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News 1/24/24

January 23, 2024 News 9 Comments

Top News

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Top researchers at Harvard-affiliated Dana-Farber Cancer Institute, including its CEO and COO, are accused of falsifying published research articles by Photoshopping scientific graphics.

Research integrity experts identified 57 studies that appear to have been manipulated, with the organization acknowledging 37 of them and moving to retract six of those studies.

Some journals are using AI tools that can identify image tampering, which is apparently common among researchers.


Reader Comments

From Summa Cum Lotta: “Re: Summa. I am surprised how loss-making hospitals with high debt are still making huge investments in technology. How long would it have taken money-losing Summa to break even on an $850 million implementation of Epic? Executives making such decisions should be let go.” The cost seemed high to me, even though I got that number directly from Summa’s website in a transcript of an interview with the CIO and CMIO. Replaying the audio, CIO Elbridge Locklear, MBA actually said “eight fifty million dollars,” which sounds more like a verbal stumble rather than an odd way of intentionally saying “$850 million,” so I’m sure he misspoke. I went through Summa’s federal tax filings, which say they spent $50 million overall on the project. They paid Epic $12 million in 2022 versus paying their Epic host Mercy Health $13 million the year before, when they also paid Cerner $5 million. I’m surprised that Summa hasn’t corrected their own podcast transcription.

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From GR_Buckeye: “Re: Epic. Has publicly published their Clarity data dictionary. Do you know why? They closely guard their IP and I can only assume that this was done as the result of some type of legal matter.” Epic published its EHI expert schema on its Open Epic interoperability information website. It was crawled by Internet Archive in February 2023, so it has apparently been there for some time.

From Watching Wins: “Re: learning from videos. You concluded that it shouldn’t be an either-or option between text and video since each have their audience. Why not use AI to create an HIStalk video of daily or weekly health tech news summary that you are already posting as text?” I could certainly do that pretty easily since I’ve researched available tools, but would anyone really watch or listen to a daily or weekly talking (AI) head video news digest?


HIStalk Announcements and Requests

A reminder to HIStalk sponsors: complete my information form for ViVE and/or HIMSS if you are participating and I’ll include you in my online guide

Dear everyone: please stop expressing your work history as “over” X years of experience. If you say “over eight,” then we know it’s not nine, and every person’s tenure is “over” the exact number, even if just by minutes. Trust me that nobody cares about your fractional years, but if your vanity requires, simply round up after the six-month mark to nine years. Related to that is expressing numbers in general — instead of “over 400 hospitals,” either give the actual number or just go with 400 since the distinction is not important.


Webinars

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

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


Acquisitions, Funding, Business, and Stock

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Healthcare pricing transparency company Turquoise Health raises $30 million in a Series B funding round, bringing its total raised to $55 million since launching in 2021.

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The annual health IT market review of Healthcare Growth Partners finds that:

  • M&A and buyout deal volume returned to pre-COVID levels in 2023 from their low in Q4 2022.
  • Although valuations did not catch up, EBITDA-based valuations have held steady throughout
  • Investment activity continued to fall through 2023, dropping to $9 billion from its all-time high of $29 billion in 2021.
  • HGP’s HIT Index gained 3% last year versus 25% for the S&P 500 and 45% for the Nasdaq.
  • HIT Index stocks whose returns were worse than negative 60% for the year include Streamline Health, Invitae, Pear Therapeutics, GeneDx Holding, NantHealth, Bright Health Group, Cue Health, and UpHealth.

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In Wisconsin’s Chippewa Valley, HSHS Sacred Heart, St. Joseph’s, and Prevea clinics will close, with HSHS blaming “a mismatch in the supply of and demand for local healthcare services” and its failure to find a partner.


Sales

  • The CDC will use de-identified EHR data from health system collective Truveta for respiratory virus surveillance and research projects involving maternal and pediatric healthcare.
  • South Carolina-based specialty pharmacy Palmetto Pharm selects Inovalon’s ScriptMed Specialty pharmacy management software.
  • Innovaccer incorporates Wolters Kluwer Health’s Health Language terminology software into its data-based offerings.

People

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Ryan Royal (Interviewstream) joins Upfront Healthcare as CTO.

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Definitive Healthcare names founder, former CEO, and current Executive Chairman Jason Krantz, MBA as interim CEO upon the departure of Robert Musselwhite.

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AMC Health names Zebadiah Kimmel, MD, MBA (Medically Home) chief product officer and promotes Jon Shankman, MBA, MPH to chief analytics officer.

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Anatomy IT names Patrik Vagenius (Flywire) chief commercial officer.

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Mount Sinai Health System (NY) names Bruce Darrow, MD, PhD interim chief digital and information officer upon the departure of Kristin Myers, MPH, who has joined Northwell Health (NY) as chief digital officer.

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1upHealth hires Andrea Kowalski, MBA (Tebra) as chief product officer.

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Kyruus hires Harshit Shah, MS (Spring Health) as CTO.


Announcements and Implementations

Amazon reportedly offers One Medical providers access to virtual consults with Amazon Pharmacy pharmacists as part of a pilot project geared towards improving outcomes for high-risk patients, particularly seniors.

The Liver Cancer Collaborative in Australia uses Aridhia’s Digital Research Environment technology to help researchers share data and collaborate on projects.

UCSD Health researchers find that a real-time alert that is powered by the Composer deep learning training library accurately predicted patient sepsis in the ED and reduced mortality significantly. The nursing alert was presented as an Epic Best Practice Advisory, but the authors note that the Epic’s own Sepsis Score has not demonstrated comparable results.

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A new KLAS report finds that physician and nurse burnout has stabilized, but remain higher than pre-pandemic levels. Both groups suggest improving staffing and getting executives to listen to the concerns of clinicians and patients. Coming in at #3 for doctors is improving EHR efficiency, while for nurses, it is increasing pay.


Government and Politics

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A federal appeals court upholds Martin Shkreli’s lifetime ban from the drug industry and a requirement that he pay $65 million in restitution. His company bought a decades-old drug for treating a rare condition, immediately raised the price 4,000%, and prevented other companies from obtaining samples of the drug that would have allowed them to sell generics. His lawyer had argued that while the “pharma bro” has since served prison time for financial crimes, those weren’t related to the drug industry, suggesting that the courts “should encourage real geniuses like Mr. Shkreli to work in the industry.” Shrekli responded via X that he is the only person in the US to ever be sued as a monopolist, says he followed the same playbook as AbbVie and many other drug manufacturers, and warned every executive that they can be held jointly and severally liable for antitrust actions that are levied against their companies.


Other

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CMS reports that telehealth usage by Medicare users has dropped nearly back to pre-pandemic levels through mid-2023.

In Bangladesh, a private hospital director is arrested after demanding that parents of a newborn pay their $365 bill, and upon hearing that they didn’t have the money, sold the baby.


Sponsor Updates

  • Pinnacle Family Care (NC) improves efficiency using the EClinicalWorks AI assistant for Prisma.
  • Censinet releases a new Risk Never Sleeps Podcast, “Future-Forward Healthcare with Sherri Douville, CEO & Board, Medigram.”
  • CloudWave will sponsor the MUSE Social (Southern California) Community Peer Group Event February 1 in Covina.

Blog Posts


Contacts

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

Morning Headlines 1/23/24

January 22, 2024 Headlines 2 Comments

Amazon Pharmacy is Piloting A Consultation Program With One Medical, Further Bolstering Amazon’s Healthcare Ecosystem

Amazon reportedly offers One Medical providers access to virtual consults with Amazon Pharmacy pharmacists as part of a pilot project geared towards improving outcomes for high-risk patients.

CMS Announces Model to Advance Integration in Behavioral Health

CMS will test a new technology-enabled Innovation in Behavioral Health Model that is designed to help community-based practices better coordinate behavioral healthcare with physical and social care services.

Ransomware gang claims responsibility for Christmas attack on Massachusetts hospital

The Money Message ransomware group claims that it has stolen 600GB of data from Anna Jaques Hospital, and that it has information related to parent system Beth Israel Lahey Health.

Curbside Consult with Dr. Jayne 1/22/24

January 22, 2024 Dr. Jayne Comments Off on Curbside Consult with Dr. Jayne 1/22/24

Many organizations are focusing their healthcare IT and clinical investments on Social Determinants of Health. This could include configuring patient portals to gather relevant information, enhancing EHR workflows to allow clinicians to view and act on patient-specific factors, and looking at the data from a population-based perspective.

For some organizations, the return on investment that is needed to gather the data is clear. For example, a community health center might be the recipient of a grant that provides funding for gathering the data and taking steps to improve outcomes based on that data. For others, the return on investment might be less obvious.

A recent article in JAMA Health Forum reviews the need for benefit-cost analysis as organizations look at making investments in care related to social determinants of health. The authors note that there are many examples of the links between social factors and health outcomes in the literature and that organizations have responded by focusing on those with the strongest links. However, adding benefit-cost analysis to the review process would allow comparison of different interventions to determine which would be likely generate the most benefit.

This approach would allow greater understanding of the importance of spending your healthcare dollars in the right place, with the authors noting, “An effective intervention to address a minor risk factor may generate much larger net benefits than a less effective intervention targeted at a major risk factor.” We all have examples of health systems and other care delivery organizations that have fallen under the spell of shiny objects and then struggle to get return on their investments.

Sometimes those projects are more exciting than others and might bring more publicity, but there may be less clarity around how they will actually improve health or reduce morbidity and mortality. On the other hand, certain interventions can have tremendous outcomes, but aren’t seen as exciting. For example, how many people think that nutrition education is sexy? Talking about balanced meals or food deserts or the benefits of community gardens certainly isn’t as exciting as seeing your orthopedic surgery practice mentioned on the wall of the local baseball stadium, that’s for sure. But which one is likely to drive improved health outcomes for the long haul?

The authors discuss this in the context of organizations that focus their attention on return on investment goals that have short time horizons. This leads to failure of visualization of potential long-term gains. We see this with payers denying expensive therapies that may lead to savings many years down the road, when the patient might be on Medicare and offer no calculable benefit for the payer. The authors summarize this: “In contrast, benefit-cost analysis is generally conducted from a societal perspective and considers benefits and costs across all sectors and populations and over extended time horizons with appropriate discounting of future benefits and costs.”

This got me thinking about how we sometimes don’t give full consideration to the longer-term impacts of the healthcare IT projects that we are doing. Leaders are often under the microscope to show positive financial outcomes almost immediately after a project goes live. They are expected to demonstrate shocking reductions in costs or dramatic increases in revenue, and projects that fail to deliver such splashy results may be at risk for being canceled, or even worse, placed on pause and left in limbo. With complex processes, however, it might not be appropriate to push for a dramatic change.

When there’s a significant change happening, I’m a big fan of using pilots to make sure that process “improvements” aren’t going to create unintended problems. However, the pressure to constantly deliver results may make technology leaders less likely to consider piloting or a slower rollout of change.

Alternatively, an intervention might deliver significant results, but then teams move on to other projects, preventing forward movement in the cycle of continuous improvement. In other situations, the maintenance phase is skipped and processes slowly drift back to inefficiency, ultimately eliminating long-term gains.

If organizations focused more on longer-term analysis and ensuring sustained change, would it make a difference in the projects they select? Unfortunately for many, being able to target long-term goals is a luxury given the fact that a results-oriented culture actually means one of immediate results rather than truly designing models that will be sustainable for the long haul. We see this phenomenon often with the rip-and-replace approach to solutions, when we know in our hearts that the organization never spent the time, effort, or money that was needed to make the first solution successful.

I saw another example of this shortsightedness in my community earlier this month. A local hospital that was looking to reduce headcount decided to shutter its medical weight management clinic. Given the obesity epidemic in the US, this doesn’t seem to make much sense at first glance. However, in our community bariatric surgery is seen as more exciting than medical weight management, primarily because it generates higher operating room utilization and therefore greater hospital revenues.

Unfortunately, patients now have fewer choices and might be pushed towards interventions that aren’t right for them. It would be interesting to look at the modeling of both service lines looking at a three-year, five-year, and 10-year horizon to examine not only which one is more favorable from a revenue standpoint, but which one is likely to deliver the best clinical outcomes. I wonder if they even looked that far.

Other organizational cuts occurred in pediatric and women’s health service lines. That looks like it will create a significant gap in services for local families. It will be interesting to see if other hospitals in the area are able to increase access in the service lines that were cut or whether families will just be left with longer waits for services that were already scarce at times. Even without a detailed analysis, I can’t imagine that making it more difficult for women and children to receive care is in the best interests of the community in the long term.

The organization is classed as a non-profit, so we will see the community benefit statements they put out over the next couple of years, detailing their efforts to serve the underserved. I suspect they hope that no one is looking, and given the way that other hospitals in the area behave, I doubt anyone is.

Is your organization looking at the longer term or bigger pictures, or is the focus on delivering results in the next two quarters? Leave a comment or email me.

Email Dr. Jayne.

Comments Off on Curbside Consult with Dr. Jayne 1/22/24

Morning Headlines 1/22/24

January 21, 2024 Headlines Comments Off on Morning Headlines 1/22/24

HHS-OIG Issues Notice of Exclusion to Founder and CEO of Theranos, Inc.

HHS OIG bans Theranos founder and federal inmate Elizabeth Holmes from participating in federal healthcare programs for 90 years, the same exclusion it gave to former Theranos President Sunny Balwani.

Hospital IT help desks targeted by sophisticated social engineering schemes

The American Hospital Association warns that offshore hackers are impersonating hospital revenue cycle employees to have their passwords reset by the hospital IT help desk, using stolen information about the employee to answer security questions.

Steward Healthcare’s financial issues could spell catastrophe for the state

Massachusetts regulators worry that Steward Health Care’s financial problems may force it to close hospitals, with the resulting loss of jobs and access to care.

Comments Off on Morning Headlines 1/22/24

Monday Morning Update 1/22/24

January 21, 2024 News 2 Comments

Top News

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Massachusetts regulators worry that Steward Health Care’s financial problems may force it to close hospitals, with the resulting loss of jobs and access to care.

Steward operates 33 hospitals in nine states, nine of them in Massachusetts. It is one of the top employers and taxpayers in towns where it operates hospitals. It has 30,000 employees nationally and operates 25 urgent care centers and 107 skilled nursing facilities.

The real estate company that bought and then leased back some of Steward’s hospital buildings says that the company is $50 million behind in rent payments.

Steward, which gets 70% of its revenue from Medicare and Medicaid, says that community hospitals in Massachusetts are paid less than academic medical centers. It has asked for state help with the cost of caring for Medicaid patients and undocumented immigrants.


Reader Comments

From Industry CEO: “Re: HIStalk. The first thing my earliest investors advised me to do as a founder was to read HIStalk every day. So I have, for many years. My team and I think really highly of HIStalk.” Thanks. These comments give me a push since I sit alone at keyboard each day, and even when I emerge into the wild, I decline to divulge my HIStalk identity because who cares anyway. I’m happy to leave it as a blank screen in an empty room with someone occasionally reading over my shoulder.


HIStalk Announcements and Requests

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Attention HIStalk sponsors: complete my information form for ViVE and/or HIMSS if you are participating and I’ll include you in my online guide. Also attention non-sponsors, because it’s not to late to get signed up for exposure for the other 359 days of the year when the exhibit halls go dark and attention is more focused.

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Twice as many provider decision-makers would rather learn about companies by reading a document or web page instead of watching a video, which is about the same percentage of those who aren’t provider decision-makers. I agree with commenter B. Efficient, who says that it shouldn’t be either-or — they won’t even look at video alone because it’s inefficient and often ends up being an advertisement, but a text-based overview with video detail such as screenshots is the way to go.

New poll to your right or here: what will be General Catalyst’s biggest challenge in its plan to buy Summa Health?


Thoughts About General Catalyst Acquiring Summa Health

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Venture capital firm General Catalyst promised to buy a non-profit health system when it formed Health Assurance Transformation Corporation (HATCo) in October 2023. The firm says that it evaluated several acquisition candidates, but it said last week that it has been talking to Summa for nine months, so perhaps that was always its choice.

Summa’s Advantages to GC

  • It is relatively small and can be acquired at a reasonable price.
  • Its market is geographically compact.
  • Its size allows changes to be implemented faster.
  • Summa has acute care hospitals, a rehab hospital, a physician network, and a small health insurance business.
  • It has been successful as an early participant in value-based care.

GC’s Health Assurance Network

GC had already formed its Health Assurance Network of health systems – their “partnership” terms have not been announced — that includes HCA, Jefferson, Intermountain, WellSpan, Banner, UC Davis, UCI Health, UHS, and others. Its goals:

  • Pair startups with health systems to develop and scale products.
  • Share best practices.
  • Move from sick care to wellness via population health.
  • Explore new care models.

Acquisition Financials

Three-hospital Summa recorded a $57 million loss on $1.5 billion in revenue in its most recent tax filing.

GC said with the original announcement that it would spend $1 billion to $3 billion for its acquisition. For-profit companies that buy non-profit health systems usually pay slightly less than 1x revenue, so GC will likely spend at least $1 billion. HCA paid $1.5 billion for North Carolina’s Mission Health, whose revenue and bed count were nearly identical.

Summa’s CEO says the health system’s financial challenges, which include $800 million of debt, didn’t give it a lot of options. He says that Summa has been seeking a partner for more than 10 years, Summa announced plans to sell itself to Beaumont Health in late 2019 until COVID caused both parties to change their minds.

GC will need to finance the deal. It has $25 billion of assets under management, but probably not $1 billion in cash sitting around. The financial details of the transaction will come out when they look for investors or lenders, or perhaps before then in the likely event that the information leaks out. The resulting leverage and carrying costs, not to mention extraction of resources to give the buyer immediate reward, often bring down acquired health systems that were already struggling.

GC Says It’s Not a Typical Private Equity Acquisition

GC makes it clear that as a venture capital firm, it won’t follow the model of a private equity acquisition, where the goal is to cut costs (often recklessly) to increase profits to allow a quick flip of the business. However, it could be argued that this transaction is more like PE than VC, other than GC’s assurance that it is in for the long haul:

  • GC is buying a mature business that has stable revenue, not a high-potential startup whose success is not assured.
  • It is acquiring a 100% share rather than partial ownership.
  • GC may or may not become actively involved in Summa’s management.

For-Profit versus Not-for-Profit

For-profit companies own a significant percentage of US hospitals, but as their core business rather than one of several business lines. GC is an investor with no experience running a health system. Regulators have grown wary of what happens after the deal is done, when the acquirer may close locations, let quality slide, sell real estate to generate cash, or shut down money-losing core community services such as obstetrics to move into high-profit ventures such as ambulatory surgery centers.

For-profit status could make it easier to raise capital, but with significant downsides:

  • They lose the tax benefits.
  • They lose the 340B drug discount program, which can be a big profit-booster.
  • They will need to renegotiate contracts.
  • They will need to retire or refinance Summa’s $800 million of debt, probably at higher interest rates as a for-profit.

Operational Challenge

GC has promised that Summa’s executive team, employee base, service lines, and name won’t change. That may be challenging if profits don’t materialize, especially when most Summa executives have no experience running a for-profit hospital. Continued losses might be hard to swallow even if Summa helps GC make money from its other investments. The business structure will be important for the availability and cost of financing.

Buying a Software Sandbox

GC is buying a sandbox for its health tech portfolio companies. The original participants in GC’s Health Assurance Network are:

  • Commure (interoperability and data).
  • Tendo (analytics).
  • Transcarent (connecting consumers with providers).
  • Olive (process automation, but the company has been shut down).

GC may also be eyeing the value of Summa’s data for AI training.

GC will need to track the value that Summa adds to its portfolio companies, especially if the health system keeps losing money, to determine if its investment is paying off.

Health System and Software Companies Sharing an Owner

GC portfolio companies benefit from bypassing the “death by pilot” process in being implemented and measured at a health system that is a fellow portfolio company. That could generate convincing proof-of-concept studies. It could also backfire if Summa’s core business struggles despite using corporate-mandated software.

Epic

Summa previously ran on Mercy Health’s shared instance of Epic, then spent $850 million in late 2022 to launch its own instance. UPDATE: That number came from a Summa interview in which CIO Elbridge Locklear, MBA says what sounds like $850 million and remains transcribed that way on Summa’s website, but tax filings say they spent $50 million, suggesting that he may have stumbled verbally.

GC companies will have a leg up on Epic integration. That assumes that GC doesn’t run into issues with Epic’s willingness to work with a health system whose parent company also owns many dozen health technology competitors. The health system cannot risk having Epic shut its system down over IP concerns or contract renegotiation, and walking away from an expensive Epic contract to self-develop software would be unprecedented and risky.

Your Thoughts

I’m interested in your opinion. Leave a comment or message me.


Webinars

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

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


Acquisitions, Funding, Business, and Stock

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23andMe CEO Ann Wojcicki says that tech investors who understand its consumer genetics testing business don’t like the burn that is involved with its drug development side, while pharma investors don’t understand its consumer business. She declined to say if the company might split into two companies, but notes that it is selling customer genetics data to drug companies under non-exclusive relationships, one of which just yielded a $20 million, one-year contract. ME shares have lost 94% of their value since the company went public via a SPAC merger in June 2021 at a valuation of nearly $4 billion, now $340 million. 23andMe reported in January that hackers had exposed the information of 6.9 million people who had activated its DNA Relatives sharing feature.

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Today I learned from LinkedIn about Veritas Data Research, which appears to have solved the longstanding healthcare data problem of not knowing if a patient/consumer has died. The company’s Fact of Death captures over 90% of US deaths, usually within a month. Tuva Health is partnering with the company, saying that it’s surprisingly hard to know whether a patient survived or not because CDC’s data takes up to a year to published, is available only to researchers, and becomes less reliable as more people choose to die outside the hospital. The use cases for providers include creating better population health and risk models and eliminating the embarrassment of sending bills and marketing communications to people who have died. Veritas has just added Cause of Death, which allows researchers to identify whether deaths may not be related to their study topic. The two founders previously co-founded Universal Patient Key, a healthcare data de-identification service that was acquired by Datavant in 2018.


People

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Darcy Nett (Wellbe) joins HealthX Ventures as principal.


Announcements and Implementations

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FDA clears DermaSensor’s AI-powered handheld device for detecting skin cancer.

Optum seeks EHR/PM vendors to test its prior authorization inquiry API.


Government and Politics

HHS OIG bans Theranos founder and federal inmate Elizabeth Holmes from participating in federal healthcare programs for 90 years, the same exclusion it gave to former Theranos President Sunny Balwani.


Privacy and Security

The American Hospital Association warns that offshore hackers are impersonating hospital revenue cycle employees to have their passwords reset by the hospital IT help desk, using stolen information about the employee to answer security questions. They then ask to have a cell phone with a local area code enrolled, which allows them to defeat multi-factor authentication to log on to financial systems to send money to their offshore accounts.


Other

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Epic CEO Judy Faulkner tells a fun story about opening the first buildings of its new campus in Verona, only to find that the entrances to their underground parking lots were too short for fire trucks. They had to buy the Verona Fire Department a new truck, which Carl Dvorak drove over with the sirens and lights on. Judy sat in the back with her white Samoyed dog, to which they had affixed black spots made of construction paper to make him look like a Dalmatian.

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Unrelated, but bizarre. The founder and CEO of a large Chicago-based ERP software company dies and its president is seriously injured during a company celebration in India. The two executives were leading the audience in singing while hanging from a cage that was suspended above the stage when its chain broke, tumbling them 15 feet to the concrete stage.


Sponsor Updates

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  • Spok staff pack gift boxes for patients and gift bags for nurses at Inova L.J. Murphy Children’s Hospital in Virginia.
  • CereCore International hires Andrew Hine (Babylon) as managing director.
  • EClinicalWorks shares a new customer success story, “Boosting Wellness Visits & Incentive Revenue in Healthcare.”
  • Nordic releases a new Designing for Health Podcast, “Interview with David K. Butler, MD.”
  • Optimum Healthcare IT publishes a new case study, “ServiceNow Clinician Connect EMR Help.”
  • SBI’s Growth Advisory Podcast features Symplr CEO BJ Schaknowski and President Nicole Rogas.
  • The American Journal of Nursing awards Wolters Kluwer Health with eight Book of the Year awards.
  • Waystar will exhibit at ASA Advance 2024 January 26-28 in Las Vegas.

Blog Posts


Contacts

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

Morning Headlines 1/19/24

January 18, 2024 Headlines Comments Off on Morning Headlines 1/19/24

Our Acquisition of Summa Health

General Catalyst signs a letter of intent to acquire Akron-based non-profit health system Summa Health, pointing out that the acquisition shouldn’t be considered as “another private equity deal” because it will not focus on cost reductions or a quick flip.

West Coast health tech company bringing dozens of jobs to new River Market headquarters in KC

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

New database of more than 83,000 surgical outcomes aimed at advancing research and training artificial intelligence algorithms now online

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

Visibly Launches Real-Time Video Consultations Through Merger With EyecareLive

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

Comments Off on Morning Headlines 1/19/24

News 1/19/24

January 18, 2024 News 1 Comment

Top News

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

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

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

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

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

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

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


Webinars

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

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

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


Acquisitions, Funding, Business, and Stock

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

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

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

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

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

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

Sales

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

People

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

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

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

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


Announcements and Implementations

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

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

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

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

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

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


Privacy and Security

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


Other

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


Sponsor Updates

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

Blog Posts


Contacts

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

EPtalk by Dr. Jayne 1/18/24

January 18, 2024 Dr. Jayne 2 Comments

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

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

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

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

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

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

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

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

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

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

Email Dr. Jayne.

Morning Headlines 1/18/24

January 17, 2024 Headlines Comments Off on Morning Headlines 1/18/24

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

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

PointClickCare Acquires CPSI Subsidiary, American HealthTech

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

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

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

Comments Off on Morning Headlines 1/18/24

Healthcare AI News 1/17/24

January 17, 2024 Healthcare AI News Comments Off on Healthcare AI News 1/17/24

News

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

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

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

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

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


Business

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

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

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


Research

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

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

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

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

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


Other

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


Contacts

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Get HIStalk updates.
Send news or rumors.
Contact us.

Comments Off on Healthcare AI News 1/17/24

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

January 17, 2024 Interviews 1 Comment

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

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Tell me about yourself and the company.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Morning Headlines 1/17/24

January 16, 2024 Headlines Comments Off on Morning Headlines 1/17/24

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

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

Care enabler 98point6 buys telehealth Bright.md

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

HCAP Partners Leads Investment in Apprio

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

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

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

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

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

Comments Off on Morning Headlines 1/17/24

News 1/17/24

January 16, 2024 News 4 Comments

Top News

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

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

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


Reader Comments

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


HIStalk Announcements and Requests

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


Webinars

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

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

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


Acquisitions, Funding, Business, and Stock

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

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

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


Sales

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

People

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

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


Announcements and Implementations

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

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

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

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

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

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

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

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


Privacy and Security

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

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


Other

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


Sponsor Updates

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

Blog Posts


Contacts

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

Morning Headlines 1/16/24

January 15, 2024 Headlines Comments Off on Morning Headlines 1/16/24

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

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

IT failure caused weekend chaos at Sussex hospitals

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

Quantum Radiology cyber attack: Former and current employees data targeted

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

Comments Off on Morning Headlines 1/16/24

Curbside Consult with Dr. Jayne 1/15/24

January 15, 2024 Dr. Jayne 4 Comments

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

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

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

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

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

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

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

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

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

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

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

Email Dr. Jayne.

HIStalk Interviews G. Cameron Deemer, CEO, DrFirst

January 15, 2024 Interviews Comments Off on HIStalk Interviews G. Cameron Deemer, CEO, DrFirst

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

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Tell me about yourself and the company.

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

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

How has the original vision of e-prescribing expanded?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

What are the company’s near-term priorities?

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

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

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

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

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

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Morning Headlines 1/15/24

January 14, 2024 Headlines Comments Off on Morning Headlines 1/15/24

Towards Conversational Diagnostic AI

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

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

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

Law firm that handles data breaches was hit by data breach

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

Comments Off on Morning Headlines 1/15/24

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