakthrough to be able to work at the top of their license, but never getting there. We’re developing our pharmacy channel to get closer to pharmacy. That takes a while. It’s a big area, and you need to build some trust. But I’m hoping that we can finally help them practically get there where they’ve really struggled before. Since we have theses massive EHRs behind us on one side and pharmacy customers on the other side, we believe that we can finally bring them together so that we get this real collaboration around the patient that has eluded the industry for a long time.

Morning Headlines 1/15/24

Towards Conversational Diagnostic AI

A Google-created AI system called AMIE that was optimized for diagnostic dialog outperforms primary care doctors in synchronous text chat with patient actors.

Broadwest’s luxury hotel to host Oracle’s larger-than-anticipated health care summit

Oracle pushes its Health Summit back from February to April and moves it to Nashville, where it will also build a new campus using $175 million in economic incentives.

Law firm that handles data breaches was hit by data breach

A law firm that specializes in business security incidents is itself hit by hackers, exposing the identity, medical, and insurance information of 637,000 people that it had collected from its security incident clients.

Monday Morning Update 1/15/24

Top News

A Google-created AI system called AMIE that was optimized for diagnostic dialog outperforms primary care doctors in synchronous text chat with patient actors. The authors warn that while this isn’t representative of clinical practice and thus places clinicians at a disadvantage to AI, the accomplishment is still a milestone in developing conversational diagnostic AI.

The evaluation criteria included history-taking performance, diagnostic accuracy, management reasoning, communication skills, and empathy.

The authors observe that history-taking and diagnostic dialog is dependent on context and requires a high level of clinician skill.

The tool was trained on medical licensing exam questions, real-life medical summaries, and audio transcripts from 100,000 medical conversations. It was further trained and refined by using self-play, where AI improves its performance by playing against itself and analyzing which of its approaches were successful.

Reader Comments

From A Beautiful Mind: “Re: Amazon. Your post about Health Conditions got me thinking about previous Amazon healthcare forays such as HealthLake, One Medical, etc. Do you speculate that they are throwing a lot of darts to see which ones stick, or is there a John Nash-like team in Seattle piecing together the chaos for ultimate world domination, and oh yeah, improving care and lowering costs?” Amazon is smarter than I, but I don’t understand its healthcare plan. The company doesn’t always hit healthcare home runs (see: Amazon Care, Haven, and Halo) but it swings a mighty bat and learns from failure. It hasn’t done much with online pharmacy PillPack, and buzz about its “all the pills you take for $5 per month” RxPass died down pretty quickly after it was announced a year ago. It paid $4 billion for money-losing primary care concierge practice One Medical, with few changes except to offer Prime members a discount on joining One Medical, which still bills insurance traditionally and is now is exposed to Amazon-recruited members who are older and less affluent that One Medical’s former client base. Amazon’s recent offerings seem to focus on charging to advertise third-party healthcare businesses. Healthcare is a financially appealing vertical, but is notoriously hard for even big-name outsiders to penetrate due to billing complexity; a hellish regulatory environment; the local and trusted presence of big health systems and national drug chains where Amazon is to many just a website or app that often sells offshore-sourced junk using phony reviews, and the challenge of scaling without killing someone. I think of Amazon as a company that makes money from selling ads, fulfillment services, and AWS with zero personal touch, which doesn’t suggest a broadly disruptive role in healthcare.

From Y2K11 Maverick: “Re: HIStalk. I last said this 10 years ago, but it has remained true. Rarely does a week go by that 1) I don’t learn something new by reading HISTalk updates and/or 2) I pass along something from your posts that my colleagues hadn’t seen before. THANK YOU for all that you’ve done, do and (hopefully) continue to do for us schmoes who are just trying to keep up! Loyal listener since 2011!” Thanks.

From JD: “Re: Billy Idol at ViVE. Your mention reminded me of John Lydon, aka Johnny Rotten of the Sex Pistols, who was his wife’s caregiver.” The 67-year-old punker was a full-time caregiver of Nora Foster, his wife of 44 years, for nearly 15 years until she died of Alzheimer’s in April 2023 at 80 years old. He said in an interview just before she died, “We know that she’s going to slowly deteriorate into something catastrophic, and then death. But she will enjoy every step of it, and I’m here to make sure of that because she’d do the same for me.”

From JustScratchingMyHead: “Re: the Texas surgeon sharing gender-affirming care records.  While technically he did redact the information, it still seems procedurally not correct and I would think the hospital would have some type of policy about screenshots being taken and sent externally. What happens when the next provider sends the information without proper redaction or none at all?” Ethan Haim, MD graduated from his Baylor surgical residency the day that HHS knocked on his door. He was an anonymous whistleblower until June 2023  and has moved on to Hunt Regional Healthcare as a general surgeon. The hospital’s bigger beef with him beyond screenshots would have been his efforts to get them in trouble with the state. He likens transgender interventions for children to COVID, arguing that both involve scant peer-reviewed medical evidence and the institutional censorship of those who question it.

HIStalk Announcements and Requests

Provider poll respondents aren’t confident that their employer-paid conference attendance generates ROI. However, commenters add that attendance has value beyond immediate ROI, such as gaining knowledge, networking, and recruiting.

New poll to your right or here, for provider employees: which is your preferred medium to learn what a vendor does? This is in response to user comments. I’ll admit that while I’m critical of TL;DR types who can’t read more than two consecutive sentences without blaming the author with indignation rather than embarrassment for their phone-stunted attention span, I’m similar with videos, however – people who host them and love themselves excessively sometimes can’t shut up and let their guests speak. I f a video can’t tell me something useful in the first 30 seconds (or a text article in three sentences), the situation isn’t likely to improve and I move on.

Your to-dos for supporting what I do:

• Join my spam-free mailing list.
• Connect on LinkedIn and join Dann’s HIStalk Fan Club so that I see your posts and job changes.
• Tell my sponsors, or potential ones, that you value their support.
• Share news, rumors, and intriguing insights.

Webinars

January 19 (Friday) 1 ET. “Unlocking Reliable Clinical Data: Real-World Success Stories.” Sponsor: DrFirst. Presenters: Alistair Erskine, MD, MBA, CIO/CDO, Emory Healthcare; Jason Hill, MD, MMM, associate CMIO, Ochsner Health; Colin Banas, MD, MHA, chief medical officer, DrFirst. Health system leaders will describe how they are empowering clinicians with reliable patient data while minimizing workflow friction within Epic. They will offer real-world experience and tips on how to deliver the best possible medication history data to clinicians at the point of care, use clinical-grade AI to infer and normalize prescription instructions in Epic, and encourage patient adherence to medication therapies for optimal outcomes.

January 24 (Wednesday) noon ET. “Medication Management Redefined.” Sponsor: DrFirst. Presenters: Nick Barger, PharmD, VP of product, DrFirst; Caleb Dunn, PharmD, MS, senior product manager, DrFirst. Clinical workflow experts will paint a reimagined vision for e-prescribing that offers enhanced patient adherence, customizable clinical support, intelligent pharmacy logic, and data integrity and safety. Join this first chapter of an ongoing conversation about what medication management should be, how to deliver greater benefits today, and how to prepare for the future. Elevating your solution and customer benefits isn’t as hard, scary, or economically challenging as you may think.

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

Sales

• Outpatient rehab provider Ability KC choses Netsmart’s TheraOffice EHR/PM.

Announcements and Implementations

Oracle moves its Health Summit to Nashville and pushes it back from February to April. Tennessee offered Oracle $175 million in incentives to build a $1.4 billion campus in Nashville that will likely have a significant Oracle Health presence. The company’s Oracle Health Conference, the former Cerner Health Conference, was held in Las Vegas in September 2023.

Government and Politics

The chairs of the Kansas senate commerce and house judiciary committees ask Governor Laura Kelly to explain why the Department for Children and Families awarded $7.7 million of a $18 million federal social services grant to software vendor Unite Us. They question why so much of the money will be sent to an out-of-state company instead of being used to support local social service programs.

A Bloomberg article on the effects of significant national relocation on elections highlights Epic, whose large headcount and 3,000 hires in 2023 are mostly young and college educated.

A Senate subcommittee reviews finds that national drugstore chains don’t require a warrant to provide law enforcement with the patient records they request for whatever reason, with Sen. Ron Wyden (D-OR) calling for HHS to update HIPAA to require pharmacies to insist on a warrant before disclosure in response to regulatory and law enforcement records requests.

Privacy and Security

A law firm that specializes in business security incidents is itself hit by hackers, exposing the identity, medical, and insurance information of 637,000 people that it had collected from its security incident clients.

Other

Former Olympic gymnast Mary Lou Retton was uninsured for her month-long hospital stay for pneumonia, for which she blamed pre-existing conditions and lack of affordable premiums. Either she’s not telling the whole story or she is unaware of Affordable Care Act plans that are legally required to cover pre-existing conditions and extend premium subsidies based on income. The 55-year-old Retton says she has since obtained insurance, but didn’t say if she paid for it from the $460,000 her four daughters raised for her via social media. She declines to name the hospital.

Sponsor Updates

• Meditech reports record international growth for its Expanse EHR in 2023.
• Nym will exhibit at the HFMA Western Region Symposium January 21-24 in Las Vegas.
• Optimum Healthcare IT announces that it has been named a Workday Staffing Partner.
• Verato publishes a new e-book, “How to overcome HHS identity management challenges.”

Blog Posts

• To sit or not to sit: How a chair can affect patient satisfaction (Nordic)
• The Power of Listening: Three key components of an effective change management program – Part 1 (Qgenda)
• How to Simplify Affordability in the Specialty Medication Workflow (RxLightning)
• Not Exactly a Crystal Ball, but 8 Healthcare Trends to Watch for in 2024 (Symplr)
• Oklahoma Supports Family Caregivers with Groundbreaking “Caring for Caregivers Act” (Trualta)
• 5 most unproductive touches in the healthcare RCM process (Waystar)

Contacts

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

Morning Headlines 1/12/24

Artisight to Scale and Advance AI-driven Smart Hospital Platform with Oversubscribed $42 Million Series B Round

Artisight, which offers a smart hospital platform, raises $42 million in a Series B funding round.

New Veradigm Leadership Provides Outlook on Business and Strategy, and Refreshed Financial Estimates for Fiscal 2023

Veradigm lowers its FY2023 revenue and earnings guidance below consensus estimates, noting in an SEC filing that it doesn’t yet know when it will file overdue financial reports for the last three quarters and year-end of FY2023 or convene its annual meeting of shareholders.

Hewlett Packard Enterprise to buy Juniper Networks in $14 bln deal

Hewlett-Packard Enterprise will acquire AI-enabled enterprise networking and security technology company Juniper Networks for $14 billion.

Graphium Health Acquires The ABG Anesthesia Data Group Strengthening Anesthesia Quality and Safety Initiatives

Anesthesia healthcare technology vendor Graphium Health purchases The ABG Anesthesia Data Group, which specializes in qualified clinical data registries management.

News 1/12/24

Top News

Artisight, which offers a smart hospital platform, raises $42 million in a Series B funding round.

Co-founder and CEO Andrew Gostine, MD, MBA formed the company while working in his anesthesiology residency.

Reader Comments

From Video Kills Brain Cells: “Re: vendor videos. I saw Dr. Jayne’s mention that she doesn’t watch them. You should conduct a poll.” I’m with Dr. Jayne in usually declining to spend time consuming vendor videos or podcasts. Skimming text visually is faster than watching even 3x speed video unless the graphics are uncharacteristically vital. My advice to those who create multimedia is to avoid making it an either-or situation – send your video or audio files to an AI-powered transcription service like I use, and for an incremental cost and time of just about zero, you can post the transcript along with the original and satisfy both audiences. Requiring people to sit through your precious AV meanderings is a vanity play that excludes some folks who might be interested. Perhaps my poll will ask whether respondents are decision-makers since I don’t picture many C-suite members using video as their preferred vehicle for gaining industry information.

From Letme Throw: “Re: AI. I”m curious to hear your thoughts about the 2024 strategies that were announced by Oracle Health and Epic.” Oracle’s Larry Ellison talked up AI and voice-powered user interfaces in announcing the Cerner acquisition in December 2021, saying that Oracle would jump-start the business converting to a primarily voice-based UI for Millennium using Oracle’s Digital Assistant (along with creating a national EHR database, rewriting Millennium, getting the VA’s implementation done, etc.) I haven’t seen examples of Oracle Health’s real-life use of AI, not to mention that it won’t really matter if they keep losing customers to Epic. Epic seems to be way ahead, with some of its clients testing or using ambient listening documentation, inbox management, scheduling automation, AI-enhanced Cosmos research inquiries, and enhanced patient communications. Epic’s user base of huge academic health systems also gives it access to on-the-ground innovators who have the resources to design, use, and even develop AI-related tools that have an actual use case that is free of Oracle’s vested interest as a tech company in selling technical products to Cerner users. I would have low expectations of the provider impact of a quick bolt-on of Digital Assistant. I would enjoy hearing directly from Cerner and Epic customers about how they are using, or hoping to use, AI with their respective products. Also note that Meditech has arguably done a lot more with AI in Expanse than Oracle Health in Millennium, and at a friendlier price point.

HIStalk Announcements and Requests

Something reminded me of one-time high flyer Nant Health, which hit $21 per share on its first day of trading in mid-2016 drug billionaire Patrick Soon-Shiong, MD launched several Nant-named companies. Those shares are now at $0.06, valuing the company at $12 million. The company’s headquarters address is a UPS store in the tiny town of Winterville, NC, a few steps away from the notable Sam Jones BBQ.

Webinars

January 19 (Friday) 1 ET. “Unlocking Reliable Clinical Data: Real-World Success Stories.” Sponsor: DrFirst. Presenters: Alistair Erskine, MD, MBA, CIO/CDO, Emory Healthcare; Jason Hill, MD, MMM, associate CMIO, Ochsner Health; Colin Banas, MD, MHA, chief medical officer, DrFirst. Health system leaders will describe how they are empowering clinicians with reliable patient data while minimizing workflow friction within Epic. They will offer real-world experience and tips on how to deliver the best possible medication history data to clinicians at the point of care, use clinical-grade AI to infer and normalize prescription instructions in Epic, and encourage patient adherence to medication therapies for optimal outcomes.

January 24 (Wednesday) noon ET. “Medication Management Redefined.” Sponsor: DrFirst. Presenters: Nick Barger, PharmD, VP of product, DrFirst; Caleb Dunn, PharmD, MS, senior product manager, DrFirst. Clinical workflow experts will paint a reimagined vision for e-prescribing that offers enhanced patient adherence, customizable clinical support, intelligent pharmacy logic, and data integrity and safety. Join this first chapter of an ongoing conversation about what medication management should be, how to deliver greater benefits today, and how to prepare for the future. Elevating your solution and customer benefits isn’t as hard, scary, or economically challenging as you may think.

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

Acquisitions, Funding, Business, and Stock

Veradigm lowers its FY2023 revenue and earnings guidance below consensus estimates. MDRX shares have lost 47% of their value in the past 12 months, much of that in a big price drop in early December. The company said in an SEC filing Wednesday that it doesn’t yet know when it will file overdue financial reports for the last three quarters and year-end of FY2023 or convene its annual meeting of shareholders.

Rune Labs, whose FDA-cleared software tracks symptoms of Parkinson’s disease via the Apple Watch, raises a $12 million funding round. CEO Brian Pepin, MSEE founded the company after leaving his senior hardware engineer job at Verily Life Sciences in late 2018.

An Apple share price drop caused by demand doubts makes Microsoft the world’s most valuable company. Had you invested $10,000 in MSFT shares 10 years ago, you would have nearly $102,000 today, or if you are former CEO Steve Ballmer, you would be rolling in $128 billion worth of shares that throw off $1 billion per year in dividends.

Sales

• Spectrum Healthcare (AZ) chooses NextGen Healthcare for EHR/PM.

People

Industry long-timer Jeff Stern (Carium) joins Brado as VP of business development.

Announcements and Implementations

AI medical scribing technology vendor DeepScribe launches integration with Epic’s SmartData elements, allowing users to customize note preferences and standards that are mirrored in Epic.

Clearsense will present Billy Idol live in concert at ViVE 2024 in Los Angeles next month. I saw him a few years ago and he puts on a good show that goes beyond sneering through “Rebel Yell.” I’m predictably skeptical about the relevance of celebrity entertainment to healthcare, but if you are spending your employer’s money to attend ViVE, you might as well happily pump your fist overhead along with the punk rocker, who has been Medicare-aged for several years.

Amazon rolls out its Just Walk Out checkout-free technology to hospitals, allowing employees to pay for food by scanning their badges to create a payroll deduction.

PerfectServe’s Lightning Bolt describes combinatorial optimization, a mathematical process that chooses the best possible solution given a finite set of possibilities. The interesting article describes, with some level of detail, how the company uses that process, rather than the more common heuristic method, to build the best physician schedules. The article wasn’t credited, but someone did a nice job of explaining a useful concept.

Caregility announces its new telehealth edge devices for hospital-based telehealth such as e-sitting, virtual rounding, patient-family communication, and tele-ICU, with OhioHealth and UMass Memorial Health being early adopters.

Palantir and University of Colorado Anschutz Medical Campus establish the Center for Linkage and Acquisition of Data as part of the NIH’s All of Us research program. The project will integrate claims and mortality data and address the challenges of linking EHR data from health information networks to improve data completeness. The principal investigator of the 18-month, renewable project – which is funded by a $30 million NIH grant —  is Melissa Haendel, PhD, the chief research informatics officer of the medical campus.

Health insurer Elevance will offer people who are covered by its Medicaid health plans a free smartphone with unlimited data, talk, and texting to provide access to digital and virtual healthcare tools, supported by funding through the FCC’s Affordable Connectivity Program.

Privacy and Security

HHS investigates a 33-year-old Texas surgeon for providing case lists of minors who were undergoing gender-affirming care at Texas Children’s Hospital to a conservative activist, which HHS deems to be a HIPAA violation. Eithan Haim, MD, who completed his residency in 2023, says that he is innocent because he redacted specific information from his Epic screen shots. The hospital said in March 2022 that it was halting provision of the services in response to the state’s interpretation that they constitute child abuse, but his records indicate that treatments continued. I’m thinking that at least from the redacted screenshot provided, he’s correct in that while he disclosed some of the 18 HIPAA identifiers (such as age and diagnosis), redacting patient-identifiable fields such as name or medical record number makes it de-identified PHI, which isn’t protected by HIPAA, although the question remains about whether he accessed and disclosed the data inappropriately if not illegally. I suppose HHS knows best.

Novant Health will pay $6.6 million to settle a lawsuit that was brought by 10 of its patients for the health system’s use of the Meta Pixel website user tracking tool.

Other

Two hospital EDs in Australia will revert to their previous IT system for six months after implementation of InterSystems TrakCare in mid-November caused long patient wait times and user frustration.

Noetik co-founder and CEO Ron Alfa, MD, PhD shares his tab for a single bottle of water at the J.P. Morgan Health Care Conference in San Francisco, where the moneylenders fly private to sit at $100 per hour lobby tables while pondering the mystery of why US healthcare is so expensive.

Sponsor Updates

• EClinicalWorks announces that McKenzie Health System (MI) is improving operations using its EHR, clinical rules engine, and robotic process automation.
• Net Health launches the next phase of its digital musculoskeletal thought leadership program in partnership with the American Physical Therapy Association.
• First Databank names Kara Zebrowski (Glytec) product manager, Hamman Eltareb (Hearst Health) health data analyst, and Christian Wong software engineer.
• Findhelp launches season two of its American Compassion Podcast about the history of the social safety net in America.
• Meditech recognizes international customers of its Expanse EHR, which include providers in East Africa, Ireland, Australia, UK, and Singapore.
• FinThrive releases a new episode of its Healthy Rethink Podcast, “He’s Here, He’s There … Virtual Care Everywhere.”
• Medicomp Systems releases a new episode of the Tell Me Where It Hurts Podcast featuring Juan Carlos Gallegos, RN senior director of product, Homecare Homebase.

Blog Posts

• A Look Back at 2023: Critical Cyber Threats in Healthcare (Fortified Health Security)
• Keys to Releasing “Hidden Clinical Capacity” (Impact Advisors)
• How Can You Use ChatGPT for Software Testing? (Keysight Technologies)
• Treatable Stage I and Stage II Colon Cancer: Importance of AI-enabled Early Detection (Lucem Health)
• 5 steps to take before embarking on your AI journey (Meditech)
• The Future of Wound Care: 5 Trends for 2024 (Net Health)

Contacts

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

EPtalk by Dr. Jayne 1/11/24

Masks are back on at my local hospitals. Our area is seeing a surge of COVID, influenza, and RSV patients. We’re seeing full intensive care units. Nursing exhaustion is approaching pandemic levels.

Across the US, hospitals are experiencing staffing challenges, which often cause beds to be unavailable because they aren’t staffed. This rolls downhill in the hospital, landing in the emergency department that has to board the patients until beds are available. In turn, this can back up ambulances, which leads to delays in 911 calls. For my friends working in EMS, this is starting to feel a lot like 2020, and in my community, the COVID-related hit to EMS staffing is still present.

If you’re on the healthcare IT side and the clinical staffers that you are interacting with seem frazzled and distracted, it’s because they are. One of my ICU nurse colleagues commented, “It’s like people forgot what we went through and just don’t care about healthcare workers any more.” Let’s remember to wash our hands, stay home when you’re sick (or wear a well-fitting mask if you can’t stay home), and look after each other. We’re all in this together.

I’ve started working on a project that involves an area of clinical informatics that I haven’t worked on in some time. To get up to speed with the vendor landscape, I’ve been visiting lots of websites to view white papers and customer case stories. Maybe my brain is just used to operating in an older way of working, but I find myself increasingly annoyed when companies have decided that the only way they’re going to share information on their websites is through videos. Some of us absorb more through reading actual words. Of course, others are more visual or auditory learners and might do better with that kind of content.

For me, it’s often a time issue. I can read much faster than most video presenters speak, which means that when there is only video content available, I tend to perceive the sites as not being a good use of my time. It left me wondering what happened to the good old written word and whether it’s just me or whether times have changed and I need to get used to my work taking 50% longer than planned.

A primary care colleague reached out to me today, venting that her organization has yet to configure the EHR to allow physicians to submit the G2211 billing code that went into effect on January 1. That’s an add-on code that allows physicians to submit charges for the time they spend building longitudinal relationships with patients and addressing patients’ issues over the long term. CMS describes the code as billable for “visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed healthcare services and/or with medical care services that are part of ongoing care related to a patient’s single, serious condition or a complex condition.”

The nature of the relationship between the patient and the physician is the factor that determines whether the code should be used. It’s worth around $16 when billed for Medicare patients, so it’s not designed to drive significant revenue, but rather to offset some of the valuable whole-person care that is provided by primary care physicians. Medicare’s documentation about the change says that the typical primary care physician who has Medicare beneficiaries in their patient panel will coordinate care with 229 physicians in 117 disparate practices. If it hasn’t yet been added to your EHR workflows, your clinicians are missing out.

The US continues to have supply and demand issues with stockpiles of personal protective equipment (PPE). A recent AP report explored the fact that states that had scarcity of supplies during the high points of the COVID pandemic are now dumping PPE at an alarming rate. Ohio has auctioned off nearly 400,000 protective gowns and has thrown away 7 million gowns along with countless masks, gloves, and other supplies. States are having to determine their go-forward strategies for supply stockpiles and preparation for potential disasters.

The amount of materials that is being shredded, recycled, or destroyed is simply staggering. Georges Benjamin, MD, executive director of the American Public Health Association, mentioned that our “bust-and-boom public health system” creates waste as well as lack of preparedness. Many states didn’t respond to the AP’s request for information, so it’s hard to know exactly how large the problem might be.

As a CMIO, I’ve worked on a number of projects around health literacy. I would bet that most people in healthcare IT don’t understand the level of understanding of the average patient. For written communications, we need to focus our writing at roughly the fifth-grade level to ensure that patients will be able to understand any instructions we provide. Organizations have also made significant efforts to provide documents for as many patient-preferred languages as possible.

I was excited to see this article that looked as the association among hospitalizations, emergency department visits, and health literacy interventions. Researchers concluded that patients who read patient education materials and summarize their understanding back to the care team are 32% less likely to be hospitalized and 14% less likely to visit the emergency department. Additionally, there was an association with overall declining health costs in patients who received the intervention. The study was performed using subjects that were part of an employee health plan, so it’s not clear if results are generalizable to all patients. Thanks to Healthwise for including this study in their blog, otherwise I would likely have missed it.

The Consumer Electronics Show is upon us, and Garmin is finally taking a giant leap forward in the realm of wearables by introducing a women’s heart rate monitor that clips onto a sports bra and doesn’t require a separate strap. For anyone who has had to deal with a heart rate monitor strap interfering with your bra, this is a welcome addition. The HRM-Fit strap retails for $150.

What are the best and worst things you’ve seen coming out of the Consumer Electronics Show? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 1/11/24

Mayo Clinic pairs with Cerebras Systems to help develop AI for health care

The Mayo Clinic will use computing chips and systems from Cerebras to develop its own AI models, such as summarizing a patient’s medical records, analyzing diagnostic images, and reviewing genomic data.

FTC Order Prohibits Data Broker X-Mode Social and Outlogic from Selling Sensitive Location Data

The FTC prohibits data broker X-Mode Social and successor Outlogic from selling or sharing sensitive location data, settling allegations that X-Mode sold data that could be used to track specific people’s visits to medical facilities, places of worship, and domestic abuse shelters.

OpenAI debuts ChatGPT subscription aimed at small teams

Boston Children’s is an early adopter of OpenAI’s new ChatGPT Team tool, using the subscription-based model to pilot GPTs for productivity and collaboration.

Healthcare AI News 1/10/24

News

OpenAI launches the GPT Store, which allows users to distribute – and eventually charge for – customized GPTs that they have created. The company also announces ChatGPT Team, a $25 per-user per-month secure workspace for teams of up to 149 people that supports GPT sharing. The company lists Boston Children’s Hospital as a early adopter, which says that it has used Team to pilot GPTs for productivity and collaboration.

OpenAI announces that wearables vendor Whoop has incorporated GPT-4 into its app that offers personalized fitness and health coaching related to heart rate, workouts, sleep, and stress. The Whoop 4.0 device is free for those who sign up for a $239 per year subscription.

Microsoft changes the layout of its keyboard for the first time in 30 years by adding a Copilot key that invokes the AI assistant.

Business

The Mayo Clinic will use computing chips and systems from Cerebras to develop its own AI models, such as summarizing a patient’s medical records, analyzing diagnostic images, and reviewing genomic data.

Sword, which offers digital health solutions and services for pain prevention and treatment, says that it delivered 1.5 million AI Care sessions in 2023. Sword says that it developed and patented the world’s first AI care solution in 2018.

ShifMed launches ShiftAdvisor, an AI-powered solution that optimizes nurse shift scheduling by considering preferred days, times, pay, and locations.

Accenture invests in Israel-based QuantHealth, which uses AI to simulate drug clinical trials in the cloud.

Innovaccer announces Sara, an AI scribing assistant that transcribes, summarizes, and analyzes visit conversations to create SOAP notes.

Direct-to-consumer drug marketing technology vendor Swoop enhances its AI drug adherence tool to allow drug companies to market their products to patients and their doctors before a diagnosis has been made. They don’t say how they do that, but its other products create custom market segments using the de-identified data of 300 million people that it gets from Datavant and Epsilon.

Other

Vanderbilt University Medical Center lists its AI accomplishments in clinical and research settings:

• Running a 10-physician pilot of Nuance DAX Copilot to create encounter notes from ambient listening.
• Offering researchers a VUMC-created, GUI-based version of OpenAI’s large language module, which is HIPAA certified under VUMC’s business associate agreement with Microsoft. VUMC has disabled access to the public version of ChatGPT on its networks.
• Creating the IQueue platform to optimize chemotherapy infusion appointments.
• Developing a stroke patient evaluation tool that delivers quantified and color-coded CT perfusion maps.
• Creating its own AI application to predict elective surgical case volume.

Contacts

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