Virtual neurology clinic Neura Health will use $8 million in seed funding round to expand into enterprise markets.
Easy Healthcare, developer of the Premom ovulation-tracking app, will pay a $100,000 fine for violating the FTC’s Health Breach Notification Rule.
Andreessen Horowitz’s A16Z invests $50 million in seeding funding for Hippocratic AI, which offers a safety-focused large language model for healthcare.
Bringing the Call Center Into the 21st Century
By Ben Moore
Ben Moore is chief product officer of PerfectServe of Knoxville, TN.
Like some of you, I was compelled to dip my toe in the healthcare waters because of a personal experience. It was over a decade ago, but I still remember it like it was yesterday.
My wife was pregnant with our daughter, who came weeks before her due date. Both my wife and daughter faced serious complications, and my stress level was exacerbated significantly by care delays that seemed almost entirely caused by inefficient communication. Simple questions and follow-ups that should have taken minutes ended up taking hours. These delays put both my wife and daughter’s health and safety at risk.
For example, to reach the specialist, a nurse would have to call the hospital operator, who then had to manually track down and page the correct specialist on call, which would often start a process of telephone tag among nurses, operators, and physicians. The physicians were, and in some cases still are, carrying one-way pager devices, which would cause lots of disjointed one-way communications.
At that time, we had purchased the first-generation 3G-connected iPad for my wife while she was in the hospital. She was able to instantly text friends and family from her hospital bed and engage in social media. I was perplexed. Why weren’t the care teams in the hospital equipped with similar state-of-the-art communication tools? My wife was able to engage in real-time and media-rich communication, but hospital staff were limited to 140-character alphanumeric pager messages, telephone callbacks, and voicemails. The contrast was stark, and to be frank, seemed a bit ridiculous.
I can tell you that archaic technology and processes like the ones I described above are still prevalent across healthcare today. As just one example, even though over 70% of communications into and out of a hospital run through the call center, these antiquated tools are still, in many cases, a major part of directing that very important traffic. That’s alarming.
By upgrading technology that has its roots in the 1990s, the call center can become a true hub for patient engagement and clinical collaboration. Here are four steps you can take to bring the call center into the 21st century.
Clinical call centers — like hospital switchboards, patient transfer centers, and answering services — can have a tremendous impact on everything from care coordination to patient experience to health outcomes. After decades of neglect, it’s time to give them the modern infrastructure they deserve to unleash their true potential.
OpenAI rolls out 70 third-party plug-ins for ChatGPT that allow Plus users to access Internet content, retrieve information from specific sites such as Expedia, analyze online PDF documents, and create integrations with Zapier. The Link Reader plug-in, which I tested above, allows ChatGPT to analyze live web pages.
The World Health Organization expresses enthusiasm for using AI in healthcare, but recommends cautious adoption to avoid errors and patient harm due to AI training bias, incorrect or incomplete responses that appear authoritative, and its possible use to generate convincing health disinformation.
Google enhances its Bard generative AI tool with a new version of its PaLM 2 large language model, adds connectivity to a user’s Google apps and services, and provides support for plug-ins.
Google also introduces Duet AI for Google Workspace, which adds AI creation to Gmail and Docs similar to Microsoft’s Copilot for Office 365.
Google’s Med-PaLM 2 is being tested to analyze diagnostic images and answer questions about its summary.
Andreessen Horowitz’s A16Z invests $50 million in seeding funding for Hippocratic AI, which offers a safety-focused large language model for healthcare. The company says that its model outperforms GPT-4 and uses clinician-validated model training that avoids bias and sources that aren’t evidence based.
BeeKeeperAI announces GA of EscrowAI, which allows HIPAA-compliant research on full PHI without exposing patient data or the algorithm’s intellectual property. The company says it acts as a “middleman and matchmaker between data stewards and algorithm developers” to reduce the effort and cost of data projects by 50%. The company was created at UCSF’s Center for Digital Health Innovation by that organization’s founder, UCSF Health Chief Digital Transformation Officer Michael Blum, MD, who serves as BeeKeeperAI’s CEO.
BayCare Health System and HealthPrecision will co-develop AI tools for nursing decision support and clinical documentation, where the system will translate nurse dictation into EHR documentation and suggest additional steps. The co-founders are Eyal Ephrat, MD and Sonia Ben-Yehuda, who together created MedCPU and PeriGen.
Kaiser Permanente will award grants of up to $750,000 to three to five US health systems to study the use of AI and ML to improve diagnoses and outcomes.
FDA Commissioner Rob Califf, MD says that large language models appear to be ushering in a fourth industrial revolution that includes healthcare, but they need to be regulated now to avoid society being “swept up quickly by something that we hardly understand,” also adding that methods need to be developed to measure and adjust the operating characteristics of algorithms based on real-life experience.
Physician and author Elisabeth Rosenthal, MD, MA says in an opinion piece that startups are offering apps and devices that address mental health therapy as an alternative to short-supply professionals, but most of them aren’t supported by outcomes research, haven’t been reviewed by FDA, and contain small print that reminds users that they are not intended to provide actual clinical services. Experts say the apps use a workbook-like approach for specific problems, which doesn’t address complexity or offer the empathy between patient and doctor that many therapy types require.
The UK government issues guidance about when sellers of software as a medical device must report adverse incidents to the Medicines & Healthcare Regulatory Agency.
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VA Signs New, Tougher Contract with Company Handling Faulty Electronic Health Records Rollout
The VA signs a one-year contract, renegotiable and renewable for up to five years, with Oracle Cerner to extend its work on the department’s EHR Modernization program
A Black Book survey of health system IT leaders finds that Care.ai is the top emerging ambient intelligence solution.
Laguna Health gets $15M to be a Waze for care transitions
Care management technology startup Laguna Health raises $15 million in a Series A funding round led by SemperVirens and HC9 Ventures.
Connected health company Validic acquires Cox Communications subsidiary Trapollo, which offers technology and services that help healthcare organizations care for patients at home.
The companies had previously partnered to support a West Coast IDN’s personalized care program.
Cox will become an investor in Validic as part of the acquisition.
From Vera Dime-a-Dozen: “Re: MDRX, formerly Allscripts and now Veradigm. Were supposed to restate their 10K on May 8, but it has been postponed to mid-June as the internal audit continues to identify issues.” The company says in a recent SEC filing that it hopes to file the 10-K by June 14, but can’t guarantee it. The company announced on March 22 that the year-end audit and 10-K filing would be extended because of “internal control deficiencies related to revenue recognition.” Veradigm expects the audit to have a revenue impact of $40 million that will require restating its 2021 financials.
Gmail suddenly started sending legitimate incoming emails to spam a few weeks ago, I noticed yesterday, including entries from the Rumor Report and Contact forms. I added some inbox rules that should fix that, but let me know if you didn’t receive a reply that you expected.
Attention HIStalk sponsors that are participating in the MUSE Inspire conference June 7-10 in Aurora, CO — send me your details and I’ll include them in my online list of sponsor activities there. I see some sponsor names sprinkled among those companies that have booths in the sold-out exhibit hall of the conference’s 40th anniversary.
None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present or promote your own.
Healthcare pricing transparency startup Cascade Health raises $1.7 million in venture funding. It has developed healthcare pricing APIs and an AI-powered chatbot that answers patient questions about procedure pricing and insurance coverage. Co-founders Ana-Maria Constantin and Pulak Goyal hail from Microsoft.
Divurgent CEO Ed Marx announces on LinkedIn that he has left the company after one year and will work as an independent consultant. The company made no announcement, but its leadership page shows that founder Colin Konschak, RPh, MBA, who stepped down from the CEO job in May 2022 but remained board chair, is again serving in both roles.
Dale Sanders, chief strategy officer of Intelligent Medical Objects, resigns to take a one-year professional break.
CereCore promotes Peyman Zand, MBA to chief strategy officer.
HCTec hires Bill Lewkowski (Lewkowski Associates) as VP of strategic client services.
Rhapsody names Jeff Chiumiento (Rocket Software) as CFO.
Jason Prestinario, MS (Komodo Health) joins Particle Health as CEO.
Jane Casey, RN, MS (Humber River Hospital) joins Tampa General Hospital as VP of CareComm Operations, its clinical command center.
Zyter|TruCare names Kevin Riley, MBA (Salesforce) as president and CEO.
John George (Validic) joins Gozio Health as chief sales officer.
CHIME opens registration for its Fall Forum November 9-12 in Phoenix, AZ for its provider members.
The West Hawaiʻi Region of Hawaiʻi Health Systems will go live on Epic June 1 through a Community Connect partnership with The Queen’s Health System.
Hendrick Health (TX) launches a wayfinding app developed by Gozio Health.
A Connected Health Initiative survey finds that 89 million Americans use a wearable device, with fitness tracking being the most common use followed by sleep and weight monitoring. Nearly all of the users are sharing data with their healthcare provider or are willing to, while 40% of those with a chronic condition say that the device has simplified their health management. More than half of HSA/FSA participants who don’t have a wearable say they would be more likely to buy one if they could fund the purchase from those accounts.
Minnesota lawmakers are planning make a single exception to the state’s proposed patient-to-nurse hospital staffing ratio regulation for Mayo Clinic, which threatened to pull billions of dollars worth of investments out of the state in protest over the bill and another involving price transparency. House Speaker Melissa Hortmann says the exception is justified because “Mayo is different” and “an asset that is known all over the world.” Draft legislation would exempt hospitals that aren’t in the Twin Cities, that use an electronic nurse acuity system, and that have 40% of patients coming from out of state, requirements that only Mayo in Rochester meets.
Netsmart earns top user satisfaction rankings among behavioral health technology vendors, according to a Black Book survey of 2,847 end-users.
UF Health launches tele-pharmacy kiosks from MedAvail Technologies at three of its ERs. Newly discharged patients can virtually consult with a pharmacist and pick up medications within about five minutes.
A Black Book survey of health system IT leaders finds that Care.ai is the top emerging ambient intelligence solution. The company has deployed AI solutions for infection prevention and control, patient and protocol monitoring, workforce optimization, and virtual care in 1,500 organizations.
A researcher warns that companies are rolling out AI-powered search tools for academic databases and research journals without understanding the opportunities and limitations of those tools. The author calls for evidence-based groups to audit individual search tools and publish their suitable uses so that research projects aren’t skewed.
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Personalized Care Company Validic Acquires Trapollo
Digital health company Validic acquires Cox Communications subsidiary Trapollo, which offers technology and services that help healthcare organizations care for patients at home.
Practice Perfect acquires Clinical Billing Solutions, and will integrate the RCM vendor’s software and services with its EHR and practice management system for outpatient rehabilitation clinics.
Healthcare pricing transparency startup Cascade Health raises $1.7 million to further scale its AI-powered chatbot designed to answer patient questions about procedure pricing and insurance coverage.
May can be a busy time for families who have graduates. When I was in Madison last week, I saw plenty of people who were taking pictures at the state capitol wearing caps and gowns. It was fun to see their excited smiles and to wonder where they are heading next on life’s adventures.
This weekend, I attended a graduation at my state’s flagship engineering and technology school, and it didn’t disappoint. It was inspiring to see so many people going into careers in science, technology, engineering, and math fields. It was particularly gratifying to see the number of women graduating in fields that have been historically male dominated, including geophysics, mining, metallurgy, and explosives engineering.
Due to the size of the ceremony, graduates of various departments were recognized in groups by their majors before coming to the stage individually to receive their diplomas. Although mechanical engineering was dominant at the ceremony I attended, there were quite a few aerospace engineers and a surprising number of metallurgical engineers who had the most stylish hair, shoes, and eyeglasses in the crowd. In addition to computer science and computer engineering, degrees from a new program in information systems and technology were also conferred.
The “best decorated graduation cap” honors goes to the biology major who had three Petri dishes affixed to her cap, along with the metallurgical engineer who had gilded designs on the top of hers. Several of the biology majors had plush bacteria toys dangling with their tassels after being gifted them from their department chair. During the departmental recognitions, the audience figured out that there was a lone economics major among the hundreds of graduates, and he received some extra applause and cheering.
I sat next to the mother of one of the information systems graduates and was learning a bit about the new program and how it was founded as part of a major donation to the university. That funding led to the addition of a college that covers entrepreneurship, information systems, technology management, and more. Although some of those disciplines existed previously as part of the college of engineering, it’s interesting to see them grouped together under a new umbrella.
My assumption is that the new organizational structure also helps ensure that they’re funded in the way that the donor intended, rather than the money being washed through a larger department and potentially sidetracked. Since the new college carries the donor’s name, it also needed to contain actual departments, so I’m sure that was a factor as well. According to his mother, that new graduate interviewed at a healthcare software company, but she wasn’t sure which one it was.
Being well into my career, it’s sometimes easy to forget what those milestones that our younger selves experienced meant to us at the time. I don’t have deep memories of my college graduation other than lining up in the bowels of the basketball arena with other graduates in my department and singing our school song for what would be my last time. (I admit, I haven’t visited since graduation, but I’ll be doing that later this month as part of a milestone road trip with my former college roommate.) I remember my medical school graduation in great detail, especially the processional that involved bagpipers and a parade down a couple of escalators. With the bagpipes and the gowns and hoods and having been through the wringer during the four years prior, it seemed quite surreal at the time.
I also remember the fact that the main speaker failed to follow the program, which led to us not being administered the appropriate oath (in our case, the Oath of Geneva rather than the Hippocratic Oath) during the ceremony. They tried to rectify that after the ceremony concluded, but many of us had already scattered to meet with families and loved ones.
I’ve made use of that fact at least once in my career, when a patient was upset that I wouldn’t give her what she wanted and told me that I had to do it because “you took an oath.” I said very calmly that actually I didn’t take that particular oath, but that wasn’t going to keep me from giving her high-quality, evidence-based care regardless of the fact that it wasn’t what she wanted on that particular day. I think most of us in medicine would agree that the core values we follow are ingrained in us long before any oaths become topics of discussion, and that we don’t need to say prescribed words to do the right thing. Quite a few medical schools allow their incoming classes to write their own oaths during the first year, enabling them to memorialize values and intentions that are important to them.
There are situations where oaths are important, and I was able to experience one of those as well while attending my first ROTC officer commissioning ceremony as part of the graduation festivities. During that ceremony, a military officer administers the Oath of Office to each newly appointed Second Lieutenant, and then family members or loved ones help pin on their ranks. They also receive their first salute from an enlisted service member who has been important to them. It was interesting to see who the cadets chose to perform the different parts of the ceremony. Some of them had relatives who were officers administer the oath, one had a former scout leader who was a naval officer do his, and one woman received the oath from her husband who graduated and was commissioned last year. The most touching was the cadet who had his grandfather, a Korean War veteran, give his grandson the first salute. There were few dry eyes in the house after that one.
It was inspiring to see these young people, most of whom could have headed off to solid careers in engineering or technical fields, commit to serving their country. Instead of following the money, they’ll be supporting our military as cybersecurity resources, civil engineers, logistics coordinators, pilots, and missile operations officers.
The latter job role is one that most people don’t think about. It feels strange to understand that in a world where so many people are focused on what they see on TikTok or Instagram, we have officers underground 24×7 ready to launch what might be world-ending missiles should the order arrive. Knowing that gives me a new perspective on my daily work struggles or the things that some of us think are emergencies on any given day. There’s a lot of uncertainty in the world that these newly minted officers are headed into, but I have high hopes that this generation has leaders among it that can do a better job than what we might be seeing today.
Are you headed to any graduations this spring, and what are your hopes for the futures of these recently degreed individuals? Are graduates gravitating to technical fields or finding their futures in the arts or humanities? Leave a comment or email me.
Email Dr. Jayne.
Should Health Systems Become Banks?
By David Stievater
David Stievater, MBA is a partner with CWH Advisors of Boston, MA.
Are healthcare organizations expected to now run banks in addition to delivering patient care services? To help patients pay for their care, providers have become lenders, offering patients the equivalent of unsecured, zero-interest loans backed by hospital balance sheets. It should come as no surprise that with additional financial stress lingering from the COVID pandemic, providers are looking for additional funding sources and financing alternatives for their patients.
Overall US healthcare spending hit 18% of GDP in 2021, up from 5% in 1960. Total patient out-of-pocket spending, not including insurance premiums, totaled $433 billion, according to the latest numbers from CMS. The out-of-pocket dollars owed by patients has risen at twice the rate of US GDP growth since 1960. More and more, patients find they do not have the cash on hand to cover medical expenses.
The financial challenges facing patients are well documented. In 2021, the Federal Reserve Board reported that 17% of adults had major, unexpected medical expenses in the prior 12 months, with the median amount between $1,000 and $1,999. The same research also said that 23% of adults went without medical care due to an inability to pay. These types of findings are corroborated by other reports, including Synchrony Financial’s Lifetime of Healthcare Costs study in 2022 in which one in four individuals said they delayed a recommended procedure due to cost. The Synchrony study also indicated that when care was delayed due to cost, respondents ended up with additional medical issues 50% of the time.
Patients will benefit from more funding sources and options to reduce and eventually pay off balances owed to healthcare organizations.
Unlike other industries, providers generally bill patients after care is delivered. They carry the patient balance owed to them as a receivable, to be collected once insurance has calculated its portion. By billing after the fact, providers essentially make unsecured loans to patients.
Many decades ago, when the patient portion of provider revenues was relatively small, it was common for unpaid patient balances to simply be written off. It wasn’t worth the effort to pursue them. Providers did not tend to accumulate large unpaid patient balances on their books for long.
Over time, as the size and frequency of uncollected patient fees grew, provider organizations looked to new propensity-to-pay algorithms, early pay discounts, early out vendors, recourse financing, pre-service collection of co-pays, in-house payment plans, and other tactics to increase the yield on the amount owed by patients. Debt collectors were asked to pursue patients deemed able to pay. In some unfortunate cases, the most aggressive health systems have sued patients (including their own employees) to recover unpaid balances.
Provider executives say they work hard to balance compassion for patient circumstances with a desire to collect from patients who they believe can afford to pay at least some of what they owe. Additionally, they would prefer not to be in the lending game and tie up so much of their balance sheet with unpaid patient balances.
We estimate that 45-55% of a typical health system’s patient balance, after insurance (including full self-pay), is never collected and is converted to charity care, some other form of financial assistance, or written off as bad debt. Providers too will benefit from offering patients more options to fund their care and reduce and eventually pay off balances.
Our 2022 PatientPay study — which included 38 in-depth interviews with executives at health systems, hospitals, and large single/multi-specialty medical groups — indicated that providers will increasingly look outside their organization for solutions. One hospital CFO said that “a lot more people are going to finance their portion of what they owe,” Another revenue cycle executive said, “We are definitely going to provide more third-party financing options and less in-house over the next two years.” Overall, 61% of the executives said they expect to make greater use of third-party patient financing over the next 24 months.
Part of the impetus to look externally for payments solutions is that the COVID pandemic has made it harder for healthcare organizations to staff their revenue cycle operations. Still, much of the motivation to seek third-party assistance is simply the need to find more flexible payment and financing options for patients that free up the health system’s balance sheet.
The study noted that the biggest investments by large provider organizations are centered on creating a more retail-like payment experience for patients. COVID pushed more dollars here immediately in the form of contactless terminals and accelerated efforts around card-on-file and other portal-based technologies. Patients can expect improved communication via portal-driven emails, text to pay, and mobile applications.
Entrepreneurs are also putting their creative minds to work and generating new solutions to help providers match their patients with available financial assistance and philanthropic programs. Companies such as TailorMed/Vivor, Annexus Health (AssitPoint), RIP Medical Debt, and Atlas Health claim their approaches are generating meaningful ROI for providers.
Longer term, providers must focus on providing patients with an accurate estimate of their costs. This will enable them to collect the patient responsibility before care is delivered, without waiting for insurance adjudication and without turning their healthcare organization into a lender.
Prognos Health Raises $23 Million
Real-world healthcare data marketplace operator Prognos Health raises $23 million in growth equity.
HC3: Sector Alert – Veeam Backup & Replication Latest Threat Actor Target
The Health Sector Cybersecurity Coordination Center warns organizations that hackers are exploiting vulnerabilities within Veeam Backup & Replication software.
Digital Health KC launches to encourage health technology professionals, especially those who worked for Cerner or other Kansas City-based companies, to return to the area.
Real-world healthcare data marketplace operator Prognos Health raises $23 million in growth equity.
The company offers life sciences customers access to the integrated lab and health record data of 325 million de-identified patients.
The co-founders are Sundeep Bhan and Jason Bhan, MD.
Most poll respondents say their employers haven’t dialed back remote work options.
New poll to your right or here, inspired by Dr. Jayne’s XGM recap: What behavior of fellow conference education session attendees do you find most annoying? I am most bugged by those who charge the microphone during Q&A to deliver pontification that is poorly disguised as a question, which clears the room like someone yelling “fire” in a theater. If your insecurity doesn’t allow you to sit quietly while someone else holds the audience’s attention, then sign up as a presenter next time.
My best HIMSS23 takeaway was an first-timer’s appreciation for Chicago’s chicken Vesuvio, which I made at home this weekend with great success. It sounds unexciting on paper, but is brilliant.
Welcome to new HIStalk Platinum Sponsor Lucem Health. The Raleigh, NC-based company transforms the science of clinical AI into trusted point-of-care solutions that scale. With its comprehensive, AI-agnostic platform for building, operationalizing, and improving clinical AI solutions, Lucem Health brings the full power and potential of clinical AI from the lab to the front lines of healthcare, where it can help clinicians deliver better care, improve patient outcomes, and lower costs. The company envisions a world in which clinicians detect problems before they become life-threatening and patients get world class care, everywhere. Thanks to Lucem Health for supporting HIStalk.
I found this overview of Lucem Health on YouTube.
None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present or promote your own.
Digital Health KC launches to encourage health technology people, especially those who worked for Cerner or other KC-based companies, to return to the area. The CEO is former Cerner executive Dick Flanigan.
Victoria, BC-based Island Health celebrates Canada’s National Nurse Week by honoring the nurses who are working to implement its Oracle Cerner EHR.
The senior director of the Collaboration to Harmonize Antimicrobial Registry Measures (CHARM), which analyzes the EHRs of participating organizations for current prescribing practices, says that up to 80% of outpatient antibiotic use is inappropriate, either because the drug isn’t needed or is ordered incorrectly.
Epic updates its Epic Research Data Tracker to publish every-other-week metric updates on respiratory illnesses and other topics using data from Cosmos, allowing continuous monitoring that is often beyond the capability of public health organizations.
John Snow Labs posts demos of AI-powered models that can summarize clinical text, medical journal articles, consumer medical questions, and radiology reports.
HHS’s cybersecurity center warns that Veeam Backup and Replication software contains a vulnerability that hackers are exploiting.
In England, the mother of a 19-year-old patient whose hand was bruised significantly during a blood draw shows the hospital a photo of the nurse watching soccer on his phone as he stuck her. The trust says the nurse was on break and decided to treat the patient anyway, which the mother says isn’t true. However, the trust adds that it will be more diligent about staff members using phones at work.
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Amino Health Secures $80 Million in Financing to Accelerate Growth and Product Innovation
Amino Health, whose platform guides members to cost-effective providers, raises $80 million in financing.
Lavita, whose health data marketplace platform allows people to control and monetize their digital health information for purposes such as clinical trials recruitment, raises $5 million in seed funding.
Richmond University Medical Center suffers ransomware attack; unclear if patient info compromised
Richmond University Medical Center (NY) works to recover from a ransomware attack that has caused network outages for the last week.
Meta punts pixel tool responsibility, says privacy fault is on providers
Meta files a motion to dismiss a class action lawsuit that accuses the company of privacy violations for sharing the medical data of users with advertisers via its Facebook Pixel website tracking tool.
London-based, digital-first primary care operator Babylon Health will take itself private, 18 months after it went public in a SPAC merger that the CEO says was a “big mistake.”
The company just reported Q1 results: revenue up 17%, EPS –$2.53 versus –$1.71, with shares falling 84% in the past two days on the news.
BBLN shares have lost more than 99% of their value since trading began on October 22, 2001, with the market capitalization of the one-time high flyer sliding from $4 billion to $30 million.
Welcome to new HIStalk Platinum Sponsor Amenities. The Dallas-based company helps health systems grow top-line revenues and earn scalable ROI. Its Digital Membership Platform is a suite of e-commerce tools designed explicitly to: (1) Acquire new patients: Verify identity and register new patients with full EMR and patient portal accounts in under 30 seconds, with just one question. That means zero data entry, photo uploads, or duplicate accounts. (2) Upgrade tools (i.e., MyChart). Improve the design, usability, and conversion rate of critical revenue drivers like provider search, provider profiles, appointment scheduling, and proxy management. Additionally, aggregate and promote same-day care options in one simple place and maximize the visibility and usage of all access options.(3) Win patient loyalty. Create memberships designed explicitly to help keep patients in network. Build personalized experiences for members (i.e., health plan, ACO, D2E, MA, or other VBC groups) with custom networks, care options, vendor services, pricing, and more. Or, better yet, offer highly unique and market-tested features like a financial package that includes “no surprise billing” guarantee, transparent pricing, affordability scores on providers, and more. You may well know CEO Aasim Saeed, MD, MPA, who launched the company in 2021 after serving as VP of digital health for Baylor Scott & White Health. Thanks to Amenities for supporting HIStalk.
A wise company has taken advantage of my “Small Booth Special” first-year sponsorship discount for non-sponsors that occupied a 10×20 or smaller HIMSS23 booth. Get with Lorre by June 1 to shed the small-booth stigma and enjoy the same ad size as everyone else, a prime location that isn’t just a waypoint on the way to the bathrooms, and a 365-day audience of heavy hitters instead of those looking for a quiet part of the exhibit hall to make phone calls.
None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present or promote your own.
National medical group Envision Healthcare is planning to file Chapter 11 bankruptcy as it struggles with $7 billion in debt, high labor costs, and federal legislation that has limited the company’s key business model element of surprise medical billing. KKR, which took the company private in 2018 in a $10 billion deal, will likely lose its entire investment.
Amino Health, whose platform guides members to cost-effective providers, raises $80 million in financing. The company previously pivoted from direct-to-consumer sales to focus on self-insured employers, health plans, and third-party administrators.
Lavita, whose health data marketplace platform allows people to control and monetize their digital health information for purposes such as clinical trials recruitment, raises $5 million in seed funding.
Business Insider lists the digital health market predictions of several healthcare bankers, which include:
Henry Archibong, MS (Inovalon) joins HealthMark Group as head of interoperability and innovation.
Scott Jones, MBA (ConnectiveRx) joins Equiva Health as COO.
Athenahealth hires George Hamilton, MBA (UnitedHealth Group) as chief corporate strategy and development officer.
Medhost launches an interoperability solution that meets ONC’s expanded requirements with an AWS data store, FHIR APIs, and common interfaces.
A small study finds that radiologists of all experience levels who use AI-supported mammography systems are prone to “automation bias,” in which they accept the technology’s assessment even when it is wrong.
A group of 21 Ontario hospitals launches the Ontario EHub HIE with technology and services from Oracle Health.
The COVID-19 Public Health Emergency officially ended at end of day Thursday. US COVID-19 deaths are at 1.1 million and continue increasing at more than 1,000 per week.
CHIME asks people to email and tweet members of Congress asking them to repeal the Section 510 funding ban on creating a unique patient identifier.
Meta files a motion to dismiss a class action lawsuit that accuses the company of privacy violations for sharing the medical data of users with advertisers via its Facebook Pixel website tracking tool. Meta says it’s the website developer’s job to understand how the technology works and to decide which information to send to advertisers.
ProPublica notes that federal law requires insurers to share claims-related documents with the insured person and offers a form for requesting the information. The file can include notes, phone call audio, and internal correspondence that was involved with deciding whether to pay a claim.
In Canada’s Prince Edward Island, a family physician is closing his practice because of burnout that he says was caused by the province’s dysfunctional EHR. Thor Christensen, MD touts the value of electronic records, but says the Telus system is inefficient, is unconnected to the systems other providers, and has forced him to take on technology and billing tasks that eat up his evening hours. The 39-year-old doctor says that issuing a prescription takes up to five minutes versus 15 seconds on paper. PEI chose the Telus Health system in February 2021 as the island’s single EHR.
Bizarre: a 23-year-old Snapchat influencer expects to make $5 million per month from her $1-per-minute “digital girlfriend” voice chatbot, which was created from her YouTube videos and ChatGPT.
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I’ve been in Wisconsin this week attending the first week of Epic’s annual XGM, or Xpert Group Meeting. Although there’s always a lot of chatter about the fabled User Group Meeting in late summer, I hadn’t heard of XGM until a couple of years ago. I’ve spent the majority of my clinical informatics career working with other EHR platforms (McKesson Horizon, anyone?) and had only interacted with Epic in an end-user capacity previously, but this has been my favorite of the Epic conferences so far. XGM is split across two weeks.
This week seemed more clinical in nature, with the more technical sessions following next week. Although I’m confident that I could learn plenty at either, this is the one that worked best with my schedule, and it’s been jam-packed. Unlike some of my experiences at HIMSS, I’ve been surrounded by thought-provoking presentations that have a lot of applicability to my ongoing work, and I’ve met lots of people who are beyond energized about working in the industry.
Some random thoughts. Epic requires you to attest to being fully vaccinated as a condition of registering for the conference. For those of us who came home from HIMSS with the plague, I appreciate it. I’ve seen a number of people who are wearing masks, including plenty of staffers. It seems prudent when you are interacting with large numbers of people, because there are plenty of circulating viruses other than COVID that I wouldn’t want to bring home to my family, and interacting with a couple of thousand people from across the country and around the world is a risk factor. I saw a couple of N-95 masks on people’s elbows or clipped to their backpacks, which isn’t doing anyone much good, but there were quite a few being worn properly as well. Distancing was possible in most of the sessions, and although mealtimes were busy, there was the option to take a carry-out box outside except for the day when it was raining.
The sessions that have been the most packed include those on clinical decision support and Epic’s Cosmos database, which includes de-identified data from millions of patients. Telehealth sessions were also popular, as were those on optimizing clinical alerts. It feels like a lot of attendees are serious about making sure that their technology investments are generating value for clinicians and making sure that patients are being included as beneficiaries of those efforts as well as clinicians and other end users.
As far as the sessions themselves, the Epic moderators run a pretty tight ship, keeping sessions on time. They’re also good at making sure that audience members who are asking questions remember to use a microphone so that the session recordings include all the questions. Of course, there are still some people who don’t want to wait for a microphone and jump right in, but the presenters were good at addressing those, too. As with any conference, there are always audience members who confuse the Q&A portion with their own personal story time, but it seemed less than what I have encountered recently at other conferences I’ve attended.
Even the “attendees behaving badly” weren’t that bad, although I was ready to throttle the person I’ll call “crinkly bag guy” who seemed to have everything in his messenger bag double-shrouded in cellophane, resulting in a tremendous amount of noise every time he looked for something, which was often during the 40 minutes we were together. His nearest neighbor even shushed him librarian-style. There was also the guy who spilled coffee on the bus (and also on himself) because he put his partially full coffee cup in the side pocket of his backpack.
Generally, though, everyone was pleasant and patient with any lines or crowded situations, which made the entire meeting feel smooth. The weather was fantastic Tuesday and Wednesday and I was able to get out and stroll the campus and have some random interactions with other attendees who were doing the same thing. The continued campus construction was a common topic, as was the legendary Epic culinary department. Highlights of the menu included the spinach-asiago breakfast tart as well as a chocolate cake that was enrobed in a delightfully crispy coating.
A couple of presenters got into the ChatGPT spirit, with one using the tool to write the introduction to his presentation and another asking it to detail some thoughts about the future of patient experience. I took what felt like a million pages of notes, trying to capture every useful thing I heard. Many of the client presentations dealt with issues that are common no matter what EHR platform you use, and I’m surprised that they’re still being discussed. This includes such advice as “put the things you want used most often at the top of a menu and the things you want used least at the bottom of the menu” which can make a huge difference for providers being able to order common tests as efficiently as possible. It can also make a difference when you’re trying to steer patient behavior, such as encouraging them to use a refill request workflow or an appointment scheduling workflow rather than just defaulting everything to a message to their primary care physician.
Reducing the continued increased in post-pandemic patient portal messages was a common theme, with several clients sharing their strategies as well as Epic giving information on its features to support their efforts.
Speaking of features, one non-technical feature that I’ve only seen at Epic conferences is the inclusion of local and regional businesses for attendees to shop in between sessions. Several Wisconsin-based businesses were featured, including one that had handmade soap and gift items, gift boxes, everything badger-themed, and local snacks. There were also chocolatiers and creameries selling a variety of cheese, snacks, honey, sweet and savory pecans, truffles, and more. This is on top of the Epic shop, where attendees could pick up themed t-shirts, notebooks, jackets, water bottles, and other items that are offered at cost. The conference also knocked it out of the park from a sustainability standpoint by having dedicated recycling and trash bins everywhere you turned, but also by including recycling instructions on the standard slides that played in the meeting rooms between sessions.
The Epic campus is known for its quirky art. The piece that gave me the most delight on this trip was this planter that appeared to have microscopes mounted on it. Instead, the eyepiece revealed a kaleidoscopic view of the plants that changed as the planter was spun, reminding the viewer that what you see is not always exactly as others see it. This will be important to remember as I bring back a virtual treasure trove of presentations of cool things that work at other institutions but might not work at my own or might be beyond what my own users are ready to experience at the moment. I met some new people who will be great to bounce ideas off of down the road as well as some who can commiserate with the challenges I run into on a regular basis.
I’m sad that I’ll miss the second week but trust that my team will bring back lots of other ideas.
What’s the best idea you’ve picked up at a conference in the last year? Leave a message or email me.
Email Dr. Jayne.
Shares in Babylon fall sharply on news of moves to take private
London-based virtual care vendor Babylon Health will revert to a privately-run company as part of a debt restructuring plan and new funding arrangement with Albacore Capital.
VA Pharmacists Don’t Trust new EHR System, Survey Finds
VA pharmacists surveyed by the House Veterans’ Affairs Technology Modernization Subcommittee say they don’t trust the new Oracle Cerner system in use at their facilities, causing them to work in a constant state of hypervigilance.
Norton Healthcare Network Update
Norton Healthcare (KY) works to restore systems impacted earlier this week by a cyberattack on its computer network.
AI-powered drug discovery could represent a $50 billion opportunity for big pharma according to a Bloomberg article, which notes that one drug company paid $4 billion for drug that was developed by a startup in just six months. The psoriasis drug is expected to generate up to $3.7 billion in annual sales.
Microsoft eliminates the waitlist for the AI version of its Bing search engine, adds persistent chats and visual capabilities, and announces third-party plug-in capability.
Microsoft expands access to the preview version of Microsoft 365 Copilot, which adds AI capability to the whiteboard function of Teams, integrates the DALL-E image generator into PowerPoint, offers writing suggestions from within Outlook, helps users create lists and generate ideas in OneNote, and creates a learning plan in Viva Learning.
AI drug discovery platform vendor Insilico Medicine offers a free course on using its PandaOmics generative AI tool for disease modeling and target discovery.
Salt Lake City-based AI drug discovery company Recursion, which has five products in Phase 1 or later studies, acquires two competitors.
The CEO of Databricks says that the best way to invest in AI is to think of it as a gold rush, in which you want to be the company selling picks and shovels to gold-seekers. He also recommends investing in companies that control proprietary data, such as from medical records.
Lucem Health, a portfolio company of Mayo Clinic Platform that turns AI advancements into point-of-care solutions, raises $7.7 million in a Series A funding round.
Researchers apply AI to early, large-scale diagnosis of pancreatic cancer, projecting that analyzing the EHR data of one million people could identify 70 who are highest risk who have not been diagnosed with the aggressive cancer.
An Atlantic article warns that ChatGPT is following a similar trajectory as mostly-forgotten IBM Watson, whose over-publicized rush to commercialization left it with little market visibility as it ended up being used to automate mundane, back-end B2B tools. The article dismisses IBM’s failed Watson oncology work with Memorial Sloan Kettering and MD Anderson Cancer Center as “a swole Clippy fed on enterprise data and techno-optimism, [that] could barely read doctors’ handwriting, let alone disrupt oncology.” The author says that ChatGPT, like Watson, is being commercialized to create “banal consumer and enterprise software” that is invisible to users.
A BMJ Global Health analysis piece calls for regulation of AI and a moratorium on self-improving artificial general intelligence, saying that AI poses threats to health and well-being.
Former VA Secretary David Shulkin, MD lists “25 Ways Generative AI Will Change Healthcare” that include specific companies:
In a preview of how ChatGPT might find its way into health system digital front doors to improve access, Expedia is testing a chat-based trip planner, while a Zillow add-on allows conversational access to its real estate listings.
UPMC CTO Chris Carmody says that the health system is working on AI chatbots that can answer patient questions about insurance coverage, but adds that the goal is to support rather than replace healthcare professionals.
A Tennessee radiologist writes 16 research papers in four months, five of which were published in journals, using ChatGPT.
An ED doctor uses ChatGPT to perform roleplay that teaches doctors how to break bad news to patients. ChatGPT provided the scenarios and feedback.
Mr. H, Lorre, Jenn, Dr. Jayne.
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Rural Hospitals Need Federal Assistance to Strengthen IT Security Posture
By Kate Pierce
Kate Pierce, MSMIITA is senior virtual information security officer and executive director of the Subsidy program of Fortified Health Security of Franklin, TN.
The majority of my career in healthcare IT has been dedicated to working for a small and rural hospital, leveraging technology advancements to improve patient care and to keep those systems safe from cyberattacks. I spent 21 years with North Country Hospital in Vermont, starting as a systems analyst and working my way up to chief information officer and chief information security officer.
Growing up in a rural community in northeast Vermont, I have a deep understanding of the challenges faced by smaller hospitals, especially those in rural settings. I also understand how vital these organizations are to the communities they serve.
When I was asked to testify before the US Senate’s Homeland Security and Governmental Affairs Committee on the challenges that small and rural hospitals face in managing an effective cybersecurity program, as well as barriers to adequate funding and human capital constraints, it was an honor to do so, as this is a topic near and dear to my heart.
Even without the cybersecurity challenges, rural hospitals are experiencing unprecedented staffing and budget constraints. More than 40% operate in the red, and nearly one in three is at risk of closure. When it’s a daily challenge to deal with basic healthcare delivery while managing higher labor costs and shrinking margins, cybersecurity isn’t a top priority for most hospital executives.
Anyone who has ever worked in a hospital knows that change is constant. However, a cyberattack is among the most disruptive and devastating events that can occur within a healthcare environment. A 2021 study by the federal Cybersecurity and Infrastructure Security Agency (CISA) found that hospitals hit by ransomware often experience additional stressors that can be correlated with higher patient mortality rates.
This can happen at any facility, but criminals shifted their focus to attacking small and rural hospitals in 2022. Even though a successful attack against a smaller facility may yield less patient data or a lower ransom to release data, the reality is that they are often easier to breach and invariably connected to larger facilities.
When an urban or suburban hospital is hit with a cyberattack, it may inconvenience patients, but they often have other care options nearby. That’s not the case for rural hospitals. The nearest facility may be 40+ miles away, which doesn’t make it feasible to simply divert patients. Even if patients are diverted, nearby facilities can become overwhelmed, creating a cascading crisis throughout the community.
The stakes couldn’t be higher, as evidenced by a 2019 attack on an Alabama hospital that knocked out the hospital’s IT systems for three weeks and is believed to have resulted in the nation’s first fatality attributed to ransomware. According to the lawsuit, patient monitors were offline while the plaintiff was in labor, leading to insufficient monitoring of a fetus that was born unresponsive with the umbilical cord wrapped around the baby’s neck. Although the child was resuscitated, brain damage occurred, and the infant died nine months later. In a recent 2022 attack, a rural Washington State hospital was so overwhelmed that an ER nurse called 911 for help.
The urgency of improving the security posture of these small and rural facilities continues to escalate every year.
As the sophistication of cyberattacks continues to grow, the federal government should be stepping in to help secure these hospitals and keep patient data safe. As I testified to the Senate committee, implementing these four measures could improve the state of cybersecurity for our small and rural hospitals.
First, we must move beyond guidance and recommendations and create minimum standards for cybersecurity that all healthcare organizations must follow. These standards must be reasonable, effective, achievable, and continually evolving as cybersecurity requirements change over time.
Based on the items outlined in the Health Industry Cybersecurity Practices (HICP) document, recommendations can be grouped into five basic categories:
Simply put, regulators must spend less time suggesting and more time providing concrete solutions.
Second, we cannot leave our small and rural hospitals behind. We must create funding opportunities to allow all hospitals to meet the standards. Options include:
Third, we need better coordination of government cyber efforts for healthcare. While the guidance and services from government are appreciated, there is often a knowledge gap regarding the unique healthcare challenges that must be considered when applying cyber best practices in this sector. Due to time and budget constraints, many rural hospitals find it challenging to access or use available resources, so coordination must be streamlined to be effective.
Fourth, the federal government should establish a cyber disaster relief program, much like the assistance provided by the Federal Emergency Management Agency (FEMA). Such a program would provide this vulnerable sector with valuable resources in the event of attack, assist organizations in their recovery process, and increase the likelihood that hospitals could keep their doors open following a cyber-attack.
Overall hospital operating margins have been in negative territory for the past 12 months, according to a February hospital report from Kaufman Hall, and margins have decreased year over year for the past eight months. Operating margins are often higher for larger facilities that have outpatient clinics and more ancillary services than a smaller hospital can offer.
Adding to the challenging complexities, nearly 700 healthcare data breaches of 500 or more records occurred in 2022, according to the Office for Civil Rights. While the number of breaches is basically flat, the number of breached records topped 51 million for the first time, apart from the anomalous 2015, when just two breaches exposed 90 million records. Cyber insurance rates also continue to increase, with insurers demanding more monitoring and detection technologies that smaller facilities may not have if facilities can obtain insurance at all.
Because healthcare records are so valuable, hackers aren’t going to stop. Small and rural hospitals need help to protect their systems and patients, and these simple measures are a sensible path forward.
Turning Data into Action to Address Social Determinants of Health
By George Dealy
George Dealy, MS is VP of healthcare applications of Dimensional Insight of Burlington, MA.
Social determinants of health (SDOH) are widely recognized as critical factors that influence the health outcomes of individuals and communities. SDOH refers to the various environmental, economic, and social factors that impact a person’s health, including food and housing insecurity, social isolation, and lack of reliable transportation options.
While most people are aware of SDOH, they often struggle with how to derive meaningful insights from the available data. Therefore, it is essential to explore practical ways to turn data into action to address SDOH and reduce health disparities.
Failing to address social determinants of health can have dire consequences, particularly for underserved populations. CDC data shows that certain populations, such as minority groups, are disproportionately impacted by SDOH. The health outcomes of these groups are often comparable to those in third-world countries.
One of the most striking examples of this is the maternal and infant mortality rates among certain minority populations. For instance, maternal and infant mortality rates are significantly higher among African American women than among other racial and ethnic groups in the United States. Addressing social determinants is a critical step in reducing these disparities and improving overall population health. This highlights the need to use data related to SDOH for actionable change.
One practical way to address SDOH is to use data and analytics. It’s first important to know where to find data related to SDOH. The data can be obtained from various sources, including national surveys, government agencies, and community organizations. One such resource is the US Census Bureau American Community Survey, which provides valuable data on community demographics, including economic and social characteristics at the neighborhood level. As SDOH information is very geographically specific, data at this level can help identify specific needs and target interventions more precisely. Another important resource is the US Agriculture Department’s Food Desert Map, which helps to identify communities where residents lack access to healthy food options.
Additionally, many non-profit organizations aggregate data from various sources into information resources. These resources include the County Health Rankings Project, run by the University of Wisconsin and the Robert Wood Johnson Foundation, and Community Commons, which is a collection of tools and resources for democratizing data related to advancing equitable community health and well-being. These data-centric resources can empower healthcare providers and policymakers with the necessary insights into the needs of the community and identify potential solutions.
The next step is to analyze the data to identify trends to better understand the specific challenges that a community is facing in relation to SDOH. One practical approach is to use technology to analyze and visualize the data. This can help identify trends and patterns more efficiently and communicate findings in a clear and compelling way.
Leveraging data on SDOH can help in the development of targeted interventions tailored to address the specific needs of each community, such as expanding access to healthy food options or improving transportation services. For instance, data mapping tools can identify areas with high rates of poverty and food insecurity, with this information then used to target interventions in those areas. Predictive analytics can forecast potential health risks based on social and economic factors. The use of data and analytics can be a powerful way to identify trends related to SDOH, develop appropriate interventions, and measure their effectiveness.
Improving population health requires a comprehensive understanding and focus on social determinants of health. While healthcare plays a crucial role, it is only one piece of the puzzle. Addressing SDOH requires a practical and collaborative approach that involves analyzing data, leveraging available resources, and recognizing the dire consequences of inaction. By turning insights into action, we can make meaningful progress in improving the health outcomes of communities, particularly among minority populations, and ensure that every citizen has access to the care they need and deserve.
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