Recent Articles:

Morning Headlines 2/2/24

February 1, 2024 Headlines Comments Off on Morning Headlines 2/2/24

Where do we go from here on digital therapeutics?

The digital therapeutics market is stagnating in the US, as evidenced by vendor bankruptcies and lack of Medicare coverage for the sector’s products.

Cohere Health Raises $50 Million in Equity to Meet Increased Demand for AI-Driven Transformation of Prior Authorization Process

Prior authorization technology vendor Cohere Health raises $50 million in equity funding, increasing its total to $106 million.

Carpl guides healthcare providers through the growing market of radiology AI apps

Carpl, a San Francisco-based startup that has developed a marketplace of vetted radiology AI apps, raises $6 million.

SAMHSA releases final rule on opioid use disorder treatment

The Substance Abuse and Mental Health Services Administration makes some COVID-19 flexibilities permanent, including the ability for Opioid Treatment Programs to prescribe opioid use disorder medications via telehealth without an initial in-person evaluation.

Network outage affects phone, internet service at Chicago’s Lurie Children’s Hospital

Lurie Children’s Hospital in Chicago works to recover from a Wednesday network outage that has impacted its internet, email, phone lines, and MyChart access.

Comments Off on Morning Headlines 2/2/24

News 2/2/24

February 1, 2024 News 2 Comments

Top News

image

A Stat review says that digital therapeutics is stagnating in the US, as evidenced by vendor bankruptcies and lack of Medicare coverage for their products.

The authors note that Pear Therapeutics shut down less than a year after CMS denied the company’s request to consider its substance abuse order product (pictured above) as a billable medical device.

Few commercial payers cover digital therapeutics because of concerns about efficacy, which poorly designed vendor studies have failed to prove.

The article says that vendors who want their products covered like traditional drugs will need to perform similar studies that meet a comparable standard of evidence, which is risky because of high cost and the possibility that their products aren’t effective. They could also sell their products to providers who might be reimbursed by payers for achieving specific results.


HIStalk Announcements and Requests

image

Thanks to the folks at DrFirst, which booked the Top Spot banner (at the upper right of the HIStalk page) for the long term, initially to showcase their participation in the ViVE conference. I appreciate the support.

Repetitive, I know, but winding down – sponsors that are participating in ViVE and/or HIMSS should complete the respective forms so I can list you in my guides pro bono (does that word make you think of U2 or Cher?)


Webinars

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


Acquisitions, Funding, Business, and Stock

Cardinal Health acquires group purchasing company Specialty Networks for $1.2 billion in cash, calling out the strategic value of its AI-driven PPS Analytics product that analyzes data from EHR/PM, imaging, and dispensing systems for clinical decision-making and for purchase by drug companies.

image

Medical practice patient communication technology vendor Vital Interaction raises $15 million in Series A funding.

image

Fabric, a healthcare enablement startup that was formerly known as Florence, acquires Gyant, which offers health systems an AI-powered virtual assistant.

image

Prior authorization technology vendor Cohere Health raises $50 million in equity funding, increasing its total to $106 million. It has five health plan customers.

Hindenberg Research predicts a “breakdown” for private equity-backed mental health rollup LifeStance, which has 6,400 clinicians, 600 centers in 33 states, a market cap of $2 billion, and a mountain of debt. It says the company is running out of cash, employs mostly therapists who bill at low rates compared to psychiatrists, provides stock grants to its highest-performing prescribers of drugs that have a high abuse potential, and pushes clinicians to see up to 30 patients per day. Former employees say that the industry has such low barriers to entry that LifeStance provides no value or even negative value because “all you need to do to open up your own private practice is post a thing on Facebook and start seeing private, cash-only patients.”


Sales

  • Smile Train will provide its partners and affiliates access to select medical journals via Wolters Kluwer Health.
  • VNAcare expands its relationship with Netsmart to implement its MyUnity EHR.
  • ACO Vytalize Health will use WellSky Next-Generation Provider Solution for care coordination between acute and post-acute providers.

People

image

Oracle expands the role of former CMS Administrator Seema Verma, MPH to EVP/GM of Oracle Health, the former Cerner business.

image

Workforce management solutions vendor Hallmark Health Care Solutions names industry long-timer Bruce Cerullo, MS as CEO. He replaces co-founder Isaac Ullatil, MBA, who will transition to strategic advisor.

image image

JTG Consulting Group hires Jaimie Augustine (Copan Diagnostics) as chief growth officer. She replaces Lisa Potter, who was promoted to COO.


Announcements and Implementations

Atlantic Health will acquire Saint Peter’s Healthcare (NJ) and move it to Epic.

ECRI lists its top health tech hazards for 2024:

  1. Usability of medical devices intended for in-home use.
  2. Insufficient cleaning instructions for medical devices.
  3. Drug compounding without technology safeguards.
  4. Environmental harm from patient care.
  5. Lack of AI governance in medical technologies.
  6. Ransomware.
  7. Burns from single-foil electrosurgical electrodes.
  8. Medication errors caused by damaged infusion pumps.
  9. Defects in orthopedic implantables.
  10. Web analytics software and the misuse of patient data.

Publicly traded hospital operator Community Health Systems migrates to a FHIR-based clinical data platform on Google Cloud and is implementing the company’s AI technologies.


Government and Politics

A law firm says that an Epic case that was heard by the Supreme Court raises the legal issue of proving that employees actually signed arbitration agreements that include employment class action waivers. It notes that employees are arguing that they don’t remember signing the agreement, which places the burden on the employer to prove that their electronic signature wasn’t provided by someone else.

The Substance Abuse and Mental Health Services Administration makes some COVID-19 flexibilities permanent, including the ability for Opioid Treatment Programs to prescribe opioid use disorder medications via telehealth without an initial in-person evaluation.

image

England’s health regulator finds that IT systems at Newcastle upon Tyne Hospitals – a Global Digital Exemplar and HIMSS EMRAM Stage 6 designee – are not always integrated and don’t always promptly provide staff with information they need. Inspectors noted that OR information is documented on paper and then entered into electronic systems afterward because of slow systems, which was measured at 45 minutes from log-in to retrieval of a single patient’s vital signs and fluid balance. The inspectors also observed that maternity staff are required to document the same information in two systems due to lack of integration.

Regional West Medical Center settles its contract dispute with Oracle for $6 million versus the $15 million that the company wanted, freeing it to convert to Epic. The hospital blamed financial losses and the lowering of its bond ratings on the revenue cycle disruption that was caused by its 2018 implementation of Cerner Millennium.


Other

image

A data manipulation expert uses AI to determine that a Harvard Medical School neuroscientist included plagiarized images in 21 journal articles, including images that came from other papers and from vendor websites.


Sponsor Updates

  • CereCore publishes a new case study, “Liverpool Women’s NHS Foundation Trust: Successful EPR Transition Journey.”
  • Hyndman Area Health Center expands its use of EClinicalWorks technology with the addition of AI solutions including the Sunoh.ai virtual scribe.
  • WellSky will use cloud, analytics, and AI technologies from Google Cloud.
  • Impact Advisors joins Epic’s new Rev Cycle Partners program.
  • Findhelp names Dallas Mudd (United Way of Northwest Arkansas) senior director of partnerships.
  • Health Data Movers welcomes Eric Williams (Kaiser Permanente) to its board.
  • Inovalon names Katie Smith (Inari Medical) senior manager of clinical analytics.
  • The Lean HealthTech Podcast features KeyCare CEO Lyle Berkowitz, MD “Virtual Visionaries: KeyCare’s Revolutionary Approach to Telehealth.”
  • Konza National Network appoints Jonathan Smith, MPH (Lawrence-Douglas County Public Health) to its Board of Directors.
  • Broadlawns Medical Center (IA) maximizes efficiency with Meditech’s labor and delivery solution.

Blog Posts


Contacts

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

EPtalk by Dr. Jayne 2/1/24

February 1, 2024 Dr. Jayne 1 Comment

Physicians who care for children — including pediatricians, family medicine physicians, and psychiatrists — have been sounding the alarm for years with regard to the negative impacts of social media on the health of the world’s youth. I’ve been following the recent hearings in the US Senate Judiciary Committee this week on the topic of child sexual abuse. Executives from TikTok, X, Snap, Discord, and Meta were grilled by senators about the platforms’ role in child exploitation.

For those of you who might not be following the issue closely, abuse and exploitation of kids via social media platforms is more than cyberbullying and child pornography. The list of problems continues to expand, and includes not only the sharing of images and videos, but also predators grooming children for abuse and potential trafficking.

Drug use is also a serious concern. I’m sure a lot of parents don’t know that you can use Snapchat to buy fentanyl. As an urgent care physician, I’ve seen the faces of parents who can’t believe that the pricey TikTok-promoted cosmetic products they gave their pre-teen daughters for Christmas have caused the horrible rashes that resulted in a $100 co-pay and prescription medications.

I continue to encounter parents who are willing to help their children lie to gain access to social media even though they’re not old enough to meet the age restrictions, because they are terrified that their children will be ostracized if they’re not keeping up with their peers. I also see children who have zero parental limits on social media use, which can manifest with sleep disturbances, poor academic performance, and serious behavioral health issues.

One hot topic during the hearing was the Kids Online Safety Act, which only two of the five platform leaders were willing to support. Others claimed that the Act contains provisions which are too broad and may clash with free speech issues. The act includes language not only addressing abuse but also predatory marketing and would potentially reduce the power of notifications and auto-played videos that trigger users’ dopamine pathways and contribute to compulsive and addictive behaviors.

YouTube was notably absent from the hearing, despite the platform’s popularity among teen media consumers. Unfortunately, the hearing ended without consensus or clear solutions and those of us who have seen countless children harmed will have to continue to wait for yet another bill on Capitol Hill to finally get passed.

image

I received a message from the CDC’s V-safe program this week, inviting me to participate in health check-ins for the updated COVID vaccine. Unfortunately, one has to register within six weeks of receiving the vaccine. For those of us who are frontline physicians of a certain age who received the updated vaccine shortly after it became available, I guess we’re out of luck as far as participating in vaccine surveillance. Seems like that should have been something they coded and released to time appropriately with the vaccine’s arrival in retail locations.

Unfortunately, this is just the kind of food for thought that conspiracy theorists latch onto, since it can be used to try to support the assertion that that “government really doesn’t want us to know about how many people are harmed by these vaccines.” I serve on the health advisory board for our local school district, and most of us are still seeing COVID-deniers in practice. Many don’t want to seek medical care because they’re afraid they’ll be tested for COVID. Maybe someday health literacy in our country will improve to a place where clinicians can spend more time rendering care and less time refuting medical misinformation.

image

As a telemedicine physician, I’m concerned about the conflicting priorities that our industry faces, including balancing patient satisfaction and perceived convenience with elements such as clinical quality and antibiotic stewardship. One of the challenges is the lack of telemedicine-specific metrics, which leads organizations to try to mold in-person clinical quality measures to virtual care. The Agency for Healthcare Research and Quality has created the AHRQ Safety Program for Telemedicine, which will help prescribers look at antibiotic usage over an 18-month period starting in June 2024. The program will provide educational sessions to providers, including scripts for navigating patient concerns about not having their wishes met when they request “a Z-Pack to nip things in the bud since we’re going into a weekend,” which universally makes physicians cringe. Providers are expected to perform better on antibiotic-related quality measures after participating in the program, and continuing education credits are available. There is no charge to providers to be part of the program, which is a welcome element for those of us already spending too much to maintain board certification and other recognitions.

image

Mr. H recently mentioned concerns by developers such as Microsoft and Google with regard to the cost of the computing power needed for AI projects. I’m a bona fide space nerd, having once wanted to be the first physician living permanently in space. Instead, I’m content to watch from the sidelines as scientists execute cool projects that I could only dream of. I’ve followed NASA’s Ingenuity helicopter, which nearly every journalist describes as “plucky,” especially since it was planned for less than a half dozen missions and eventually flew 72. Ingenuity weighs less than 4 pounds, but provided an amazing amount of data about the ability to achieve powered autonomous flight on another planet.

A headline about the craft caught my eye this week, noting that the craft “packed more computing power than all other NASA deep space missions combined.” This was a challenge given its small size, with engineers having to forego heavy components whose design would mitigate radiation damage and the extreme temperatures on Mars. Instead, designers specified off-the-shelf components, including the brain of the helicopter: the Qualcomm Snapdragon 801 processor, which was used in smartphones nearly a decade ago. Here’s to those IPhone 6, Blackberry Passport, and Google Nexus 6 users whose daily calls shared NASA-worth technology and they didn’t even know it. Photo credit: NASA/JPL.

What was your childhood dream? Are you working in a related field or would you give up your meeting-filled days for a ride into outer space? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 2/1/24

January 31, 2024 Headlines Comments Off on Morning Headlines 2/1/24

Cardinal Health to acquire Specialty Networks and its PPS Analytics platform, a technology enabled multi-specialty group purchasing and practice enhancement organization in urology, rheumatology and gastroenterology

Cardinal Health will acquire Specialty Networks and its PPS Analytics software for $1.2 billion.

Oracle Taps Former Trump Official Seema Verma to Lead Cerner Business

Confirming HIStalk reader rumors, Oracle taps former CMS Administrator and current Oracle Life Sciences lead Seema Verma to head up Oracle Health.

Austin-Based Vital Interaction Closes $15M Series A Funding Round to Revamp Patient Communication with Hyper-Personalization

Austin-based patient engagement and retention technology startup Vital Interaction raises $15 million in a Series A funding round.

Health care operations enabler Fabric pays cash for AI helper Gyant

Fabric, a healthcare enablement startup formerly known as Florence, acquires Gyant, which offers health systems an AI-powered virtual assistant.

Comments Off on Morning Headlines 2/1/24

Healthcare AI News 1/31/24

January 31, 2024 Healthcare AI News Comments Off on Healthcare AI News 1/31/24

News

image

Oracle announces a generative AI service that supports text generation, text summarization, and LLM-contextualized search results. The company says it will release search, aggregation tools, and prebuilt agent actions across its SaaS applications, including those of Oracle Health.

Apple will reportedly release AI features with IOS 18 in June, reportedly including enhancing Messages to answer questions and auto-complete sentences.

The State of Illinois launches a Google AI-powered portal for families to access behavioral and mental health resources.

image

In UAE, Emirates Health Services launches an AI-powered virtual nurse that answers patient questions, provides medical advice, and helps with assessment and triage. EHS will also assess patient-reported symptoms to schedule appointments with the correct specialty. EHS is running a long list of AI projects, including those related to diagnosis, treatment, disease prediction, patient monitoring, and speech-powered clinical documentation.

Microsoft and Google warn investors that the arms race to develop AI products will be expensive due to the computing power it requires.


Business

The Justice Department is reportedly issuing subpoenas to drug companies and EHR vendors to determine if AI is being used to influence prescribing in ways that breach anti-kickback and false claims violations

Microsoft and OpenAI are reportedly in talks to invest up to $500 million in AI-powered robot developer Figure AI, which could value the 2022 startup at $2 billion. The latest autonomous model is 5’6” tall, can carry 44 pounds, walks at 1.2 meters per second, and operates for five hours when charged.


Research

Researchers apply AI and sophisticated analytics methods to test the detection of Medicare fraud, noting that traditional auditors only have enough time to look for specific suspicious patterns.


Other

image

Cleveland Clinic says in its annual meeting that it is piloting AI for answering the questions of patients with chronic disease, creating ambient clinical documentation, predicting patient volume, and creating draft responses to questions that are submitted via Epic’s MyChart.

The hottest job in corporate America is the executive in charge of AI, according to the New York Times. It notes that Mayo Clinic in Arizona has hired its first chief artificial intelligence officer. 

An AAMC story describes the experience of physicians who are using AI to create documentation from recordings of their patient encounters. Eric Poon, MD, MPH (Duke Primary Care) says he is finishing his clinical schedule on time for the first time in his life, also noting that he didn’t realize how his EHR typing was slowing down the visit. Matthew Anderson, MD (Atrium Health) says he has a summarydraft in his hand 15 seconds after the visit ends. However, users say that ambient listening tools aren’t perfect in deciding what parts of the conversation to include or exclude, and some of them report that they spend quite a bit of time editing out extraneous information. They also say that it works well for quick visits, but less so when visits involve multiple medical issues.


Contacts

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

Comments Off on Healthcare AI News 1/31/24

An HIT Moment With … Steve Shihadeh

January 31, 2024 Interviews 1 Comment

An HIT Moment With … is a quick interview with someone we find interesting. Steve Shihadeh is founder of Get-to-Market Health of Malvern, PA.

image

Startups have been forced to adjust their strategies, execution, or expectations as investment activity dropped substantially. How will that change the industry over the next few years and how should companies prepare for a turnaround?

At the end of 2022, and throughout 2023, startups and most mid-sized companies shifted their #1 priority to conserving cash. Forecasts of possible recession and rising interest rates put a damper on spending of all types, and especially the more expensive industry events. Companies lowered expectations, cut staff, and tried to do more with less, or at least hold their own. In my opinion, industry momentum, risk taking, and progress on using tech to improve healthcare were all off course for the last 18 months.

2024 has a much different feel already, with several significant funding announcements and a renewed focus on growth. Digital health investors who showed lots of patience over the last year and a half are pushing for the returns they were promised when their funds launched. As a result, I expect attendance, new product announcements, and customer interest at the big national shows to be on the upswing.

The HIMSS conference has a new owner and competition from ViVE and HLTH, with an emphasis on hosted buyer programs by all three. How would you advise companies to plan their participation in these conferences for maximum return on investment?

HIMSS23 in some ways seemed a little dated. It was big as ever, but when compared to the feel of ViVE and HLTH, it needed a reboot. I guess HIMSS understood that, and I am really curious how the show will change this year under new leadership.

To get maximum returns on your tradeshow investment, I think my assessment last year mostly holds true. The top three of the top 10:

  1. Pick the most important show for any booth investments.
  2. Have a presence, even if just one key person, at as many shows that you can.
  3. Send only your best, most committed people.

What has changed in health tech marketing since the pandemic eased?

The pandemic pushed people to hone great digital marketing skills and tools. That is table stakes today, and now we have the full return to strategic in-person events like trade shows and targeted regional and bespoke events. 

The vast improvements in marketing in our space continues to impress me. When I first started Get-to-Market Health in 2017, we presented to a CEO about how we would recommend he revamp marketing. He said something to the effect of, “I am going to just hire a grad assistant type instead.”

That was then. Now, to keep pace, most digital health companies have a strong marketing VP who is directly aligned with the sales VP. Awareness, public relations, lead generation, lead conversion, pipeline development, and deal closure are very much a team effort. Digital tools, social marketing, and micro-targeted outreach are mandatory today, and it is great to see companies taking full advantage of new ways to educate customers.

How will the increased healthcare involvement of big tech firms such as Microsoft, Oracle, and Google affect the ways that healthcare-only vendors run their business? 

I was able to see firsthand the impact of a big tech firm committing to healthcare when I was with Microsoft about a decade ago. The company made large-scale market development investments, engaged in key policy discussions that smaller companies just can’t do, and along with Amazon, laid the foundation for the cloud business in healthcare as we know it today.

I am bullish that the big tech firms that stay committed to the space — “stay committed” being the key point — can really drive change and make a difference. I would advise our clients and friends in the space to carefully evaluate who has the staying power before they go all in with one of the bigger players.

What is your advice for health tech startups given the business and industry conditions that you expect over the next two years?

Assuming the general economy stays strong, I see a great run for the companies in our space who have most of these attributes:

  • Differentiated products or services.
  • Demonstrable ROI that holds up to CFO scrutiny.
  • Company culture that your employees enjoy and your clients can feel.
  • Sales and marketing teams that work together.
  • A thoughtful plan of how to work with or around the big vendors.

Healthcare delivery in the US is complicated. but when it works, is the envy of the world. Technology improvements need to be made in all facets to drive down costs — the US is not the envy of the world on this point — and continually improve care. Every hospital in our country can benefit from all that tech has to offer, which is why I remain so positive on the runway in front of health tech companies.

Morning Headlines 1/31/24

January 30, 2024 Headlines Comments Off on Morning Headlines 1/31/24

DOJ’s Healthcare Probes of AI Tools Rooted in Purdue Pharma Case

The Justice Department is reportedly issuing subpoenas to drug companies and EHR vendors to determine if AI is being used to influence prescribing in ways that breach anti-kickback and false claims violations

Regional West leader outlines changes, hears feedback during forum

Regional West Medical Center (NE) will pay Oracle $6 million to settle a contractual lawsuit, after which it will move forward with implementing Epic.

Valendo Health wants to bring value to diabetes care

Valendo Health, a remote diabetes patient monitoring and value-based care startup that works directly with endocrinology practices, raises $4 million in seed funding.

Peloton Equity Leads Growth Investment in OnPoint Healthcare Partners

Health IT and services company OnPoint Healthcare Partners secures an undisclosed amount of funding from Peloton Equity and Fort Maitland Capital.

Comments Off on Morning Headlines 1/31/24

News 1/31/24

January 30, 2024 News 3 Comments

Top News

image

A district attorney in New York charges a 21 year-old Florida man with stealing the prescribing credentials of hundreds of doctors, which he used to fill and sell tens of thousands of prescriptions for narcotics across pharmacies in multiple states. He faces 19 charges, including illegally selling controlled substances and diverting prescription medications.

Devin Magarian sold prescriptions that customers picked up themselves or would provide the actual drugs that his team of runners obtained from the pharmacies. He charged premium prices to customers, who he recruited via a Telegram advertisement board, because the drugs came directly from pharmacies with no chance of adulteration.

He was arrested while visiting New York to collect $14,000 from a customer who had bought 630 Oxycodone pills using one of the fake prescriptions.

The Nassau County, NY district attorney warns that drug dealers have turned into cybercriminals who know how to exploit e-prescribing systems, noting that the defendant issued 18,500 phony prescriptions to pharmacies in 18 states in a single five-hour period. Authorities have not provided details on which system he compromised or how he did it.


Reader Comments

From Force of Nature: “Re: Summa Health. I heard the podcast stumble that you mentioned about their cost of implementing Epic. Summa has corrected the transcript to $85 million.” Thanks.


HIStalk Announcements and Requests

Sponsors: you still have time to complete my information form for ViVE and/or HIMSS if you are participating.


Webinars

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


Sales

  • HHS’s Advanced Research Projects Agency for Health selects IT support, design, development, and implementation services from Leidos.
  • Torbay and South Devon NHS Foundation Trust in England will replace 25 systems with Epic.
  • Vytalize Health will use WellSky’s Next Generation Provider technology to enable bi-directional communication and care coordination between Vytalize’s ACO members and acute and post-acute care providers.

People

image

Unlock Health names Kevin Thilborger, MHA (Huron) chief managed care officer and chief revenue strategy officer.

image

Kerry Armstrong (Care.ai) joins LookDeep Health as VP of sales.

image image image

Glytec names Patrick Cua (HealthStar Growth Partners) CEO; Erik Eaker, MHA (LetsGetChecked) COO; and Ashley Reynolds, PhD, RN, MSN (Vault Coaching and Consulting) chief product and experience officer.

image

Keith Eggert, MHA (University of Miami Health System) joins Abax Health as chief strategy officer.

image

Aaron Rucker, MBA (University Clinical Health) joins Murray-Calloway County Hospital as CIO.

image

Manhattan Surgical Hospital (KS) hires Joe DeSimone (Umbrella Managed Systems) as CIO.

image

Katie Peppler (Tegria) joins B.well Connected Health as VP of strategic accounts.

image

Retired industry long-timer Matt Atwood, MBA, MSHI, who was most recently global implementation leader of Philips Connected Care Informatics, died of colon cancer last week. He was 55.


Announcements and Implementations

Israel’s Health Ministry confirms that at least 20 hospitals have been affected by a software glitch within Elad Health’s Chameleon EHR that has led to dozens of patients being given incorrect medications. Ministry officials were first alerted to the problem 10 days ago, when hospitals began reporting that patient discharge letters contained the wrong prescriptions. Elad Health says the malfunction has been fixed. The EHR is used by 75% of Israel’s hospitals.

Atropos Health collaborates with Google Cloud to connect its de-identified patient database to Google Cloud’s tools.

Philips will stop selling its Respironics sleep apnea machines in the US to settle federal charges that the devices contained noise-reducing foam that the company knew could disintegrate and cause cancer in users. The company recalled the machines in mid-2021, several years after it was made aware of the problem. Users were advised to stop using the machine during the recall period that lasted more than a year. Philips, whose CPAP machines held a 37% market share in the US, could also face criminal charges.


Government and Politics

The Justice Department is reportedly issuing subpoenas to drug companies and EHR vendors to determine if AI is being used to influence prescribing in ways that breach anti-kickback and false claims violations. EHR vendor Practice Fusion, now owned by Veradigm, paid $145 million in 2020 for using EHR alerts to push the prescribing of opioids in a contract with drug maker Purdue Pharma. The lead investigator who pursued Practice Fusion and four other EHR vendors says that Practice Fusion made some attempt at compliance, AI-driven recommendations could be harder to track and could make more persuasive recommendations using personalization.

Texas Attorney General Ken Paxton requests medical records from a second out-of-state provider, seeking information from a Georgia telehealth clinic to verify that it does not offer gender-affirming care to Texas minors. The state requested extensive records from Seattle Children’s Hospital in November, and the Georgia clinic owner says she has seen similar letters that were sent to other organizations. The requests raise questions about the Texas AG’s authority over other states and HIPAA’s requirement to provide patient records only in response to a court order or subpoena after notifying the patient.


Other

image

Meritus Health (MD) credits its Epic system for helping it reduce opioid prescriptions by 55% over the last five years. The switch to Epic in 2018 allowed doctors to see facility-wide prescriptions in real time and yielded data that was used to create the policies of its new Pain Management and Opioid Stewardship Committee.


Sponsor Updates

  • CereCore publishes a new e-book, “The Buyer’s Guide to IT Managed Services: Elevating Healthcare Excellence.”
  • Agfa HealthCare celebrates a 20-year image management partnership with Amiri Hospital in Kuwait.
  • Cardamom Health names Jennifer Riffle (Nordic) a senior consultant.
  • Censinet will support healthcare organizations interested in assessing, managing, and improving coverage of and compliance with the Healthcare and Public Health Sector Cybersecurity Performance Goals recently released by HHS.

Blog Posts

Black Book’s list of top, physician-rated ambulatory EHR vendors include the following HIStalk sponsors:

  • Netsmart – behavioral and mental health / geriatrics / physical therapy and rehab / psychiatry
  • Medhost – emergency medicine
  • Experity – urgent care and occupational medicine

Contacts

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

Morning Headlines 1/30/24

January 29, 2024 Headlines Comments Off on Morning Headlines 1/30/24

FL Man Who Allegedly Commandeered E-Prescribing Privileges of Doctors Charged with Criminal Sale

A district attorney in New York charges a Florida man with stealing the e-prescribing credentials of multiple doctors, which he then used to illegally issue and sell tens of thousands of prescriptions for narcotics across multiple states.

Russian National Sentenced for Involvement in Development and Deployment of Trickbot Malware

Vladimir Dunaev is sentenced to five years in prison for his role in a wave of Trickbot ransomware attacks that extorted millions of dollars from hospitals, schools, and businesses between 2016 and 2022.

ApolloMed and Bass Medical Group to Forge a Value-Based Healthcare Partnership

Bass Medical Group will use a $20 million investment from ApolloMed, as well as the physician network optimization company’s value-based care and operational technology and services, to expand its value-based care arrangements in California.

Comments Off on Morning Headlines 1/30/24

Curbside Consult with Dr. Jayne 1/29/24

January 29, 2024 Dr. Jayne Comments Off on Curbside Consult with Dr. Jayne 1/29/24

I’m a big fan of virtual care. It has the potential to revolutionize healthcare if we can get patients, providers, payers, and state regulators all on the same page.

Unfortunately, there’s still a lot of disagreement on how reimbursement should work for the typical “outpatient” telehealth visit. Provider organizations are having to grapple with state licensure issues, especially if they are on a state border or have large numbers of patients who frequently travel away from the brick and mortar delivery site, or if they have large numbers of patients who live elsewhere but travel to the facility for care. It seems like most of the research articles I read are about that method of delivery, so I’m always interested when one comes up that features a different use case for telehealth.

This week’s JAMIA featured an article that looked at community tele-paramedicine (CTP) and how it can impact patient experience and patient satisfaction when varying levels of health disparities are present in a community. When I was a medical student doing ride-along shifts with our city’s fire and rescue squads, we spent most of our time transporting patients to the emergency department even though they didn’t have truly emergent medical conditions. A fair number of patients used EMS for transportation since they felt they didn’t have other options due to economic and geographic issues.

As a future physician, I felt powerless. It seemed like there should be a way for the paramedics and emergency medical technicians to deliver a basic level of care, such as a dressing change, without transporting the patients. However, the regulations and economic realities of the time left them with limited options.

Fast forward, and now that telehealth has become just another care delivery modality, healthcare professionals who are used to first responder roles now have other options for helping patients. New York City has embraced this, using community-based teams to deliver home-based care. Although the most visible parts of the team include community paramedics who can evaluate patients and facilitate video visits with emergency physicians, the teams also include care managers who are registered nurses that have with additional training in patient education and motivational interviewing. They coordinate with patients’ primary and subspecialty care teams, social workers, and others to make sure patients get the follow up appointments or home health services that they need. The paramedics also have additional training in the management of chronic diseases and assessing patient home environments.

Given the growth of the program and its interaction with patients who are part of vulnerable populations, the authors set out to look at patient satisfaction across areas of the city that were classified into high, moderate, and low health disparity Community Health Districts. As part of another clinical trial, the patients who were selected for this study were diagnosed with heart failure. The community paramedics who were part of the program had additional training on heart failure that included both lectures and case-based learning to simulate patient visits.

The service was available for home visits seven days per week, with nurse care managers staffed five days per week. The physicians who provided coverage for the video visits all had at least five years of post-residency experience and were certified by regional EMS officials to serve as online medical control for medics.

Patients were referred to the program after either a hospital admission or an emergency visit. Referrals could be initiated by ED / inpatient / ambulatory physicians as well as social workers and care managers, and referral was triggered within the EHR. Patients were deemed ineligible if they had active substance abuse or psychiatric issues, had been discharged to another medical facility, or were unhoused. Patients, family members, or the care team could request a home visit at any time using a triage process. Patients typically remain in the program for three months, and the program has completed 5,000 home visits since 2019.

Patients received a 12-question satisfaction survey that electronically collected anonymous data after each visit. Although medics could help patients access the survey, they could not help with completion. The authors found high levels of patient satisfaction that were similar across areas with different community-level health disparities.

They also conducted a small number of qualitative interviews, which identified some differences in how valuable patients found the service.  Those in high-disparity areas made comments that aligned with improved health literacy and more engagement with the health system, where those from areas with less disparity were more likely to comment on convenience.

The article includes direct quotes from the qualitative interviews, which touches on themes that we have known have influenced healthcare for a long time: transportation, the need to have someone to check on patients between scheduled appointments, medication education and tracking, and convenience for patients who have a large number of healthcare encounters, such as dialysis patients. 

The authors note that the program used in the study is “specific to our institution and geographic location” and that results might not be generalizable to other cities. However, I would hazard a guess that any large metropolitan area could conceivably achieve similar results. They also noted that the specific design around a heart failure diagnosis may create issues with trying to generalize performance to other chronic conditions. I would also guess here that other chronic conditions such as pulmonary disease, kidney disease, or diabetes may yield similar outcomes. However, we won’t know for sure unless we study other conditions in other geographies.

I’m hoping that other institutions might see this publication and consider conducting research on their own populations, or seeking funding for similar programs that might tell us more about healthcare in rural or other underserved areas.

Additionally, if you couple studies about these kinds of programs with cost savings data, we can build a stronger case about why telehealth provides good value in an environment where healthcare spending is constantly on the rise. We can also couple it with outcomes data to identify cases where care is not only equivalent to in-person care, but where it might actually be better. I think that if we fast-forward another five years, we will be able to make a lot stronger conclusions than we can make today.

Is your organization considering a community paramedic program or does it already have one in place? Leave a comment or email me.

Email Dr. Jayne.

Comments Off on Curbside Consult with Dr. Jayne 1/29/24

Readers Write: Reducing Medicaid’s Fraud & Waste: Program Integrity Systems

January 29, 2024 Readers Write Comments Off on Readers Write: Reducing Medicaid’s Fraud & Waste: Program Integrity Systems

Reducing Medicaid’s Fraud & Waste: Program Integrity Systems
By Gerald Maccioli, MD

Gerald Maccioli, MD, MBA is chief medical officer of HHS Technology Group of Fort Lauderdale, FL.

image

Medicaid, a cornerstone of healthcare support for low-income individuals and families in the United States, is a vital safety net. With an annual expenditure of approximately $824 billion in 2022, Medicaid ensures access to necessary medical services for millions of vulnerable Americans.

Like any large-scale government program, Medicaid is not immune to the challenges that are posed by fraud and abuse. Estimating the exact extent of Medicaid fraud, though, is challenging due to its clandestine nature and constantly evolving tactics used by perpetrators. However, some reports and estimates provide insights into the scale of the issue. For example, in 2020, the US Department of Health and Human Services (HHS) reported recovering $1.8 billion from fraud and abuse cases in healthcare, including Medicaid.

State Medicaid programs are determined to combat fraud when it does occur, and, ideally, prevent it before it happens in the first place. To that end, many Medicaid programs are looking to invest in robust program integrity systems to comprehensively address fraud, waste, and abuse. In this context, program integrity describes any of various oversight activities to ensure that Medicaid dollars are spent appropriately and accurately.

Like the healthcare industry itself, Medicaid fraud can be complicated, byzantine, and varied. The following is a description of six of the most common types of fraud that is associated with Medicaid.

  1. Billing fraud. Healthcare providers, including physicians, clinics, and hospitals, may engage in billing fraud. This type of fraudulent activity involves submitting false claims or inflating bills for reimbursement. Common tactics include billing for services that were never provided, misrepresenting the cost of services, and engaging in other deceptive practices. Billing fraud not only diverts financial resources from the program but also reduces the availability of funds for legitimate healthcare services.
  2. Identity theft. Fraudsters may employ identity theft tactics, such as using stolen or fabricated identities, to access Medicaid benefits. Identity theft can be perpetrated by both providers and beneficiaries, resulting in unauthorized use of healthcare services, prescription drugs, and medical equipment. This practice places undue strain on program resources and can lead to significant financial losses.
  3. Phantom billing. Phantom billing occurs when providers bill for services that were never provided to beneficiaries. This fraudulent practice not only drains program resources but also can lead to suboptimal care for beneficiaries who do not receive the services they are billed for, putting their health and well-being at risk.
  4. Kickbacks and referral fraud. Unscrupulous providers may engage in kickbacks or referral fraud, offering incentives to beneficiaries or other providers in exchange for Medicaid referrals. This unethical practice not only compromises the integrity of patient care but also diverts program resources for personal gain, diminishing the overall quality and efficiency of the Medicaid system.
  5. Overutilization. Some beneficiaries may overuse Medicaid services, receiving unnecessary medical treatments or prescription drugs. This results in inflated healthcare costs and can deprive other, more deserving beneficiaries of necessary care.
  6. Prescription drug fraud. The abuse of prescription drugs within the Medicaid system is a growing concern. Beneficiaries or providers may engage in the overuse or diversion of prescription drugs, leading to escalating costs and potential health risks.

To effectively combat the extensive scope of fraud and abuse in Medicaid, robust program integrity systems are indispensable for several compelling reasons:

  1. Financial sustainability. Fraud and abuse divert scarce financial resources from Medicaid, reducing the program’s ability to provide essential healthcare services to those who genuinely need them. Effective program integrity systems are essential to protect the financial sustainability of Medicaid, ensuring that resources are available for legitimate healthcare needs and program expansion.
  2. Quality of care. Fraudulent activities can lead to suboptimal patient care. Phantom billing and overutilization practices, for instance, can result in beneficiaries either not receiving necessary services or receiving services they do not require, compromising their overall health and well-being. Robust program integrity systems are instrumental in maintaining the quality and appropriateness of healthcare services.
  3. Preventive measures. Program integrity systems include proactive measures that are aimed at preventing fraud and abuse. By identifying and addressing potential issues early, these systems act as deterrents to fraudulent activities and contribute to preserving the program’s integrity.
  4. Legal accountability. Program integrity systems play a crucial role in identifying and prosecuting those involved in fraudulent activities. They ensure legal accountability for individuals or entities attempting to exploit the program, thereby acting as a powerful deterrent to fraudulent practices.
  5. Public trust. A transparent and well-monitored Medicaid program is essential in building and maintaining public trust. When beneficiaries and taxpayers have confidence that their contributions are used judiciously and ethically, it enhances the program’s reputation and garners greater public support.
  6. Program longevity. Effective program management is essential for the long-term viability and effectiveness of Medicaid. Robust program integrity systems help extend the lifespan of Medicaid, ensuring that it continues to provide essential healthcare services to those in need for generations to come.

In conclusion, the scope of fraud and abuse in Medicaid is extensive and multifaceted, presenting complex challenges that require vigilant attention and comprehensive solutions. Robust program integrity systems are not merely desirable but necessary for safeguarding the financial sustainability of the program, maintaining the quality of patient care, preventing fraudulent activities, ensuring legal accountability, building public trust, and securing the longevity of this crucial lifeline for low-income Americans.

Program integrity systems are a cornerstone in the fight against fraud and abuse, playing an indispensable role in preserving the Medicaid program’s integrity and the health and well-being of its beneficiaries.

Comments Off on Readers Write: Reducing Medicaid’s Fraud & Waste: Program Integrity Systems

Morning Headlines 1/29/24

January 28, 2024 Headlines Comments Off on Morning Headlines 1/29/24

Concerns over new laws that could end use of WhatsApp in the NHS

UK doctors warn that patient care will suffer under new laws that would limit their use of messaging apps such as WhatsApp and Signal for clinical use.

Core systems restored at Bluewater Health: CEO

Ontario’s Bluewater Health restores systems that have been down since an October 23 cyberattack, which affected five hospitals that had formed an IT shared services group.

    Virtual and at-home brain health and memory care company Isaac Health raises $5.7 million in seed funding.
Comments Off on Morning Headlines 1/29/24

Monday Morning Update 1/29/24

January 28, 2024 News 6 Comments

Top News

image

UK doctors warn that patient care will suffer under new laws that would limit their use of messaging apps such as WhatsApp and Signal for clinical use.

A journalist’s BMJ article says that a law requires that encrypted messages be placed under government surveillance by the national communications regulator to look for harmful or illegal content, rendering patient data insecure.

A law also requires that messaging app security upgrades be approved, which could take months, leading major tech providers such as Meta, Apple, and Signal to threaten to withdraw services to the UK. Wikipedia has already said it will not be able to operate under a law that tracks user identities, actions, and content submissions.

Clinical informatician Marcus Baw, MBChB says that NHS should have built its own encrypted app that connects to its email system.


Reader Comments

From Industry Recruiter: “Re: LinkedIn an ageism. Here are my thoughts.” A summary of this recruiter’s list, sent in response to my comments last week:

  • It’s ideal to include a headshot on LinkedIn, taken professionally within the past 10 years, but lack of a photo doesn’t dissuade them.
  • List all relevant work experience, even if it goes back more than 10 years, if it adds credibility to the industry or job you are seeking.
  • Listing more credentials never hurts unless you can show no real work experience with them.
  • Include at least one bullet for each job in your summary that highlights a specific accomplishment.
  • Don’t make the write-up so wordy that people can’t get a good review in a minute or two. Save descriptions of skills, such as teamwork or mentoring, for the resume.
  • Ask for LinkedIn recommendations.
  • It doesn’t hurt to publish LinkedIn articles, but that isn’t going to shift their view from the work experience.

From Unleaded: “Re: Epic Showroom. It brings together legacy partner programs such as App Orchard, Connection Hub, and Partners & Pals. It has four key parts: (a) Supply Shot for people support; (b) Health Grid, for providers connecting to the broader ecosystem such as payers, labs, and telehealth networks; (c) Products, a three-tiered partnership list that includes a list of all third-party apps, Toolbox for specific apps like Nuance DAX that follow Epic’s integration guidelines, and Workshop for companies like Abridge that are co-developing with Epic; and (d) Cornerstone Partners, companies like InterSystems and Microsoft whose software is used significantly by Epic.”


HIStalk Announcements and Requests

image

Poll respondents say that General Catalyst’s biggest challenge as a venture capital firm that is buying a non-profit health system is to either swing it to long-elusive profitability or hope that its losses are made up elsewhere in its portfolio.

New poll to your right or here: Which of the following forms of discrimination do you suspect had the strongest negative influence on your career in the past five years? It’s your best guess, of course, since companies and managers who discriminate aren’t usually stupid enough to brag about it.

How to support HIStalk with practically no effort:

  • Sign up for spam-free email updates that I send when I post something new.
  • Connect and follow on LinkedIn and join Dann’s HIStalk Fan Club. The first thing I do if someone wants a favor is to see if we are connected or if they are among the 4,195 fan club crew.
  • Mention HIStalk to your colleagues and vendors.
  • Share news, rumors, and intriguing insights.

Sponsors: complete my information form for ViVE and/or HIMSS if you are participating and I’ll include you in my online guide. In the immortal words of John Blutarsky, don’t cost nothin’.


image

Reader comments about Medicare’s conclusion that telehealth use has dropped of to nearly pre-pandemic levels led me to look beyond the headlines:

  • The Medicare Telehealth Trends Report looked at the percentage of eligible Medicare beneficiaries who had at least one Part B claim for a telehealth encounter between January 1, 2020 and June 30, 2023, suggesting that the yearly percentage has dropped from 48% in 2020 to 34% in 2021 and 29% in 2022.
  • The quarterly percentage jumped from 7% in Q1 2020 to 47% in Q2 2020, then settled into a 15% or so level from Q2 2022 until now.
  • Medicare didn’t report pre-COVID numbers to provide a true baseline, but a previously reported GAO review said that 0.3% of Part B beneficiaries used telehealth services in 2016, so basically nobody used it until the pandemic shut down many practices and CMS started paying providers equally for in-person and telehealth visits.
  • Medicare’s numbers cover only Medicare beneficiaries who signed up for the optional, extra cost Part B that covers physician visits and outpatient care, although most people enroll in both. I’m assuming that the report also covered traditional Medicare only and not Medicare Advantage, which jumped from 39% of all beneficiaries in 2019 to 51% in 2023, but that’s a guess on my part.
  • We don’t know the percentage of providers who offered telehealth services from 2020 until now, or how many beneficiaries would choose a telehealth encounter if their regular provider offered it.
  • We don’t know how many Medicare beneficiaries received telehealth services that weren’t billed to Medicare.
  • The recently noted surge in Medicare-covered services such as procedures – which is tanking the share price of Medicare Advantage insurers – may have temporarily or permanently reduced the demand for telehealth services as patients returned for deferred office visits.
  • We don’t know how many providers discourage telehealth visits for their patients, either because they don’t like doing them or they prefer an in-person visit where additional services can be offered and billed.

Webinars

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


Acquisitions, Funding, Business, and Stock

A Boston Globe article says that while CVS Health is generating record revenue and executing a healthcare center strategy that includes its Aetna insurance, CVS Caremark pharmacy benefits management, and Oak Street/Signify provider businesses, profits are down because its core business of drugstores suffers from lower payments, a shortage of pharmacists, general labor shortages that create customer lines, widespread store closings, and the perception of dirty and poorly managed locations. The company blames PBMs for their efforts to reduce prescription costs, one of which is its own CVS Caremark, which controls 33% of that market.


Announcements and Implementations

JAMA Network publishes an interview with UCSF’s Atul Butte, MD, PhD, who is chief data scientist over the entire University of California Health System:

  • UC’s 11-year repository of Epic data covers 9.1 million patients across 10 hospitals, 1.5 billion drug orders, 40,000 cancer genomes, and 50 million medical devices.
  • He says that health systems will want to undertake similar work to develop standard medical practices that reduce care variation.
  • UC uses “leave one medical center out” cross-validation, where they leave out one medical center when performing analysis and then see if the conclusions from the rest pan out for that remaining hospital.
  • The organization will work with drug and AI companies only if its own patients benefit.
  • He foresees a day when EHR-trained AI can be deployed to doctors via order sets and decision support tools and even to patients, who might have their own decision support tool on their smartphone. He says that big health systems will probably developed their own branded AI assistant, but their data could be used to help hospitals that don’t have those resources.
  • Butte says he personally uses AI to write letters of recommendation, emails, and programming code.

image

In England, surveyed NHS doctors report that physician associates, who are being used to replace doctors despite having completed only a two-year post-graduate program, are prescribing drugs illegally and missing critical diagnoses. Physicians object to the plan to regulate PAs alongside physicians, and doctors report that PAs – who are renaming themselves from “physician assistant” to “physician associate” — are introducing themselves as doctors to patients. Meanwhile, a physician X user doctor calls PAs “noctors” (not a doctor), with screen shots showing a Royal London Hospital PA who brags on signing DNR forms and conducting an Instagram poll to decide how to perform an exam.

Cardiologists recommend in JAMA Cardiology that clinicians be mandated to capture SOGIE data (sexual orientation and gender identity and expression) in EHRs to help researchers understand the cardiovascular health of LGBTQ+ adults.


Privacy and Security

Ontario’s Bluewater Health restores its hospital systems that have been down since an October 23 cyberattack that affected five hospitals that had formed an IT shared services group. The hospital says legal implications prevent it from saying which parts of Meditech remain down, but confirms that it will be replacing the 20-year-old system with Oracle Cerner by the end of the year.

In the UK, former prime minister Tony Blair and former Conservative Party leader William Hague call on NHS to sell de-identified patient data to AI companies to use for training to develop patient monitoring tools. They also envision an NHS app that would give patients access to their own information and capture more data to sell. They call for NHS to set up a new data trust company that would oversee privacy in commercializing access to the information.


Other

image

An NHS doctor who was flying to a skiing vacation responds to the flight crew’s call for a doctor to assess a 70-year-old passenger’s health problems. The plane wasn’t equipped with a pulse oximeter, so he used a crew member’s Apple Watch to determine that the woman had low blood oxygen levels, which he successfully treated with oxygen. He praised the Ryanair staff afterwards, adding a recommendation that all plans carry emergency physician kits that include tools for basic measurement, diabetes, blood pressure, and oxygen saturation. He luckily borrowed an older watch since a patent dispute has forced Apple to disable the pulse oximetry function that he used in recently sold Apple Watch models.


Sponsor Updates

  • SnapCare will provide contract staff transparency in its workforce marketplace, where it will itemize pay rates, travel costs, a standard rate that covers benefits and payroll taxes, and the company’s fee, saving clients an estimated 15%.
  • NeuroFlow publishes a two-part case study featuring the success EvolvedMD found using NeuroFlow’s technology as a part of its efforts to integrate behavioral and physical healthcare services for its customers.
  • Frost & Sullivan recognizes Wolters Kluwer Health as an “Innovation & Growth Leader” in clinical decision support systems.
  • Centerpoint Health leverages data from the EClinicalWorks EHR and its Healow no-show prediction AI model to improve its clinical workflows.
  • Vyne Medical releases a new customer success story, “Streamlining Fax Operations: A Growing Medical Center’s Success Story.”
  • Revuud shares its key highlights of its 2023 performance, including 16 new customers.
  • Symplr publishes its “Provider Credentialing 2024 Guide.”
  • Waystar will exhibit at the HFMA Minnesota Winter Conference January 30-31 in Minneapolis.

Blog Posts


Contacts

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

Morning Headlines 1/26/24

January 25, 2024 Headlines Comments Off on Morning Headlines 1/26/24

PC3 Health relocating in Jeffersontown with multimillion-dollar investment, adding high-paying jobs

Physician Care Coordination Consultants will use a $2.5 million investment to relocate its Louisville, KY headquarters, doubling its office footprint and hiring 21 new FTEs.

HHS releases voluntary cybersecurity goals for health care

HHS publishes voluntary Cybersecurity Performance Goals for healthcare, which are broken down into 10 “Essential” and 10 “Enhanced” goals.

Swift Medical Announces New Financing Round to Further Enhance Its AI-Based Wound Care Technology

Toronto-based digital wound care company Swift Medical will use $8 million in new funding to enhance its technology’s data security, interoperability, and device capabilities.

Comments Off on Morning Headlines 1/26/24

News 1/26/24

January 25, 2024 News Comments Off on News 1/26/24

Top News

image

Humana shares dropped 16% on Thursday as the health insurer issued full-year earnings guidance that was half of Wall Street’s expectations.

The company, which primarily sells Medicare Advantage insurance, said that its medical expenses have soared as patients return to hospitals to undergo pandemic-delayed procedures such as hip replacements. It warned that the trend is not related to respiratory conditions and thus is likely to continue.

Shares in other insurers such as UnitedHealth Group and CVS Health also slid on the news as investors became concerned about increased medical costs in their Medicare Advantage business.

The company reports Q4 results: revenue up 18%, adjusted EPS –$0.11 versus $1.97, beating revenue estimates but falling short on earnings.

HUM shares are down 29% in the past 12 months versus the S&P 500’s 22% gain, valuing the company at $44 billion.


Reader Comments

From Copy Cat: “Re: Dana-Farber research cheating. When did it become OK to replace ‘cheating, plagiarism, and lying’ with ‘data falsification’ or ‘inadequate citation?’ Any chance us non-academic elites would get a similar reprieve after falsifying resumes or dissertations?” I’m far from an expert since I’ve co-authored only a few articles in peer-reviewed journals and my contribution was incidental, but I’m guessing it relates to intent and extent (did they do it intentionally for some personal benefit and did it affect the article’s conclusions). Sometimes it’s a gray area, such as when authors publish on a topic without citing the seminal work of a pioneering researcher that they most certainly have read even if not used directly. The Dana-Farber researchers appear to have faked scientific graphics, although whether they did so to prove an incorrect conclusion or because of some logistical reason wasn’t stated (but is being investigated). The conclusion is that it’s better to do your own double-checking of citations instead of letting some cheap seats observer catch your misbehavior, whether inappropriate or not and even if it sneaks by peer reviewers.

From Conference Escalator: “Re: HIMSS24. The exhibitor count seems pretty low.” My interest level isn’t high, but since you asked, I scrolled and counted about 650 exhibitors, compared to maybe 1,200 to 1,500 before COVID and the emergence of competing conferences. But on the bright side, the exhibit hall will probably have carpeted aisles this year.


HIStalk Announcements and Requests

A reader asked about expressing years of work experience on LinkedIn while avoiding ageism. My initial reaction is that LinkedIn content doesn’t matter since at best it will get you an interview where you might face age discrimination anyway. Still, you have to avoid being shut out by recruiters and HR people who perform the initial screening, and there’s little effort required to make a better first impression. My conclusions (and it would be great to hear from recruiters who use LinkedIn to find or vet job candidates):

  1. Use a professional, contemporary headshot from years ago, or doctor your photo to look younger. Nobody will feel offended or duped. You could omit the headshot entirely like a resume, but I assume most employers are like me in finding it creepy if someone intentionally leaves out a photo.
  2. List only work experience going back a few years or a couple of jobs. Nobody cares before then.
  3. Highlight (or obtain, if necessary) technical skills that prove that you keep up as well as younger people. Take a quick course in ChatGPT, Excel, Python, or sales prospecting software to prove that you stay current. Likewise, remove obsolete credentials and irrelevant accomplishments, especially those that go back to the college years.
  4. Punch up the summary to emphasize accomplishment rather than elapsed time, especially if you can back up your achievements with numbers.
  5. Emphasize your ability to work with a team, mentor, and expend extra effort.
  6. Have a younger executive review your profile and resume to make sure that you are using modern terms and aren’t listing experience that is actually detrimental to finding a job.
  7. Ask for LinkedIn recommendations.
  8. Publish occasional LinkedIn articles ongoing, not just when you are suddenly facing a job search.

Webinars

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


Acquisitions, Funding, Business, and Stock

image

Mercy Hospital – Iowa City and Altera Digital Health settle their contract dispute that stood in the way of the bankrupt hospital’s acquisition by University of Iowa Hospitals & Clinics. The hospital’s contract with Altera will be dissolved and Mercy won’t pay any amount owed, although it will pay $6 million as unsecured debt. Altera will sign a new contract with UIHC so that the hospital can keep using Sunrise with vendor support as required by the acquisition.


Sales

  • The State of Pennsylvania launches PA Navigate, a Findhelp-powered online tool that connects state residents with community-based organizations, county and state agencies, and healthcare providers to address basic needs.
  • NorthStar Care Community and Hospice of Michigan will expand their use of Netsmart’s CareFabric platform, including the MyUnity EHR for hospice, home care, and palliative care.

People

image

Clearsense hires Jason Rose, MHSA (AdhereHealth) as CEO and board member. He replaces founder Gene Scheurer, who will remain on the board.

image

Ochsner Health promotes Amy Trainor, RN, MHSA to SVP/CIO.

image

Emory Healthcare names Nitu Kashyap, MD (Yale New Haven Health) as chief health informatics officer.

image

Stacy Sand, MS (Healthwise) joins Get Well as VP of marketing communications.


Announcements and Implementations

image

Blue Spark Technologies, which offers the TempTraq Bluetooth-enabled temperature monitoring patch, launches VitalTraq, which uses a “selfie scan” that is taken with a smart phone’s camera to report heart rate, heart rate variability, blood pressure, and respiratory rate.

image

Black Book Research publishes the 2024 “State of the Global Health Information Technology Industry” report, which analyzes the response of 19,000 global health IT customers to rate 109 vendors on 18 key performance indicators. The 655-page research report can be downloaded instantly at no cost.

Fortified Health Security publishes its “2024 Horizon Report” on cybersecurity.


Government and Politics

image

A federal court denies the motion of Erlanger Health to dismiss a lawsuit that accuses the hospital of allowing surgeons to bill for overlapping surgeries that they didn’t perform and allowing residents and interns to perform procedures without proper oversight if patients lacked insurance. The lawsuit was brought by two orthopedic surgeons and Erlanger’s former CIO, Stephen Adams, MD. It claims that the health system allowed surgeons to share their Epic login information with unlicensed staff to make entries under their names, and when the privacy offer was overwhelmed with lists of inappropriate chart access, Erlanger limited the number of events that would be reported because of the risk involved. The lawsuit also claims that the death of a child who was placed under anesthesia for a MRI was initially blamed on an Epic flaw, but audit logs indicated that the CRNA left the room to complete charts and the CRNA student who remained then made a fatal medication ordering error.

image

U.S. News & World Report sues the city attorney of San Francisco, who has issued two subpoenas seeking information about the criteria it uses to create its “Best Hospitals” list, the possibility that high-ranking hospitals pay for the privilege, and that its rankings encourage hospitals to invest in specialties instead of primary care. The publication says the attorney is harassing it because he doesn’t agree with its rankings.

HHS publishes voluntary Cybersecurity Performance Goals for healthcare.


Sponsor Updates

  • MRO earns Validated Data Stream designation in NCQA’s Data Aggregator Validation program.
  • Healthcare IT Leaders adds health industry veteran Mary Mirabelli to its board.
  • Surescripts customer Elation Health adopts the Surescripts Real-Time Prescription Benefit tool.
  • Florida Digestive Health Specialists adds Sunoh.ai virtual scribing capabilities to its EClinicalWorks EHR.
  • Health Data Movers releases a new episode of its “Quick Hits” podcast featuring Kunjan Divatia.
  • Emanate Health (CA) adds to its suite of Meditech solutions, implementing the company’s Smart Pump Infusion Integration with the Baxter Spectrum IQ infusion system.

Blog Posts


Contacts

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

Comments Off on News 1/26/24

EPtalk by Dr. Jayne 1/25/24

January 25, 2024 Dr. Jayne Comments Off on EPtalk by Dr. Jayne 1/25/24

I had dinner the other night with a group of family physicians. It was an interesting bunch. Three of them have left employed practice models to open their own primary care practices. One is practicing with the local visiting nurse association. Another is working as the medical director for a local hospice. Several are on faculty at residency training programs, and two of us are clinical informaticists.

As one can imagine, telehealth was a hot topic. One of the physicians who is employed by a local health system was complaining about how her organization has brought in a third-party vendor to perform urgent care telehealth visits. In particular, she feels that continuity of care has suffered. One of our colleagues mentioned a recent study that was published in JAMA Network Open that looked specifically at virtual visits that were performed by the patient’s own family physician compared to those that were performed by an outside family physician.

The authors looked at 5 million Ontario residents who met criteria for having a family physician and for having had a virtual visit. They concluded that visits with an outside physician were 66% more likely to be associated with an emergency department visit in the next seven days compared to those visits that were conducted by the patient’s own physician.

If you dig deeper into the results, they looked at a matched subset of patients and found that the changes of an emergency department visit in the next week was even greater for patients with “definite direct-to-consumer telemedicine visits.” They specifically excluded virtual visits that were performed by another physician in the same group as the family physician, since they “sought to contrast the highest-continuity virtual visits (own physician) with lowest-continuity virtual visits (outside of group).” The authors go on to conclude that the findings “suggest that primary care virtual visits may be best used within an existing clinical relationship.”

The authors noted that increased emergency department utilization that were associated with low-continuity visits suggest that “virtual visits may serve a triaging function, allowing for the identification of patients who would benefit from an in-person assessment.” It would be interesting to see a similar study performed in the US, since there are likely differences in service utilization due to the payment landscape here. When patients are worried about co-pays and emergency department costs, they often make different decisions than they might if they were part of a system where they were at less exposure for unexpected healthcare bills. The authors noted that one of the limitations of the study was the lack of ability to identify patients where access was an issue, such as hours of clinic operation, physician availability, or scheduling difficulties.

The next time I see them, I’ll have to get my family medicine colleagues to weigh in on “The Case of the Disappearing Thank Yous,” which was published in JAMA Health Forum earlier this month. It begins by detailing a physician’s dissatisfaction when her employer began to filter messages from patients that said, “Thank you.” Although some may feel that such messages represent clutter, including EHR vendors who have acted on client requests to suppress them, this physician found them meaningful.

It’s the classic case of whether the good of the one outweighs the good of the many, but the author went on to discuss other ways that he feels that appreciation of accomplishments is lacking in healthcare. As an example, he mentions that Medicare costs have stabilized and that important public health worth continues to progress despite the persistence of negative headlines.

He mentions what most of us already know – negative news tends to generate more clicks than positive news. It’s all about monetizing those eyeballs. He notes that “a failure to appreciate past victories can also jeopardize efforts to tackle the health challenges of the future,” especially in the setting of low trust for government agencies which includes those that are involved in public health.

Especially for healthcare workers who have really taken a beating over the last several years, it’s important to feel appreciated. Employers tried to say thank you by issuing challenge coins and sending pizza, but it’s time to figure out how to demonstrate appreciation in a meaningful way. I know I would like to grow old in a society with highly qualified nurses that love their jobs, but the chances of that being a reality are becoming smaller every day. Here’s a challenge to administrators to start figuring out what really matters and putting their money to work.

image

I’m always on the lookout for healthcare technology that has an interesting backstory. Habit Camera is a wireless camera that is designed to allow users to inspect areas of the skin that they might not otherwise be able to see. Daily skin inspection is important for many patients, including those with diabetes, limited sensation, or active wounds. The camera connects to a smartphone app to enable live viewing of high definition images as well as video and image capture for sharing with clinicians or caregivers. The company is led by a US Marine Corps veteran who was paralyzed while serving in Afghanistan. He and his wife run the company, which employs veterans and their family members to assemble the devices.

I particularly liked the answer to one of their FAQ questions, which asks, “Is my clinician going to look at pictures if I send them?” The response: “It depends! Your clinician may be interested in doing this, but some may not. If you can’t share an image or video with your clinicians, then it can be really hard to explain what you see over the phone. Until a clinician can see it with their own eyes, they probably will ask you to make an appointment and come into clinic. This can be a bit of a hassle, especially if you have to take off of work and drive far, so we hope that pictures and video can help reduce unnecessary visits. A picture is worth a thousand words.” I don’t care how much a company pays for its marketing experts; you really can’t portray the patient experience any better than that.

What technology vendors have the best messaging? Is there a particular one that you feel just tells it like it is? Leave a comment or email me.

Email Dr. Jayne.

Comments Off on EPtalk by Dr. Jayne 1/25/24

Morning Headlines 1/25/24

January 24, 2024 Headlines Comments Off on Morning Headlines 1/25/24

Apollo Medical Holdings, Inc. Announces Planned Corporate Rebrand as Astrana Health

Tech-enabled practice management and optimization company Apollo Medical Holdings will rebrand to Astrana Health next month.

Health2047 Portfolio Company Heal Security Launches from Stealth with $4.6 Million Raised

Heal Security, a healthcare cybersecurity software startup spun out of the American Medical Association’s Health2047 venture arm, raises $5 million.

Mercy Iowa City and Altera Digital Health reach agreement

After months of legal wrangling, Mercy Iowa City and Altera Digital Health resolve to dissolve their software implementation agreement dating back to March 2021.

Comments Off on Morning Headlines 1/25/24

Text Ads


RECENT COMMENTS

  1. I read about that last week and it was really one of the most evil-on-a-personal-level things I've seen in a…

  2. Giving a patient medications in the ER, having them pop positive on a test, and then withholding further medications because…

  3. Apple legacy? Seems I heard that before. Say around 1997. Jobs put out a 15 min video where a guy…

Founding Sponsors


 

Platinum Sponsors


 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Gold Sponsors


 

 

 

 

 

 

 

 

RSS Webinars

  • An error has occurred, which probably means the feed is down. Try again later.