Morning Headlines 6/2/23

FDA-approved Alzheimer’s drugs will be covered by Medicare, with some limitations, CMS says

CMS announces that Medicare Part B will cover the use of FDA-approved monoclonal antibodies to slow the progression of Alzheimer’s disease, but will require doctors to populate patient registries for real-world tracking of the performance of those treatments.

Biden plans to pick physician Mandy Cohen to lead CDC

President Biden will reportedly choose Aledade executive and former North Carolina health secretary Mandy Cohen, MD, MPH as director of the CDC.

Lightning Step Divests AVA Billing & Consulting, Reinforcing Focus on Core Behavioral Health Software Solutions

Behavioral healthcare software vendor Lightning Step sells its Ava Billing & Consulting subsidiary to RCM company Medusind.

News 6/2/23

Top News

CMS announces that Medicare Part B will cover the use of FDA-approved monoclonal antibodies to slow the progression of Alzheimer’s disease, but will require doctors to populate patient registries for real-world tracking of the performance of those treatments.

The Alzheimer’s Association says that requiring patient registries for coverage should be reconsidered because of the clinician data entry workload that is required. The association wants to know more about how data will be submitted, how the CMS-facilitated portal or other registries will work, and how patients and physicians can enroll.

Reader Comments

From Zippydoodle: “Re: non-existent HIPAA certifications. HIPAA compliance is a process, not an event, and there is no single body that certifies a company as being HIPAA compliant. Startups in particular that should be saying ‘we will sign BAAs’ instead declare that they are HIPAA compliant or HIPAA certified.” Companies need to be HIPAA compliant, not HIPAA certified,  and HHS has been clear that it requires the former and doesn’t recognize the latter. 

From Austin Keeping Weird: “Re: Founder Wellness and Blood Draw Party. Some influencer who isn’t affiliated with healthcare is promoting a digital health startup event. So many things wrong: the free blood draw panel for folks who are likely amply insured while much of Texas isn’t, the IV bar that has nothing to do with wellness, and the ice baths that create images of attendees in Speedos. Digital health companies who attend will soon discover that their sustainability is associated with payers or prescribers, not vanity faux medicine.” Maybe the unnamed company should launch a TikTok challenge.

From Laff Riot: “Re: Florida patient data law. I’m surprised that few comments have been made given the number of health IT companies that use offshore resources for support, development, or billing services. Florida providers and their vendors have little time to review or modify contracts to ensure that offshore resources do not have access to PHI.” The newly modified Florida Electronic Health Records Exchange Act, which takes effect July 1, prohibits providers from storing patient records offshore or allowing access to US-stored data to anyone who is outside the US or Canada. Providers must also ensure that patient data that is stored in the cloud is physically housed in the US.  A couple of websites mentioned of the law a few days after reading about it on HIStalk, but otherwise it has drawn little attention. Given that compliance will be far from universal by the due date, it’s all about enforcement and penalties.

From Billie Gene: “Re: gene editing to reverse/stop a hereditary condition. Laudable R&D to advance precision medicine or another over-reach by pharma?” Genetic telehealth provider Genome Medical will offer genetic counseling to participants in a company’s clinical trial of a gene editing process for treating sickle cell disease. Much of medical research isn’t laudable since profit is the intention and the reward, but I would have good feelings about the company if their treatment alleviated my SCD symptoms.

HIStalk Announcements and Requests

Are you Rockies-bound next week for MUSE Inspire? Some of my sponsors are, and here’s what they will be doing there.

I have some very slightly overlapping background with someone I was interviewing today and they asked if I knew Brad Dodge. I instantly said yes, recalling that his company back in the day, Dodge Communications and specifically Brian Parrish, designed the HIStalk logo you see at the top of this page that has served me well for more than 10 years (I am obviously from the “ain’t broke” school of rebranding). Thanks to Brad and Brian for volunteering to create what turned out to be a long-lasting graphic.

Listening: WITCH (We Intend To Cause Havoc), a Zamrock band from 1970s Zambia, where bands emulated the psychedelic sounds they heard from the US. The band’s (and the country’s) rough history left it with just one surviving member, 72-year-old Emmanuel “Jagari” Chanda, whose day job is gemstone miner. They are releasing a new album this week and are on a long US tour.

HIStalk turns 20 years old this week. I was bored over the Memorial Day weekend of 2003 and decided to jot down a few temporary thoughts about my health system IT job to help me keep things straight in my head. I didn’t expect or necessarily even want anyone to read it, and given my limited attention span and lack of interest in hobbies in general, I definitely didn’t plan to still be doing it 20 years later.

Webinars

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

Acquisitions, Funding, Business, and Stock

BJC HealthCare and Saint Luke’s Health System will merge to form a 28-hospital system with $10 billion in annual revenue.

Sales

• Ardent Health Services will deploy Loyal’s consumer engagement solutions.

People

Leadership Development Worldwide hires Shane Danaher, MBA (Divurgent) as COO.

Government and Politics

President Biden will reportedly choose Aledade executive and former North Carolina health secretary Mandy Cohen, MD, MPH as director of the CDC.

Other

UnitedHealth cancels its plan to require prior authorizations for colonoscopies, instead requiring physicians to submit patient information before performing a procedure to quality for a “gold card” expedited approval process that will be rolled out next year. Three provider groups say the new plan is just as laborious for practices as the PA process would have been.

A New York Times report says that doctors at the “wealth nonprofit” Allina Health System aren’t allowed to see patients who have unpaid medical bills. Reporters found a document in which employees were told to cancel appointments for patients who own $4,500 or more and to lock their EHR records so that appointments can’t be scheduled. Doctors say they are used to seeing EHR messages that a patient “will no longer be eligible to receive care because of unpaid medical balances.” Patients with unpaid bills can continue to be seen only if they obtain a loan from the hospital or file bankruptcy.

Sponsor Updates

• Careport Health staff volunteer with Cradles to Crayon, which provides children with the resources they need to thrive.
• University Health (TX) upgrades to Agfa Healthcare’s Enterprise Imaging 8.2, and adds Enterprise Imaging for Cardiology.
• Arrive Health publishes a new whitepaper, “The Terrifying Truth About America’s Healthcare Affordability Crisis.”
• Baker Tilly releases a new Healthy Outcomes Podcast, “Key insights for not-for-profit leaders in behavioral health.”
• ChartSpan partners with HAPevolve, a subsidiary of The Hospital and Healthsystem Association of Pennsylvania, to offer preventative care programs to Medicare patients.
• CHIME launches its Trailblazers Podcast, with the first episode focused on “Developing the HIT Leaders of Tomorrow.”
• Divurgent releases a new episode of The Vurge Podcast, “Tips for Managing Cyber Risks in Healthcare.”
• Azara Healthcare releases a resource and strategy guide titled “Leveraging Social Drivers of Health Data to Promote Health Equity Advancement.”
• Ellkay will exhibit at AHIP June 13-15 in Portland, OR.
• The VA’s Veterans Data Integration and Federation Enterprise Platform, which supports longitudinal patient records using InterSystems HealthShare, wins a 2023 Forum Innovation Award.
• Rhapsody publishes a new case study, “From data ingestion to production in less than 30 days: How Zephyr AI uses Rhapsody Semantic to create precise AI models at scale.”

Blog Posts

• 4 Business Insights to Help Your Healthcare Practice Grow in 2023 (AdvancedMD)
• Robotic Process Automation Nets Multiple Benefits for Tidewater Physicians Multispecialty Group (AGS Health)
• How Southwestern Health Resources uses quality data to transform care delivery (Arcadia)
• Helping Intensive Care Teams at Great Ormond Street Hospital to Navigate Data (Aridhia)
• 4 Steps to Streamline Your Revenue Cycle Tech Stack (Availity)
• Building Board Engagement to Mature Your ECRM Program (Clearwater)
• Consensus Cares: The DEI Council and the #DoGoodChallenge (Consensus Cloud Solutions)
• Building the Future of Data: Dimensional Insight’s Mentorship Initiative (Dimensional Insight)
• Empowering Healthcare Excellence: Vital Role of Clinical Asset Management (Optimum Healthcare IT)
• How to build organizational resilience: six proven steps (Everbridge)
• 3 Elements for Successful Workforce Management: Embracing a New Way of Thinking in Health Delivery (Impact Advisors)
• Figure it out or fail: Extracting the value from unstructured data (Intelligent Medical Objects)
• 4 Strategies to Help a Multigenerational Workforce Thrive (Keysight)
• Guide Patients to the Right Care With Your Find Care Experience (Kyruus)
• 3 Tech Considerations for Painless Anesthesia (Medhost)

Contacts

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

EPtalk by Dr. Jayne 6/1/23

Midwestern health systems BJC Healthcare and Saint Luke’s (Kansas City) have announced plans to join through a $10 billion merger. They have been previously connected through participation in the BJC Collaborative, which Saint Luke’s joined in 2012 as the organizations sought to share resources and cut costs.

Announcements from the organizations note plans to operate under their existing brands and operate from headquarters in both St. Louis and Kansas City. Detailed plans for the merger are slated to unfold through the rest of the year, with a goal of closing the deal by the end of the year. I reached out to some Midwestern friends who know both organizations well and it sounds like there may be some significant cultural differences that come into play. It should be an interesting one to watch.

I receive dozens of cold call emails every day despite my best efforts to filter them into junk mail or spam folders. My favorite of the week was one that gave three different stylistic treatments to the healthcare entitlement program for seniors: MediCare, MediCARE, and ultimately Medicare. Maybe their marketing team will eventually create a style guide so that they can remain consistent, but since I made use of the block sender functionality, I hopefully won’t be seeing it again.

I don’t practice as often as I used to, but when I do, there’s always a patient who asks about something they saw on the internet and how it might relate to their reason for seeking medical care. A recent Forbes article discusses data that more than a third of members of Generation Z trust TikTok more than doctors. It’s not the only player in the equation – another 44% of adults surveyed visit YouTube before contacting their physician. One in five respondents trust health influencers more than they trust medical professionals, citing access, cost, and avoiding judgment from medical professionals.

The article goes on to emphasize the need for care providers to meet patients where they are. I agree with that approach. I’ve not seen many mainstream health organizations fine tuning their social media sites to go after that demographic, but I’ll keep an eye out. There is plenty of medical misinformation out there that needs to be countered, but competing against influencers might be an uphill battle.

For health systems and other organizations that are trying to build their brands (and often renaming themselves in the process), they might want to target older demographics. A recent article notes that members of Generation X and Baby Boomers are twice as likely to trust brands than members of Generation Z. Topping that brand list and possibly providing inspiration for marketers: Band-Aid, UPS, Amazon, Lysol, and Kleenex followed by Cheerios, Visa, Dove, The Weather Channel, and FedEx. The survey noted that Generation Z doesn’t trust many brands to do the right thing – non-profit brands were the only category to which it responded well. I tried to poll a couple of the members of Generation Z about the topic, but hit a dead end because they were heads-down on their phones.

I have a visit later this week with a new physician who is part of the medical group where I’m already established. I was relieved to receive an electronic check-in notice through the patient portal. My previous physician left the practice for health reasons, but I’ve been a patient in both the practice and its database since 2019 (and in its precursor, which was converted, for a decade prior) so it should have been smooth sailing.

I completed the electronic check-in and was met with a notice that “you might be asked to complete additional paperwork in the office,” which jogged my memory that indeed they had mailed me a packet six months prior. I found it in the file sorter on my desk and was dismayed to find that it contained four pages of materials that are redundant to my existing chart, including the pharmacy information and medication list that I just confirmed during the electronic check-in process. When I scheduled the appointment, I made it clear that I was transferring from her former partner. Since I’ve been seen within the past three years by a physician of the same subspecialty who bills under the same tax ID, I’m technically an established patient even though I’m new to her. I assume they send the “new patient” paperwork to everyone, but it’s still disheartening.

No one wants to arrive at the office and be turned away because they don’t have the (totally unnecessary) paperwork, so here I sit filling out information when I’m 100% confident that it’s all in the chart already, because I’ve seen it in my past visit notes. The real kicker was when I arrived at page four and found the “physical examination do not write below this line” section, where presumably the physician (who has a multi-million-dollar EHR) will not be documenting my exam because her contract requires her to use said EHR if she wants to get her annual bonus. I helped institute those contracts in a past life, and according to my former colleagues, they are still in place, so that should make for a fun conversation when I get to my appointment. The photocopies themselves are no longer crisp and are marked by smears from repeated copying, which is just sad.

Getting to the end of the paperwork, I realized that it didn’t even ask for some of the key elements of my history that are important to the topic of the upcoming visit, as well as being critically important for a physician in that subspecialty regardless of whether they’re a topic of this specific visit or not. As a physician, I know this is a big deal, but many patients might not volunteer that information if the physician doesn’t specifically ask for it.

Based on the paperwork and the pre-visit experience, I’m not confident of what to expect from this visit. For an organization that is worried about patient experience and their patient satisfaction ratings, I’ll be sure to give appropriate feedback when the inevitable survey arrives in my inbox. If they’re interested in some management consulting and EHR optimization, I might just know someone.

What’s the most frustrating healthcare IT-related issue you encounter as a patient? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 6/1/23

Hyro Raises $20M in Funding to Advance Responsible AI-Powered Communications for Enterprise

Hyro, which offers conversational AI-powered healthcare workflow and conversation solutions, raises $20 million in a Series B funding round.

Wellstar to open innovation center in Midtown Atlanta

Wellstar Health System will open an innovation center in Atlanta this fall to house its recently launched Catalyst venture firm.

Axuall Secures $20 Million Series B Capital Raise after Accelerated Market Growth and Healthcare Enterprise Adoption

Healthcare workforce software firm Axuall raises $20 million in a Series B funding round.

Strive Health Raises $166 Million in Series C Funding from NEA, CVS Health Ventures and Others

Kidney care company Strive Health raises $166 million in a Series C funding round, bringing its total raised to $386 million since launching five years ago.

Healthcare AI News 5/31/23

News

Microsoft adds intelligent meeting recap to Teams Premium, which generates meeting notes, a task list, and personalized timeline markers.

In Australia, five-hospital South Metropolitan Health Service orders doctors to stop using ChatGPT for work-related activity, citing confidentiality concerns. SMHS found that at least one doctor used ChatGPT to create a discharge summary, backtracking on an earlier statement in which it said that several doctors were creating notes in ChatGPT and then pasting them into the EHR.

Business

AI chipmaker Nvidia hits a market capitalization of $1 trillion following a strong quarterly report, joining nine companies that have reached that mark including Apple, Microsoft, Alphabet, Amazon, and Saudi Aramco. A $10,000 investment in the company five years ago would be worth nearly $60,000 today.

Hyro, which offers conversational AI-powered healthcare workflow and conversation solutions, raises $20 million in a Series B funding round.

In England, AI drug discovery company Benevolent AI, which went public last year in a SPAC merger, will cut half of its workforce and scale back its laboratory facilities. The company had hoped to license its AI-designed drug candidate for atopic dermatitis, but it failed to improve symptoms in early-stage clinical trials.

Research

Researchers use AI to design an antibiotic for treating hospital-acquired infections caused by the broadly resistant Acinetobacter baumannii bacteria. Researchers tested thousands of drugs for their ability to kill the bacteria or slow its spread, trained AI on the results, and then ran the resulting AI model against 6,700 other drugs to generate a 240-drug short list of candidates. The AI-chosen drug, abaucin, targets the bacteria specifically and therefore is less likely to cause drug resistance. Laboratory and clinical testing will take several years, with the first AI antibiotics expected to reach the market in 2030.

Opinion

Google Health debunks five myths about medical AI:

• The more data, the better. Data quality matters more and expert adjudication in touch cases helps improve labeling quality.
• AI experts are all you need. Building an AI system requires a multidisciplinary team.
• High performance provides clinical confidence. Real-world validation is needed to make sure the model generalizes to real-life patients.
• AI fits easily into workflows. AI should be designed around human users.
• Launch means success. AI systems must be monitored to detect potential issues when patient populations or environmental factors change.

Other

Nvidia profiles Nigeria-based physician, informaticist, and machine learning scientist Tobi Olatunji, MD, MS, who started Intron Health to transcribe physician dictation using AI with 92% accuracy across 200 African accents. The company was supported by Nvidia’s startup program. He earned a Georgia Tech computer science master’s and a UCSF master’s in medical informatics after he completed medical school in Nigeria.

Contacts

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

Readers Write: It’s Time for EHRs to Alleviate, Not Exacerbate, Clinician Burnout

It’s Time for EHRs to Alleviate, Not Exacerbate, Clinician Burnout
By Nancy Pratt, RN

Nancy Pratt, RN, MSN is senior vice president of clinical product development of CliniComp of San Diego, CA.

We all see the headlines – clinician burnout is taking an enormous toll. It is estimated that 47% of US healthcare workers may leave the profession by 2025. One of the most-cited sources contributing to burnout is electronic health records (EHRs), with nearly 60% of physicians in one poll suggesting that EHRs need a complete overhaul.

In my work with clinicians, their biggest frustration with EHRs is time. So much of their time is spent doing manual, EHR-related tasks, causing them to spend nearly twice as much time in the EHR as they do with patients. A poll by Stanford Medicine found that hospital-based physicians spent 25 of the 37 minutes on behalf of each patient in the EHR.

It doesn’t need to be this way. By collaborating with physicians, nurses, pharmacists, and other clinicians, EHRs can become a trusted part of care delivery processes, freeing clinicians to focus on their patients and recapture the most satisfying qualities of their professions. With a focus on human-centered design, EHRs can help reduce clinician burnout in three ways:

Capture documentation naturally as part of the workflow

Given the frustration with documentation, EHRs need to move beyond focusing on transactions to creating efficient, supportive workflows for all clinicians. One process that is often frustrating and burdensome is medication reconciliation. A well-designed EHR workflow can present this critical step at a natural point in the care process. By presenting a side-by-side comparison of what’s current and what’s needed for the patient, the process becomes a fast and accurate way for physicians to manage medications.

Bring device data into the workflow automatically

Using standard integration protocols, such as APIs, EHRs can automatically integrate data from bedside monitoring and other devices into user-focused workflows. Instead of requiring nurses to enter data manually, the EHR should be fully integrated, perform calculations automatically, and present in a user-friendly way. In addition to reducing errors and manual tasks, nurses working with monitored patients report saving as much as 15 to 20 minutes per patient per shift with this level of integration.

Remove downtime as a barrier

It’s surprising that system maintenance and upgrades still require planned downtime for many EHRs, slowing down care delivery with manual, paper-based workarounds. Unplanned downtime, experienced by 96% of organizations according to one study, can be even more onerous. EHRs should be built upon modern foundational architectures that don’t require scheduled downtime and have built-in redundancy to prevent unplanned downtime. Preventing downtime alleviates a common source of stress for clinicians when care delivery is hampered by lack of access to patient information.

It’s time for the industry to listen when so many clinicians say EHRs need to be revamped. Using flexible, well architected technologies and collaborating with clinicians, EHRs can enhance rather than hinder care delivery. At last, EHRs can support clinician wellness by enabling them to provide the highest quality patient care, bringing the joy of helping patients back into their day-to-day work.

Readers Write: Ineffective TCM Programs are Keeping Patients in the Hospital

Ineffective TCM Programs are Keeping Patients in the Hospital
By Briana Rodriguez, RN

Briana Rodriguez, RN is director of clinical services of LIghtbeam Health Solutions of Irving, TX.

The healthcare industry is facing an uphill battle, as staffing shortages persist while the demand for clinical professionals continues to increase. With fewer skilled workers to perform necessary care delivery tasks, healthcare organizations must be thoughtful with their clinical resources. One area that is causing clinical and financial strain on organizations due to limited resources is transitional care management (TCM) programs.

According to the Centers for Medicare and Medicaid Services (CMS), nearly 20% of all Medicare patients discharged from a hospital will be readmitted within 30 days, driving over $26 billion in additional costs each year. There are a multitude of reasons, both preventable and unpreventable, that a patient may be readmitted to the hospital. Chief among them is being enrolled into an inefficient, uncoordinated transitional care management program that fails to maintain engagement and make timely contact.

Understanding how and why your organization’s TCM program is insufficient is the first step to make meaningful process changes that demonstrate success in reducing readmission rates, lowering healthcare costs, and improving patient outcomes.

The goal of any TCM program is to perform timely and thorough patient follow-ups within crucial post-discharge windows to ensure quality of care and reduce patient complications. A standard transitional care management program comprises three main elements:

• Interactive contact. Initial patient outreach is performed within 48 hours post-discharge by a supervised staff member with the skills to address the patient’s status.
• Coordinating care behind the scenes. Care teams provide non-face-to-face services, such as clinical education, addressing follow-up needs, provider communication, referrals, and scheduling assistance.
• Follow-up visit. A face-to-face visit is scheduled with a provider within 7-14 days post-discharge, depending on medical severity

However, staffing shortages and insufficient resources can make even the three basic components of a TCM program difficult to accomplish. What sets a successful, effective TCM program apart is the ability to provide regular outreach, keep patients engaged, and identify issues before they require inpatient stay. These processes begin long before a patient is discharged from a hospital.

In today’s digital age, healthcare organizations have options that have only emerged within the last decade. Solutions like remote patient monitoring and telehealth garnered attention following the social distancing periods that took place during the COVID-19 pandemic. Ever since, the healthcare industry at large has seen how beneficial similar strategies can be when it comes to reaching more vulnerable patients. When given the right capabilities, clinical professionals can work at the top of their license and provide the highest quality care to patients, wherever they are.

Leveraging these tools and resources, transitional care management teams can automate repetitive tasks, streamline workflows, and reach more patients by engaging them at home. Some key aspects that can be further built into an efficient TCM program to increase patient engagement and reduce costs include:

• Coordinating with hospitals to notify care teams of discharges.
• Making the initial patient contact within 48 hours of discharge.
• Reviewing the discharge process and medication schedule with the patient.
• Scheduling a face-to-face visit within 1-2 weeks.
• Confirming all patient appointments to ensure continuity of care.
• Performing follow-up calls.
• Providing support for barriers to care by leveraging local, available resources.
• Supporting patients in the 30-day period post-discharge.
• Documenting all services throughout the patient’s TCM journey.

There are several reasons that transitional care management programs can fail. If providers are not able to identify high-risk patients with co-morbidities before they are discharged, these patients have a higher chance of developing complications that could result in further inpatient stay. TCM programs can also fail if clinical staff is not able to contact patients during crucial follow-up windows, especially the initial 48 hours post-discharge.

Noticing an increase in readmissions, post-discharge complications, and delays in interactive contact with patients may indicate that care teams are not reaching patients in a timely manner. If you notice these issues, it is important to find out the cause of the gap and to pinpoint the right solution, workflow, or strategy to close it.

Ineffective TCM programs cause patients to return to the hospital and drive avoidable costs into the billions. The first step to improve an inefficient TCM program is to arm healthcare staff with the tools and resources they need to reach out to patients, make an impact, and maintain engagement throughout their care journey. This can include investing in technology to streamline communication, leveraging analytics to identify high-risk patients, and enabling staff to work at the top of their license.

With the technology of today, healthcare organizations have access to solutions that weren’t available ten years ago. Outsourcing care coordinators extends the capabilities of care teams, while adopting tools like remote patient monitoring expands their reach.

Even when a TCM program possesses all these elements, it’s essential to assess their performance regularly, make process updates, and assess patient feedback and satisfaction. This can be done by tracking certain metrics, such as readmission rates, acute events, skilled nursing facility data, and more.

By understanding the elements of an efficient TCM program, identifying where gaps exist, and making necessary process changes, healthcare organizations can reduce readmissions, lower costs, and improve outcomes.

Readers Write: Return Data to Hospitals and Researchers for Patients

Return Data to Hospitals and Researchers for Patients
By Amanda Borens

Amanda Borens, MS is chief data officer of Aridhia Informatics of Glasgow, Scotland.

As a data scientist formerly working in global health, I have firsthand knowledge of how challenging it is to recruit patients for clinical trials and observational studies, and how transformational a culture of open collaboration and data sharing can be. I have cancer diagnoses in my history, accompanied by so much fatigue from being extensively examined and poked and prodded, but I’m also a scientist in the health technology industry with appreciation for the way that humans advance medical knowledge.

I have eagerly signed up for clinical studies and taken on extra burdens, such as blood draws and filling out forms, to help researchers as well as those in training. Even when that means being examined by a nervous medical student and then repeating myself to a physician.

Then why did I balk when my health system asked me to participate by openly sharing my EHR data for research?

I collaborated with renowned medical ethicists who taught me to embrace the idea that a patient owns their data. That idea was cemented in me when I became a participant in various studies that led to peer-reviewed publication. I had been working in my non-profit world to aggregate data from multiple sources to learn more about rare diseases. I became frustrated that companies would keep shareable data confidential to avoid letting competition find insights that they had missed. I was shocked to learn that many scientists in academic settings hoard data in the same way, fearing that someone might find something they missed in the data and publish it.

In all cases, the stewards of the data seemed to forget that patients sacrificed time, blood, energy, and more to help all humanity, not the personal careers of their physicians or the bottom lines of sponsoring drug companies. That intention matters, and is worth honoring.

This brings me to my personal hesitation when asked to share my EHR data for research. I’ve been to data science conferences where abstracts were presented by employees of this health system. I know the kinds of questions my data would answer. Those questions tend to be focused on how to keep hospitals profitable. While I know that this is a valid concern for administrators in hospitals, I want my personal health information to be used to help other patients like me have a better experience, and I don’t much care what that would cost.

I want to be a piece of data that led to a cure for this, a better treatment for that, an earlier detection of my cancer for others, a less-invasive surveillance journey, or a better experience with caregivers. I want to share my EHR data with my incredible team of oncologists and researchers so they can learn. I want my data to be compiled with that of others so that they can learn more and faster.

However, I know that my doctor won’t be able to access aggregated data that way in my clinic. I know he had to use an Excel spreadsheet to keep track of data in the landmark oncology study he recruited me to join.

Conversely, aggregated claims databases can be used to answer questions about health economics. Some cost money to access, and sometimes researchers can access those external data sources with cost waived. Beyond payer-aggregated data sets, Epic has a respectable database and Cerner does too, both of which are valuable for review of de-identified patient data. But what about empowering researchers and clinicians in their unique patient communities? Shouldn’t we be honoring the patients’ commitment to advancing medical science by empowering clinicians and researchers to more easily use more data in their own hospitals? What does that look like?

The US government mandates that healthcare IT developers like Cerner and Epic provide their customer base with a certified FHIR API to support patient access to health information by December 31, 2022 as part of the 21st Century Cures Act Final Rule. This mandate requires that certified health IT developers publish “service base URLs” or “endpoints” for all customers in a machine-readable format at no charge. I hope this will be an inflection point.

Additionally, patient-focused drug development mandates are demanding greater listening to the voice of the patient, and that means tighter connection between pharmaceutical companies and real-world data from clinical settings. Hospitals with an investment in a next-generation research environment will be able to procure industry funding to collaborate in a secure, audited cloud environment that is dynamic and connected to anonymized EHR data alongside observational or interventional study data. A nice side benefit? That same (already funded) environment may provide a subset of hospital researchers with identifiable patient data that can be used to implement research findings into clinical practice in a timelier fashion.

As a patient, I’d donate my data to that hospital in a heartbeat.

Imagine a world where patients and clinicians collaborate to improve healthcare, then take a look at what Great Ormond Street Hospital for Children is doing with their research environment for a wonderful example. Pediatricians there have been studying precision dosing regimens and collaborating across continents to share dosing models where pediatric populations were excluded from clinical trials. This isn’t happening in one hospital’s data warehouse, and it isn’t happening with access to a single EHR or aggregated repository. It’s possible because of connecting different types of data of across borders and across time, but all in a next-generation research environment that connects people.

The transformative possibilities do not end there. What if a research hospital was able to collect clinical data from EHR and combine it with multiomics data from an academic research university where bioinformatics pipelines are optimized to provide a list of variants for each patient? How might they learn about patient subpopulations and disease progression or predict responses to interventions? That sort of collaboration should be the norm, but it requires us to think bigger than one data warehouse, one data type, or one organization at a time. Let’s make it happen.

HIStalk’s Guide to MUSE Inspire 2023

Access EForms

Booth #413
Contact: Landon Light, national sales representative for Meditech accounts
landon.light@accesseforms.com
972.897.2877

Access is the preferred ESignature partner for Meditech hospitals, and for good reason. Our relationship with Meditech goes beyond just being a “partner” – it’s a deep integration that enables our solutions to seamlessly integrate with Meditech’s ecosystem. By expanding Meditech’s capabilities, we empower hospitals to provide patients with convenient ESignature solutions on their own devices anywhere, anytime. With Access, Meditech hospitals can streamline their workflows, reduce errors, and improve the overall patient experience. Join the many Meditech hospitals that have already chosen Access as their trusted ESignature partner and revolutionized their patient ESignature solutions. And, discover Focus by Access, the solution that simplifies patient intake by extending ESignature and intake capabilities directly to your patients’ devices, providing the experience and convenience they expect in today’s modern world.

CereCore

Booth #418
Contact: Jillian Whitefield, business development manager
Jillian.Whitefield@CereCore.net
248.891.5557

Your top priorities at MUSE are ours, too. Visit to see all the ways you can connect with CereCore about providing an EHR that best supports patient care, including educational sessions and career opportunities. Our team is ready to connect. Making the move to Meditech Expanse? Let’s talk about your journey to one EHR, navigating a multi-EHR health system, and more. Optimizing Meditech one of your priorities? Help us understand your goals, because we have helped health systems across the nation 0improve efficiency from clinical operations to revenue cycle. Looking for secure Meditech hosting and backup solutions? Sometimes this needs to be your first step. Let us help you determine the most cost-effective solution by comparing your options. Wanting to grow in your career? Career-changing, industry-shaping job opportunities are on our horizon, and possibly yours. Talk with us about your career plans.

CloudWave

Booth #512
Contact: Christine Mellyn, VP of marketing
cmellyn@gocloudwave.com
781.636.8169

Visit us in booth #512 to learn how CloudWave can help with your cloud strategy or how to advance your cybersecurity readiness. The company will also be sponsoring the Charging Station. Also at the event, members of CloudWave’s team will be presenting the following educational and showcase sessions:  

• “Best Practices for Securing Healthcare IT Across Public, Private, and Cloud Edge Environments.” Thursday, June 8 3:10 p.m. MT. Moderated by Tim Quigley, chief client officer, CloudWave. Presenters include Matt Donahue, chief technology officer, CloudWave; John Gomez, chief security and engineering officer, CloudWave; and Eric Gasser, RN, CHCIO, vice president and CIO, information systems, Wooster Community Hospital Health System.
• “Take Advantage of Emerging Healthcare Cybersecurity Trends to Advance Your Security Strategy.” Saturday, June 10, 8:30 a.m. MT. Presented by John Gomez.
• “Product Showcase: Cybersecurity-as-a-Service – Advance Your Cybersecurity Program and Remove the Burden from Your IT Team.” Thursday, June 8, 1:30 p.m. MT. Presented by John Gomez.

Elsevier

Booth # 609
Contact: Clint Jones, senior director of partnerships
w.jones.2@elsevier.com
816.262.6634

As a global leader in information and analytics, Elsevier helps physician and nurse professionals advance science, reduce care variability, engage patients, and improve health outcomes for the benefit of society. For over 140 years, healthcare professionals have trusted our content to support education, training, development, and decisions about patient care. We offer solutions and services that help customers utilize and integrate content to improve practice, reduce care variability, engage patients, and promote a culture of quality, safety, and satisfaction.   

We invite MUSE attendees to stop by our booth #609 to discuss how Elsevier’s advanced clinical knowledge solution, ClinicalKey, streamlines access to consistent, evidence-based information to help clinicians, as well as hear your thoughts and input on future development, your needs, skills learning, and integration. Let’s talk about where you want to expand your own Meditech relations and where we can offer help. Elsevier is participating in the MUSEO prize drawings, so bring your game card with you when you come to visit us, and we’ll give you a MUSEO sticker to help you become eligible to win great prizes!

Fortified Health Security

Booth 218

Contact: Rob Pullins, growth manager
rpullins@fortifiedhealthsecurity.com
615.600.4002

Fortified Health Security provides a wide variety of purpose-built services to help healthcare organizations evaluate their unique risk appetite, strengthen their cybersecurity posture, and improve operations throughout their security journey. The company is committed to creating a stronger healthcare landscape that benefits more clients, protects more patient data, and reduces more risk.   

Fortified activities and team member talks: 

• “Incident Response Program Maturity: How to Prepare for the Worst Day Ever,” Thursday, June 8 at 2:20 pm with Russell Teague, VP, advisory services and threat operations.
• Networking event and cocktail hour at the Après Ski section of the Pinyons Lobby Bar, Thursday, June 8, from 6-9 pm.   
• Stop by our booth to play MUSEO.

Tegria

Booth #409
Contact: Mark Valutkevich, senior account executive
mark.valutkevich@tegria.com

Tegria is a full service, READY-certified consulting and technology services firm. We offer comprehensive end-to-end solutions including advisory, consulting, and managed services to help clients maximize technology, transform operations, improve financials, and optimize care. Please stop by Booth #409 to say hello and speak with our Meditech experts.  

Tegria is hosting a subterranean happy hour at the Rockies Grotto in the Grand Lodge on Wednesday, June 7 from 4:30 to 7:00 p.m. MT. The event will feature an open bar and a variety of light bites. Prepare to unwind and connect with fellow MUSE attendees in this unique space. Tegria team members will be mingling and are ready to chat all things Meditech, including how you can best navigate the road to Expanse. We hope to see you there! RSVP here.

Tegria team members will be participating in two educational sessions:   

• “Hardware Planning – Do’s and Don’ts When Moving to Expanse.” Thursday, June 8, 1:30 – 2:10 p.m. MT. Presenters: Priscilla Sandberg (Pure Storage), Nassim Abouzeid (Meditech), and Frank Tollefson (Tegria). Room: Red Rock 8. If you are planning on going to Expanse from Magic, Client/Server, or 6.x, there are few challenges you need to understand about the new infrastructure you will be running. Join us to discuss the major differences in platform infrastructure and some of the adjustments that customers can anticipate making when moving to Expanse. We will also be discussing the best practices behind the infrastructure design, data protection, and ongoing system support.   
• “A Study in Moving to Expanse – Pre, Intra, and Post-LIVE.” Friday, June 9, 1:20 – 2:05 p.m. MT. Presenters: Mike Bartman (Tegria), Mark Valutkevich (Tegria), Todd Prellberg (RML). Room: Red Rock 8. This session aims to provide attendees with a comprehensive understanding of the key principles and best practices involved in successfully implementing Meditech Expanse in a hospital setting. By the end of the session, attendees will be able to apply these principles and practices to their own healthcare organizations, identifying opportunities for improving their current EMR systems or adopting new ones.

Morning Headlines 5/31/23

Carrum Health Raises $45M in Series B Funding

Carrum Health, whose platform helps employers manage employee healthcare costs, raises $45 million in a Series B funding round.

Anatomy IT Acquires Iris Solutions to Expand Presence in Ambulatory Healthcare

Health IT and cybersecurity solutions vendor Anatomy IT acquires dental and medical software company Iris Solutions.

Florida Bans Offshoring of Certain Patient Information

A new Florida law prohibits the state’s providers from storing EHR data outside the US, its territories, or Canada, including those patient records that are hosted in the cloud or by a third party.

News 5/31/23

Top News

Carrum Health, whose platform helps employers manage employee healthcare costs, raises $45 million in a Series B funding round.

HIStalk Announcements and Requests

Poll respondents aren’t convinced that the VA will finish its Oracle Cerner implementation.

New poll to your right or here: Did you sell $10,000 or more in products or services from your own company in the past year?

Listening: new from Yes, a 55-year-old band with no original members left whose recent live shows have been innumerable but awful. I walked out on them a couple of years ago because they sounded like a bad tribute band (which they kind of are) in playing their old album cuts slower, lower, and lazier in a seemingly desperate money grab, but this new music is actually pretty good even if a bit wimpy compared to their sweeping epics of yesteryear. I still prefer old concert videos, such as original singer Jon Anderson doing “Awaken” with Iceland-based rock band Todmobile (gets me every time) and the the full band’s symphonic live version of “Soon.” For me, Yes scores high in the all-important “what music would you want played at your funeral” test. It will outlive the many band members who wrote, recorded, and performed it over decades.

Webinars

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

Acquisitions, Funding, Business, and Stock

Health IT and cybersecurity solutions vendor Anatomy IT acquires dental software company Iris Solutions.

Dock Health, which specializes in automated healthcare task management, raises $5 million in funding. The company was created from Boston Children’s Hospital’s innovation department in 2020.

Weight loss app Noom launches a telemedicine service to offer consumers access to prescription weight-loss medications like Ozempic and Wegovy.

A new KLAS report looks at remote patient monitoring technology vendors.

Sales

• Niagra Health in Ontario will implement Sectra One enterprise imaging.
• Corterra Healthcare (KS) chooses Medsphere’s Wellsoft EHR and RCM Cloud for a new behavioral health hospital.

People

Rebecca Manne, RN (Optimum Healthcare IT) joins Continuum Health IT as EVP of EHR Implementation.

Announcements and Implementations

Premier launches SmartPO, digital supply chain procurement and inventory management technology that will enable continuum of care providers to better identify cost savings and use staff resources more effectively.

A University of Michigan national poll of people aged 50-80 finds that 78% have a patient portal (half of those have more than one), 55% used it in the past month, half provided access to family members, and most were comfortable logging in and navigating it. People preferred the portal over the telephone for getting test results, updating personal information, getting medical records copies, and requesting refills, but they liked the telephone better for reporting symptoms, scheduling appointments, and requesting referrals.

The former Cerner Continuous Campus is under purchase contract to be turned into apartments and commercial space, although no companies have expressed interest in the campus’s 660,000 square feet of vacant offices.

A small study finds that smart watches and wristbands do a good job of correctly detecting atrial fibrillation even though they don’t have access to outside algorithms.

Government and Politics

VA Secretary Denis McDonough promises to look into reports that the VA medical center in Spokane will be forced to cut staff due to a budget shortfall caused by the troubled EHR Modernization program. He reiterated that he stands by statements made by VA Under Secretary for Health Shereef Elnahal that budget concerns related to the Oracle Cerner system will not result in layoffs.

Former Theranos CEO Elizabeth Holmes reports to a Texas prison after her losing her bid to remain free while appealing her conviction for investor fraud, which led to an 11-year sentence.

Privacy and Security

A new Florida law prohibits the state’s providers from storing EHR data outside the US, its territories, or Canada, including those patient records that are hosted in the cloud or by a third party.

Other

The bankrupt, non-profit Idaho Health Data Exchange replaces its executive director. The organization launched in 2009 using federal grants and ongoing funds from the HITECH act that ran out in 2021.

Mayo Clinic and University of California, San Francisco researchers determine that pairing AI imaging and volumetric breast density algorithms can help in predicting long-term risk of breast cancer, particularly invasive diseases. Their study used Volpara Health’s TruDensity algorithm and ScreenPoint Medical’s Transpara image-based risk tool.

In perhaps the first incident of AI leading to professional embarrassment or worse, defense attorneys ask to have a man’s personal injury lawsuit dismissed after noticing that most of the legal citations it included were not real. The plaintiff’s lawyer, who has practiced for 30 years, admitted that he had used ChatGPT for the first time and was not aware that it could generate false information. He even asked ChatGPT if the citations were real and was assured incorrectly that the cases “are real and can be found in reputable legal databases.”

Sponsor Updates

• Wolters Kluwer Health wins the NorthFace ScoreBoard Service Award for the twelfth consecutive year for superior customer service.
• OptimizeRx CEO Will Febbo provides a mid-year strategic update.
• Nordic Consulting names Samara Lattimer (Akkodis) a new client partner in the UK and Ireland.
• Aridhia Informatics Chief Data Officer Amanda Borens, MS is featured in an “Engineering Field of Dreams” podcast titled “Spelunking Adventures in Data.”
• Spok will join the broad-market Russell 3000 Index on June 26.
• West Monroe releases a new podcast, “Why All Companies Should ‘Shift Left’.”

Blog Posts

• COVID-19 Interoperability Alliance Retrospective (Clinical Architecture)
• AONL 2023: Drawing inspiration to fuel the future of nursing (Meditech)
• Amplifying Success: How Integrated Behavioral Health Programs Can Achieve the Quintuple Aim (NeuroFlow)
• How Can Healthcare Providers Improve Their Data Integrity to Achieve Better Insights? (NTT Data)
• 360Dx: Legislation Would Provide Medicare Coverage for Pharmacy-Based Testing (OmniSys)
• Safeguarding security and privacy in the age of generative AI (Orbita)
• Healthcare Coding Series: LOINC Codes (Pivot Point Consulting)
• Partnering with a Revenue Cycle Management Company to Tackle Hospitalist Billing (PMD)
• Young Upstart to Four-Star Admiral: The Chance Events of Dr. Brett Giroir (Surescripts)
• Designing a Comprehensive Caregiver Support Strategy: Empowering the Unsung Heroes of Healthcare (Trualta)
• 4 Signs Your PT Patient is About to Drop Out (WebPT)
• Jump to the Front of the Line for National Network Access (Zen Healthcare IT)
• What is the Focus of a Care Plan? (Zynx Health)
• Healthcare CIOs Talk: How to Navigate AI, Analytics, and Automation (CereCore)

Contacts

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

Morning Headlines 5/29/23

Walgreens’ Profit Drive: Employee Cuts Amid Transformation to Consumer Healthcare

Walgreens will lay off 504 mostly corporate employees as the retail pharmacy shifts its focus to more patient care.

Health startup Noom is now adding Ozempic and other weight loss injectables to its offerings, says ‘outcomes are so much better’

Weight loss app Noom launches a telemedicine service to offer consumers access to prescription weight-loss medications like Ozempic and Wegovy.

$1 million donation will expand Montana Pediatrics’ after-hours telemedicine program

Montana Pediatrics will use a $1 million donation to expand its after-hours pediatric telemedicine program.

Morning Headlines 5/26/23

Healthcare Triangle, Inc. Announces 1-for-10 Reverse Stock Split as Part of Nasdaq Compliance Plan

Shares of Healthcare Triangle, Inc. drop sharply on the news that it will conduct a 1-for-10 reverse stock split to meet Nasdaq’s share price requirements.

Quovis, a health tech startup in Cleveland, lands $1M investment

Cleveland-based health information exchange startup Quovis raises $1 million.

VA secretary says Spokane VA’s budget won’t suffer as result of flawed records system

VA Secretary Denis McDonough promises to look into reports that the VA medical center in Spokane could be forced to cut staff due to a budget shortfall caused by the troubled EHR Modernization program.

TA Announces Strategic Growth Investment in Alpha II

RCM software vendor Alpha II secures an undisclosed amount of funding from TA Associates.

Dock Health Secures $5M in Funding Led by MassMutual with Participation from DaVita Venture Group and August Capital

Dock Health, which specializes in automated healthcare task management, raises $5 million in a funding round led by MassMutual.

News 5/26/23

Top News

Mobile patient intake form platform vendor Florence acquires Zipnosis, which sells a white label asynchronous telehealth solution that is based on questionnaires.

Florence launched in March 2023 with $20 million in seed funding.

Failing insurer Bright Health acquired Zipnosis in April 2021.

Webinars

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

Acquisitions, Funding, Business, and Stock

Shares of Healthcare Triangle, Inc. drop sharply on the news that it will conduct a 1-for-10 reverse stock split to meet Nasdaq’s share price requirements. HCTI shares are down 50% in the past 12 months to $0.26, valuing the company at $11 million. Shares have lost 93% of their value since the company’s IPO in October 2021.

Vodafone creates Vodafone in Health to accelerate the use of healthcare technology in the UK.

Sales

• Health information sharing non-profit Contexture will implement Verato’s healthcare master data management solution for patient matching.

People

Nicole Kerkenbush, RN, MN, MHA (Monument Health) joins CHIME as VP of education.

Carteret Health (NC) promotes VP of general services / CIO Kyle Marek, MS to president and CEO.

Announcements and Implementations

Conduent releases a provider data management solution to help insurers keep their physician directories current.

Synapse Medicine and CompuGroup Medical will partner to offer clinicians prescription support.

In Canada, Meditech will support electronic prescribing for Expanse EHR users by connecting to the PrescribeIT national prescribing service.

UK-based Acurable earns US FDA clearance for its self-applied wearable that diagnoses sleep apnea without a polysomnography study.

Government and Politics

Rep. Cathy McMorris Rodgers (R-WA) demands that the VA avoid reducing headcount or services at its Spokane and Walla Walla facilities to offset a $35 million shortfall caused by its Oracle Cerner implementation. She says the VA should redirect the money that it would have spent to implement the system in other facilities since those go-lives are on hold, and instead move those funds to those hospitals that are already live.

Husband and wife doctors who are charged with sharing the medical records of US military officials with Russia to support its invasion of Ukraine were recorded by FBI agents who were posing as Russian operatives. Johns Hopkins anesthesiologist Anna Gabrielian, MD is accused of sharing her laptop screen containing patient records with the undercover agent. Her spouse, Army Major Jamie Lee Henry, MD – who was one of the first active duty US military officers to come out as transgender in 2015 – reportedly described themselves as a “coward” over potential HIPAA violations, struggled with technology problems in trying to share their screen with the undercover agent, and ending up giving the agent a paper notebook of records. The doctors, who are charged with conspiracy and HIPAA violations, argue that they were entrapped.

The American Hospital Association asks HHS OCR to stop considering the IP addresses of hospital website visitors as protected health information under HIPAA. AHA says pending lawsuits over pixel tracking have pushed website technology providers such as Google to stop supporting hospital websites, making regulation unnecessary, but if HHS OCR disagrees, then IP addresses should only be considered PHI if they are used from within patient portals.

Privacy and Security

Medical practice services vendor Practicefirst will pay $550,000 to the state of New York for failing to protect patient records that were exposed in a 2020 cyberattack. The breach, which involved the records of 1.2 million people of which 428,000 were New Yorkers, happened after the company failed to apply firewall software updates.

Sponsor Updates

• IntegrityCheck, the house band of InterSystems, wins $100,000 for the ALS Foundation in a Boston battle of the bands for charity.
• Healthcare Growth Partners advised Intelligent Medical Objects in its acquisition of Melax Technologies.
• InterSystems launches HealthShare Health Connect Cloud in AWS Marketplace.
• Healthcare Triangle sponsors CalvertHealth’s annual golf tournament in Lothian, MD.
• Indiana Health Centers reduces onboarding errors by using the EClinicalWorks Business Optimizer.
• Tegria CMO Ray Gensinger, MD joins Symplr’s effort to “Advance Healthcare Operations.”
• Nordic releases a new episode of its In Network podcast, “Designing for Health: Dr. John Whalen.”
• Netsmart earns top user satisfaction rankings among home health technology vendors, according to a Black Book survey of 2,285 end-users.
• Dimensional Insight publishes a new case study featuring Children’s Hospital of the King’s Daughters.
• In Europe, elder care organization Korian Benelux selects AI-powered enterprise solutions from Juniper Networks, including wireless and wired access, to optimize network performance and reliability.
• Konza National Network congratulates over 200 Konza-powered members that have been awarded accreditation through the NCQA Data Aggregator Validation program.
• The Patient Journey Pioneers Podcast features Kyruus CEO Graham Gardner, “Find a Physician & Beyond: Guiding the Digital Patient Journey.”

Blog Posts

• What IT advancements are needed to improve value-based care (Optimum Healthcare IT)
• A Different Point of View: The Age of TEFCA and QHINs Mandate Point-of-Care Diagnostic Filtering and Interoperability (Medicomp Systems)
• 10 Best Interview Questions to Ask Candidates (Direct Recruiters)
• Why Healthcare Needs Organizational Change Management (Divurgent)
• The pros and cons of using ChatGPT in clinical radiology: An open discussion (Elsevier)
• An inch deep and a mile wide (Nordic)
• Does Your Data Analytics Solution Find Patients Missing from Cohorts? (First Databank)
• Single sign-on vs. multi-factor authentication: Do you know the difference? (Fortified Health Security)
• Managed Services: The Case for Externalizing Aspects of Health System IT Operations (HCTec)
• Expanding After-Hours Virtual Care Options for Children (Health Data Movers)
• Am I Information Blocking? (With Examples!) (HealthMark Group)
• Five Key Considerations for a Successful EHR Optimization (HealthTech Resources)
• Does Your Patient Education Experience Pass the Accessibility Test? (Healthwise)
• When to Consider an Oracle Cerner Optimization Assessment (Healthcare IT Leaders)
• From raw to refined: Striving for high quality data in healthcare (Intelligent Medical Objects)
• How AI-Driven User Experience Testing Enhances Digital Health Accessibility (Keysight)
• Patients Need More Than a Better Compass to Navigate Healthcare (Lumeon)
• How EHRs Enhance Care Planning for Nurses (Medhost)

Contacts

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

EPtalk by Dr. Jayne 5/25/23

A recent article in the American Academy of Family Physicians’ journal FPM summarized “Clinical Workflow Efficiencies to Alleviate Physician Burnout and Reduce Work After Clinic.” The first of their four suggestions was for EHR users to make use of macros and defaults in their systems so that they can easily insert content into their visit notes.

I continue to see physicians who won’t take advantage of basic system personalization. When I was in traditional primary care practice, my goal was to be able to do visits using as few clicks as possible and there’s no way I could have been as fast as I was without defaults for common physical exams and orders. It’s still difficult for me to understand the psychology where a user will waste time visit after visit, day after day, week after week, but won’t spend 90 seconds to create a default. The article even includes a link to a blog with a starter list of EHR macros for those who might have users who are reluctant to take steps to make their lives easier.

One of their other recommendations was to “consider cutting note bloat by writing in short phrases rather than full sentences and including only what is essential.” My first EHR made it easy to create notes in a format that was more akin to a bulleted list than beautiful, flowing prose. For many, reading a list like that is easier than reading a block of text, so I agree that it’s a valid strategy.

They also go on to mention that the EHR should be used as a database and not as a way to recreate the paper chart. Providers are encouraged to ask for help and to take advantage of organizational resources such as clinical informaticists, or even to get help from more efficient colleagues.

Even as a CMIO, I’m always willing to sit down with our clinicians to coach them through more efficient workflows. One of my early clinical informaticist roles involved implementing some challenging users. I miss the days when I could work with them and watch the proverbial light bulb go on when they had figured out how to breeze through their visits.

Many of the organizations I work with are big on telehealth, and I hope all organizations are making their plans to move to HIPAA-compliant telehealth technologies now that the public health emergency has ended. Organizations have had three years to move to compliant tools, but there are always going to be groups that wait until the bitter regulatory end before they do the right thing for patient privacy. The Office for Civil Rights is providing a 90-day grace period, but penalties for HIPAA violations will resume on August 10.

In the interim, organizations should look at their telehealth programs and technology, conduct a risk assessment, and confirm that they are using HIPAA-compliant tools. I suspect some purchases may be on the horizon and can imagine some vendors salivating at the organizations that left their transitions until the bitter end.

From Jimmy the Greek: “Re: marketing. Check out some of the language on this corporate website. ‘We create value by making sustainability an integral part of our vectors of superiority.’ There’s also ‘Improving lives for generations to come with irresistible superiority that is sustainable.’” Wow.” Any time I see the word “vectors,” my infectious disease brain immediately thinks of rats, flea bites, ticks, and other disease vectors. These linguistic gymnastics are found on the Procter & Gamble investor site, which is an otherwise interesting read if you’re so inclined. Given their product lines, I suggest that P&G might be better served by a tagline such as, “Assimilation through personal care, one buzzword at a time.”

Speaking of buzzwords, I’m currently disliking this one the most: omnichannel. The way I keep seeing it used, it falls squarely into the “I do not think it means what you think it means” category more often than not. I’ve also recently run into a resurgence of “circle back,” which I think should be eradicated from the business lexicon, along with “synergy,” “new normal,” and “out of the box.”

I had a visit at my primary care physician’s office this week. I scheduled it online and had my choice of a next-day visit that didn’t work for my schedule or one the following week, which I booked. Online check-in was a breeze, and the patient questionnaire related to my issue was easy to navigate.

The only blemish in the workflow was when the medical assistant had to free text every field when documenting my vaccine administration. At a minimum, I would have hoped the EHR would have had a vaccine inventory management system that would have presented things like the lot numbers and expiration dates as dropdowns or pick lists to help reduce errors and manage inventory. Even the site had to be free texted despite the fact that there are generally only six places on the human body where intramuscular injections are administered. She also had some kind of paper sheet that she was performing dual entry on, so I’m not sure what was going on with that and was afraid to ask.

When I arrived home, I was pleased to see that my patient-visible note contained an accurate History of Present Illness and that the exam matched what was actually performed, which is a big contrast to a visit I had with a specialist in the group last year. However, as I was reading my note, I realized that they never asked to collect my co-pay. Since they’re owned by my former employer, I know that collecting the co-pay at the time of service is a requirement. It’s also an industry best practice that everyone should know about. It helps avoid statement costs as well as the risk of never receiving the co-pay.

This means that I’ll get an annoying statement in the mail (I haven’t been able to turn off paper statements despite trying) and then have to go online and make a payment. Usually, I don’t receive an electronic statement notification until after the paper one has arrived, which seems to be a less than optimal way to configure your revenue cycle.

What makes you cringe when you visit a healthcare facility and see that best practices aren’t being used? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 5/25/23

Florence Acquires Zipnosis to Solve Clinical Capacity Constraints and Create Omnichannel Transformation Across Telehealth and Hybrid Care

Patient enablement and workflow automation startup Florence acquires white-label virtual care company Zipnosis from Bright Health.

McMorris Rodgers Demands VA Secretary Commit to Preventing Cuts at Spokane, Walla Walla Medical Centers

Cathy McMorris Rodgers (R-WA) calls for VA Secretary Denis McDonough to commit to preventing staff cuts at Mann-Grandstaff and Jonathan M. Wainwright VA Medical Centers in light of budget shortfalls and impending staffing cuts caused by the roll out of Oracle Cerner.

Attorney General James Recoups $550,000 from Erie County Medical Management Company for Failing to Protect Patients’ Data

Practicefirst Medical Management Solutions will pay $550,000 in penalties for failing to update its firewall software – a vulnerability that enabled hackers to steal the data of 1.2 million patients.

Healthcare AI News 5/24/23

News

Microsoft will integrate ChatGPT into Windows 11, where it will run in its own Copilot window as a personal assistant to perform Windows commands and summarize documents that are dragged into it. The user rollout will start in June.

Tell, whose app allows users to seek advice from medical experts, integrates ChatGPT to translate medical jargon into accessible language.

OpenAI says that AI systems will exceed expert level in most domains within 10 years and recommends steps to mitigate its risks:

• Coordinate development efforts across countries and hold companies to a high standard of responsibility.
• Create an organization similar to the International Atomic Energy Agency provide oversight and inspection AI efforts that exceed a specific level of capability or resource requirements.
• Develop technical capabilities to make superintelligence safe.

OpenAI launches a ChatGPT app for the IPhone.

In Pakistan, the government of Punjab launches a two-hospital pilot of using AI to assist in diagnosis.

Google launches the Google for Startups Growth Academy: AI for Health program for companies based in Europe, Middle East, and Africa. Startups from seed to Series A will be offered a three-month virtual program of tailored workshops, collaboration, and mentorship.

Business

Alicja AI offers a $500 per month enterprise clinical documentation tool that integrates with EHRs. 

Research

ChatGPT has passed several medical exams, but researchers find that it falls just short of passing the American College of Gastroenterology Self-Assessment Tests.

A University of Arizona Health Sciences-led study finds that participants are almost evenly split in preferring a human doctor versus AI for diagnosis and treatment. The authors recommend further research about how AI can be incorporated into the work of physicians and the decision-making process of patients. 

Other

Business Insider profiles ED physician and two-company VP of innovation Joshua Tamayo-Sarver, MD, PhD, who says that it “probably should be embarrassing” that has sometime uses ChatGPT to explain medical issues in patient-friendly terms. He concludes that ChatGPT is “the most brilliant, talented, often drunk intern you could imagine” that is great at explaining concepts but not good at diagnosis or other tasks that require clinical reasoning.

Kaiser Permanente ED doctor and technologist Graham Walker, MD pens an excellent piece on how he views AI as a physician:

• AI can pass a medical school exam, which involves basic multiple choice questions, but that capability is not very related to interacting with patients to determine their multiple issues and their viewpoints about options.
• Doctors know how to successfully address a patient problem up to 95% of the time due to their specialization, residency training, and repeated exposure to the same common issues, and therefore would see no value in asking a “medical bot” for recommendations.
• Where AI could help is to differentiate among possible problems that exhibit similar symptoms.
• AI might offer a convincingly objective second opinion to a patient who is told, for example, that they don’t need antibiotics for a viral infection.
• He says he would “virtually hug and kiss a digital agent” that could generate discharge instructions, describe the logic behind the chosen medical plan, and answer questions are likely to have.
• AI could help identify and correct confirmation bias, where the doctor needs fresh perspective to see that evidence might not support the suspected diagnosis.
• AI could help steer an ED patient to local sources of help that might be better than the ED.
• AI could help doctors and patients understand why lab tests may not be indicated and how to react to positive or negative results.

Contacts

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