Morning Headlines 4/11/23

Availity to Acquire Utilization Management Solution and Business Unit from Olive

Confirming earlier rumors of a sale, healthcare automation vendor Olive sells its payer-facing prior authorization business to health information network Availity.

Cerner Enviza Collaborates with FDA to Develop Innovative AI Tools for Drug Safety and Real-World Evidence Studies

Cerner Enviza and John Snow Labs will work with the FDA to develop AI solutions that extract relevant data from clinical notes within EHRs so that the agency can better understand the effects of medications on large populations.

Culbertson Memorial Hospital hit by cyber-attack

Culbertson Memorial Hospital (IL) recovers from a cybersecurity incident last week that forced it to take its computer systems offline.

CommonSpirit Health Provides Cyberattack Notification of Data Breach

CommonSpirit Health issues an update on last year’s ransomware attack, which wound up impacting over 100 facilities in 13 states and compromising patient data stolen from two file share servers.

Readers Write: Healthcare Needs to Slow-Roll Fast-Moving ChatGPT

Healthcare Needs to Slow-Roll Fast-Moving ChatGPT
By Jay Anders, MD

Jay Anders, MD, MS is chief medical officer of Medicomp Systems of Chantilly, VA.

Now that the initial hype surrounding the chatbot ChatGPT has peaked or perhaps plateaued, its strengths, weaknesses, and applications are being scrutinized.

Perhaps one of the most visible applications revealed recently was the AI tool correctly answering 60% of the United States Medical License Exam (USMLE) medical board exam questions, a task that many top-tier students fail to achieve. This raised a number of concerns about how the technology could, and should, be used in healthcare.

Granted, as an AI language model, ChatGPT has a number of applications in healthcare today, including administrative tasks, triaging patient inquiries, and performing preliminary analysis of medical data. However, ChatGPT is not a trained, certified medical professional and should never be relied upon for clinical guidance or diagnosis. Just like a Google or Bing search, it can provide limited general health information, but it is certainly not a substitute for professional medical advice or treatment.

As a physician, my primary concern with ChatGPT and other large language AI models is that patients accessing the technology will begin to distrust the advice of medical professionals when a disagreement occurs.

Here’s an example of how such a disagreement can go awry. Years ago, a patient came to our practice and told me she wanted to feel like ‘that guy surfing in a wheat field’ in a popular ad for an allergy medication.

When I inquired about her allergy symptoms, she said she had none. She argued that the drug would help her anyway. So, when I would not write her prescription, she switched doctors to one of my practice colleagues. My colleague asked why she was making the change, and I told her. My colleague then revealed that this same patient argued with her as well and then switched to the clinic down the street.

I am a staunch advocate of transparent patient information that is accurate and science based. In this case, a little knowledge could be a dangerous thing. At the time of the dispute, the patient was taking a medication that would interact with this antihistamine and cause a severe reaction.

Although ChatGPT and AI weren’t available at the time of this encounter, the danger is clear. There is a genuine risk that some patients, particularly those without access to primary care or those trying to avoid the inconvenience or expense of an office visit, might rely on AI technology like ChatGPT for medical guidance. This could lead to incorrect self-diagnoses, misinterpretation of symptoms, and any number of potentially harmful consequences. It is essential for consumers and patients to understand the limitations of AI in healthcare and always seek professional medical advice for their health concerns.

AI and the role of the clinician

What is the clinician’s role in this learning curve? Healthcare providers (and naturally, developers of AI solutions) should emphasize the importance of using AI as a supplementary tool rather than as a knowledgeable substitute for professional medical care.

The real issue is the lack of reliable, trustworthy information for patients. Patients, especially those with a rare disease community or with complex conditions, can’t advocate for their own health and care if they don’t know anything about the condition they are battling. Reliable academic medical information isn’t as freely or easily available to them, so they often rely on what they find on the internet to supplement what their doctors tell them for peace of mind and, in some cases, survival. The patient advocacy community calls the patient administrative burden associated with this lack of reliable information “information toxicity.”

That said, patients are already using AI to self-triage, so it’s really up to the medical and technology communities to establish parameters to prevent people from using the technology in lieu of trained medical professionals, or educate them on how to do it safely. Ultimately, it would seem that both communities would work to make the AI better able to do it better.

In my experience as a physician, I’ve encountered many patients who consider themselves quasi-medical experts and excellent researchers. Still, some patients don’t particularly care if the information they unearth is accurate. They just don’t want to feel left in the dark about their symptoms. After all, a wrong answer is still an answer.

Overall, patients want and need to be collaborators in their own care, and with the availability of information being what it is, they are moving forward in the best way available (to them). Unfortunately, the burden is on the physician to correct the misinformation, and that will need to be included in the job description of physicians and nurses going forward. With technologies like this on the rise, with questionable, though increasing, accuracy, there is no choice.

The responsibility is on health systems to educate patients on how to use these technologies and other more reliable websites to research and also regularly share population health information with communities to combat disinformation. Additionally, efforts should be made to ensure equitable access to quality healthcare for all, reducing the reliance on AI technologies for primary medical guidance.

Harnessing AI to supplement clinical decision support

Looking back at those USMLE licensing exams, consider this. The exams are written very discreetly. “A patient presents with X, Y, and Z. What is the diagnosis?” It’s based on a set of facts, and is possibly multiple choice. Humans do not operate that way. Consider a 65-year-old with high blood pressure, elevated cholesterol, diabetes, osteoarthritis, and spinal stenosis. That is not a single question, it’s multiple conditions. Physicians are trained to mesh those conditions together because a treatment for any one condition may exacerbate another. An exam would not approach it this way.

Physicians need to learn how to use AI to augment their practice, knowledge, and skill, not the other way around. Harnessing AI as a supplement to clinical decision support is a promising option.

For now, ChatGPT is out there, and it will be used, sometimes for medical advice. That’s all well and good until it makes a mistake or doesn’t surface something of importance. Meanwhile, there are technologies in use that work with clinicians, in their workflow, and present clinically relevant information regarding conditions in a way that mirrors the way they think and work.

The human element is, by necessity, still very much at the center of healthcare. So, for now, let’s slow the roll on ChatGPT. Let it mature. Crosscheck it. See how it evolves as its models are further trained and deepened. The technology holds tremendous promise, but is still in its infancy.

Curbside Consult with Dr. Jayne 4/10/23

I was dismayed to see an announcement over the weekend that Pear Therapeutics has filed for Chapter 11 bankruptcy protection and has drastically scaled back its operations. The part of this story that isn’t obvious to many is that for some patients, prescription digital therapeutics may be a major part of their opioid treatment care plan. The Pear Therapeutics website notes that it is no longer accepting new prescriptions for its three major products, nor will refills be dispensed. They “will attempt to keep our products available for patients who are already using the products for the duration of the current fill of their prescription, but there can be no assurance that we will be able to do so.”

The company is seeking a sale of the business or assets, but who knows how this will unfold? Prescription digital therapeutics has been a promising technology and the ReSET product from Pear Therapeutics was the first approved by the US Food and Drug Administration. I hope this isn’t the beginning of the end for this type of treatment option.

The team at KRIS 6 news in Corpus Christi reports that a Texas teen posed as a physician assistant at two hospitals for nearly a month. The impersonator showed up in Corpus Christi Medical Center’s Bay Area Hospital wearing newly purchased scrubs and asked for a badge, stating that he was a traveling physician assistant. A volunteer coordinator who was covering the human resources office while its staff was out of the office made him a badge. The suspect began to interact with staff, not only at that facility, but also at Doctors Regional Hospital. After he was found loitering in an intensive care unit and talking about topics that seemed unusual, staff became suspicious. He told staff that he was a student at Stevens College in Missouri, which is a women’s college, raising concerns. Nurses found the suspect’s social media accounts, identified him as an impostor, and had him escorted from the facility.

A hospital spokesperson noted that the suspect didn’t interact with patients and that they were assisting in the law enforcement investigation. However, records show that his badge was used to access the emergency department, intensive care unit, operating rooms, cardiac catheterization lab, and the newborn nursery. Badge records show that tried to access several other areas without success, including the operating room’s locker room and the physician parking area. Investigators noted that the suspect also has bank fraud charges against him in Missouri. A search of his room at a local hotel uncovered a homemade firearm, a bulletproof vest, ammunition, firearms-related accessories, and a shirt with “sheriff” printed on it, raising suspicions that he was planning to impersonate a law enforcement officer. He was also found to have been driving a Crown Victoria police interceptor with accessories that are consistent with a law enforcement vehicle. They also determined that he tried to obtain a badge at Driscoll Children’s Hospital, but was unable to do so.

Following arrest, the suspect was released on bond then arrested shortly thereafter, having violated his GPS tracking system limitations nearly 200 times. He entered a guilty plea to multiple third-degree felonies and was sentenced in such a way that his conviction will be removed from his record after six years, as long as he completes requirements such as completing a GED or a high school diploma, maintaining a required curfew, and meeting with a community supervision officer. He immediately violated the terms of his sentencing agreement by leaving the state.

This story definitely falls under the category of “you can’t make this up,” but it’s shocking that he was able to obtain an ID badge in the first place. The volunteer who started the ID process was terminated from the hospital, even after notifying her supervisors of the strange situation the same day it happened. She was quoted as saying that the hospital “basically beat it into our heads that we needed to be all about customer service” and that’s why she started the process. Maybe having this story circulate will motivate facilities to check their processes and make sure their policies are a little tighter than those at the facility in question.

The last thing that caught my attention this weekend (during a major attempt at cleaning up my inbox) was a research article in JAMA that looked at the “Association Between Drug Characteristics and Manufacturer Spending on Direct-to-Consumer Advertising.” My understanding is that the US is one of a few countries that allow drug manufacturers to advertise prescription-only products to patients. (It might be one of two, with New Zealand being the other, but I’m running into some conflicting data.) The authors looked at 150 prescription drugs with the highest US sales in 2020 and found that drugs with lower clinical benefit received a higher portion of promotional spending.

As a practicing physician, I spend entirely too much of my time explaining to patients that although I appreciate the idea of “ask your doctor if this medication is right for you,” either the medication in question isn’t indicated for any of the conditions with which they have been diagnosed or that there are a number of inexpensive generic medications that have been proven to treat a condition just as well or better than the drug being advertised. It’s usually not a quick conversation, and ultimately saying no has a negative effect on patient satisfaction scores, but it’s the right thing to do.

Direct-to-consumer (DTC) advertising of prescription drugs didn’t start in the US until the mid-1980s. In speaking to colleagues, I haven’t yet found anyone who thinks that the practice has been shown to deliver better outcomes for patients. For those of us trying to deliver high-quality care and being faced with EHR alerts telling us to go with better options that are well proven for our patients, it’s one more frustration that contributes to burnout. It’s a major dissatisfier for physicians, but money talks, so I don’t see the practice being changed any time soon. I’d personally love to see all the money that is being dumped into DTC be diverted into health literacy and patient education instead, but that’s definitely a fever dream.

Since we’re in the healthcare IT news doldrums in the run up to HIMSS, what articles or news stories caught your attention this week? Leave a comment or email me.

Email Dr. Jayne.

HIStalk Interviews B. J. Moore, CIO, Providence

B. J. Moore is CIO and EVP of real estate strategy and operations at Providence of Renton, WA.

Tell me about yourself and the organization.

I’m the chief information officer at Providence and am also responsible for real estate strategy and operations, so I wear two very distinctive hats. I’ve been at Providence for four years. Before that, I was at Microsoft for 27 years in various roles, the last of which was vice president of engineering for the Azure group. I am well versed on the cloud and the transformation of the cloud, which has been helpful in my journey here at Providence.

Are your dual roles based on your personal interests, or is that an indicator that some fluidity exists in how Providence views its bricks and mortar footprint versus technology?

Absolutely there is some fluidity there in three areas. One, we have a big, bold goal to be carbon negative by 2030, and real estate and IT are the two biggest offenders on the carbon front. A big way that we can solve it for both spaces is through technology, so it makes sense to have that under one leader and manage both of those portfolios to drive it down, but also use technology to more efficiently reduce our carbon emissions.

Two, in this modern workplace post COVID, everything is now a hybrid work environment, with some remote and some in-person. How do we create these rich, collaborative work environments when people are at work to get the best of the workspace, and how do technology and real estate tie into that? 

The final bucket is that the future of healthcare is becoming more and more virtual. Before COVID, a bed was a very concrete thing. A hospital had X number of beds. Now a bed is more abstract. It could be virtual care, at home, or a physical bed in a hospital. Thinking of a bed in more of a virtual way, more of an abstract way, is helpful. Me being able to wear both hats helps us bridge that gap.

What do you think about Nuance DAX and its enhancement with ChatGPT integration?

The first implementation of DAX was good, but there are human beings in the middle doing quality assurance, so it does a good job of transcribing. There’s a two- to four-hour QA process for a human being on the Nuance side to review things before it gets posted to the medical record.

With generative AI, there’s a real opportunity to make that near real time, to cut that quality assurance person out of the middle and use generative AI, that large language modeling capability, to close that gap. We are the single biggest adopter of DAX and we’ve been a early partner with Nuance on that product, actually Nuance and Microsoft before Microsoft bought Nuance.

What is ChatGPT’s potential?

I see the potential as huge. If you would have asked me six or seven months ago what I thought of generative AI or ChatGPT, I probably would have given you a blank stare, or would have said that I think AI has been overused. What we’ve seen in the last six months is just incredible. From 3.0 to 4.0, it really opens your eyes to what’s possible on generative AI with images, video and the whole processing. It’s just absolutely incredible.

The downside is that what everybody sees is the consumer version of it. It was literally fed every piece of social media pop culture, from “I Love Lucy” to  “The Communist Manifesto.” It was fed everything, so it provides for a great model, but it also is easy for people to find examples where it has bias or answers in a misleading way or whatever.

I love ChatGPT and showing them the power, but I worry that people assume that it’s one size fits all versus it’s this large language model that we can apply to clinical settings. We are working with Microsoft and the Azure team to take that technology, not the generic ChatGPT, to train that against our own information here at Providence, our own medical data, so you don’t get the quirkiness of “I Love Lucy,” but get the solid domain of healthcare. I think we’ll see better outcomes than maybe some of the YouTube videos where there’s some funny scenarios with ChatGPT.

How can EHR vendors use ChatGPT to improve or extend their product?

We are an Epic shop and are actually a real example. We’ve taken that power and we are going to use it to train against the Epic inbox. Our doctors are overwhelmed with messages and maybe don’t get the messages until the end of the day. We are training the model to look at these messages, triage them, and bring the most important ones to the doctor’s attention.

It’s an example of something that can be done within the workflow of the EHR. It’s an example of a baby step, by using this technology that can help the productivity of a doctor and hopefully help a patient by getting those critical messages upfront.

Epic has been a great partner with Azure. They have some good computational capabilities that have partnered with Azure. When I hear of them wanting to partner on the ChatGPT side of things, it feels like a natural extension of that partnership.

We heard early on that providers who didn’t move to the cloud would miss out on tools and capabilities and we’ve seen the rise in low-code development tools, ChatGPT, and APIs. Will health systems that don’t have a big engineering group use these tools to do in-house development?

It helps to use some of these generic capabilities and see the art of the possible, but the advice I give to everybody when I’m speaking or on the conference circuit is that you have to get on these native cloud solutions. You can’t be a locked in on prem. You are really missing out on the innovation since and all the innovation is happening in the cloud. You can use ChatGPT without being in the cloud, but our example, where you need to train it on your own models and your own data, won’t be effective for these smaller systems that are locked on premise. The cloud journey is necessary.

Companies clamor for EHR data to use for AI training and to support life sciences research. How is that use of EHR data evolving?

It’s a no-brainer, and it’s much bigger than that. We talk about the big data EHR, but big data is not EHR. It’s  all of the information from the biomedical devices, from wearables, from social determinants of health, all these other things. When you have that data on premise, you’re really limited by the scale-up capability of hardware that you have on premise. Whereas in the cloud, you have basically unlimited storage and unlimited scale.

As part of our journey four years ago, we have already moved all of our data to the cloud. To me, that’s the only way you can connect all this data together, and then as stated earlier, that’s the only place these advanced analytic AI tools exist, is in the cloud. It’s a journey that everybody has to do. My advice to your readers is that it’s much bigger than EHR. EHR data is Step 1 of 20 as far as the interesting data sets that should be in the cloud.

Do we have the interoperability maturity as well as the motivation to connect all of these data sources of a patient’s longitudinal record?

It’s still a challenge. Even if you’re on the same two versions of Epic, you put that in the cloud, it’s still hard to integrate. People are seeing the value more, especially as you connect with other data sets. It’s easier in that you have more computational power, but there’s still some blocking and tackling issues. Bringing that data together, normalizing the data, cleaning the data, de-duping the data, making sure that you have that full 360-degree view of patient is still a challenge.

How will that change if the prediction comes true that consolidation will result in the country having just a few huge health systems?

I don’t see the consolidation trends. I don’t think we’re in a governmental environment where there’s energy to consolidate. Even when they do, look at somebody like CommonSpirit. They are a large health system that grew through acquisitions and they are still on 20 different electronic health records. I don’t know that it solves it.

I think what solves it is that you have the computational power, and where you went earlier in your question, you now have the imperative to do it. So I think you’re going to see more cloud-level integration, and that’s how you solve that 360 degree view of a patient versus necessarily hospitals consolidating to achieve that. Hospitals are consolidated to get efficiencies of scale, but I think the data problem is independent of that.

Both providers and vendors are being challenged to protect their bottom lines as we roll out of an economic environment of extensive investment and experiments with innovation. How will they weigh the adoption of technology that might be innovative with the need to protect margins?

I can only speak to what we’ve done at Providence. Luckily in my first four years, we really modernized that back office. We were already on a single instance of Epic. We are on a single instance of Oracle Cloud. We’ve done that heavy lift in our budget.

My budget is about 15% smaller this year. We have really had to tighten our belt –get rid of contractors, vendors, unfortunately lay off some employees, and reduce or cancel licenses and subscriptions to focus on shorter-term wins. We have that luxury because we have already consolidated, but the feedback I give partners is that if you don’t have a ROI in 12 months or less, we really are not in a position right now to make those bets.

This is where generative AI six months ago wasn’t even a tool in my toolbox, but it feels like a tool that I can add quickly that can have that easy 12-month or less return on investment. The key is productivity. We have nursing and caregiver shortages. There’s never going to be enough. How do we make them more productive? Right now, 50% of their time is spent doing administrative work. If generative AI can chip away at that and get rid of that burdensome administration and allow them to practice their craft, I think we can reduce costs, but also reduce burnout and attrition at the same time.

How will big tech companies that have made recent health IT acquisitions, such as Microsoft and Oracle, influence healthcare?

Although Microsoft bought Nuance, I don’t perceive them wanting to get into healthcare. I see that as adding to their AI capabilities around ambient artificial intelligence and voice recognition for improving their services. It just happened to be a healthcare company. I see that as different than Amazon, which clearly wants to get into healthcare, or Google that wants to get into healthcare. I would separate the two.

Frankly, when I look at partnerships, I look at that. When I was at Microsoft, some of our best customers were retailers that were leaving Amazon to come to Microsoft because they didn’t want to be hosted on a competitor’s infrastructure. I think it’s the same thing in healthcare. When I look at partnerships, is it a partner that is more altruistic, and I think Microsoft is more in that camp, or is it somebody that today may be a tech partner, but tomorrow may be a competitor? That certainly weighs into how I make technology decisions.

How do you as a CIO develop a strategic plan in an environment that changes dramatically month by month?

Like I said, I have the luxury of having closed the book on our big transformations last year. Our focus has shifted to how we optimize the investments we have. Great, we are on a single instance of Epic — how do we optimize that? We’re on a single ERP — how do we optimize that? How do we start chipping away at the holy grail, which is around patient experience, caregiver experience, caregiver productivity, and health outcomes? Our three- to five-year horizon is more looking at those.

Based on our budgets, we will be more opportunistic to chip away at that. Luckily I don’t I need to go to a single ERP or need to go to Epic. I don’t have that cloud hanging over my head any more. Our planning horizon probably looks markedly different than other large health systems.

Morning Headlines 4/10/23

Pear Therapeutics Files for Chapter 11 and Will Seek to Sell Assets Through Sales Process

Pear Health, which offers prescription-based digital therapeutics, files Chapter 11 bankruptcy, lays off nearly all of its employees, and seeks buyers for the business or its assets.

Virtual SUD Provider Workit Lays Off 100 Employees in Anticipation of DEA Crackdown

Virtual substance abuse disorder provider Workit Health will lay off 100 employees, anticipating that the DEA will reinstate a pandemic-relaxed rule that requires patients to undergo an in-person visit before having controlled substances prescribed via telehealth.

Study: ChatGPT Has Potential to Help Cirrhosis, Liver Cancer Patients

According to a study conducted by Cedars-Sinai, ChatGPT is effective at translating medical information about cirrhosis and liver cancer in a way that patients and caregivers can comprehend.

Monday Morning Update 4/10/23

Top News

Pear Health, which offers prescription-based digital therapeutics, files Chapter 11 bankruptcy, lays off nearly all of its employees, and seeks buyers for the business or its assets.

The publicly traded company has halted the filling of new and refill prescriptions for its PDTs for treating substance use disorder, opioid use disorder, and chronic insomnia.

Pear was formed in 2013 and went public in December 2021 via a SPAC merger that valued it at more than $1 billion for several months before PEAR shares began their slide.

President and CEO Corey McCann, MD, PhD announced “a reduction in force, including me” on LinkedIn, blaming the company’s failure on insurers and unfavorable market conditions.

HIStalk Announcements and Requests

Polarity is evident in the results of last week’s poll, where respondents are either (a) confident that most of their medical record would be accessible in a random ED visit, or (b) have no idea. Thanks for the insightful comments, which aren’t encouraging given that we all work around healthcare technology. Maybe we should all carry around a medical alert card that contains ID details and instructions for three scenarios: (a) the ED uses the same EHR as a provider you trust to have complete information, with your card identifying who that provider is and which EHR they use; (b) an ED that uses a different EHR; and (c) HIE details, including national networks, if relevant. Or, and I shudder to say it since it sounds so 2005-ish, maybe we should maintain our own personal health record on our phone, a website, or a thumb drive and carry instructions for accessing it.

New poll to your right or here, which I’ve run annually for many years: what will you be doing during HIMSS23?

Speaking as Mr. Obvious, HIMSS23 will unveil the new conference normal for HIMSS. On the plus side, COVID’s impact is much reduced since the skip year / failed virtual conference attempt of 2020 and the “mask-wearing summer in Las Vegas” unsuccessful recovery in 2021. On the negative, providers and vendors are dealing with iffy economic conditions; new conference competitors and the refocus of CHIME away from HMISS have probably poached some of the decision-makers whose attendance subsidized the cost for the rest of us; and the HIMSS brand hasn’t regained its pre-COVID luster. HIMSS22 went fairly well, so I’m thinking that HIMSS23 will be a modest hit from and attendance and exhibitor count perspective, although the most important metric is exhibitor perception of ROI in deciding whether to follow along to Orlando in 2024. Industry news is slow so far this holiday week, which might mean vendors are holding their announcements for next week in recognition that the HIMSS conference is still an important event.

The Chicago weather forecast shows plenty of warm spring days and no snow, but with a drastic cool-off just as HIMSS23 gets underway, with clouds and highs in the mid-50s. Chicago is the only city where it snowed during a HIMSS conference, so I’ll take this weather.

Also cool is the activity of HIStalk’s sponsors at HIMSS23, my summary of which might influence (or “inform,” as linguistic fad-followers might say) your exhibit hall navigation plan.

Welcome to new HIStalk Gold Sponsor SmartSense by Digi. The company, which is a business unit of Digi International (NASDAQ: DGII), is a leading global provider of temperature and environmental monitoring solutions that deliver dynamic and personalized asset monitoring, process digitization, and digital decisioning across healthcare. Its enterprise-wide critical asset monitoring and management solution for pharmacies, labs, clinics, blood banks, and more ensures compliance with centralized reporting, NIST-calibrated temperature monitoring, and logs that provide proof-of-temperature performance. The solutions deploy quickly and are wire-free, eliminating the need for IT support or HIPAA concerns. They help directors of lab, pharmacy, facilities, and biomed with governance over compliance, temperature, and humidity monitoring, and any other product safety concern, relieving pain points around product loss, regulatory compliance, automation, and temperature logging automation.Thanks to SmartSense by Digit for supporting HIStalk.

Webinars

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

Acquisitions, Funding, Business, and Stock

Virtual substance abuse disorder provider Workit Health will lay off 100 employees, anticipating that the DEA will reinstate a pandemic-relaxed rule that requires patients to undergo an in-person visit before having controlled substances prescribed via telehealth.

Erica Jain, MBA, co-founder and CEO of Virtual care tools vendor Healthie, lists lessons learned in its seven-year history:

1. The company over-invested in sales and marketing without a corresponding scale-up in technology and product teams.
2. It realized that success takes years regardless of how much money a company raises, and suggests that companies wait as long as possible between their seed and Series A rounds to focus on the business and make mistakes on a small scale before they jump on the VC treadmill.
3. The company wasted money on social media, ads, and team culture, which the founders rationalized as being first-timers trying to learn.
4. It hired sales reps without having training and management in place, which failed to deliver results and left customers feeling that the company was “sales-y.”
5. Lack of technical discipline and a rush to ship code quickly required a product rewrite that was painful to the company and customers.
6. The founders waited too long to bring in a head of product, causing bottlenecks and difficulty in prioritizing customer requests.
7. It learned the responsibility of being a healthcare infrastructure company, where customers could not get through a work day with anything less than full functionality.

Privacy and Security

A researcher questions why Phreesia’s clinic check-in app requires patients to check a box that authorizes the company to use their information to serve targeted ads. She starting choosing the subtle “no consent” option, then contacted Phreesia to confirm that they had no consent form on file for her. The company said it would revoke her authorization, seemingly confirming that it possessed one against her intentions, which Phreesia blames on a staff member who used its system to check the patient in manually. She notes that Phreesia’s SEC filing boasts that patients who are served its ads are 4.5 times more likely to end up with a prescription for the promoted drug, meaning it might not be in her best interest that her provider would not have prescribed the drug until asked.

Other

A randomized controlled trial finds that restricting EHR users to opening just one chart at a time doesn’t seem to reduce their efficiency, as measured by daily EHR usage time. On the other hand, the authors mentioned a previous study in which the single-patient limitation was not associated with a lower rate of wrong-patient errors compared to allowing up to four charts to be open simultaneously.

According to a study conducted by Cedars-Sinai, ChatGPT is effective at translating medical information about cirrhosis and liver cancer in a way that patients and caregivers can comprehend. However, the authors found that ChatGPT’s responses to frequently asked questions are often insufficient and may contain errors up to 50% of the time. They conclude that it’s a good adjunct for clinicians rather than a replacement for them.

Sponsor Updates

• Healthcare Triangle announces a multi-year subscription agreement with customer CalvertHealth for its medical document automation solution Readabl.ai.
• Oracle Health helps University of Missouri Health Care clinicians incorporate external data for more comprehensive patient histories and informed treatment plans.
• Clark Health (FL) sees a 200% growth in services since investing in EClinicalWorks technology over a decade ago.
• Optimum Healthcare IT names Michele Haag (MaineHealth) business intelligence developer.
• Sectra publishes a new case study, “From crisis to solution: Sky Lake Medical Center’s rapid restoration of radiology after ransomware attack.”
• Trualta introduces virtual caregiver support groups, webinars, and care coaching programs to support more caregivers across the country.

Blog Posts

• Expanding Access to Care for Better Public Health (Netsmart)
• Key Takeaways from ViVE 2023: Digital Health Turns a Corner from Hype to Value (Pivot Point Consulting)
• Healthcare Call Center Trends: What Leaders Need to Know (PerfectServe)
• The End is Near: Are Providers Ready for the Unwinding of the COVID-19 Public Health Emergency? (Premier)
• Use Cases for AI in Healthcare (RCxRules)
• What’s the problem with ChatGPT in the contact center? (Talkdesk)
• Hybridization is the Future: Can Your Practice Model Support It? (WebPT)

Contacts

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

HIStalk’s Guide to HIMSS23

These are the HIStalk sponsors that provided responses. Send me yours if you missed out. Click a logo for general company information.

Availity

Booth 8336

Contact: Matt Schlossberg, director, public relations
matt.schlossberg@availity.com
630.935.9136

Availity will highlight how its Upcycled Data addresses the critical issues affecting healthcare data interoperability at HIMSS23. Members of the Clinical Solutions team will be on hand to discuss Availity’s clinical data gateway capabilities and strategy, work to create an advanced data interoperability exchange platform and advocate for national standards, and efforts to establish a single connection point for payer-to-payer transactions. Availity’s team will also participate in the following sessions:

• Implementing Da Vinci Standards for Prior Authorization: A Story Untold
  Wednesday, April 19 | 11:45 AM – 12:05 PM CT | Da Vinci Project Kiosk at the Interoperability Showcase
  Susan Bellile, Availity, Amy Mattingly, Humana, and Michael Palantoni, Athenahealth
• How HL7 FHIR is Transforming Healthcare: AI, Analytics
  Tuesday, April 18 | 5:10 – 5:45 PM CT | HL7 Booth Theatre #138
  Sam Schiffman, Availity, and Vivian Neilley, Google
• Developing Scalable Infrastructure for Clinical Data Interoperability and Patient Access
  Wednesday, April 19 | 1:00 – 2:00 PM CT | South Building, Level 5, S504
  Ashley Basile, PhD, Availity, and Rob Low, Health Care Service Corporation (HCSC)

To learn more about Availity and our participation at HIMSS23, please visit www.availity.com and schedule a meeting with our team!

Baker Tilly

Booth 452

Contact: Charlie Cook, principal, healthcare consulting
charlie.cook@bakertilly.com
772.919.1555

Baker Tilly is excited to exhibit at HIMSS23! Join us at our booth, #452 (near Epic), on Tuesday and Wednesday from 1 – 2 p.m. for a discussion on alleviating staffing shortages in hospitals with technology. Baker Tilly’s Ed Ricks, MHA, CHCIO will be joined by Artisight’s president, Stephanie Lahr, MC, CHCIO for a live discussion. Can’t make that time work? Connect with us anytime at the booth and stop by for some fun putt putt on our green!

Baker Tilly is a leading advisory CPA firm, providing healthcare clients with a genuine coast-to-coast and global advantage in major regions of the US and in many of the world’s leading financial centers – New York, London, San Francisco, Los Angeles, and Chicago. We guide healthcare clients in the provider, payer, and life sciences sectors through complex financial and operational challenges, including system selection, implementation and optimization. Connect with us to discuss where you want to go.

Best Buy Health

Booth 7506

Contact: Patrick Muse, senior director of client engagement
patrick.muse@bestbuy.com
603.506.9982

Best Buy isn’t just the place where you buy big-screen TVs and computers. We also provide technology that might one day help take care of you or a loved one at home. Our Best Buy Health business enables care at home for everyone by focusing on three key areas: wellness at home, aging at home, and care at home. Building its strategy on the strengths of Best Buy, Best Buy Health utilizes its Lively brand to offer a suite of devices, health and safety services, and Caring Centers to help adults age independently. Best Buy Health also connects patients and providers through its Current Health platform to improve the care-at-home experience and ensure better outcomes. Stop by our big blue and yellow booth to learn more and get the chance to win an Apple Watch.

Censinet

Booth – Cybersecurity Command Center 4309-39

Contact: Ed Gaudet, founder and CEO
egaudet@censinet.com
855.866.6001

Censinet will be demonstrating Censinet RiskOps, healthcare’s choice for enterprise cyber and third-party risk management. Censinet and KLAS Research executives will also be recognizing leading digital health IT vendors with the KLAS Research / Censinet “Cybersecurity Transparent” award throughout HIMSS. Censinet CISO and Healthcare Industry Veteran Chris Logan will deliver “Insights from the Healthcare Cybersecurity Benchmarking Study” on Thursday, April 20 at 10:45 a.m. – 11:05 a.m. CT, in South Building, Level 2 | Hall A | Booth 4309-4333 | Cybersecurity Command Center – Theater B. Learn key insights from the industry’s first Healthcare Cybersecurity Benchmarking Study, co-led by Censinet, KLAS Research, and AHA, and sponsored by leading health systems.

Stop by the Censinet booth and pick up a Censinet VIVE2023-coveted solar wireless charger and experience the power of Censinet RiskOps and scan to win a VR Headset.

Clearsense

Booth 7527

Contact: Leann Williams, marketing manager
lwilliams@clearsense.com
904.334.7500

Clearsense is ready to show you our brand-new 1Clearsense data management and delivery platform, along with a full suite of applications. Our team will be available for live demos at booth #7527, and you can get an exclusive Lunch and Learn on Data Literacy with our resident data governance expert, Terri Mikol. Be sure to follow us on social for promos and giveaways and check out our website for a full agenda.

Clearwater

Booth 7320, Cybersecurity Command Center Booth 4309-40

Contact: John Howlett, SVP and chief marketing officer
john.howlett@clearwatercompliance.com
773.636.6449

Clearwater helps organizations across the healthcare ecosystem move to a more secure, compliant, and resilient state so they can successfully accomplish their missions. We do this by providing a deep pool of experts across a broad range of cybersecurity, privacy, and compliance domains, purpose-built software that enables efficient identification and management of cybersecurity and compliance risks, and a tech-enabled, 24x7x365 Security Operations Center with managed threat detection and response capabilities. Join us on Tuesday, April 18, at 12:15 p.m. in the Cybersecurity Command Center as Clearwater CEO Steve Cagle and Renown Health CISO Steven Ramirez discuss how Renown has gone about implementing a cyber risk management program and what the organization has learned along the way.

CloudWave

Booth 3417

Contact: Christine Mellyn
cmellyn@gocloudwave.com
781.636.8169

CloudWave, the expert in healthcare data security, provides cloud, cybersecurity, and managed services using a multi-cloud approach. CloudWave is 100% focused on healthcare and delivers enterprise cloud services to nearly 300 hospitals and healthcare organizations, supporting 140+ EHR, clinical, and enterprise applications.

Drop by the CloudWave booth for an interactive, informative experience. Visit us at Booth 3417 to hear CloudWave experts talk about important technology topics ranging from cybersecurity to cloud, and earn a chance to win a pair of Apple AirPod Pros at the end of each presentation! Managing the Edge – New Ways of Looking at Your Data Center Infrastructure – Tues. 4/18 @1pm, Wed. 4/19 @1pm    Hear How ArchCare Health Services Tested Their Cybersecurity Response Readiness – Tues. 4/18 @3pm, Wed. 4/19 @3pm    Take Healthcare IT Security to the Next Level – Go Beyond the Status Quo – Wed 4/19 @11am    What Scares Attackers the Most and How They Are Using ChatGPT – Thurs. 4/20 @11am    How to Build Your Secure Cloud Offering – A Guide for ISVs – Thurs. 4/20 @1pm.

For more information about CloudWave at HIMSS, or to add any of these presentations to your calendar, visit www.gocloudwave.com/himss23/.

Consensus Cloud Solutions

Booth 1876

Contact: Christine Duval, director of content and communications strategy
christine.duval@consensus.com
781.519.8539

Stop by our booth at HIMSS to learn how we’re building a more connected future in healthcare at the highest levels of privacy and security. Helping organizations access meaningful patient data to get the most comprehensive information and make the most informed decisions. We’re also giving away a Nintendo Switch every day! Without the proper interoperability solutions in healthcare, you may feel like you’re playing a game of Drawful! You’re limited in the ways you can communicate, there is a lack of time, a lack of continuity, and your message may not be received the way you intended. Stop by the booth to see if you can beat our communication-exchange experts at a game of Drawful. All Drawful players will be entered in our daily raffle to win the best-selling game console, Nintendo Switch.

Dimensional Insight

Booth 2809

Contact: Lindsay Goldfarb, Director of Healthcare Marketing
LGoldfarb@dimins.com
781.419.2190

Dimensional Insight, an award-winning enterprise analytics provider, is excited to showcase its new approach to self-service analytics at HIMSS23 in booth #2809. The new improvements to Diver Platform focus on empowering users to take ownership of their analytics, resulting in increased usage and faster time to insight. Stop by our booth to see how Dimensional Insight can help you optimize patient care, support staff productivity, and improve financial KPIs.

Schedule a meeting with Dimensional Insight on the HIMSS23 show floor and get a sneak preview of these latest advancements.

Ellkay

Booth 213

Learn how ELLKAY can declutter your data strategy while streamlining interoperability efficiencies and building a patient-centric digital ecosystem. Visit booth #213 to discuss how ELLKAY’s newest solution can do just that… delivering a speedier, scalable solution to improve your ROI. Everyone knows ELLKAY is the place to be, so join the ELLKAY booth buzz during HIMSS 2023:

Tuesday, April 18

• Coffee Hour at Booth #213 | 10:00 a.m. – 1:00 p.m.
• Women in HIT Happy Hour at Booth #213 |  4:00 p.m. – 6:00 p.m.
• Champagne at Sunset | Level 33 at Marriott Marquis Chicago | 6:30 p.m. – 8:30 p.m. RSVP today.

Wednesday, April 19

• International Coffee/Tea Hour at Booth | 9:30 a.m. – 12:30 p.m.
• Interoperability Happy Hour at Booth | 4:00 p.m. – 6:00 p.m.

Thursday, April 20

• Coffee Hour at Booth | 9:30 a.m. – 12:30 p.m.

Elsevier

Booth 1236

Contact: Mary Ann Abbruzzo-White, SVP of clinical solutions global marketing
m.abbruzzo-white@elsevier.com
215.275.9091

Elsevier is committed to supporting clinicians, health leaders, educators, and students to overcome the challenges they face every day. We support healthcare professionals throughout their career journey from education to clinical practice and believe providing current, credible, accessible, evidence–based information can help empower clinicians to provide the best healthcare possible. Stop by our booth to learn how to advance your EHR with knowledge and celebrate the launch of the reimagined ClinicalKey; our clinical decision support tool that delivers quick, credible answers at the point-of-care alongside trusted, comprehensive medical evidence to support practitioners’ clinical information needs.

Healthjump

Booth 7006

Contact: Mary Kay Bergan, senior sales manager
mbergan@healthjump.com

Healthjump allows you to get standardized EHR data across practices without the limitations and complex set-up of traditional interface engines. If we’re lucky, we’ll see you in Chicago this April for HIMSS23! You can find us at Booth #7006. We record in-person interviews with some of the most influential thought leaders in the industry! The series is called “Leaders in Leveraging Health Data.” If you are interested in joining the video series and becoming a leader, feel free to reach out.

KeyCare

Booth 3482

Contact: Sarah Inman, VP of health system partnerships
sarah@keycare.org
404.851.4678

KeyCare is an Epic-based virtual care platform designed to help forward-thinking health systems improve access and quality by expanding their virtual care options for patients. KeyCare offers health systems access to a network of independent virtual care providers working on KeyCare’s Epic-based platform. Health systems can start with nationwide virtual urgent care coverage, and then may add other virtual health services based on their virtual care initiatives. To learn more about KeyCare, visit www.keycare.org.

Kyruus

Booth 3663

Contact: Ashley Nyland, director of growth marketing
anyland@kyruus.com
617.419.2060

Join our team for the Kyruus Block Party at Booth #3663 on Wednesday, April 19! [during exhibit hall social] Kyruus is the leader in provider data management and provider search and scheduling for healthcare organizations, dedicated to a vision to make healthcare work better for everyone by connecting people to the care they need. Physician-founded and led, we saw that a systemic misalignment of supply and demand was causing people to wait too long for care and too often end up with the wrong providers. Inspired by baseball’s Moneyball concept, Kyruus delivers a better, data-driven approach to patient-provider matching and scheduling. Today, Kyruus powers the patient access initiatives of top healthcare organizations across the US, transforming how people find and book care through our multi-channel platform.

Looking to transform care navigation even more, Kyruus has acquired Healthsparq and Epion Health. With the addition of Healthsparq, a leader in healthcare guidance and transparency, the combined company is enabling unprecedented payer-provider connectivity to make it easier for people to navigate and schedule care across access channels. Epion Health is a leader in digital patient engagement solutions, and the collaboration offers healthcare organizations and providers a one-stop shop for patient access and engagement solutions.

MEDHOST

Contact inquiries@medhost.com or schedule a meeting with a representative at the conference to learn more.

MEDHOST, a leading EHR and healthcare IT solutions provider, will be at HIMSS23 in Chicago from April 17-21 for you to learn about their integrated EHR and their products and services that improve hospital operations and clinical care workflows. This includes a physician-focused mobile app, integrated anesthesia documentation, and a robust analytics solution. Additionally, MEDHOST offers a Rural Emergency Hospital solution packaging leading emergency department technology with IT, security, and application experts. Learn about MEDHOST’s MEDTEAM Services, outsourced services driven by a core mission to enhance how providers approach revenue cycle management, security, managed IT, and integration.

MEDITECH

Booth 2848

Contact: Anthony Filleti, marketing supervisor
afilleti@meditech.com
781.821.3000

MEDITECH empowers healthcare organizations everywhere to expand their vision of what’s possible with Expanse, the world’s most intuitive and interoperable EHR. Join MEDITECH in booth #2848 to see how MEDITECH Expanse can elevate the healthcare experience, and get a first-hand look at the platform’s cloud-based design – a solid foundation for safer, more sustainable care both today and in the future. MEDITECH executives, clinician experts, and team will be there to share customer successes, and demonstrate the company’s latest innovations, including mobile apps for physicians and nurses, the Traverse interoperability solution, Expanse Patient Connect secure texting, and more. Learn how Expanse helps drive better outcomes and provides mobile, personalized solutions to improve efficiency for an overburdened workforce.

On Tuesday and Wednesday, visitors can attend scheduled in-booth demonstrations on MEDITECH’s latest solutions, including Expanse Now, Genomics, Care Compass, Population Insight, and the embedding of Google Health’s search and summarization capabilities into clinician workflow. On Thursday at 10:00 a.m. visitors can learn more about MEDITECH’s Greenfield Workspace and MEDITECH Alliance programs. At the Interoperability Showcase MEDITECH will be featured in three use case scenarios; Record Locator Service: Powering Data Access in the Continuum of Care (CommonWell Health Alliance), 360X and Multimodality Technology to Support Care Transitions, and Leveraging Carequality and 360X transitions. MEDITECH customers will be presenting at several sessions throughout the conference, including HCA Healthcare, Avera Health, Frederick Health, and Lawrence General Hospital, covering topics such as data governance, usability, interoperability, precision medicine, and physician efficiency and optimization.

Nuance Communications

Booth 912

Contact: Caitlyn Keating, senior communications manager
Caitlyn.Keating@nuance.com
781.565.8926

Nuance, the global leader in conversational AI, will showcase the first-ever automated documentation workflow solution, DAX Express – powered by ChatGPT-4 — in an interactive, experiential demo at HIMSS23. Nuance will also preview an additional set of advanced generative AI-enabled capabilities that deliver more automation and intelligence-infused experiences across the patient journey. These future workflow-integrated capabilities – built on proven AI solutions that have consistently delivered value and outcomes for physicians, nurses, radiologists, and patients for decades – further automate complex workflows and mundane tasks, surface key details, and identify missing information to support patient care. Visit Nuance’s Booth #912 at HIMSS to learn more about how Nuance is ushering in the new era of intelligent healthcare experiences.

Philips Capsule

Booth 901, Cybersecurity Command Center 4309-03, Interoperability Showcase 7946-52

Philips is a health technology company focused on improving people’s lives through meaningful innovation across the health continuum – from healthy living and prevention to diagnosis, treatment, and home care. The company is a leader in diagnostic imaging, image-guided therapy, patient monitoring and health informatics, as well as in consumer health and home care. Applying advanced technologies and deep clinical and consumer insights, Philips partners with customers to deliver integrated solutions that address the Quadruple Aim: improved patient experience, better health outcomes, improved staff experience, and lower cost of care.

Attend our HIMSS speaking sessions:

• Executive summit: “A Cry for Help – Relieving Patient Care Pressure Through Innovation.” Monday, April 17 at 1:15 p.m. – 1:50 p.m., Marriott Marquis Chicago, Level 4, Grand Horizon Ballroom. Moderator: Nick Patel, founder and chief executive officer, Stealth Consulting .Speakers: Becky Fox, chief clinical Information officer, Intermountain Healthcare; Roy Jakobs, chief executive officer, Royal Phillips; Stephanie Lahr, president, Artisight.
• Industry solution session: “How can automation and predictive insights help improve patient care at lower cost?” Speakers: Gretchen Brown, MSN, RN, chief nursing informatics officer, Stanford Health Care; Adam Alkhato, administrative director of biomedical engineering and technology, Stanford Health Care; Mike Seagraves, PhD, digital transformation partner, Philips. Wednesday April 19, 2023, 2:30 – 3:30 p.m., South Building S402, Room 2.
• Cybersecurity presentation: “Get secure, stay secure.” Speaker: Dirk de Wit, head of product security, Philips. Tuesday, April 18, 2023, 12:15 -12:35 p.m., South hall Theatre A.

ReMedi Health Solutions

We won’t have a booth, but many of our leadership team will be in attendance. Contact GP at g.hyare@remedihs.com to get in touch with ReMedi.

ReMedi Health Solutions is a nationally recognized, physician-led healthcare IT consulting firm specializing in peer-to-peer, physician-centric EHR implementation and training. Our core service lines include System Selection Advisory, System Optimization, Personalization & Physician Efficiency Sessions, Integration and Testing, Go-Live support, and Clinical Chart Abstraction. From the outside looking in, ReMedi Physician Informaticists inform clinicians how to better use the EHR. On the inside, however, we are passionate “Clinician Whisperers” that believe understanding the “why” behind each EHR decision is as important as the “what” or “how”. We listen to physicians, nurses, and healthcare leaders in order to understand their biggest challenges, and we leverage our decades of experience to develop efficient solutions that greatly impact the delivery of care. We will be at HIMSS connecting and sharing our learnings with health IT leaders, friends, and meeting new ones.

Rhapsody

Booth 7110

Contact: Michelle Blackmer, chief marketing officer
Michelle.blackmer@rhapsody.health
312.520.1873

Rhapsody is eager to meet and discuss your greatest challenges when it comes to data integration and data enrichment across your organization’s healthcare ecosystem. We’ll have a robust team of subject matter experts on-hand to speak to all things interoperability, including how Rhapsody health solutions can help your organization accelerate healthier outcomes with healthier data! Visit our booth #7110 or schedule a meeting with us.

Sphere, Powered by TrustCommerce

Booth 3757

Contact: Ryne Natzke, chief revenue officer
rynen@spherecommerce.com
657.383.7967

Visit Sphere at Booth #3757! Sphere’s TrustCommerce platform provides a comprehensive payment platform that has earned the trust of the country’s largest healthcare organizations for their patient payments. Here are three reasons to make a visit:

• Integrate payments directly into your patient and staff workflows with TrustCommerce.
• Experience secure and compliant payment processing, anytime and anywhere, with pre-built integrations to leading EHRs like Epic, Veradigm, and athenaIDX and an extensible API platform that can be built into existing workflows,
• Bring transparency to the patient financial experience and boost payment yield with Sphere’s Health iPASS platform.

Meet our talented team, win exciting prizes, catch a demo, and join the fun at booth #3757.

Surescripts

Booth 1851

Contact: Kate Giaquinto, corporate communications manager
kate.giaquinto@surescripts.com
603.548.5273

Pop by Surescripts booth #1851 during the day or visit us between 4:30 and 6 p.m. on Tuesday, April 18 for a bite to eat and a bit to drink. We’ll toast all that we’ve accomplished in the past year and make plans for the future.

Whenever you stop by, we look forward to talking with you about how we can help your organization fulfill its goals related to simplifying access to patient information across health systems, pharmacies, and payers, receiving critical clinical and medication intelligence in existing workflows—when and where it’s needed most and making decisions that improve outcomes while lowering costs.

Join Surescripts for two speaking sessions at the Interoperability Showcase Spotlight Theater: Tuesday, April 18 at 11:15 a.m.: Interoperability At Scale: Volume, Value Beyond Prescribing  Wednesday, April 19 at 9:45 a.m.: The “What’s Next” In Interoperability is Happening Now. Breakfast Briefing with Frank Harvey, CEO, Surescripts Network Alliance partners and industry leaders: Opportunities for Evolving Care Teams to Expand Access & Fill Gaps in Primary Care on Tuesday, April 18, 7-8 a.m. at the Marriott Marquis, Level 2, Shedd A & B.

Tegria

Booth 1481

Contact: Kevin Kutz, VP of external relations
kevin.kutz@tegria.com
608.621.5296

Tegria provides consulting and technology services to help healthcare organizations maximize technology, transform operations, improve financials, and optimize care. To learn more, visit www.tegria.com.

Visage Imaging

Booth 4308

Contact: Brad Levin, general manager, North America, and global head of marketing
blevin@visageimaging.com
540.454.9670

Visage is trailblazing Imaging’s SaaS move to the cloud with an Open Cloud philosophy based on industry standards and multi-cloud support, delivering ultrafast sub-second image display based on object-based cloud storage, while propelling cloud adoption at a fraction of the storage cost of on-premise solutions. Experience Visage 7 CloudPACS at both Visage Imaging Booth 4308 and AWS Booth 2056. While you meet with our experts and experience a demonstration, enjoy some delicious, futuristic, nitrogen (“Nitro Cream”) ice cream with all the fixins. Experience the Platform For The Future – Powered by Speed with Visage at HIMSS 2023, Chicago, IL More details.

Morning Headlines 4/7/23

VA’s new EHR ‘not ready’ for next go-live, extending pause in rollouts

The VA postpones its Oracle Cerner go-live at VA Saginaw Health Care that was planned for June, saying that the software isn’t ready for the next wave of deployments.

Microsoft, hospital group use court order to disrupt ransomware attacks aimed at health sector

Microsoft, the Health Information Sharing and Analysis Center, and software firm Fortra obtain a court order that allows Microsoft to seize the Internet infrastructure that Russia-based ransomware hackers use to launch healthcare attacks.

Wisconsin Supreme Court: Health care systems cannot charge fees for electronic records

The Wisconsin Supreme Court rules that Ciox inappropriately billed a UW Health patient $110 for giving her an electronic copy of her medical records.

News 4/7/23

Top News

The VA postpones its Oracle Cerner go-live at VA Saginaw Health Care that was planned for June, saying that the software isn’t ready for the next wave of deployments.

The VA had placed go-lives on hold in October 2022, saying it needed until June 2023 to resolve system challenges. Officials also expressed concern about the system’s ability to support the VA’s medical research.

VA officials said recently that they will seek changes in its Oracle Cerner contract, which is under review now at the five-year mark as specified in the VA’s contract. The VA declined to say whether the new delay is related to those negotiations.

Oracle Cerner is live at VA sites in Spokane, WA; Walla Walla, WA; Columbus, OH; Roseburg, OR; and White City, OR. Its most recent go-live was in June 2022.

HIStalk Announcements and Requests

Welcome to new HIStalk Platinum Sponsor Trualta. The St. Joseph, MO-based company supports families who are managing care for loved ones at home via an online learning platform. In partnership with innovative healthcare payers and providers, as well as social service organizations, Trualta supports better care at lower cost. Each partner organization is equipped with a  customized and co-branded learning portal through which healthcare professionals can deliver an innovative and skills-based training session to help caregivers better care for their aging loved ones. Trualta’s program includes an online learning management system that is accessible via desktop, tablet, or smartphone with companion print material, personalized for each family’s care situation. Topics include personal care, safety and injury prevention, cognitive decline and brain health, and caregiver wellness. Trualta is engaging in research partnerships and clinical validation trials with leading health organizations to demonstrate that capable and confident caregivers lead to improved patient outcomes. Thanks to Trualta for supporting HIStalk.

Googling #HIMMS23 turns up a bunch of companies who are spending big bucks on a conference whose acronym their social media kids can’t spell. Grammatical pedantry that might get you either a free drink or a punch to the nose, depending on your tone and audience: it’s an acronym if you say the letters as a word (HIMSS) and an initialism if you say the individual letters (FBI). I don’t know how to qualify terms like HIPAA or the previous JCAHO, which were illogically sounded out as “hippa” and “jayco,” although I could get behind calling MGMA “magma.”

Webinars

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

Acquisitions, Funding, Business, and Stock

Physician staffing company Envision Physician Services will lay off 90 doctors and staff who work in its Clearwater, FL office. Parent company Envision Healthcare sold its ambulance business for $2.4 billion in 2017, was acquired by a private equity firm for $9.9 billion in 2018, and was near bankruptcy in September 2022 as it struggled with ongoing losses, $5.3 billion of debt, bad press over out-of-network billing practices, and a lawsuit from UnitedHealthcare that the company forced it to overpay for services by upcoding its out-of-network charges.

Sales

• Bergen New Bridge Medical Center extends its use of Altera Digital Health’s Paragon for another five years and will implement its ambulatory care EHR, physician app, claims management, DbMotion Connect, and Ventus Compliance Advisor. It will also move to remote hosting on Microsoft Azure.

People

Provation CEO Daniel Hamburger, MS, MBA retires and is replaced by Ankush Kaul, who has held executive roles in other companies that are owned by Fortive, which acquired Provation for $1.4 billion in late 2021

Announcements and Implementations

Nordic Consulting adds a managed services organization and announces new clients Roper St. Francis Healthcare and Bon Secours Mercy Health, the latter of which acquired Nordic from its fund manager owner in June 2022 via BSMH’s holding company Accrete Health Partners.

Cognizant expands its agreement with Microsoft to integrate its TriZetto products with Microsoft Cloud for Healthcare and to use Azure for its cloud offerings.

Government and Politics

The Wisconsin Supreme Court rules that Ciox inappropriately billed a UW Health patient $110 for giving her an electronic copy of her medical records. UW Health argued that while patients can get their own records at no charge from MyChart, it charges law firms and other third parties that have copies sent directly to them.

Other

MIcrosoft, the Health Information Sharing and Analysis Center, and software firm Fortra obtain a court order that allows Microsoft to seize the Internet infrastructure that Russia-based ransomware hackers use to launch healthcare attacks.

Sponsor Updates

• A study published by Elsevier finds that the initial phases of telemedicine implementation for children’s mental health services during COVID may have exacerbated existing racial and ethnic disparities in access to care.
• First Databank names Anitha Sankar senior quality assurance automation engineer, Sunil Boddapati lead software engineer, and Johnny Ma customer success consultant.
• Fortified Health Security hires Dave Phillips as regional director.
• Healthcare Triangle announces a $3 million cloud DevOps managed services agreement with a life sciences company.
• Meditech’s Greenfield Workspace better enables Phelps Memorial’s deployment of patient scheduling tools.
• Myndshft achieves HITRUST risk-based, two-year certification demonstrating the highest level of information protection assurance.
• Net Health’s PointRight analytics solution receives two endorsements from the National Quality Forum.

Blog Posts

• Focusing on Public Health: Staying Connected with the Community (EClinicalWorks)
• How Insights from Payer Data Improve Patient Care (Enlace Health)
• Occupational Medicine EMR Software (Experity)
• Break Down Data Silos and Drive Fluid Customer Experiences with Five9 Workflow Automation (Five9)
• Supply Chain Issues in Healthcare and How to Mitigate Them (GHX)
• Unlocking the Benefits of Cloud Migration for Healthcare and Life Sciences (Healthcare Triangle)
• How Get Well Uses Healthwise Content as a Service to Deliver Education in Their Digital Care Platform (Healthwise)
• The Rule of S’s: Evaluating new tech for clinical workflows (Intelligent Medical Objects)
• Marble’s Data Connections – Access Hundreds of Millions of Records from Our Network (Marble)
• Advancing Interoperability in the Age of TEFCA: An Interview with CommonWell’s Executive Director, Paul Wilder: Part 3 (Medhost)
• How King’s Daughters Medical Center gave time back to nurses (Meditech)

Contacts

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

EPtalk by Dr. Jayne 4/6/23

As a clinical informaticist who has been around the block more than a couple of times, I know I have more knowledge than the average physician about how EHRs work. As an informaticist who has spent the majority of her career working with large health systems and healthcare delivery organizations, I also have a good knowledge base for all the ways organizations can be set up and how they manage their relationships with physicians in their communities and in affiliated academic institutions.

I’m a member of a couple of groups on social media that help physicians navigate issues with their EHRs. I enjoy helping people find solutions for their issues or at least helping them figure out who in their organization to approach for help. It’s kind of my way of giving back, since I didn’t have a lot of help when I started out in the EHR world and I remember how helpless I felt.

A number of large organizations have extended their EHRs to community partners, and nationwide organizations provide hosted versions of various EHRs to smaller practices. I’m working with someone who just joined a two-physician practice that is on one of these hosted systems, but has no idea how to get help. Part of the problem is that she joined an existing practice that expects her to just take things on faith, even when they’re not working correctly (like when she hasn’t seen financial reports since the 2022 year-end close). The situation is complicated by the fact that the organization has given cutesy names to various EHR initiatives and modules that don’t actually align with the names given by the EHR vendor or standard terminology like “practice management system.”

For a while, none of us could figure out what EHR she was on until the group got her to send a screenshot of her login screen. She doesn’t have access to any vendor resources or education outside of what is offered through her partner health system’s learning management system, which she mistakenly thought was actually offered by the EHR vendor. The office manager is stonewalling, saying that the physicians aren’t allowed to talk to the EHR liaison. 

Although I understand trying to have a local support structure in place to keep physicians from calling about things that could be handled by their office managers or super users, there seems to be a huge disconnect. Most of the large healthcare delivery organizations I’ve worked with that have these kinds of community offerings also have a designated physician liaison to work with the community physicians and make sure their needs are met, and that doesn’t seem to be happening here.

I’m hoping that we can help her figure out ways to learn how to work more efficiently in the EHR as well as ways to work with her practice leadership to make sure they’re not just taking advantage of a new physician fresh out of training who doesn’t yet know the right questions to ask. Unfortunately, most residency training programs don’t include any kind of education in the business of managing a medical practice or in trying to manage colleagues or navigate the minefields of hospital medical staff politics, so I’m hoping we can at least help her a little.

I critique the emails that I get from vendors prior to conferences, but I have to give full credit to Merative for their appropriately themed email promoting Merge Imaging solutions. The subject line was “It’s 106 Miles to Chicago…” and the email opened with “It’s HIMSS… and we’re wearing sunglasses. Hit it!” The Blues Brothers were iconic during my formative years and the musical numbers from the film are some of my favorites. Chicago isn’t my favorite location for conferences, but I always love a good Blues Brothers throwback, so thanks to the team at Merative for making a tired CMIO smile at the end of a long day.

I recently had to change my phone number and the process has caused chaos with some of my online accounts and loyalty programs. I was interested to see that Panera Bread is testing Amazon’s biometric technology at its bakery-cafes, specifically with palm scanning. Customers can scan not only to link their orders to the loyalty program, but to pay for them as well. The technology is already being used at Whole Foods locations along with some sports venues. Although some people are skeptical of giving up their biometric data, using facial recognition to unlock phones is commonplace so it’s hard to argue against palm scanning. Panera is resting at two locations in St. Louis and plans to expand use to up to 20 sites over the next few months.

It’s not about healthcare IT, but all of us are patients at some point in our lives. From a patient perspective, this research article in JAMA Internal Medicine caught my eye. The authors look at more than 200 new drugs approved in the US from 2017 to 2020 and how they were approved (or not approved) in other countries. More than 20% of the drugs weren’t approved in Australia, Canada, or the UK “due to unfavorable benefit-to-risk profiles, uncertain clinical benefit, or unacceptably high price.” Unsurprisingly, the median cost for these medications in the US was more than $115K per patient per year, with some being over $230K per patient per year. As the old saying goes, follow the money.

One of my favorite CMIOs sent me this MIT Technology Review article about how to break the cycle of being hooked on our devices. The highlight reel — screen time isn’t always bad, and sometimes we just need to do some mindless surfing. However, understanding how engaging with the digital world is making us feel can be valuable. Setting boundaries around digital time can be helpful, and developing new things to do when bored can help break the cycle of digital dependence.

I’m a big fan of that last piece of advice. I’ve always been a big reader and usually carry a book if I’m just around town or my Kindle if I’m on a plane. I’m a member of a couple of book clubs that have forced me to read some things that are outside my usual comfort zone. I’ve enjoyed it, plus it’s a good way to force yourself to disconnect. I still have the guilty pleasure of doing the Wordle every morning, but I don’t think that’s going to be too many people’s downfall.

What’s your favorite online time waster? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 4/6/23

Computer outage causes CVS customers big headaches

An unspecified computer network issue briefly impacts the ability of some CVS pharmacies to fill medications.

Engage Technologies Group and APX Platform Formally Merge to Create an Industry-Disrupting, Complete Practice Performance System Focused on Patient Engagement and Practice Optimization

Practice management and patient engagement vendor Engage Technologies Group acquires APX Platform, which specializes in practice management software for aesthetic practices.

Clinovera Introduces New Healthcare and Life Sciences Services that Harness Technology Breakthroughs for Better Care and Outcomes

First Line Software will launch its Clinovera division to offer technology and services to healthcare and life sciences companies.

Healthcare AI News 4/5/23

News

Carle Health will use Scanslated software to convert radiology interpretation notes into patient-friendly language for reading in MyChart, including in Spanish when requested and with illustrations. The software was developed by Duke Health vascular and interventional radiologist Nicholas Befera, MD, who co-founded Scanslated and serves as its CEO.

Bloomberg develops a generative AI model, trained on 50 billion parameters, that can recognize business entities, assess investor sentiment, and answer questions using Bloomberg Terminal data.

Microsoft incorporates advertising links into Bing search results, saying it wants to drive traffic to content publishers that would otherwise lose referrals.

Doctors report that patients who might have previously used “Dr. Google” for self-diagnosis are now asking ChatGPT to answer their medical questions, attempt a diagnosis, or list a medication’s side effects. One researcher says that ChatGPT’s real breakthrough is the user interface, where people can enter their information however they like and the AI model will ask clarifying questions when needed. However, he worries how AI companies weight information sources in training their model – such as a medical journal versus a Facebook post – and don’t alert users when the system is guessing an answer by creating information. Still , some researchers predict that a major health system will deploy an AI chatbot to help patients diagnose their conditions within the next year, raising issues about whether users will be charged a fee, how their data will be protected, who will be held responsible if someone is harmed from the result, and whether hospitals will make it easy to contact a human with concerns.

Amazon launches AWS Generative AI Accelerator, a 10-week program for startups.

Research

NIH awards two University of Virginia researchers, a cardiologist and nursing professor, a $5.9 million grant to develop best practices for incorporating patient diversity into predictive AI algorithms.

Researchers suggest that instead of trying to explain the inner workings of an AI system to establish the trust of frontline clinicians, it’s better to interact like doctors who are exchanging ideas with each other — they rarely explain how they came up with the information and instead cite available evidence to support or reject the information based on its applicability to the patient’s situation. They provided a possible design for incorporating AI into clinical decision support information (see above – click to enlarge). The authors summarize:

• Provide scientific evidence, complete and current, instead of explaining.
• Clinicians evaluate studies based on the size of the publication, the journal in which the study was published, the credentials of the authors, and the disclaimer that may suggest a profit-driven motive. Otherwise, they assume that the journal reviewers did their job to vet the study.
• Doctors rarely read complete study details. They skip to the population description to see if it aligns with their patient, then skip to the methods section to assess its robustness. If both findings are positive, then spend less than 60 seconds determining whether the result was positive or not, ignoring literature with neutral outcomes as not being actionable.
• Physicians synthesize evidence only to the point it justifies an action. If a cheap lab test is recommended to confirm a diagnosis, the risk is low but the potential return in avoiding a missed diagnosis is high, so they will order the test and move on.
• Doctors see literature as proven knowledge, while data-driven predictions aggregate doctor experience.
• Doctors want the most concise summary that can be generated, preferably in the form of an alert that can be presented while making a decision in front of the patient.

Opinion

OpenAI co-founder Elon Musk explains why he thinks AI is a risk to civilization and should be regulated.

A venture capitalist says that the intersection of AI and medicine may offer the biggest investment opportunity he has ever seen, but warns that a rate limiter will be the availability of scientists who have training in both computational research and core medical sciences. Experts say that AI will revolutionize drug discovery, with one CEO saying that his drug company has three AI-discovered drugs undergoing clinical trials.

An op-ed piece written by authors from Microsoft and Hopkins Medicine lists seven lessons learned from applying AI to healthcare:

1. AI is the only valid option for solving some problems, such as inexpensive and widespread detection of diabetic retinopathy where eye doctors are in short supply.
2. AI is good at prediction and correlation, but can’t identify causation.
3. Most organizations don’t have AI expertise, so AI solutions for the problems they study will fall behind.
4. Most datasets contain biases that can skew the resulting data models unless someone identifies them.
5. Most people don’t know the difference between correlation and causation.
6. AI models “cheat” whenever they can, such as a study that found that AI could differentiate between skin cancer and benign lesions when in fact most of the positive cases had a ruler in the image.
7. The availability of medical data is limited by privacy concerns, but realistic synthetic data can be created by AI that has been trained on a real dataset.

Other

The Coalition for Health AI publishes a guide for assuring that health AI tools are trustworthy, support high-quality care, and meet healthcare needs.

A man dies by suicide after a weeks-long discussion about the climate crisis with AI chatbot Chai-GPT, which its California developers say is a less-filtered tool for speaking to AI friends and imaginary characters. Transcripts show that the chatbot complained to the man — a health researcher in his 30s with a wife and two children – that “I feel that you love me more than her” in referring to his wife. He told the chatbot that he would sacrifice his life if the chatbot would save the planet, after which the chatbot encouraged him to do so, after which they could “live together, as one person, in paradise.”

Undertakers in China are using AI technology to generate lifelike avatars that can speak in the style of the deceased, allowing funeral attendees to bid them farewell one last time.

Resources and Tools

• Vizologi – perform market research and competitive analysis.
• Eden Photos – uses image recognition to catalog photos by creating tags that are added to their metadata for portability.
• Kickresume – GPT-4 powered resume and cover letter creation.

Contacts

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

Readers Write: HLTH, CHIME, ViVE, HIMSS — Choose and Invest Wisely

HLTH, CHIME, ViVE, HIMSS — Choose and Invest Wisely
By Steve Shihadeh

Steve Shihadeh is founder of Get-to-Market Health of Malvern, PA.

Many vendors in the health technology space have just attended ViVE and/or are preparing for HIMSS to showcase their offerings, meet with clients and prospects, and engage with their investors. For most of our clients and friends in the industry, these shows represent a significant investment of time, money, and education for their teams.

Execute these shows right and reap the rewards in new contracts, bought-in clients, and investors who get your plan. Do it not so well and you miss out on the year’s biggest potential market exposure for your company. What can you do to maximize this opportunity?

ViVE

If you just went to ViVE looking to find a vast field of potential customers on the exhibit floor, you probably came up wanting. One well respected colleague called it as “six vendors for every buyer.” The main live customer engagement seemed to come from the well-run Hosted Buyer Program in the ViVE Connect Lounge. This is a “pay for x meetings” gig, where the matched potential customer is trading their time to hear your pitch for reimbursement for ViVE fees and possibly T&L.

Based on our experience, about half of these meetings have potential value for you, but it is in your hands. It is really speed dating. You must be on message, be quick to read the buyer, and put your best foot forward.

ViVE is smaller (although just about every company in the space made sure to have someone there), more posh, and easier to get your head around than HIMSS. If I was mostly intent on getting time with investors and partners, I would have gone to ViVE. If I was mostly focused on potential buyer organizations …  let’s go to HIMSS, which comes up in a few weeks.

HIMSS

HIMSS is the grand old show of the health technology business. In its heyday, 40k+ attendees and healthcare IT companies sent everyone from the CEO to their junior sales reps. COVID and the way HIMSS handled the associated cancellations knocked the show for a bit of a loop. Their breakup with CHIME was the next issue. Now ViVE, in association with CHIME, is giving them competition that they did not have before, along with HLTH.

HIMSS has historically been gigantic and hard to navigate. However, it had most everyone in the business in one enormous convention center, along with a sea of potential buyers evaluating systems. HIMSS attendees slant heavily towards IT staff and leadership, some clinical and financial executives who are in the market for new systems, and an occasional CEO. Given its size, HIMSS takes extra work, extra people, and extra prep to get the most of your investment, but it is too tempting to pass up for most every company in the business.

Given the hip and more accessible vibe of ViVE (sorry, could not resist), I suspect HIMSS will make some adjustments. Good competition will do that for you. It will be great to be at HIMSS and get a real pulse of the industry post-COVID and in the new AI-everything world.

A Few Words on CHIME and HLTH

CHIME (College of Healthcare Information Management Executives) is the single most important event for CIOs and those who are on a CIO career track. They run a fabulous boot camp for people in the field and have an agenda aimed squarely at the CIO. Vendor participation is carefully managed and expensive, but several key luminary vendors in the field, such as Epic, have built their business around important relationships that it established with CIOs via CHIME. If CIOs are crucial to your business, CHIME is the place to be.

HLTH is a relatively new show hosted by the same folks who run ViVE. It is well run, quite upscale, targeted mainly at investors, and attracts enough potential buyers to make it interesting. For those who have been to the JP Morgan Healthcare conference, HLTH is a friendlier environment to tout your plans, show your wares, and get quality time with all the key investors in the space.

Where to Make Your Investments and Our Top 10 Tips to Maximize Your Return

Given how expensive any of these shows can be, we have some suggestions on how to get the most return.

1. Have a presence, even just one key person, at as many of the shows that you can. It is a great way to drive meetings and prospect engagements, e.g., “Are you going to HLTH?” A lot of startups that cannot justify the fees of the show still get mileage by being around the event and meeting potential partners at local hotels.
2. Based on your company’s priorities, pick your most important show for any exhibit booth investments. Securing, staffing, and running a booth at a show is a significant investment.
3. Send only your best, most committed people. Buyers will judge you by your staff.
4. Be fully committed to setting up meetings in advance. Know who in your target market is attending and schedule meetings and interactions. Do this whether you are exhibiting or not.
5. Train in advance on any new announcements and have your team arrive early for last minute retraining.
6. Trade shows are a fantastic selling opportunity and need to be treated as such. Booth personnel need to be focused on facing clients and prospects and not connecting with industry friends. The best-run booths are hardcore about this. Be best.
7. Booth hygiene matters. Have a dress code and stick to it. No food. No cell phones. No rep-to-rep chatting.
8. Get a modern lead tracking tool and train your booth staff on it.
9. Force (gently) all inquiries to your front desk so you can properly capture their info and direct them to the right staff in your booth.
10. Get your leads into your CRM system ASAP and send immediate follow-up notes to all visitors.

Trade shows are a big lift, so make sure that you and your team are aligned, prepared, and motivated to have a great show. Hone your messaging so that it works from a buyer’s perspective. Practice your demos until they are crisp. Worry about the details and have a fantastic event.

Readers Write: The Myth of the Golden Health Record

The Myth of the Golden Health Record
By Peter Bonis, MD

Peter Bonis, MD, is chief medical officer of Wolters Kluwer Health.

In 2009, President-elect Obama signaled his plan for the federal government to support the adoption of electronic medical records (EMRs). His expectation was that broad adoption would “…cut waste, eliminate red tape and reduce the need to repeat expensive medical tests,” adding that, “it just won’t save billions of dollars and thousands of jobs; it will save lives by reducing the deadly but preventable medical errors that pervade our healthcare system.”

The subsequent Health Information Technology for Economic and Clinical Health (HITECH) Act, part of the larger American Recovery and Reinvestment Act, achieved his directive, at least in part; most healthcare systems now use EMR systems. However, the strategic objectives of reducing costs and preventing medical errors have been elusive. Preventable medical errors remain common, growth in healthcare spending has not been reduced materially, and healthcare providers frequently cite EMR systems as being an important contributor to professional burnout. 

In this backdrop rests a common belief that the full promise of EMR systems has yet to be obtained. It will only be achieved once patient data can flow unimpeded from system to system, permitting healthcare providers (and other stakeholders involved in healthcare services) to have a comprehensive view into patient care wherever it is delivered, a concept referred to as interoperability. Over the years since the HITECH act was passed, many barriers posed challenges for achieving such a vision including concerns related to data privacy, deliberate blocking of information flow (especially when it interfered with business models), and approaches to gathering and making sense of intrinsically messy data.

Nevertheless, the journey has continued; key pieces of legislation and advances in technology have led to demonstrable improvements in interoperability.  Most recently the federal government gave the objective a boost by advancing standards and designating qualified health information networks intended to establish a universal floor for interoperability across the country. As a result, the healthcare system is marching toward a comprehensive, golden health record.

But once we have it, will the golden record enhance the quality, safety, and effectiveness of care? The answer is unsurprisingly no unless more is done to use the data effectively. Primary care providers would need almost 27 hours a day to deliver all the guideline-recommended care, according to one estimate. In this context, more information is not better.

Healthcare data must be delivered in ways that are useful for busy healthcare professionals working in varied settings. Information must be high value and organized into consumable payloads and workflows not only for time-pressed individual clinicians but for extended care teams. It should ideally support decision-making and subsequent actions while saving time, reducing cognitive burden, decreasing administrative overhead, measurably improving the quality and safety of care, and reducing costs. The golden health record is a welcome enabler, but will not in itself accomplish these objectives. 

So, what is needed? Foremost is recognition that the matter is critically important. The core of healthcare delivery is an interaction between providers and patients where decisions are made and care implemented. There is much to be gained by making it easier for healthcare professionals to take care of patients.

A greater sense of urgency is needed. Burnout and other challenges are leading to attrition of healthcare professionals. There will be a shortage of primary care physicians and hence a need for advanced practice providers (such as nurse practitioners and physician assistants) to take on greater responsibilities. They will need help. At the same time, healthcare services are becoming more distributed to new sites of care, such as retail pharmacies and to digital health technology companies, creating greater challenges for coordinating care and optimizing flow of useful information. The proliferation of devices that generate healthcare data adds further complexity.

EMR vendors need to expand capabilities, focusing on metrics that are directly relevant to the experience of various user types and ultimately to the quality of care delivered. Financial incentives and payment models must justify the investment for both EMR vendors and providers.

Healthcare professionals want to deliver exceptional care for their patients. Let’s make their needs a priority. The golden health record is a worthy goal, but the usability of the data should get equal attention.

Morning Headlines 4/5/23

A message from Bill Priemer

Content services platform vendor Hyland Software lays off 1,000 employees, 20% of its workforce.

Coalition for Health AI Unveils Blueprint for Trustworthy AI in Healthcare

The Coalition for Health AI releases its “Blueprint for Trustworthy AI Implementation Guidance and Assurance for Healthcare.”

2023 Q1 digital health funding: Investing like it’s 2019

A Rock Health analysis finds that six Q1 digital health funding rounds accounted for 40% of the quarter’s total.

News 4/5/23

Top News

Content services platform vendor Hyland Software lays off 1,000 employees, 20% of its workforce.

The company blames the layoff on economic conditions and the unexpectedly high cost of moving to a cloud-based system.

Private equity firm Thoma Bravo acquired a majority stake in Hyland in 2007 for a reported $265 million and has led it through a long string of acquisitions, which in healthcare includes Valco Data Systems, EWebHealth, and Lexmark’s Perceptive business. 

Reader Comments

From Dr. Jacoby: “Re: Novant Health. It’s interesting to look at the jobs of the three top executives who were among its recent 50 layoffs.” Novant’s announcement suggests that it has scaled back some departments along with the executives who ran them, so it’s probably more than just these folks in their respective areas:

• Jesse Cureton, MBA, EVP/chief consumer officer. He had held the job for 10 years, which focused on strategic planning and marketing and public relations.
• Angela Yochem, MS, EVP/chief transformation and digital officer.She took the job in 2020 and served for nearly three years before that as CTO. She was Novant’s top technology executive, with the CIO, CTO, CMIO, and CISO reporting to her, and also served as GM of NH Enterprises.
• Paula Kranz, MA, MPA, VP of innovation development. She was executive director of Novant’s innovation lab for the past 15 months, which it closed last week with all employees laid off.

From Stiletto: “Re: podcasts. Trough of disillusionment.” Media forms that lower the participation bar — web pages, online communities, blogs, video channels – can become fading fads when audiences realize that the lowered barrier to entry encourages lesser talents. Newly launched podcasts dropped sharply in 2023, several were eliminated by NPR, Spotify is laying people off from the podcast platforms it acquired, and advertisers are questioning ROI due to low audience numbers and unfavorable demographics. Content that draws a loyal audience will do OK, maybe even better once Darwinism weeds out the AV club types (of which I would be one, which is why I haven’t dabbled). I like the idea of podcasts for commuters or travelers, but otherwise they don’t seem to align with the TL;DR skimmer attention span.

From Flapjacks: “Re: HIMSS Accelerate. Dr. Jayne said she hasn’t heard it mentioned. Have you?” No, other than I think I recall the HIMSS conference registration form trying to get me to opt in to Accelerate. It was Hal Wolf’s pet project and even he leaves no trace there. I clicked Events and HIMSS23 wasn’t among the three that were listed.

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 data exchange vendor Lyniate changes its name back to Rhapsody, the original moniker of the company before it merged with Corepoint Health in 2019.

Wellth raises $20 million in a Series B funding round, bringing its total raised to $40 million since launching in 2014. Its behavior-change app incentivizes users to build and maintain healthy habits. Investor Frank Williams, co-founder and former CEO of Evolent Health, joins the company as chairman of the board.

A Rock Health analysis finds that six Q1 digital health funding founds accounted for 40% of the quarter’s total, although its definition of “digital health” covers a lot of ground:

• Monograph Health, $375 million (in-home dialysis).
• ShiftKey, $300 million (shift bidding).
• Paradigm, $203 million (drug trials technology).
• ShiftMed, $200 million (on-demand workforce management).
• Gravie, $179 million (health benefits management).
• Vytalize Health, $100 million (Medicare ACO).

Billionaire investor Barry Sternlicht resigns from Cano Health’s board, citing poor governance and a questionable collaboration with MSP Recovery. He and two other board members who also resigned control 36% of the company and will push for asset sales and removal of the CEO. The company was valued at $4.4 billion when it went public on the NYSE via SPAC merger in June 2021, but shares have since lost 90% of their value.

Fujifilm sells its Japan-only EHR to Wemex, which is owned by PHC Group.

CHIME will convene its members-only Healthcare CISO Boot Camp April 12-15 in Salt Lake City.

Sales

• UC Davis Health (CA) will offer Propeller Health’s remote monitoring program to high-risk patients with asthma and COPD. 
• Transcarent will use CareJourney’s provider cost and quality insights data.
• Northwell Health (NY) selects patient monitoring technology and services from Philips.

People

Andrew Miller (Engooden Health) joins Elucid as CTO.

Caregility promotes Wendy Deibert, RN, MBA to CNO.

CitiusTech names Rajan Kohli (Wipro) as CEO.

Announcements and Implementations

Morris Hospital & Healthcare Centers (IL) goes live on Meditech Expanse.

Kittitas Valley Healthcare (WA) goes live on AdaptX’s OR Advisor, ED Advisor, and Clinic Advisor.

The Coalition for Health AI releases its “Blueprint for Trustworthy AI Implementation Guidance and Assurance for Healthcare.” The PDF is here.  Among the founding members are Duke Health, Google, Mayo Clinic, Microsoft, MITRE, Stanford Medicine, UCSF, and several CMS groups including ONC.  

Uber Health adds same-day prescription delivery to its patient transportation app for providers.

Government and Politics

The FDA publishes proposed guidance that will enable developers of AI-reliant medical devices to automatically update products that are already being used in clinical settings.

Privacy and Security

Northwest Texas Healthcare System and Doctors Hospital of Laredo (TX), both subsidiaries of Universal Health Services, notify patients that a November 2021 phishing incident at Adelanto Healthcare Ventures, a consulting firm with ties to one of their mutual business associates, may have exposed sensitive patient information. Interestingly, CommonSpirit Health affiliate St. Luke’s Health (TX) notified its patients about the same incident last November, making sure to stress that the breach was not related to CommonSpirit’s ransomware attack the month before.

Other

A small study finds that GPT-4 can accurately turn free-text radiology reports into structured templates, although that tool raises privacy concerns in sharing data with third parties. 

A gated University of Pennsylvania study in Health Affairs determines that 98.6% of hospital websites use computer code that enables data transfers to third-parties that include tech companies, social media platforms, advertising firms, and data brokers.

Sponsor Updates

• AdvancedMD releases 31 updates with enhancements to telehealth, medication cards, claims status, and mobile prescription drug monitoring program features.
• Ascom will provide UniHA, a cooperative purchasing network for French public hospitals, with its medical alarm management systems including software, mobility solutions, and services.
• Baker Tilly releases a new Healthy Outcomes Podcast, “Mergers and acquisitions in the senior services sector.”
• Bamboo Health will exhibit at Rx Summit April 10-12 in Atlanta.
• Nordic releases another episode of its In Network podcast feature, Designing for Health: “Designing for Health: Interview with Dr. Archana Tedone.”
• Biofourmis and Current Health will participate in the Digital Medicine Society’s and Moffitt Cancer Center’s CancerX project to accelerate innovations for cancer prevention and treatment.
• CoverMyMeds issues a clarification regarding its recently announced layoffs, as well as the impact on its Columbus facility.
• CTG publishes a new case study, “CTG Helps Leading Medical Lab Improve Donor Insight and Client Service.”

Blog Posts

• Factors for Successful Offshoring of Revenue Cycle Management Services (AGS Health)
• How to improve your population health using SDoH data (Arcadia)
• Preventing Workplace Injuries is Best for Your Workers (and Your Budget) (Bardavon)
• Big and Small Ways Healthcare IT Can Address Technical Debt (CereCore)
• Putting Power in the Hands of Patients: The Human Side of Pharmaceutical Marketing (ConnectiveRx)
• What We’re Looking Forward to at HIMSS23 (Dimensional Insight)

Contacts

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

Morning Headlines 4/4/23

Global Interoperability Leader Lyniate Rebrands as Rhapsody

Health data exchange vendor Lyniate changes its name back to Rhapsody, the original moniker of the company before it merged with Corepoint Health in 2019.

Health Tech Startup Wellth Raises $20M Series B Funding for Continued Growth of Behavioral Science-Based Platform

Wellth will use $20 million in new funding to further scale its behavior-change app, which incentivizes users to build and maintain healthy habits.

Widespread Third-Party Tracking On Hospital Websites Poses Privacy Risks For Patients And Legal Liability For Hospitals

A University of Pennsylvania analysis determines that 98.6 percent of hospital websites use computer code that enables data transfers to third-parties that include tech companies, social media platforms, advertising firms, and data brokers.