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Morning Headlines 12/6/23

December 5, 2023 Headlines Comments Off on Morning Headlines 12/6/23

CVS To Rebrand Growing Health Services As ‘CVS Healthspire’

CVS Health will use the name CVS Healthspire for its health services business that includes Oak Street Health, Signify Health, MinuteClinic, Caremark, and its recently created biosimilar company Cordavis.

Tower Health laid off 30 people on Tuesday

Tower Health (PA) lays off 30 employees and outsources some of its IT department to an outside vendor.

Army veteran files lawsuit alleging VA computer system delayed cancer diagnosis

A Mann-Grandstaff VA Medical Center (WA) patient sues the federal government and the companies responsible for the development of the center’s Oracle Health-based EHR over alleged flaws in the system that led to a delay in his now-terminal cancer diagnosis.

Comments Off on Morning Headlines 12/6/23

News 12/6/23

December 5, 2023 News 1 Comment

Top News

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CVS Health will use the name CVS Healthspire for its health services business that include Oak Street Health, Signify Health, MinuteClinic, Caremark, and its recently created biosimilar company Cordavis.

The company is following the lead of competitors that offer both health insurance and health services, such as UnitedHealth Group (Optum), Cigna (Evernorth Health Services) and Elevance Health (Carelon).

CVS also announced that its pharmacy pricing formula will change to a more transparent cost-plus model, following the lead of Mark Cuban’s Cost Plus Drugs.


Reader Comments

From Joy DiVive: “Re: North Carolina’s NCCARE360. A non-profit human services organization says that that weaknesses in Unite Us’s referral platform is the biggest threat to the $24 million Healthy Opportunities Pilot as funded by federal taxpayers.” Verified, per the communication that HSO Reinvestment Partners sent to the state complaining of poor invoice tracking, deficiencies in protecting confidential patient information, deficient case tracking, and the inability to upload and export data. That’s one organization’s opinion, anyway.

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From Ellipse: “Re: CareRev. Another reduction in workforce today, about one-fourth of the company.” Unverified. The nurse shift-bidding platform reportedly laid off 100 employees, about one-third of its headcount, in June. The decreased use of gig clinicians post-COVID was a problem, unnecessarily enhanced by the loose lips of the now-departed co-founder and CEO who told co-workers of his love for microdosing LSD.

From Tick Tock: “Re: Oracle Health. Have they lost interest in the VA or in healthcare in general? None of the promised improvements have been delivered and the company no-shows congressional hearings.” Either they are focusing on basic blocking and tackling with the VA or they have lost interest as the project struggles. Oracle closed its Cerner acquisition in June 2022, and after some initial lofty healthcare pronouncements from Larry Ellison, most of the news since has involved layoffs, an expressed fervor to milk Cerner’s profits harder in a provider climate where that will be difficult, and selling unrelated Oracle products to health systems. They were supposed to rewrite Millennium, deliver a new pharmacy system to the VA by April 2023, and switch to a voice-first user interface. The company also promised to grow Cerner’s community presence in Kansas City, which has gone the other way. It will get ugly if the VA can’t get its implementations going again or if ORCL shares tank for unrelated reasons and all-important investors demand a quick turnaround. Their best hope, given Oracle’s army of lobbyists, would have been federal government, except that not much is left after bagging DoD, VA, Coast Guard, and IHS. Second best hope is overseas sales, although Epic is growing in the most attractive areas. The company promised a couple of big sales this quarter that added up to $1 billion, although much of that may come as subcontractor to General Dynamics for the $2.5 billion Indian Health Service contract.


HIStalk Announcements and Requests

Generous donations from Michael and Natalie, matched with funds from multiple sources including those from my Anonymous Vendor Executive, fully and anonymously funded these Donors Choose teacher grant requests:

  • Headphones for Mr. S’s elementary school class in San Antonio, TX.
  • STEM and engineering tools for Ms. T’s elementary school class in Waluku, HI.
  • Science materials for Ms. M’s high school class in Homestead, FL.
  • Math supplies for Ms. C’s elementary school class in Peoria, IL.
  • Books for the computer science lab of Ms. C’s elementary school in Revere, MA.
  • Math workbooks for Ms. A’s elementary school class in Spring Valley, CA.
  • Headphones for Ms. F’s elementary school class in San Diego, CA.

Webinars

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


Acquisitions, Funding, Business, and Stock

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KONZA National Network and the Kansas Department of Health and Environment are piloting the use of real-time alerts for incoming or transferred patients who are actively diagnosed with multi-drug resistant organisms. The alerts are delivered directly to a provider’s EHR in less than five minutes using Direct Secure Messaging, allowing immediate isolation and implementation of transmission-based protocols. 


Sales

  • UofL Health (KY) will implement Verato’s healthcare master data management software to help improve identity management across its system.
  • Emory Healthcare (GA) will use Nference’s Nsights de-identified patient data technology to support its research in several therapeutic areas.

People

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Children’s Hospital Colorado promotes Amy Feaster to SVP/CIO and chief digital officer. She replaces Dana Moore, who will retire at the end of the month.

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Ric Downs (Veris Health) joins Fuse Oncology as VP of sales.

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Amenities Health names Scott Heatherly (Hyro) VP of sales.

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Stanford University medical school professor and Stanford Health Care radiology informatics director Curtis Lanlotz, MD, PhD is named president of RSNA. He earned his medical degree, master’s in AI, and doctorate in medical information science from Stanford.


Announcements and Implementations

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Ireland’s National Forensic Mental Health Service goes live on InterSystems TrakCare.


Government and Politics

HHS will name the initial group of Qualified Health Information Networks in a livestreamed QHIN Designation Ceremony next Tuesday at 9:00 a.m. ET.

Politico says that members of Congress are concerned that Google is using advanced AI in healthcare before the government has created guidelines for such use, with particular concerns about patient privacy. The article notes that Google is hiring former federal healthcare regulators —  such as former National Coordinator Karen DeSalvo, MD, MPH, MSc and several former FDA officials — and is raising the concerns of startups that its deep pockets will squeeze smaller companies out.


Privacy and Security

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Seattle-based Fred Hutchinson Cancer Center announces that it was the victim of a cyberattack just before Thanksgiving.

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The Rhysida ransomware gang claims responsibility for a ransomware attack on London’s King Edward VII Hospital. The hackers allege that some of the stolen data, which they’ve threatened to put up for sale online, includes information pertaining to the British royal family. Hospital officials, on the other hand, insist that only a limited amount of “benign hospital systems data” was copied from its IT system.


Other

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UCLA Health researchers find that 20% of patients whose electronic medical data showed them as suffering from serious illness were in fact dead. Researchers analyzed the health data of 11,700 patients across 41 UCLA Health clinics over two years, then compared it with data from California’s Department of Public Health Public Use Death File. A state law prohibits death file data from being shared with healthcare institutions, resulting in what the researchers deem “wasteful outreach that strains resources and healthcare workers’ time.” The authors say the problem could be easily solved if the state didn’t restrict death record sharing except for financial institutions.

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A fascinating LinkedIn post by Chris Deacon, JD questions how big-brand, non-profit health systems (Cleveland Clinic, Brigham) are allowed to accumulate billions of dollars in hedge funds and overseas investments – generated from US tax breaks, astronomical patient charges, and charitable donations – to build massive medical palaces in London, UAE, and China. She calls for non-profit health systems to account for their international spending given that their local communities are footing the bill even as services to those local communities are curtailed or to overloaded to book. A comment by my favorite curmudgeon Matthew Holt speculates that big health systems hold $250 billion in hedge funds, with another $250 billion owned by non-profit insurers like BCBS and Kaiser Permanente.


Sponsor Updates

  • Nordic releases a new Designing for Health Podcast, “Interview with Billy Nicolich.”
  • Agfa HealthCare recaps its time at RSNA with daily updates.
  • AvaSure publishes a new whitepaper, “Roadmap to virtual nursing: How UCHealth scaled its program and saved lives.”
  • The HLTH Matters Podcast features Bamboo Health Chief Clinical Innovation Officer Nishi Rawat, MD.
  • The Safeopedia Podcast features Bardavon Chief Clinical Officer Dorothy Riviere and VP of Injury Prevention Scott Coleman, “Revolutionizing Workplace Safety: The Power of Tech-Enabled Safety Cultures.”
  • Black Book Research’s latest user satisfaction survey ranks MedEvolve as the leading vendor for RCM workflow optimization and automation services.
  • Censinet releases a new Risk Never Sleeps Podcast, “The Key to Job Fulfillment: Autonomy, Complexity, and Reward, with Matt Christensen, Senior Director Cybersecurity at Intermountain Health.”
  • ConnectiveRx releases a new podcast, “Empowering Communities: Pharmacists’ Crucial Role in Patient Health.”
  • Dimensional Insight will sponsor the Massachusetts Health & Hospital Association’s Annual Women Leaders in Healthcare Conference December 7 in Waltham.
  • Divurgent releases a new episode of The Vurge Podcast, “Coming Together for Women in HIT and Cybersecurity.”
  • DrFirst publishes a new case study, “Cone Health Finds Medication History for 93% of Patients by Connecting with Local Pharmacies and Leveraging AI.”

Blog Posts


Contacts

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

Morning Headlines 12/5/23

December 4, 2023 Headlines Comments Off on Morning Headlines 12/5/23

Gemspring Capital Announces Sale of Valant

Gemspring Capital sells mental health-focused EHR and practice management software company Valant Medical to private equity firm Resurgens Technology Partners.

Digital Health Strategies Closes Series A Funding Round to Expand Its Share of Health Patient Loyalty Platform

Digital Health Strategies, a patient loyalty and healthcare marketing firm based in Washington, DC, secures an undisclosed amount of Series A funding.

Notice of information security incident involving Fred Hutchinson Cancer Center

Seattle-based Fred Hutchinson Cancer Center announces that it was the victim of a cyberattack just before Thanksgiving.

Comments Off on Morning Headlines 12/5/23

Curbside Consult with Dr. Jayne 12/4/23

December 4, 2023 Dr. Jayne 2 Comments

I was invited to yet another retirement party this week. It was again for a primary care physician who is leaving medicine at an age that is decidedly less than the oft-discussed 65.

Burnout played a role in every retirement gathering I’ve attended over the last couple of years. It’s sad to see so much knowledge and experience leaving the field. More than half of these physicians would have been interested in continuing to practice part time, but it sounds like their corporate employers weren’t terribly interested in trying to make that happen. The practices they left continue to be slammed and have wait lists for new patient appointments that are several months long.

Most of my local primary care physician peers are a number of years away from being able to retire. I struggle to think of one colleague who isn’t suffering from some degree of burnout.

When asked what might help the dumpster fire that is healthcare in the US, quite a few cite artificial intelligence as the answer. Just use ChatGPT to write your prior auth letters! Or insurance appeals! Or letters for emotional support animals, educational modifications for school-aged patients, Family and Medical Leave Act documents, and more! The enthusiasm that people voice about these solutions seems to be contagious, but it’s rare that those who are using it fully understand the risks of feeding protected health information into different solutions, or that they can be liable if they’re allowing staff to use AI solutions for patient management but aren’t doing 100% review of the output.

With this in mind, I was excited to read a special communication in last week’s Journal of the American Medical Association titled “Will Generative Artificial Intelligence Deliver on Its Promise in Health Care?” If the title alone wasn’t enough to catch my attention, seeing Dr. Robert Wachter listed as the first author definitely helped.

Wachter and his co-author Erik Brynjolfsson note that historically, it usually takes many years for technologies to deliver promised benefits. Because healthcare is such a complex environment, this can make the incorporation of new technologies even more challenging. They go on to say that generative AI is different, though, and has “unique properties that may shorten the usual lag between implementation and productivity and/or quality gains in health care.” They also note that not only are health organizations more receptive to the technology, but that many “are poised to implement the complementary innovations in culture, leadership, workforce, and workflow often needed for digital innovations to flourish.”

The latter is an interesting point, especially since I’m often working with organizations that struggle to implement “innovations” that are more than a decade old. These solutions may not be heavy on technology, but are often fairly straightforward people and process adjustments that have the potential to improve patient care, reduce staff and clinician frustration, and create more efficient interactions in the healthcare system. Often they are relatively inexpensive to implement, but require the sometimes elusive stakeholder alignment in order to bring them to fruition.

Given all the buzz around AI-related solutions, I’m starting to wonder whether we can slap a label on them that says “AI-driven” and use that as a way to convince people to take some steps towards making their organizations run more efficiently.

Turning back to the JAMA article, some interesting facts jump out. First, nearly one-third of the $4.3 trillion that is spent in the US each year adds little to no value. I’ve seen that first hand in the urgent care trenches, where patient demand for testing and imaging studies often overshadows the physician’s judgment, particularly when an organization places a high value on patient satisfaction scores. Clinicians are trained to use a variety of clinical decision support rules to determine whether someone needs an x-ray after injuring their ankle, or whether a child needs an imaging study when they fall off their bed. However, insistent patients or parents may push or escalate, resulting in thousands of dollars in healthcare spending that could have been avoided.

It feels like we’re rarely able to make clinical diagnoses anymore, relying on the history, exam, and our education and training. Instead, we have to perform laboratories to prove ourselves sometimes, even when the answer is very straightforward. One organization I worked at pushed clinicians to order unneeded medications that could even be harmful, in the guise of “patient satisfaction.” Needless to say, I frequently wound up on the wrong side of that organization’s quality reports, but at least I had my integrity.

Second, preventable harms are still a major problem in the US, with tens of thousands of deaths happening each year due to situations that could have been mitigated. These range from simple medical errors that might be prevented with the application of basic technology (such as allergy warnings that appear when medications are prescribed) or complex errors that result from multiple failures along the way. Those can be particularly hard to work through as a clinician, since there are often many steps where the problem could have been prevented, but the system failed regardless. Electronic health records were initially seen as a solution to these difficult situations, but some days it feels like they have created two new problems for every one that they solved.

The article goes in depth to describe “the productivity paradox of information technology,” where technologies fail to deliver value. One main reason for this is the flawed nature of many early versions of technologies and the need to have multiple iterations before a successful tool is achieved. The second reason, which the authors view as more important, revolves around “the processes, structure, and culture of the workplace.” I felt validated when reading that sentence since I’ve lived it so often while trying to help organizations with their clinical transformation initiatives. The authors note the need to often have multiple complimentary innovations to overcome the productivity paradox. It’s another way of saying that no silver bullet exists for solving a difficult problem.

They go on to explain some of the “particular challenges” of implementing technology in healthcare. These are the factors that so many companies fail to understand as they promise to fix healthcare or revolutionize the patient experience. These challenges include the highly regulated nature of healthcare, differing opinions on data ownership, the need to protect patient privacy, and the fact that all these factors at times interfere with each other.

They go on to list other challenges, including the fact that the EHR market is highly concentrated with only a few major players left. In contrast, parts of healthcare have a plethora of players, including clinicians, care delivery organizations, payers, employers, pharma, device vendors, government, and more. As such, new technologies are likely to progress when they can make improvements for multiple stakeholders rather than for just one subset of players in the industry.

Other challenges that they list include the fact that healthcare data can be messy depending on where it comes from (billing, clinical documentation, compliance) and that healthcare is constantly evolving, often through research and changes in practice. As such, AI tools that are based on historical patient data may not be applicable in the present and in fact might be dangerous.

Last, they note that healthcare is high stakes, with the very real impact on patients making it potentially harmful to do the “fail fast and iterate” approach that happens in other technology environments. We’ve all seen innovations that harm patients, whether it’s an inadequately studied drug, a faulty medical device, or an improperly implemented clinical decision support tool.

Despite the fact that previous AI technologies haven’t delivered, (IBM Watson, anyone?) the authors see several factors that may lead to improved solutions this time around. They cite the relative ease of use of generative AI as a positive, along with the fact that the technology can be delivered to users easily through devices they’re already using. The ability to interact with new solutions via application programming interfaces (APIs) is also a plus, as is the speed of evolution of the generative AI solutions themselves.

The authors believe that healthcare leaders are better prepared to consider workflow redesign than their predecessors, in part due to the presence of clinical informaticists (yay!) and those with experience in user-centered design. They feel that leaders have learned from past failures as well. They mention the irony that many of the problems that were created by prior digital innovations – such as documentation burden and the EHR inbox – may be addressed by new generative AI powered tools, which would be a lovely thing for all of us.

It will be interesting to revisit the premises of this article after we’re six months or a year down the road. Maybe by the time generative AI reaches its second birthday, we’ll be living in a world of smoother patient care, streamlined communications, and improved clinical quality, all thanks to the wonders of artificial intelligence. It’s more likely, though, that major improvements will still take years, but at least that will be faster than the decades of inertia we’ve all been living in.

The authors call on AI developers to address elements such as bias, safety, cost, and hallucinations. They note that regulators need to develop standards that promote innovation as well as safety. They state that most important is for healthcare leaders to “prioritize the areas where genAI can create the greatest benefits for their organizations, paying close attention to those complementary innovations that remain necessary and striving to mitigate the known problems with genAI and any unanticipated consequences that emerge.”

What do you think about the role of generative AI in coming years? Are we on the cusp of greatness, or heading down the road to ruin? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 12/4/23

December 3, 2023 Headlines Comments Off on Morning Headlines 12/4/23

Culmination Bio Raises $10M From Amgen Ventures and Merck Global Health Innovation Fund to Bring Longitudinal Health Data to Biopharma

Intermountain Health spinoff Culmination Bio, which offers drug companies a clinical study recruitment platform that contains 40 years’ worth of de-identified EHR and biospecimen data, raises $10 million from two drug company investment funds.

Potrero Medical Announces Restructuring and Continued Operations

Potrero Medical, which offers medical devices and analytics for monitoring acute kidney injury, files Chapter 11 bankruptcy.

Hippocratic AI Launches Early Access Partnership Program With Leading Healthcare Organizations Including OhioHealth, Roper St. Francis Healthcare, Evernow, HarmonyCares, and Guidehealth

Hippocratic AI launches a development partnership program that includes OhioHealth, Roper St. Francis Healthcare, Evernow, HarmonyCares, and Guidehealth.

Comments Off on Morning Headlines 12/4/23

Monday Morning Update 12/4/23

December 3, 2023 News Comments Off on Monday Morning Update 12/4/23

Top News

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Intermountain Health spinoff Culmination Bio, which offers drug companies a clinical study recruitment platform that contains 40 years’ worth of de-identified EHR and biospecimen data, raises a $10 million investment from two drug company investment funds.


Reader Comments

From Spangler: “Re: physicians in rural areas. It’s concerning that we are facing a shortage even if telemedicine and AI try to help.” The real issue is that the dismal conditions of working as a corporate physician are driving many away from patient care or out of medicine. This exodus is tempered only by the need to repay massive school loans. It’s worth reconsidering the necessity of an eight-year education plus internships and residencies for primary care physicians (PCPs) that push their career entry into their late 20s or early 30s. Alternatives could include expanding the roles of nurse practitioners, physician assistant, and pharmacists. Additionally, integrating AI into medical training could accelerate training, especially given the rapid obsolescence of classroom work, and could be used to provide support as needed for more unusual cases. Meanwhile, the profit-obsessed US healthcare system is increasingly strained as major physician employers compete for the essential yet limited clinical workforce.

From Poppy: “Re: ChatGPT 4 Plus or Pro. You can now add any file type and it will analyze and even visualize the data for you. I’ve used it to sort DEI survey responses as either friendly or antagonistic and it works like a charm.” ChatGPT keeps adding features to the point I can’t keep up. I use custom instructions to ask it to include source links as well as its numeric confidence rating of its response, both of which are helpful. I’ve also upload images and files and asked it to perform simple functions, although I’m still using it mostly to analyze writing or to generate ideas, and while I wouldn’t call it mission-critical to my work, it’s getting there. I would like to hear from readers – what are some less-than-obvious ChatGPT capabilities that you are using to get work done? I’m still anxiously awaiting an easily installed, inexpensive chat/search function that would provide a front-end for searching HIStalk, which contains everything important that has happened in health IT since 2007.


HIStalk Announcements and Requests

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The biggest PCP frustration among poll respondents by far is trying to book an appointment.

New poll to your right or here: How would you grade health IT conferences on their level of presenter diversity? An additional question that is more for commentary than polling – should conferences be held accountable for offering a diverse roster of presenters and panelists when the underlying cohort mostly involves white males? 


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Generous donations from Karen, Bill, another Bill, and Mike, with matching funds from third parties and my Anonymous Vendor Executive, fully and anonymously funded these Donors Choose grant requests from teachers who are working in historically underfunded schools:

  • A math book series for Ms. K’s middle school class in Fort Stockton, TX.
  • STEM station materials for Mr. G’s middle school class in Greenacres, FL.
  • STEM activity kits for Ms. G’s elementary school class in Baltimore, MD.
  • A lectern for Mr. P’s high school class in Pharr, TX.
  • Headphones and math manipulatives for Mr. W’s elementary school class in North Las Vegas, NV.
  • Math games for Ms. C’s elementary school class in Jamaica, NY.
  • A coding robot and math manipulatives for Ms. K’s elementary school class in Orlando, FL.
  • Headphones for Ms. M’s middle school class in Glendale, AZ.
  • Home health aide training books for Ms. W’s high school class in La Jara, CO.
  • A bilingual STEM center for Ms. R’s elementary school class in Las Cruces, NM.
  • Headphones for Mr. S’s elementary school class in Yonkers, NY.
  • Headphones for Ms. K’s elementary school class in Tyler, TX.
  • Science books for Ms. S’s elementary school class in Natchez, MS.
  • STEM books for Ms. P, a librarian at a middle school in Coffeyville, KS.
  • An achievement button making machine for Ms. E’s high school class in Goodyear, AZ.
  • Books for Ms. K’s high school class in Bronx, NY.
  • STEM development activities for Ms. F’s elementary school class in Indian Orchard, MA.
  • STEM model building kits for Ms. W’s elementasry school class in South Ozone Park, NY.
  • Programmable robots for Ms. J’s elementary school class in San Diego, CA.
  • Headphones for Mrs. H’s elementary school class in Kinston, NC.
  • Classroom supplies for Ms. G’s elementary school class in Mission, TX.
  • Accelerated reading and anti-racism books for Ms. H’s elementary school class in Shreveport, LA.

You can do these things to support HIStalk:

  • Join my spam-free mailing list.
  • Connect on LinkedIn and join Dann’s HIStalk Fan Club, which tells me when you change jobs and gives you Swiftie-level influence points for favors asked.
  • Tell my sponsors, or potential ones, that you value their support of what I do.
  • Share news, rumors, and intriguing insights.
  • Consider being interviewed if you are full of brash, eminently quotable expertise.
  • Companies, consider booking my Top Spot Ad that lords over the entire HIStalk page and earns a commensurate number of reader clicks.

Webinars

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


Acquisitions, Funding, Business, and Stock

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Hippocratic AI launches a development partnership program that includes OhioHealth, Roper St. Francis Healthcare, Evernow, HarmonyCares, and Guidehealth.

Potrero Medical, which offers medical devices and analytics for monitoring acute kidney injury, files Chapter 11 bankruptcy.


Announcements and Implementations

Black Book posts results from its healthcare cybersecurity satisfaction analysis, with the overall KPI leader being CrowdStrike. The report concludes that cybersecurity solutions that were purchased before the beginning of 2023 may already be outdated in their ability to protect against hacks and breaches, with remote patient access systems and telehealth offering new entry points for cyberattacks. 


Sponsor Updates

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  • Netsmart takes first and third place among 115 teams that competed in the AWS re:Invent Jam.
  • Nordic expands its partnership with Fortified Health Security to strengthen security operations and deploy global response capabilities for customers.
  • Wolters Kluwer Health expands its Sentri7 clinical surveillance suite to include the Sentri7 Drug Diversion solution, formerly Flowlytics from Invistics.
  • Gartner names NTT Data a Leader in its 2023 Magic Quadrant Managed Network Services and a Leader in its 2023 Magic Quadrant Network Services, Global.
  • Nuance shares success stories from early adopters using its PowerScribe Smart Impression generative AI solution for radiology reporting.
  • Nym names Hen Sinai junior backend engineer, Adi Sivan software engineer, Yuval Shtechman medical data analyst, Barbi Elmore director of product, Zack Hechtman customer success associate, and Yuval Tov junior backend engineer.
  • Rhapsody announces a long-term partnership with Blackford Analysis to enhance Blackford’s medical AI solutions platform by providing deeper clinical workflow integrations.
  • RxLightning names Christopher Hemminger cloud data architect and Karen Outlaw project manager.

A Black Book Market Research survey of top cybersecurity customers ranks solutions according to highest user satisfaction. HIStalk sponsors include:

  • Clearwater – cybersecurity advisors and consultants / compliance and risk management solution.
  • Fortified Health Security – cybersecurity awareness training and education.
  • CloudWave – outsourcing and security networked managed services.
  • PerfectServe – secure communications platforms: physician practices
  • Spok – secure communications platforms: hospitals and health systems.

Blog Posts


Contacts

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

Comments Off on Monday Morning Update 12/4/23

Morning Headlines 12/1/23

November 30, 2023 Headlines 6 Comments

Cigna, Humana in Talks for Blockbuster Merger

Health insurers Cigna and Humana are negotiating a merger that they hope to finalize within the next four weeks, according to insider reports.

Experian Health Acquires Wave HDC, Immediately Enabling Real-Time, Single Inquiry Insurance Discovery/Verification at the Point of Patient Registration

Experian acquires Wave HDC, which captures patient insurance and demographics at registration.

HFMA Aligns with FinThrive to Introduce the Industry’s First Revenue Cycle Management Technology Adoption Model for Health Systems

HFMA and FinThrive launch a peer-reviewed, five-stage Revenue Cycle Management Technology Adoption Model, with initial analysis indicating that 42% of health systems are at Stage 1.

News 12/1/23

November 30, 2023 News Comments Off on News 12/1/23

Top News

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Health insurers Cigna and Humana are negotiating a merger that they hope to finalize in the next four weeks, according to insider reports.

The companies are sure to face anti-trust challenges as they did in their failed 2015 merger attempt.

Humana focuses on Medicare Advantage plans, while Cigna recently announced its intention to exit that business to focus on its pharmacy benefit and commercial insurance offerings.

The value of the combined companies would approach $140 billion. Cigna and Humana shares dropped on the news.


Reader Comments

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From Ex-HHC: “Re: Donors Choose. Can you re-post donation instructions?” I will, while adding that while I use the term “my Donors Choose project,” I don’t actually have a project and I don’t actively bug readers to support one (that constitutes “virtue signaling,” as one cynical reader stung me with). It’s a great cause in which you are donating directly to Donors Choose, I apply matching money from my Anonymous Vendor Executive, and I fully and anonymously fund STEM-related teacher projects of my choosing as that person requests. Above is a photo from Ms. D, whose Ohio middle school class has already received a tablet and 30 sets of headphones courtesy of Mark’s donation just two days ago. Anyway, long story short (too late):

  • Purchase a gift card in the amount you’d like to donate.
  • Send the gift card by the email option to mr_histalk@histalk.com (that’s my Donors Choose account).
  • I’ll be notified of your donation and you can print your own receipt from Donors Choose for tax purposes.
  • I’ll pool the money, apply all matching funds I can get, and publicly report here the projects I funded, including occasional teacher follow-up messages and photos.

From Litany of Brittanys: “Re: winter holiday. What was that one you mentioned last year?” That holiday is Yalda, which falls on December 21. Below is my explanation from last year, but I’ll also throw in an interesting and slightly related factoid — while the winter solstice signifies the fewest hours of daylight for those of us who are north of the equator, the earliest sunset occurs on December 8, for reasons that are too astronomically complicated to explain here. Back to Yalda:

Yalda celebrants, most of them in Iran and nearby countries, observe the winter solstice, the last day of autumn and the longest night of the year, after which hours of daylight start increasing again. People stay up all night, eat watermelon and pomegranates (their glowing colors symbolize dawn and life), read poetry, and dance and play drums when the sun rises in a triumph of light over dark. Yalda means “birth.” I like it even beyond my personal obsession with changing hours of daylight — nobody is excluded or favored since the same sun shines down on us all, although I suppose folks in the Southern Hemisphere would need to buy their Yalda pomegranates in June.


HIStalk Announcements and Requests

I’m getting inquiries lately from companies that want to pay me to do a video interview or podcast with an executive, highlight their product, or feature their press release. Other sites do this without disclosing the paid arrangement, they say, so they seem surprised when I tell them that my integrity isn’t for sale. I appreciate the interest, but it’s a no.


Webinars

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


Acquisitions, Funding, Business, and Stock

Meanwhile, a KFF article notes that some hospitals are dropping their acceptance of Medicare Advantage plans — even as seniors more frequently choose that alternative to traditional Medicare — because of low and late payments and bureaucratic approval and denial processes. This could be a significant issue because it isn’t easy for a consumer to switch from an MA plan to traditional Medicare with a Medigap policy, potentially leaving them insured but with no in-network hospital nearby.

Experian acquires Wave HDC, which captures patient insurance and demographics at registration.

Stat’s Bob Herman notes that UnitedHealth Group’s Optum Health provider division now employs 90,000 physicians, up from 70,000 one year ago.

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Mayo Clinic will spend $5 billion to redesign its Rochester campus that features “health neighborhoods” that are more convenient for extended care and for patients who have multiple health issues. Technology will play a key role, Mayo says. The plan is built around Rochester’s “Destination Medical Center” 20-year economic development plan, not that US healthcare wasn’t already confusing enough to the rest of the developed, longer-lifespan world without hinging regional growth on selling medical services.


People

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PeriGen hires John Parker, MD (OhioHealth) as chief medical officer.


Announcements and Implementations

Duke Health begins its use of Microsoft Copilot, with IT employees developing Microsoft 365 use cases involving email management, editing and creating documents and presentations, and creating summaries of virtual meetings.

St. Joseph’s / Candler Health System (GA) goes live on Meditech Expanse ambulatory and launches implementation of Expanse Oncology.

HFMA and FinThrive launch a peer-reviewed, five-stage Revenue Cycle Management Technology Adoption Model, with initial analysis indicating that 42% of health systems are at Stage 1.

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HIMSS announces Alabama football coach Nick Saban as the HIMSS24 closing keynote speaker, trying to pre-refute “any willing celebrity” smirks with the dubious explanation that there exist “so many parallels from football to healthcare.” I’ll consider this as validation of my decision to skip attending the boat show for the first time in forever. The HIMSS24 exhibitor count is at 483 versus the 1,216 of HIMSS23, which suggests either exhibitor procrastination or a disastrous drop under conference operator (or is it owner?) Informa Markets.

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A new KLAS report on PACS finds that 20% of health systems plan to replace their systems in moving from legacy systems and moving toward enterprise imaging strategies. Sectra leads by far in purchase energy due to peer recommendations, strong customer relationships, and EHR integration, although cost considerations sometimes discourage smaller organizations. Visage Imaging’s cloud-based diagnostic viewer is gaining momentum among large health systems who like its radiologist-friendly user interface and strong integration, although its recently introduced vendor-neutral archive has seen limited adoption. (click the image to enlarge).


Other

A survey finds that 72% of consumers are unable or unwilling to pay their medical bills immediately, two-thirds of them because of money problems. Half of the respondents say they have postponed care and prescription fills due to cost, while one-third have no confidence in their ability to pay a medical bill over $500.

Tech expert Robert Scoble highlights how a Texas prison is using AI mental health conversation analysis software from Savantcare to address the 1,300 inmates who are being unconstitutionally held because they can’t mentally understand the charges they face.


Sponsor Updates

  • Health Data Movers announces a strategic partnership with Workday as a certified Workday Advisory Services Partner.
  • CHIME selects Meditech vice chair Howard Messing for its CHIME Foundation Industry Leader Award.

Blog Posts


Contacts

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

Comments Off on News 12/1/23

EPtalk by Dr. Jayne 11/30/23

November 30, 2023 Dr. Jayne 1 Comment

We’ve made it past some of the early fall holidays, and those of us on the front lines are waiting to see if they will cause a spike in respiratory illnesses.

Heading into Thanksgiving, many parts of the US were feeling the pressure already. Respiratory Syncytial Virus (RSV), COVID, and influenza are leading the pack. At one point, all of the pediatric hospital beds in the Dallas-Fort Worth area were full, which should ring alarm bells for those who care about children.

My colleagues at Cook Children’s in Fort Worth mentioned that they were seeing up to 500 patients daily in the emergency department and were boarding critically ill patients in the emergency department because there were no ICU beds. New vaccines for RSV are in short supply in some regions, which will likely add to the problem later in the season.

This week, I ran across a couple of articles that talked about the fact that ChatGPT has only been around for a year or so. Headlines included phrases such as “ChatGPT scared the heck out of us,” and there was a lot of retrospective thought about whether its launch opened as big of a Pandora’s box as everyone thought it might.

Generative AI has certainly matured over the last year. There’s still a lot of hype about how it’s going to transform the way people work. One suggested that managers use AI to help define ambitious deadlines for projects that are underway, or that they can use it to create motivating speeches for their teams. It went on to say that AI could help identify ways to make the workplace more exciting.

Another gave the idea that AI could be used to create employee satisfaction surveys and to process results to determine how employees want to be incentivized. I kind of like this one since I’ve worked for several employers that totally disregarded employee sentiments. Maybe because AI is such a darling, they’ll pay attention to those results just because they were processed using a tool versus a basic employee survey. One article brought up an interesting tidbit about OpenAI’s GPT-4, namely that certain restrictions can be bypassed by using less-common languages such as Gaelic or Zulu. That’s definitely interesting, and you can bet I’ll be playing around with that idea.

Just a few days prior to the Veterans Day holiday in the US, the Department of Veterans Affairs (VA) met its goal of enrolling one million veterans in its genetic database, aptly named the Million Veteran Program. The database is unique because it links genetic information with electronic health records and also includes information on diet and environmental exposures. Researchers have been working for 12 years to reach the goal. Compared to other genetic databases in Europe, this one represents a more diverse population. The data is only available to physicians and scientists at VA facilities. Veterans can continue to enroll either through the link above or by calling 866.441.6075 to make an appointment at a VA facility.

Although the VA’s EHR project certainly gets a lot of press, there is so much more that the organization is doing to support veterans. It’s a vast organization, with locations from coast to coast. This year, the Veterans Health Administration delivered 116 million patient appointments at 1,300 facilities, beating the previous record by 3 million. It’s not only a care provider, but manages benefits applications and compensation programs, which necessitates maintaining a different staffing profile than other healthcare organizations. It’s also responsible for delivering services around those parts of its business. To give you an idea of scale, its Health and Benefits App reached 1 million downloads this year.

The VA is also actively investing in the artificial intelligence space, working on tools to reduce employee burnout. It plans to launch an AI-related contest that features $1 million in prize money for teams that create the best solutions in speech-to-text for medical appointments and in document processing as non-VA medical records are added to the patient’s VA chart.

Several of the physician groups that I follow on Facebook have had an overwhelming number of posts about cybersecurity incidents. Since organizations tend to take their entire network down when there is an incident, that means that physicians have no access to downtime solutions such as disaster recovery servers or third-party information archives. Although the health systems in question typically put out press releases that state that patient care is being delivered safely and effectively, comments from the trenches seem to reflect an environment that is anything but:

  • No ability to look up labs.
  • No way to access history and physical forms for surgical procedures.
  • Hand writing operative reports.
  • Clinicians who are relatively new grads have never charted on paper.
  • Systems haven’t practiced for downtime events, resulting in mass chaos.

One clinician whose system recently went through a cybersecurity event but is back online noted that she recommends keeping copies of all handwritten notes. Apparently, many were lost during the event and were not scanned or otherwise added to the system, resulting in requests for her to redo documentation weeks after the event. Another reported that his hospital was down for over a month, which as a clinician, I can’t even imagine. Hackers are a reality and organizations that think it couldn’t happen to them are mistaken. I challenge all the CIOs and CMIOs out there to ensure their organizations have adequate supports in place and that they’re practicing for a potential event.

I dropped by my primary care office this week to get a vaccine booster. Despite having just had my photo ID scanned at another office in the same system last week, I had to again present photo ID to be scanned as opposed to just being verified. I could see the previous scan of my photo ID on the receptionist’s screen, since there was no privacy filter on the monitor. I could also see my photo on my patient chart, which matched the already-scanned ID. I understand she was likely just following an office policy, but this is where I challenge people to make sure that the policies in place make sense and/or provide value or whether they’re just process for process sake.

I was also greeted with a 2020-esque COVID interrogation, including being asked if I had traveled internationally in the last six months (yes), whether I had been around sick people (yes), whether I had traveled internationally in the last 30 days (yes), and whether I had any respiratory symptoms (no). There were no follow-up questions to any of the positive responses.

As I sat waiting to be called back, another couple came in, and when asked the question about sick people, they asked, “What do you mean by sick?” It was clarified to be “measles, mumps, or chicken pox.” I suppose I should have been a “no” on that one then. They weren’t asked the question about symptoms. The couple was already wearing medical masks, so I’m guessing the receptionist made an assumption if the intent of the questioning was to determine if patients should have masks. Respiratory season is upon us and it will be interesting to see if the questionnaires morph as the season progresses.

The good thing that came out of that visit is that they pointed out that I had an open order for follow-up testing, which was interesting because the test had been allegedly scheduled during the in-person visit at another office last week. Apparently it hadn’t been scheduled properly, and had I not gone for that vaccine, I wouldn’t have had a clue. Four phone calls later, I finally had it scheduled, and I must say the patient experience component of the entire process has been lacking. At no point during any of the conversations did anyone apologize for the dropped ball, not even a lukewarm “I’m sorry you’re feeling frustrated by this.” It’s not an experience I want for my patients either, which is making me rethink my referral patterns. Where’s a patient satisfaction survey when you need one?

Does your organization actively work to stamp out non-value-added processes, or is it content with simply doing things the way they’ve always been done? Have they shifted processes to put more of the burden on the patient? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 11/30/23

November 29, 2023 Headlines Comments Off on Morning Headlines 11/30/23

Tampa General and Synapse Florida Seek Innovation Solutions to Reduce Cancer Mortality in Rural Communities

Tampa General Hospital, its Innoventures venture capital arm, and Synapse Florida launch a $50,000 innovation challenge to discover solutions that may improve cancer care in rural areas.

Mayo Clinic unveils plans for a new $5 billion campus in downtown Rochester

Mayo Clinic will redesign its campus in Rochester, MN to create health neighborhoods where patient care is more streamlined through remote patient monitoring, AI, and automation.

Honoring Excellence: CHIME Recognizes Outstanding Achievements of Digital Health Leaders and Professional Services Firms with the 2023 CHIME Awards

CHIME names Tufts Medicine EVP, Chief Digital Officer, and System CIO Shafiq Rab its 2024 CIO of the Year.

Comments Off on Morning Headlines 11/30/23

Healthcare AI News 11/29/23

November 29, 2023 Healthcare AI News Comments Off on Healthcare AI News 11/29/23

News

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Amazon announces Amazon Q, a generative AI assistant for businesses that provides personalized company content to employees.

NHS England will use AI to identify patients who are at risk for an ED visit or hospital admission and could instead be contacted by health coaches, including the use of sensors on refrigerators and teakettles to identify changes in eating and drinking habits. It is also using AI to predict the  top at-risk patients who are then contacted by staff who offer social care assessments and medication reviews. NHS has also expanded its hospital-at-home program to 10,000 patients. It expects the new programs to prevent 4,500 ED visits, 17,000 overnight hospital stays, and 23,000 physician appointments.

Hong Kong’s hospital authority will pilot the use of AI to identify potentially inappropriate ordering of certain broad spectrum antibiotics following a jump in vancomycin-resistant infections. Broad-spectrum antibiotic prescribing jumped during the pandemic as COVID-19 patients used most available isolation beds. 

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A Denver news outlet describes the efforts of UCHealth to apply AI to sepsis detection. CMIO C.T. Lin, MD says its initial deployment of Epic’s tool was causing alarm fatigue and a flurry of end-of-shift alerts as overworked nurses back-entered vital signs they had scrawled on their arms all day. The health system redirected the alerts to its virtual health center, where 24/7 ICU nurses monitor the vital signs of up to 500 patients and can immediately review the EHR and live video feeds. UC Health estimates that the sepsis alerts are saving 375 lives per year, with another 800 patients saved by early detection of other forms of deterioration.


Business

Drug maker Roche’s Genentech subsidiary will collaborate with microprocessor vendor Nvidia to advance drug discovery.

Vivodyne, which uses AI-powered robotics to cultivate, dose, and analyze prospective drugs on human tissues, raises $38 million in seed funding.


Research

Researchers use AI to identify brain imaging markers that may help diagnose ADHD in adolescents.

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A Microsoft study finds that GPT-4’s performance on medical specialty questions can be improved by the use of more carefully structured prompt alone, without being expensively trained on more detailed data.

Republic of Korea researchers develop a machine learning model to predict cardiac arrest in ICU patients using ECG data, which they say is a better predictor than EHR information and can be used for continuous monitoring. 


Other

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Sports Illustrated gets caught running AI-generated articles that are bylined to AI-generated writers with headshots that were acquired from online marketplaces. One article purportedly written by “Drew Ortiz” expertly opines that “volleyball can be a little tricky to get into, especially without an actual ball to practice with.”


Contacts

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

Comments Off on Healthcare AI News 11/29/23

Morning Headlines 11/29/23

November 28, 2023 Headlines Comments Off on Morning Headlines 11/29/23

Here is why IT major TCS has to pay $210 mn to rival firm DXC

Tata Consultancy Services, which was just assessed with $140 million in punitive damages for stealing Epic’s intellectual property by having its employees pretend to be hospital consultants, is hit with a similar $210 million judgment involving insurance software.

Aidoc Unveils $30M Investment in Revolutionary Foundation Model for Imaging AI at RSNA 2023

Medical imaging AI vendor Aidoc will use $30 million in recently announced funding to develop an imaging AI foundation model.

Harmony Healthcare IT Partners with Novacap to Accelerate Innovation and Growth in Healthcare Data Management

Health data management company Harmony Healthcare IT secures an undisclosed amount of funding from Canadian investment firm Novacap.

PayGround Announces $19.7M Oversubscribed Series A Funding Round

Patient payment app startup PayGround raises $19.7 million in a Series A funding round, enabling it to expand beyond its ambulatory roots into more inpatient settings.

Comments Off on Morning Headlines 11/29/23

News 11/29/23

November 28, 2023 News 4 Comments

Top News

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Ardent Health Services works to recover from a November 23 ransomware attack that forced it to take its computer systems offline across its six-state network of 36 facilities.

The health system specifically mentions in its latest data security update that it is working to restore access to Epic.

Numerous of its providers resorted to ED diversions and postponing surgeries and appointments.


Reader Comments

From Drupal: “Re: community hospitals that offer oncology and don’t use Epic or Cerner. I am looking to speak to a hospital contact who understands the market opportunity for chemotherapy ordering, medication preparation, and patient-reported outcomes. Can you offer advice or contacts?” I’ll ask readers who have ideas to contact me and I’ll connect you.

From Reese Peace: “Re: AI. It seems that use cases have polarized to the complex and theoretical on one end and and the rather dull effectiveness boosters on the other.” I expect initial AI successes to focus on that latter category, where solutions could be developed that are inexpensive, non-threatening to clinicians, free of FDA oversight, and non-intrusive to patients. Examples:

  • Journal article search, although that will be limited by the paywalls of for-profit journals that will expect to be paid for allow their content – which was provided free by authors, many of them working under taxpayer grants – to be used for AI training and then for user access.
  • EHR search, including PDFs and free text. This is simple and already being done to unknown extent.
  • Creating patient-facing documents, including those specifically create clinician dictation and then formatted and optimized for patient-level reading.
  • Pre-visit triage and summarization. In-person visits could be prefaced, as with telehealth, by a pre-visit chatbot interview or data collection to avoid wasting encounter time.
  • Encounter transcription and data extraction, as with ambient clinical documentation.
  • Continuous monitoring of data from wearables and remote patient monitoring.
  • Streamline insurer prior authorization and initial claim validation.
  • Monitoring during surgery with visual and audio alerts or responses to questions.
  • AI-powered robotics for manual tasks.
  • Improving and personalizing available clinical decision support.
  • Inbox management, which is clearly the frontrunner for AI value in healthcare.
  • Guide non-physicians through patient encounters via protocols and guidance under some level of supervision.
  • Predict workload, staffing needs, patients who are likely to miss appointments, and scheduling preferences.

HIStalk Announcements and Requests

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I added a previously unnoticed sort-by-date option to the HIStalk search function, which is powered by Google Site Search and is listed as a link at the top of the page. I’ll definitely use this.

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Bitdefender offered me a one-year renewal for my soon-expiring five-device Total Security for $50, after which a quick Google search led me to find a two-year renewal on Best Buy for $31. You can buy a renewal at any time, and paste the key code into Bitdefender Central, where it tacks the additional years onto your expiration date.

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Reader Mark once again celebrated the holidays with a generous donation to my Donors Choose teacher grant project, which I then boosted with GivingTuesday matching funds as well as those from my Anonymous Vendor Executive to fully and anonymously fund these STEM-related projects:

  • Noise-cancelling headphones for Ms. D’s middle school science academy class in Youngstown, OH.
  • Math games for Ms. O’s elementary school class in Rosharon, TX.
  • Math manipulatives for Ms. R’s elementary school class in Redford, MI.
  • Hydroponic gardening kits for Mr. K’s high school class in Burton, MI.
  • STEM manipulatives for Ms. I’s elementary school class in Far Rockaway, NY.
  • Gardening kits for Mr. H’s elementary school class in Paterson, NJ.
  • STEM activity kits for Ms. A’s elementary school class in Savannah, GA.
  • Math puzzles for Mx. R’s middle school class in Saint Cloud, MN.
  • Geometry review books for Mr. H’s high school class in Bronx, NY.
  • A laptop speaker for Ms. G’s elementary school class in San Lorenzo, CA.
  • Math manipulatives for Ms. R’s elementary school class in Magna, UT

Webinars

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


Acquisitions, Funding, Business, and Stock

India-based Tata Consultancy Services, which was just assessed with $140 million in punitive damages for stealing Epic’s intellectual property by having its employees pretend to be hospital consultants, is hit with a similar $210 million judgment involving insurance software. The lawsuit alleges that a TCS employee copied a competing firm’s source code and documentation and sent it to colleagues who were struggling to figure out how to perform an insurance calculation.

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Bloomberg says that Amazon has failed to disrupt healthcare while over-promising and under-delivering. Current and former employees say the company is overconfident that it can beat healthcare incumbents without hiring healthcare expertise or listening to experts, adding that its recently announced One Medical discount for Prime members isn’t much of a development.


Sales

  • Baptist Memorial Health Care (TN) chooses Optimum Healthcare IT to lead its EHR implementation on Amazon Web Services.

People

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PointClickCare Technologies promotes Travis Palmquist to SVP/GM of emerging markets.

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Sondra Hornsey, MS (Stanford Health Care) joins Vanderbilt University Medical Center (TN) as chief privacy officer.

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Hearst promotes Carolyn Simpkins, MD, PhD to president of its Zynx Health business.

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Shally Pannikode, MBA (Liberty Mutual) joins Zelis Health as CTO.

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Erica Drazen, MS, ScD — who retired in 2013 after a 40+ year health IT career that included roles at Arthur D. Little, First Consulting Group, and CSC — died November 25. She was 77. 


Announcements and Implementations

Klickitat Valley Health (WA) launches virtual consult technology from Eagle Telemedicine to support its ED, hospitalists, and nurses.

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Nym makes its autonomous medical coding technology available to inpatient facilities.

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Glacial Ridge Health System will go live on Meditech Expanse this week.

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Amazon Web Services announces Amazon Q, a generative AI assistant for businesses.


Other

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A technology conference is exposed for using AI to create fictitious female speakers to create the illusion of gender diversity and attract presenters who decline events with all-male lineups. The for-profit DevTernity conference brags that it selects speakers using the “Hollywood Principle” in which it replaces calls for papers with “don’t call us, we’ll call you.” The conference organizer says it was too hard to get women speakers for the $870 online conference and the phony bios were just a placeholder. The conference was cancelled after speakers and sponsors pulled out. The conference organizer is also suspected of creating a fake female tech Instagram influencer who mostly showed skin as she pitched the conference.

A South Dakota hunting lodge operator is gored by a bison and is evaluated and treated in the ambulance from an ED doctor who was 140 miles away. Jim Lutter, 67, was picked by a ambulance squad volunteer, who left his hardware store job to respond to the 911 call and used the state-funded ambulance telehealth system to get ED physician instructions and then alert the hospital that they were coming.


Sponsor Updates

  • EClinicalWorks publishes a new customer success story, “Transforming Care with RPM Seamless Integration.”
  • Sydney Adventist Hospital in Australia enhances its MRI appointment utilization and patient care through Foxo and Agfa HealthCare’s enterprise imaging platform.
  • Dimensional Insight announces that it has been recognized as the top outsourced analytics solution in Black Book Market Research’s annual outsourcing services survey.
  • Trillium Health Partners in Canada adds AI-as-a-Service capabilities from Sectra to its Sectra enterprise imaging technology.
  • SouthLake Regional Health Centre clinicians in Ontario reduce time spent on medication reconciliation by 64% using DrFirst’s MedHx powered by SmartSuite technology, according to the results of a recent pilot study.

Blog Posts


Contacts

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

Morning Headlines 11/28/23

November 27, 2023 Headlines Comments Off on Morning Headlines 11/28/23

Ardent Health Services Reports Information Technology Security Incident

Ardent Health Services works to recover from a November 23 ransomware attack that forced it to take systems offline across its six-state network.

RepeatMD lands capital to grow its aesthetics and wellness booking business

Patient acquisition and retention software startup RepeatMD raises $40 million, bringing its total raised to $56 million.

Wyden, Merkley: USDA Invests $2.28 Million to Expand Health Care and Broadband Assistance in Rural Oregon

Senators Ron Wyden (D-OR) and Jeff Merkley (D-OR) will distribute a grant of $2.28 million to providers in five Oregon counties so that they can provide more virtual care.

Comments Off on Morning Headlines 11/28/23

Curbside Consult with Dr. Jayne 11/27/23

November 27, 2023 Dr. Jayne 3 Comments

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We’ve made it past the Thanksgiving holiday, and hopefully people were able to spend time with their loved ones and then have a little time on their own to de-stress before heading back to work.

Historically, this time of year brings out all kinds of family drama. Looking at the data from one of the practices I work with, over the past couple of years there have been upticks in the number of visits for anxiety and depression between mid-November and mid-January.

Although I avoided dinner time conversations about Medicare, one family gathering involved a conversation about hospital-affiliated primary care practices that are charging facility fees. Another covered the move of private equity organizations into the local care ecosystem, leading to decreased access as they cut providers from their rosters following acquisition. US healthcare is certainly in a dark spot, and patients are paying the price as they find it more difficult and more expensive to get the care they need.

Local pharmacies have been eager to step into this gap. However, one elderly relative discovered that it wasn’t as easy to get appropriate care as it should have been. She’s in her 80s and has multiple risk factors for severe disease from RSV infection, so she tried to make an appointment for the recently approved vaccine. She walked into a location of a nationwide retail pharmacy chain and was told she couldn’t get the vaccine without an appointment. However, per her recollection of the story, they wouldn’t make an appointment for her, instead telling her to call for one. She called and wound up in a phone tree system, which kept prompting her to choose a location despite the fact that she was standing in one. When she selected the prompt to speak to a representative, it continued to ring, but no one answered.

She went to another location, which refused to administer the vaccine because she didn’t have a prescription. I’m not sure if this was because the pharmacy didn’t have the appropriate standing order in place from their medical director, or if it was some kind of insurance issue, or if they didn’t want to do the counseling since the vaccine isn’t strictly recommended based on age but rather as a part of a shared clinical decision-making process.

Either way, she left without her vaccine and instead spoke to her primary care physician. It sounds like the primary physician isn’t keeping up with the literature, because he told her she didn’t need the vaccine because she “isn’t around babies,” which has nothing to do with the indications for the vaccine. It’s designed to reduce the burden for a disease that hospitalizes more than 60,000 older adults each year and results in up to 10,000 deaths among retirement-age adults each year.

I’m hoping that the EHR team at her primary care physician’s office ensures that the vaccine is added to health maintenance dashboards so that physicians who aren’t keeping current might be prompted to address the condition with their patients. Hopefully that hospital-affiliated organization will also be providing continuing education to ensure physicians are aware of current recommendations, since it’s foolish to assume that technology alone can solve a clinician knowledge gap.

But in the mean time, thinking about my family members, I was tempted to dig out a prescription pad and just write the order myself. I don’t practice medicine like that, though, so I provided some coaching to hopefully help the patient have a better conversation with her physician. In the mean time, I’ll be calling a couple of pharmacies to see if they have standing orders in place that would allow her to get the vaccine.

Is this a place where telehealth-only organizations might help patients that can’t get what they need? Probably not, since many of them won’t allow their clinicians to order injectable medications even if they are low risk, like vaccinations. At one telehealth organization where I worked during the height of the COVID pandemic, we weren’t even allowed to write letters that would have explained that patients were high risk and could receive priority vaccinations. Even though providers on those networks are usually independent contractors, they’re often constrained by group policies that prevent them from doing things that might otherwise be straightforward in a traditional medical practice.

Speaking of telehealth, a recent article in JAMA Network Open looked at how patients complete tests and referrals when those services are ordered as part of a telehealth visit compared to those ordered during in-person visits. The telehealth visits were delivered by providers at a large hospital-affiliated primary care practice and community health center in Boston during the time period between March 1, 2020 and December 31, 2021. The authors looked at colonoscopy orders, dermatology referrals for suspicious skin findings, and cardiac stress tests. They found that only 43% of orders placed during a telehealth visit were likely to be completed, compared to 58% of orders placed during in-person visits. Interestingly, 57% percent of orders placed without a visit (perhaps as a result of a non-visit telephone call, or a patient portal message) were completed.

The authors suspect that one reason for the discrepancy might be the absence of schedulers or medical assistants to help patients during telehealth visits, or the lack of follow up communications encouraging patients to close the loop on their orders. That doesn’t explain why the non-visit orders were completed as frequently as they were, however, unless schedulers were assisting those patients. I would be curious to look at completion rates for orders from third-party telehealth organizations. Some of them won’t even generate orders for patients because they have no way to get those orders to a performing facility near the patient. Others limit their orders to those that can be done as part of an employer wellness program, such as diabetes screening tests or cholesterol testing. Third parties are often worried about liability, and given the transactional nature of many visits, there isn’t a mechanism to follow up on abnormal test results or to easily communicate follow up instructions to patients.

As someone who has done a lot of process engineering work, these are the “people” and “process” parts of the equation, but I continue to see organizations that try to solve them with “technology” alone. I’d love to see more organizations put their money towards solving people and process problems, whether it’s integrating a checkout person or scheduler into a telehealth workflow or making it easier for patients to self-schedule certain tests and procedures or doing a better job of reminding patients of orders that aren’t completed. Certainly, technology is part of all of those solutions, but it’s not the only answer.

How is your organization making it easier for engaged patients to receive the services they need? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 11/27/23

November 26, 2023 Headlines Comments Off on Morning Headlines 11/27/23

DOD’s EHR Deployment Nearly Complete

The Department of Defense completes the last of 23 MHS Genesis go-live waves.

BSA diverting ER patients after ‘potential security incident’ causes network outage

BSA Health System (TX) reverts to downtime procedures including ER diversion due to a Thanksgiving Day network outage.

Hackers accessed sensitive health data of more than 8 million Welltok patients

A notice filed by Virgin Pulse-owned Welltok says the personal information of 8.5 million people was exposed in a breach of its Moveit file transfer system, with affected customers including BCBS plans, Sutter Health, Stanford Health Care, and The Guthrie Clinic.

HHS’ Office for Civil Rights Settles HIPAA Investigation of St. Joseph’s Medical Center for Disclosure of Patients’ Protected Health Information to a News Reporter

Saint Joseph’s Medical Center (NY) pays $80,000 to settle HHS OCR charges that it provided photos and information of three patients in April 2020 to the Associated Press, which was writing an COVID-19 story, without the approval of the patients.

Comments Off on Morning Headlines 11/27/23

Monday Morning Update 11/27/23

November 26, 2023 News 10 Comments

Top News

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The Department of Defense completes the last of 23 MHS Genesis go-live waves.

The military’s final Oracle Health implementation is scheduled for March 2024 at Lovell Federal Health Care Center, which it jointly operates with the VA.

DoD says that its teams are anxious to move on to optimization and applying analytics at the site and enterprise levels.


HIStalk Announcements and Requests

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Poll respondents aren’t optimistic that any of the usual suspects can disrupt healthcare, but they choose retailers as the best hope. I’m intrigued that they chose employers as the least likely given that they are footing much of the bill and have the only significant amount of clout, which they never seem to use.

New poll to your right or here: What is your single biggest frustration with your primary care provider? I’m allowing only one answer to hide the noise of problems that aren’t the main one.


Webinars

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


Acquisitions, Funding, Business, and Stock

London-based Phare Health, which offers medical coding tools, raises $3.1 million in a seed funding round.


Sales

  • Memorial Hermann Health System will implement Laudio’s worklfow automation tool for frontline leaders and has invested in the company.

Announcements and Implementations

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Researchers develop a wireless acousto-mechanical system whose wearable sensors continuously transmit data about body movement sounds such as breathing, digestion, and cardiac activity.

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London-based digital-first home healthcare provider Cera says it will provide 5 million care visits this winter to help address hospital capacity problems. Founder and CEO Ben Maruthappu, BM BCh. MPH was trained at London School of Hygeine and Tropical Medicine, University of Cambridge, Harvard, and University of Oxford.

A health official in China touts the country’s digital health success, listing online diagnosis and treatment, prescription services, fever clinic information, and hospital wait time.

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A16z lists the jobs that AI could perform to reduce provider burnout and increase effectiveness, which it says should be supported by CMS in the form of increased payment for AI-assisted or augmented care (click the image to enlarge).


Privacy and Security

Saint Joseph’s Medical Center (NY) pays $80,000 to settle HHS OCR charges that it provided photos and information of three patients in April 2020 to the Associated Press for a COVID-19 story without their approval.

A notice filed by Virgin Pulse-owned Welltok says that the personal information of 8.5 million people was exposed in a breach of its Moveit file transfer system. Affected customers include BCBS plans, Sutter Health, Stanford Health Care, and The Guthrie Clinic. Virgin Pulse acquired the company in November 2021.


Other

Politico notes that a physician shortage will force the federal government to stitch together a primary care system that is delivered by nurses, physician assistants, and virtual visits, with no promise that people can get, much less keep, a regular doctor. Long appointment waits are sending sick people to the ED, urgent care, or pharmacy-located clinic where services are purely transactional with no promise of prevention or taking the patient’s personal or even medical history into account.

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Cigna creates public outcry when it denies transplant coverage to a 47-year-old woman who was being prepped for a double lung transplant after being rushed to Vanderbilt University Medical Center when a matching donor had been found. VUMC sent her home and took her off the transplant waitlist. Cigna had previously approved the procedure, but found that the woman had the unapproved condition of terminal cancer. As is often the case, the insurer paid more attention to the bad press than to the patient and doctors in reversing its decision that it declared to have been an “error.” The patient now requires additional tests, the donor lungs are no longer available, and her only hope is to be placed back on the waitlist. Cigna got the black eye, while VUMC has drawn no public ire for declining to perform the transplant in the absence of Cigna’s willingness to pay.


Sponsor Updates

  • Health Data Movers appoints Curtis Cole, MD (Cornell University) to its board.
  • Through partnerships with Redox and Xealth, Tidepool develops EHR integrations for its diabetes data visualization software.
  • Five9 will present at the UBS Global Technology Conference November 29 in Phoenix and the Barclays Global Technology Conference December 7 in San Francisco.
  • Fortified Health Security names Kameron McNicholas senior SOC engineer.
  • Health Data Movers names Curtis Cole (Cornell University) to its Board of Directors.
  • Healthcare IT Leaders releases a new Leader to Leader Podcast, “Leading Through Growth and Change.”
  • Inovalon develops Converged Analytics Benchmarking to provide health plans with monthly determinations of their relevant national and state benchmarking for quality measurement and improvement initiatives.
  • InterSystems launches its HealthShare Health Connect Cloud solution in New Zealand.
  • A recently published study on brain health, “Using digital assessment technology to detect neuropsychological problems in primary care settings,” features Linus Health’s Core Cognitive Evaluation digital assessment technology.
  • Nordic names Claire Staple VP of strategy and country manager in Ireland.

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