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Morning Headlines 7/29/22

July 28, 2022 Headlines No Comments

Teladoc loses $3 billion in three months, stock plummets 24%

Teladoc Health shares drop 18% on Q2 results: revenue up 18%, EPS –$19.22 versus –$0.86, missing Wall Street expectations for both.

NeuroFlow Launches a Comprehensive Referral Network to Meet Demand for Behavioral Health Care

Behavioral health integration vendor NeuroFlow launches a referral network of behavioral health providers, tele-therapy companies, and tele-psychiatry organizations to expand access to care.

BD Acquires MedKeeper to Offer Cloud-based, Connected Pharmacy Software

BD acquires MedKeeper, which offers cloud-based hospital pharmacy applications for IV verification and medication delivery tracking.

News 7/29/22

July 28, 2022 News 2 Comments

Top News


Teladoc Health reports Q2 results: revenue up 18%, EPS –$19.22 versus –$0.86, missing Wall Street expectations for both.

The loss was driven by a Q2 impairment charge of $3 billion, which followed a $6.3 billion charge in Q1.

Share price dropped 18% Thursday after the announcement, valuing the company at $5.7 billion. Teladoc’s market capitalization was over $40 billion in early 2021. It paid $18.5 billion to acquire Livongo in the fall of 2020.

From the earnings call:

  • The company is optimistic about its chronic care business that came from its acquisition of Livongo, but its pipeline is slower than expected due to competition and employer financial uncertainty.
  • Its BetterHelp online therapy business grew revenue 40% year over year, which was still on the low end of company expectations as smaller private competitors have priced their services unsustainably low to earn market share.
  • The $3 billion impairment charge was driven by an increased discount rate and the decreased market multiples for other digital health companies.
  • The company will look at its cost structure to maintain near-term profitability and will market bundles of services to prospects.
  • Teladoc is entering into more value-based arrangements, where payment is driven by clinical outcomes or cost savings.

HIStalk Announcements and Requests


The June 2020 expiration date of my 2016-vintage, seldom-used Asus Chromebook meant it could no longer receive Chrome OS or Chrome browser updates, so I decided to shell out $99 for a comparable Lenovo one from Best Buy. My only requirement was the same 11.6 inch screen, which I like because it’s barely bigger than my standard IPad in a package that weighs just 2.4 pounds. It feels elegant, the keyboard is nice, and when I logged into Chrome OS , everything was right where it was on its predecessor, although that means that the intoxicating new-computer smell was offset by the lack of satisfaction I would have earned from successful setup tinkering. It seems crazy that an entirely usable computer, as theoretically underpowered as it might be, costs less than $100.


August 10 (Wednesday) 12:30 ET. “Navigating healthcare’s data quality challenge: An actionable discussion.” Sponsor: Intelligent Medical Objects. Presenters: Alastair Allen, CTO, Better; Dale Sanders, chief strategy officer, IMO. Achieving a consolidated patient record is challenging in an environment of hospital M&A, where EHR rip-and-replace projects are expensive and HIEs and FHIR connectivity haven’t significantly accelerated progress. The underlying problem is that systems don’t speak the same language due to a lack of comprehensive, persistent clinical terminology and data standards adoption. UK-based Better offers a unique, FHIR-based approach to integrating disparate EHR data. The presenters will explore how to improve clinical data quality and how interoperable information can be used to support patient safety, reimbursement, and population health management.

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

Acquisitions, Funding, Business, and Stock


Payment integrity platform vendor ClaimLogiq acquires SyTrue, which offers natural language processing technology for medical claims and coding. ClaimLogiq says NLP will give clinicians and coders the ability to make rapid payment integrity decisions.


NextGen Healthcare reports Q1 results: revenue up 5%, adjusted EPS $0.16 versus $0.25, beating investor expectations for both. NXGN shares are up 15% in the past 12 months versus the Nasdaq’s 18% loss, valuing the company at $1.2 billion.

BD acquires MedKeeper, which offers cloud-based hospital pharmacy applications for IV verification and medication delivery tracking.


  • Availity is named as the single-source technology partner for California’s provider directory utility.
  • Vizient will offer its members digital patient engagement and behavior change programs from PatientBond.



Malissa Bennett (Optum) joins Curation Health as chief commercial officer.


Tegria promotes Brian Bircher to RVP of sales.


Austin Awes (Infor) joins Commure as VP of sales – platform.


Optimum Healthcare IT hires Chris Mader (TotalTek) as chief revenue officer.

Announcements and Implementations


AmerisourceBergen launches DTx Connect, which allows patients to access physician-prescribed digital therapeutics and diagnostics via EHR-integrated ordering and patient fulfillment monitoring.


Behavioral health integration vendor NeuroFlow launches a referral network of behavioral health providers, tele-therapy companies, and tele-psychiatry organizations to expand access to care. The company’s technology performs digital, population-wide behavioral health screening, then provides AI-powered “best next step” clinical decision support for care teams. I interviewed co-founder and CEO Chris Molaro in March 2022, marveling at his pre-entrepreneur background as an assistant clerk to the US Supreme Court, graduating from West Point and then earning a Wharton MBA, and serving five years as as US Army platoon leader with deployment to Iraq.

Government and Politics

Rep. Mike Bost (R-IL) warns that the House Veterans’ Affairs Committee may consider “pulling the plug” on the VA’s Oracle Cerner implementation if its larger sites don’t go live successfully early next year as the VA has promised. Bost also told a committee that the VA’s Cerner project is “a bad investment at any price” and that the project’s cost could be as high as $63 billion over 25 years “if everything goes wrong, and I see a lot of things going wrong.”

Sen. Mitt Romney (M-UT) proposes creating the Center for Public Health Data as an independent data subagency of HHS. It would create a single system of community-acquired infectious disease health data, including aggregating de-identified hospital and laboratory that is already being collected for real-time access. Former FDA Commissioner Scott Gottlieb, MD supports the idea, saying that CDC’s analysis is too slow to assist local officials who are making decisions and it holds the data from outside review until it reaches its own conclusions.

Sponsor Updates

  • Ellkay earns NCQA Data Aggregator Validation designation, which allows health plans to gather supplemental data for quality measures and to prove its validity. 
  • The specialty medication solution of Surescripts is being used by 24% more prescribers year-over-year who generated 8.2 million prescriptions between January and May, saving patients an average of $535 per prescription.
  • RCM solutions vendor Brundage Group will offer its clients integration from Redox to connect to hospital EHRs.
  • InterSystems opens an office in Auckland, New Zealand, to better accommodate new TrakCare customers at Auckland City Hospital and Starship Children’s Hospital.
  • Juniper Networks will exhibit at Black Hat 2022 August 10-11 in Las Vegas.
  • Myndshft celebrates reaching the milestone of 1 million patients served by its prior authorization platform.

Blog Posts


Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
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EPtalk by Dr. Jayne 7/28/22

July 28, 2022 Dr. Jayne No Comments

I was exited to see a Tweet from my favorite bowtie-wearing crush Farzad Mostashari @Farzad_MD as he shared information about the Aledade FIRST program, which is designed to support medical residents pursuing family medicine. FIRST stands for Fostering Independence, Readiness, Sustainability, and Togetherness. The program strives to better educate new physicians about value-based care and to equip them for successful careers. Aledade will offer the program to up to 20 second-year family medicine residents who will receive additional training in value-based care and practice management while receiving one-on-one mentorship. Residents can also opt to participate in a subsidized clinical experience. In exchange for agreeing to serve for 3-5 years in an Aledade member practice, clinic, or Community Health Center of their choice, residents will receive monthly stipends, signing bonuses, and more. The program is open to those who intend to practice full-time in North Carolina after completing residency. If we truly want to transition to value-based care, we need clinicians who understand the model and how to maximize patient outcomes. I’ll be looking forward to following it over the next several years.

Lately, I’ve been receiving some random faxes intended for other providers, which I can only assume is from crossed wires deep in some database somewhere. My practice has been trying to correct it, but I suspect it will take some time. Given that context, I was interested to see this Kaiser Health News piece about the challenges of inaccurate provider directories. The article’s introduction is painfully true: “If you have medical insurance, chances are you’ve been utterly exasperated at some point while trying to find an available doctor or mental health practitioner in your health plan’s network.”

As an urgent care physician, I saw hundreds of patients in that situation who ended up in front of me because they didn’t know where else to turn after finding out that the wait was too long,  in-network providers weren’t taking new patients, or providers no longer participated in their insurance plans. Many of these patients needed specialty care that we were not equipped to provide, and they became even more frustrated when they learned that we couldn’t help.

Despite regulations that require accurate provider directories, they’re often a mess. The article cites a study from the Journal of Health Politics, Policy, and Law that found that in a best-case scenario, patients could only schedule timely appointments for urgent issues with about half of the physicians listed in a directory. The worst-case scenario was 28%. For general medical appointments, best case was 64% and worst was 35%. The article notes the challenges in getting providers to update their files with each payer, but from experience, even when providers do provide updates, they are often not incorporated.

Case in point – my previous employer sent termination notices to all plans when I left the practice. I was copied on all the communications. Even as recently as last month, one payer sent me multiple notices that I needed to update their directory and didn’t respond to my attempts to clarify that I hadn’t been a participant in well over a year.

The article closes with some good advice for patients who might find themselves fighting an out-of-network charge despite thinking that a provider was in-network. It recommends taking a screenshot of the provider directory showing the provider’s name, calling the physician office to confirm, and taking notes of the name of each person that was spoken to. That’s more work than the average patient is going to do, even assuming they know that it’s a good idea, which most don’t. Despite recent “no surprises” legislation, fighting unanticipated out-of-network bills is still an irksome task even for those with experience.


The American Academy of Family Physicians was on fire regarding healthcare technology topics in the recent issue of its FPM Journal (previously known as Family Practice Management). One article looked at strategies for reducing documentation burden through EHR simplification. It called out the fact that changes to documentation require buy-in from leadership, appropriate resource allocation to make changes, and adequate support for implementing change.

The author provides an example of institutional policies not keeping up with government simplification of Evaluation and Management guidelines. Their project team engaged subject matter experts to identify ways in which documentation could be simplified, used clinician surveys to identify problematic workflows, and worked with technology teams to identify the best solutions. The authors also noted the need for providers to take advantage of basic EHR functionality such as templates or exam defaults, along with time management strategies such as completing notes throughout the day rather than saving them for the end of the day. I continue to see physicians who will complain endlessly about EHR templates that don’t meet their needs, but who are unwilling spend the time to update them to better suit their needs. If the article spurs even a handful of physicians to take steps to improve their workflows, it has value.

The second article that caught my eye listed five administrative tasks where technology could improve physician workflow. The list includes some features that are readily available in EHRs, including the calculation of patient risk scores and synthesis of data needed to facilitate pre-visit planning. The list also features technology-assisted workflows, such as using voice recognition for visit documentation and using digital solutions to assist with prior authorization tasks. Although many practices are using EHRs, I would wager that a minority are fully optimized and there is still much for clinicians to incorporate into their day-to-day workflows.

The third article addressed quality metric reporting and why practices are struggling to rebound from the impacts of COVID-19. It highlights three burdens impacting practices: the emotional burden, the workload burden, and the payment burden. Technology can help with workload through automation and delegation, allowing diverse members of the care team to assist in closing care gaps and recommending services for patients. It can also help with the payment burden through solutions that promote improved charge capture, demonstration of higher quality in the face of risk-based contracts and ensuring that incentives are maximized. As noted in the previous articles, these efforts take time and resources, but it’s important for organizations to understand that making the effort now will pay dividends in the future and to provide leadership to make changes a reality.

How is your organization using technology to bolster struggling primary care practices? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 7/28/22

July 27, 2022 Headlines 2 Comments

Payment Integrity Leader ClaimLogiq Acquires NLP Pioneer SyTrue

Payer-focused payments company ClaimLogiq acquires healthcare natural language processing technology vendor SyTrue.

NextGen Healthcare Reports Fiscal 2023 First Quarter Results

Despite Q1 revenue growth, NextGen’s revised 2023 revenue and earnings estimates cause shares to drop 5% in after-hours trading.

VA’s $16 billion health records overhaul may be scrapped if fixes aren’t made

House lawmakers say VA administrators will have to seriously consider pulling the plug on its EHR modernization efforts if improvements aren’t made in time for further roll outs early next year.

Readers Write: The Next Frontier for Healthcare Consumerization

July 27, 2022 Readers Write No Comments

The Next Frontier for Healthcare Consumerization
By Aaron Fulner

Aaron Fulner, MS is senior director of product marketing at Edifecs of Bellevue, WA.


The pandemic accelerated consumers’ move to the driver’s seat of their healthcare. Consumers are using digital health devices now more than ever and are demanding a personalized, on-demand healthcare experience. To meet these heightened expectations, the healthcare industry needs to better stitch together all of the pieces – telehealth, artificial intelligence (AI) and machine learning, and interoperability standards – to create a comprehensive delivery model. A model, where data can be exchanged quickly and accurately. This is the next frontier for the consumer healthcare movement.

To reach this next stage, the healthcare industry needs to ensure data can be shared seamlessly across the healthcare system to best equip providers with real-time health information. Here’s how we get there:

Expand Telehealth from Acute Care to Chronic Condition Management

It’s no secret that telehealth use skyrocketed during the pandemic. Even following its peak in 2020 and 2021, telehealth usage is still 38 times higher than prior to the pandemic. Patient and provider muscle memory is changing, and telehealth is now the go-to for urgent care needs. The next chapter of the telehealth story includes a movement from tele-urgent care to telehealth for chronic care management and preventative care. This is especially important as 40% of adults in the U.S. reported avoiding medical care due to the pandemic. This means providers are playing catch up to ensure patients’ routine and preventative care needs are met.

Additionally, as providers work to offer comprehensive care to patients, they must have access to rich datasets about each patient. This includes using administrative information from encounter and enrollment files as well as clinical data stored in electronic medical records.  A comprehensive view of a patient enables the provider to be an informed partner in the care of a patient.

Integrate Artificial Intelligence and Machine Learning into the Internet of Things

Beyond telehealth, consumers are embracing the Internet of Things (IoT) to monitor their health at home. These digital health devices – smart watches, exercise bikes, glucose monitors, etc. – are used by more consumers today than ever before. For example, a recent Rock Health analysis found that digital health wearable ownership increased from 13% of consumers surveyed in 2015 to 45% in 2021.  The question remains: How can the industry enhance the impact of these tools with machine learning and artificial intelligence (AI)?

Remote monitoring devices combined with machine learning and AI create a powerful tool for providers by delivering real-time information and changes in patient health. For example, if a patient’s glucose is low, a glucose monitoring device with a layer of machine learning and AI proactively sends a notice to their provider to reach out and determine if a change in their care plan is appropriate. Ultimately, this gives providers the data to intervene earlier, work with more patients at a time, and improve margins.

Connect Consumer Digital Health Device Data with Provider Workflows

This increase in digital health tool utilization is ushering in a flood of new patient data. To move forward, the industry must integrate siloed data into provider workflows so providers can deliver holistic care. Connecting consumer health data with provider workflows signifies the convergence of healthcare and business data management standards.

To date, the Health Insurance Portability and Accountability Act (HIPAA) and recent interoperability rules declare the consumer as the agent of personal health data. Meanwhile, Health Level Seven International (HL7)’s Fast Healthcare Interoperability Resources (FHIR) and the Da Vinci Project have established the technical standardizations with consumer data and how it is exchanged across stakeholders.The Office of the National Coordinator for Health Information Technology (ONC) is leading the final push through its Trusted Exchange Framework and Common Agreement (TEFCA), which outlines business rules for data exchange and determines allowable uses for payment, reimbursement, and care data without consumers’ permission. The last mile for closing this gap between consumer data, payer, and provider workflows lies in empowering service providers to adopt these standards industry-wide.

The key to the future of healthcare consumerization is to determine how data is exchanged across the healthcare industry to better inform care, improve provider workflow, and integrate digital health data solutions into one place.

Readers Write: The ABCs of Using NLP for SDOH

July 27, 2022 Readers Write 1 Comment

The ABCs of Using NLP for SDOH
By Marty Elisco

Marty Elisco, MBA is CEO of Augintel of Northbrook, IL.


It has been established loud and clear: social determinants of health (SDOH) have a huge impact, even more than physical health, in determining the overall well-being of individuals. Yet obtaining an understanding of how specific SDOH factors affect individual patients is extremely difficult because SDOH data is not methodically collected by clinicians and social workers. This is a problem.

Unfortunately, it is just too difficult and time-consuming for clinicians to make sense of all the SDOH data because most SDOH data is buried in patient notes. This ultimately inhibits their ability to consume the data to inform decisions about individuals receiving care.

Natural language processing (NLP), a key discipline of AI that uses computers to understand the written word, tackles this problem head on. I encourage hospitals and health and human services organizations to explore NLP in their practices, particularly as technological innovation in this area is rising across healthcare.

Listed below are the simple ABCs of why health and human services organizations and hospitals should adopt NLP to make sense of SDOH. But before diving into the list, I want to emphasize: the technology is now here. NLP has matured significantly over the last five years, and it is now a proven method to extract key concepts in narrative healthcare data, such as SDOH, from text.

Cost Savings and More Efficient Care

Clinicians and case workers spend an overwhelming amount of time combing through narrative data — for example, reading typed or handwritten patient notes and case notes — to understand the status of their patient and think through potential courses of treatment. All of this time spent reviewing unstructured data is time that could be better spent in any number of ways, such as spending more time with patients.

The beauty of NLP is that it automatically highlights impactful indicators and trends across case or patient notes, thereby quickly revealing SDOH to the case workers and clinicians on the case. An NLP platform relieves health and social services workers of the time it takes to comb through the staggering amount of records by readily highlighting SDOH across a case.

Improved Outcomes

NLP empowers caseworkers and clinicians with the information they need to make impactful decisions and allow supervisors to maximize quality of care delivered. This is because NLP provides a deeper understanding of a patient or case.

The Gravity Project is a national public collaborative creating diagnostic codes for SDOH factors with the goal of having those codes incorporated into the existing list of medical diagnosis codes. The idea for the Gravity Project originated in 2017, and prior to then, hospitals and health and human services organizations had no way of incorporating SDOH into their care besides entering it in free-form into patient notes, even though it is now widely understood that a range of social, environmental, and economic factors impact health status often greater than the actual delivery of health services. NLP can extract the information in unstructured data and translate that to Gravity codes to support the diagnostic process. These diagnoses can lead to treatments and interventions that improve outcomes.

Risk Mitigation

NLP enables organizations to quickly identify patients at the highest level of risk so interventions can be provided. I firmly believe that you can only truly identify risk by understanding what is included in the narrative data. Most risk stratification systems today simply look at claims data to do this. But claims data is an incomplete picture. If care coordinators had a full picture through SDOH, then they would have a much better tool to identify those who are at most risk, and where early interventions can be referred to prevent serious health conditions from occurring.

The case for using NLP is as easy as ABC. Described above are three tangible benefits to hospitals and health and human services organizations for incorporating NLP into their practices. All players in the healthcare ecosystem share the ultimate goal of improving outcomes while saving costs, and NLP is a surefire way to do just this.

Morning Headlines 7/27/22

July 26, 2022 Headlines No Comments

Clearwater Adds 24/7 Managed Detection and Response Services and HITRUST, CMMC and PCI Certification Services Through Acquisition of Tech Lock

Healthcare cybersecurity, compliance, and risk management vendor Clearwater acquires RevSpring subsidiary Tech Lock, which offers similar services for a variety of industries including healthcare.

Mayo Clinic, Mercy Collaborate to Globally Transform Patient Care

Mayo Clinic and Mercy announce a 10-year partnership in which they will transform their de-identified treatment and outcomes data into actionable insights for improved patient care.

RLDatix Acquires Galen Healthcare Solutions

Governance, risk, and compliance vendor RLDatix acquires Galen Healthcare Solutions, which offers system support, implementation, optimization, data migration, and cloud-based legacy system retirement.

Elation Health Announces $50M Series D for Innovative Primary Care

Primary care EHR vendor Elation Health raises $50 million in a Series D funding round, increasing its total to $109 million.

3M Announces Plans to Create Long Term Value Through Spin-Off of Health Care Business

3M will spin off its healthcare business into a stand-alone company focused on health IT, wound care, oral care, and biopharma filtration.

News 7/27/22

July 26, 2022 News 3 Comments

Top News


Governance, risk, and compliance vendor RLDatix acquires Galen Healthcare Solutions, which offers system support, implementation, optimization, data migration, and cloud-based legacy system retirement.

The CEO of RLDatix is industry long-timer Jeff Surges (Healthgrades, Allscripts, Merge Healthcare).

HIStalk Announcements and Requests

The wildly uncertain intricacies of email delivery, spam filters, and company email server policies mean that HIStalk update subscribers are constantly falling off my list as undeliverable, often without realizing it. Sign up and you’ll know first when I post something new. You won’t get spam from me or anyone else and don’t worry about getting multiple emails – the list ignores duplicate email addresses.


August 10 (Wednesday) 12:30 ET. “Navigating healthcare’s data quality challenge: An actionable discussion.” Sponsor: Intelligent Medical Objects. Presenters: Alastair Allen, CTO, Better; Dale Sanders, chief strategy officer, IMO. Achieving a consolidated patient record is challenging in an environment of hospital M&A, where EHR rip-and-replace projects are expensive and HIEs and FHIR connectivity haven’t significantly accelerated progress. The underlying problem is that systems don’t speak the same language due to a lack of comprehensive, persistent clinical terminology and data standards adoption. UK-based Better offers a unique, FHIR-based approach to integrating disparate EHR data. The presenters will explore how to improve clinical data quality and how interoperable information can be used to support patient safety, reimbursement, and population health management.

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

Acquisitions, Funding, Business, and Stock


Healthcare cybersecurity, compliance, and risk management vendor Clearwater acquires RevSpring subsidiary Tech Lock, which offers similar services for a variety of industries including healthcare. Tech Lock leadership will transition to senior roles within the new Clearwater subsidiary.


Former pharma bro and just-released federal convict Martin Shkreli launches Druglike, a drug discovery software platform. He says its use will benefit patients with rare disease, which a cynic might add would include those parasitic disease sufferers who saw the price of 60-year-old drug Daraprim jump from $14 to $750 per tablet after it was acquired by the former hedge manager’s company. Druglike will run computational chemistry problems on the computers of “miner” users who will be paid in tokens called MSI (Martin Shkreli Inu).


Theator, which uses AI to derive insights from surgery videos, announces a Series A funding round of $39.5 million. Mayo Clinic joined the round as an investor and commits to using the company’s video analytics.


Automated patient intake software company Health Note raises $17 million in a Series A funding round led by SignalFire.

3M will spin off its healthcare business into a stand-alone company focused on health IT, wound care, oral care, and biopharma filtration. 3M had attempted to sell off its health information systems revenue cycle and software business earlier this year.

AI-powered data quality company Cornerstone AI raises $5 million in seed funding.

Cloud, managed services, and analytics company Healthcare Triangle opens an office in Singapore, where it expects to create 500 jobs over the next five years.


Cleerly raises $192 million in a Series C funding round, bringing its total raised since launching last year to $248 million. The company has developed predictive intelligence and clinical decision support software for patients with heart disease.

Columbus-based chronic condition management technology vendor AndHealth will triple its headcount in a new space downtown. The company was launched in 2021 by CEO Matt Scantland, who sold his previous company CoverMyMeds to McKesson for $1.1 billion in 2017. I interviewed him in February 2022.

7wireVentures portfolio company Caraway emerges from stealth mode with a $10.5 million seed funding round. It will offer mental health, reproductive, and physical healthcare services to college-aged women.


Primary care EHR vendor Elation Health raises $50 million in a Series D funding round, increasing its total to $109 million. Ascension Vendors and Jonathan Bush were among the round’s participants.


  • Presbyterian Healthcare Services (NM) selects Commure’s Strongline staff safety alert system to better protect employees at its 70 facilities.
  • Deep River & District Hospital, Kemptville District Hospital, and Winchester District Memorial Hospital in Ontario will go live on Epic in November.
  • Akron Children’s Hospital will use analytics and population health management software from Health Catalyst.
  • St. Dominic Hospital and and Southwest Mississippi Regional Medical Center will go live on Epic next year through their affiliation with Franciscan Missionaries of Our Lady Health System.
  • UPMC (PA) signs a five-year contract with Microsoft for its cloud computing, AI, and machine-learning software.
  • Cooper University Health Care (NJ) will implement Sectra’s enterprise imaging technology.



Harsha Panyadahundi (Wolters Kluwer) joins Sharecare as CTO.


CareJourney names Mah-Jabeen Soobader (Archway Health) chief analytics officer.


University of Florida Health promotes Jiang Bian to the new role of chief data scientist.

image image

Brad Porter (Fisher & Paykel Healthcare) will become CEO of Orion Health when his father-in-law, Orion founder and CEO Ian McCrae, steps down in late August. McCrae will remain involved as an executive director focused on products.


Teladoc Health names Mike Waters (Providence) COO.


Jerald West, PhD (AdvanSix) joins Access as CISO.


Change Healthcare promotes Benjamin Gold to VP of product management.

Announcements and Implementations

Vital announces GA of CareAdvisor, whose tools track health progress and discharge readiness and and offer care plans and educational content.


Experity adds a business intelligence module to its EHR and practice management software for urgent care clinics.

Government and Politics

Sources report that the Roseburg VA Health Care System’s Cerner-based EHR went partially offline for several hours last week due to a system overload that affected patient registration.


An AMA survey of consumers finds that 92% think their health data shouldn’t be sold, and while most respondents are comfortable with their doctors and hospitals using their data, they are least comfortable having it used by a prospective employer or technology companies. Nearly all want app developers to disclose how their data is used, 88% think hospitals and doctors should review apps before they are given access to health data, and 75% want the chance to approve use of their data in advance and to be able to opt out.

Studies find that despite federal and state requirements for health plans to keep their provider directories current, consumers are still wasting time trying to book appointments with listed providers who no longer take insurance or new patients, and in some cases, receive services only to be charged out-of-network prices because of insurer directory errors.

Sponsor Updates

  • Experity will host the 2023 Urgent Care Connect conference February 22-23 in Aventura, FL.
  • EClinicalWorks releases a new customer success story featuring Orthopaedic Institute of Ohio, “Prisma: How Better Data Improves Care and Reduces Costs.”
  • AGS Health publishes a new e-book, “5 Reasons to Select AGS Health as Your Offshore Service Provider.”
  • OptimizeRx partners with Cooler Screens to offer healthcare advertising agencies  a pharmacy advertising presence for their pharma clients via retail surfaces, such as the doors of in-store coolers.
  • Bamboo Health sponsors the National Association of State Mental Health Program Directors Annual 2022 Meeting.
  • Cerner publishes a new client achievement, “The University of Tennessee Medical Center automates processes to optimize throughput and reprioritize valuable resources.”
  • Nordic releases a new episode of its “DocTalk” video series.
  • CloudWave announces the availability of its OpSus Recover disaster recovery service in the AWS Marketplace.
  • The B2B Leadership Podcast features Dimensional Insight VP of Marketing Kathy Sucich, “How Putting Employees First Makes You a Better Leader.”
  • Divurgent will present at the Arch Learning Collaborative Summit July 27.
  • Optimum Healthcare IT joins TriZetto Consulting Partner Network. 

Blog Posts


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


Morning Headlines 7/26/22

July 25, 2022 Headlines No Comments

Theator, an AI platform that analyzes surgery videos, closes out its Series A at $39.5M

Theator, which uses AI to derive insights from videos of operations, caps its Series A funding round at $39.5 million.

Your Pediatrician is a Message Away: Announcing Summer Health and our $7.5M Seed Round from Sequoia and Lux

Text message-based concierge care provider Summer Health announces $7.5 million in seed funding.

VA Roseburg medical center hit with electronic health records outage

The Roseburg VA Health Care System’s Cerner-based EHR went down for several hours last week due to a patient registration programming glitch.

HIStalk Interviews Matt Roberts, Healthcare Industry Practice Lead, Juniper Networks

July 25, 2022 Interviews No Comments

Matt Roberts is global practice lead, healthcare industry of Juniper Networks of Sunnyvale, CA.


Tell me about yourself and the company.

I’ve been in healthcare IT for over 20 years. Right out of college, I started working in network closets, doing desktop rollouts as part of an internship with Health Midwest back in 2000. I was supporting one of the first Cerner Millennium projects in Kansas City, which led to them offering me a job that I accepted. I worked for Cerner for 10 years, living in hospitals and clinics. I helped them set up one of the first HIEs at the Tiger Institute at University of Missouri. I had an offer come my way to take my healthcare expertise over to the networking industry and I joined a company called Brocade. I led their healthcare go-to-market for roughly six years before we were acquired.

I’m now at Juniper, which is a pure play networking and security company. We are absolutely focused on delivering simple and secure experiences for those who run the networks, and even more importantly, the patients, the clinicians, and the staff who depend on the network.

What are the biggest network challenges of health systems?

We see a lot of Band-Aided networks. I’m a big fan of treating the cause, not the symptom, so when we  look at what happened through the pandemic, there was a lot of stress. It was a dark place for all of us. We all have our own experiences, but it was tough. Through tough, we find ways to innovate.

During this time, many providers discovered that their network should have, and could have, been a more strategic asset, probably more so than originally perceived. We walk up to a water faucet, we turn it on, and we expect water to come out. That was the perception of the network. Until it goes down, nobody really cares. But we have seen the whole delivery model shift, so we have moved to a more virtual model and distributed model, Everything is Internet of Things.

As things continue to shift, you have to take a look at the network. It has become more important. A healthy network puts the organization in a position to scale, to integrate emergent technologies. The chief nursing officer walks in and says, “I need this technology connected today.” IT has always been a “no” center. It has to become a “yes” center and say, “We are going to be able to accommodate that for you and figure out how to integrate it into the workflows.”

How extensive is the need to re-architect health system networks due to consolidation, where new care venues of all kinds need to be brought into the connectivity fold?

Consolidation and acquisition play a major role in being able to integrate the technology seamlessly. As seamless as some of it sounds, you are also often acquiring organizations that don’t have the same standards that you have. How do you rely on integrating proprietary technologies and the way things have been architected at a technical layer from a topology standpoint? You may have to unwind some things to get that new system on board, whether it happens to be multiple hospitals or multiple clinics. It plays a critical role.

Open standards, or standards-based technologies, are important for this exact purpose. Being able to onboard quickly, to integrate seamlessly, and to provision your networks more efficiently, as opposed to having to wait weeks, months, and even sometimes years when you start to get into the project work.

Is it challenging to bring those new locations and networks up to security standards?

Yes. Security gaps are everywhere. The harsh reality is that no one vendor does it all. When you start to look holistically at the security posture of the organization, we are doing something differently at Juniper. We treat the entire network as an enforcement domain, looking at every connection point that exists within your network. It’s not just next-generation firewall, DLP, or an ATP appliance or software. Cyber criminals are getting smarter, where minutes, much less days and hours, aren’t fast enough. How do you identify and mitigate a threat immediately as it comes in?

I use the analogy of how many locks you have on your door at home. You have deadbolt, a push button, an extra lock, a Ring doorbell, and maybe a German Shepherd behind the door. You have multiple layers of different protection. When you look at your security posture, there’s not a one-all, be-all.

Healthcare is among the top industries, maybe number one, for cyber criminal activities because the information is so rich. You have to look at new ways instead of just throwing a bunch of firewalls out. Protect the entire domain and know what’s going on in the entire domain. Then be able to identify something that looks fishy and shut it down so it doesn’t propagate through the entire network.

What changed during the pandemic?

The network is the lifeblood of the healthcare enterprise, like the vascular system of the human body that pumps our blood to and from the heart. The network is your vascular and immune system. If you don’t have a healthy network, the organization is at risk. The pandemic created gaps. But we see positivity as people understand how strategic the network is. It’s not just watching how the packets pass and getting bits and bytes to their destination without latency. You have to look at the whole thing, the hard and soft costs around the economics. Are you buying the same brand because that’s all you’ve known for the last 20 years? Look at what’s fit for purpose. Look at what molds well to what your organization is trying to do. Are there better organizations out there that are leading edge about trying to help also make you more efficient?

That’s where we come in. We are focused  on experiences. If you’re the IT operator, on the network or help desk teams, or an end user such as a doctor or nurse or a radiologist sitting at home, how can that network work for you? Or how can you not have to pick up the phone and call the help desk if you’ve got a really crappy connection? We are starting to see small, medium, and large entities, from smaller hospitals to larger health systems, looking at the network. It’s exciting because they are looking at newer technologies that are different from what they have done over the past 20 years. 

The industry has evolved so much. It involves AI. It involves a lot of capabilities that have moved beyond the marketing hype that allow you to focus on not only delivering a 24/7/365 experience, but to put you in a position where the network is working for you versus having to dig and spend hours trying to troubleshoot issues. That’s where we can help as well.

How are organizations using indoor location services?

When I talk about location services, everything is built into our access point. Think w-fi. We use what’s called virtual Bluetooth low energy. We have a patented array that sits in the access point. We are the only one in the industry that does that. In the Gartner Magic Quadrant for indoor location services, we are in the leader quadrant far over to the right. We are the only networking vendor in that particular space.

Delivering location services is a journey, to be fair. An organization has to have a strategy around that. It starts at looking at the use case. Maybe you want to greet people as they walk in the front door and offer them a turn-by-turn indoor navigation experience because of late or missed appointments or people getting lost throughout the facility. Maybe you want to track critical medical assets because wheelchairs and pumps are getting lost – studies have found that 20 to 30% of mobile medical equipment is lost or stolen. You can deliver these location services directly off of wi-fi now instead of buying a bunch of different pieces and parts and overlay RTLS systems.

However, we integrate seamlessly with those. We’re an open standards-based company. The value for healthcare is to look at open API strategies, to look at exchanging SDKs and other software defined kits, to integrate into other entities like Stanley and CenTrak so you don’t have to do a rip and replace. Cost preservation is big in healthcare. I’ve been in healthcare 20 years and I want to save healthcare a lot of money and make it more efficient. We seeing an uptick in all the different types of location use cases to get a consumer engagement platform in place. Hospitals and health systems can engage with patients and guests while also helping their staff become more productive.

What about proximity alerts involving visitors or employees?

It is opening more opportunities. It creates this platform for IOT, but it also creates a platform for at least understanding who is coming into your facility. We don’t record PHI. We’re just looking at devices. If you walk in with a  Bluetooth capable or enabled device, such as a phone, it  can be detected. You see this in retail, hospitality, and a lot of different industries. We can get within one to three meters, or even closer to the one-meter mark by using  BT11 devices.

That lets you understand what is happening with your facility’s foot traffic. It came more important in the heat of COVID for proximity tracing and dwell times. If a facility needs to disperse a hot zone, they can push a notification out to everybody who was congregating when they shouldn’t have been. We can do these directly out of our dashboarding capabilities and the integration work that we can do with engagement type devices over mobile.

What healthcare developments will we see in the company and the industry over the next few years?

We literally are changing the game again. The accolades are out there. Everybody can go look and see from a lot of the analyst community and industry recognitions that we truly are improving the end-to-end visibility. Insights into users, devices, and applications creates a fine-tuned experience for clinicians, patients, and the people who are running the networks.

We are dramatically simplifying the operation. Using AI to proactively notify IT when there’s a problem, provide a fix, and automatically open up trouble tickets in ServiceNow or whatever your ticketing system is. Imagine not having to chase a doctor or nurse to ask them to re-create an issue. We are eliminating all of that.

Nobody has seen this in healthcare. It’s a foreign concept, and it sounds too good to be true, but the reality is that we are changing the dynamics of how we make people more efficient. Talk about provisioning all those acquired clinics and hospitals as we mentioned before. We can use the cloud and microservices so that the AP and the switches are ready. As soon as you acquire somebody, and you have plans to basically roll out a new network, with single-click activation it literally can be plugged in as soon as you ship it to that device. Or let’s say that the clinic is two hours away and somebody can’t travel there, you can have somebody do this over distance, reducing the truck rolls, the touches, provisioning networks by 50 to 70% better.

Nobody has seen it in healthcare, and this is where we get excited. This is where I get excited sharing my message with you on what we’re doing. We are at an interesting time where people are coming out of the pandemic and doing digital transformation initiatives. The network should be considered when you start throwing all of these other things on top of it. That’s your foundation, and we want to make sure that you have the most modern foundation that is possible, one that can scale for many, many years.

Curbside Consult with Dr. Jayne 7/25/22

July 25, 2022 Dr. Jayne 3 Comments

This weekend marked the first time in a decade that I took a trip without my laptop. It was weird at first because my backpack felt surprisingly light, but it was good to know that I couldn’t slip into the trap of doing work even if I tried.

Now that the workplace is more mobile, and especially when some companies offer unlimited time off, it’s tempting to blur the lines between the work day and the rest of your life. It was a great opportunity to connect with old friends and focus on spending time together as we crammed as much adventure into 48 hours in the Big Apple as possible.

Of course, since we were a group of healthcare IT people, there were plenty of opportunities to discuss where the industry has gone since we all worked together at a big health system. Several in the group have moved into the non-profit space and payer space, which was interesting to learn about compared to others’ experiences in the vendor and consulting spaces. One person’s resume reads like he’s a job hopper, but in reality, he has been in the same job, but his company has just been merged and acquired multiple times. I’m not sure everyone would pick up on that just looking at his employment history.

There was a lot of chatter about the Amazon acquisition of One Medical for nearly $4 billion. Nearly everyone in the conversation was concerned about Amazon having access to patients’ protected health information, even though the company issued a statement that they don’t plan to share health information to advertise or market other Amazon products without clear permission from patients.

Several of us brought up the point that most consumers don’t read terms and conditions, even when there are limited updates to an agreement, so it’s likely that Amazon could obtain such a consent without patients full understanding what they’ve accepted. Most of us are a bit skeptical about how this is going to play out, so we’re going to have to watch it as the deal moves towards the regulatory approval it needs for closure.

Digital health startups were a hot topic throughout the weekend, and one of my traveling companions sent me an article that caught his attention. It’s from the Journal of Medical Internet Research and looks at the “clinical robustness” of companies in that sector. The background for the article notes that “health care technology stakeholders lack a comprehensive understanding of clinical robustness and claims across the industry.” That phrase caught my eye as well, since I’m constantly seeing companies that make me wonder what exactly it is that they do and why people, including investors, are so excited about them. Certainly there’s a hype factor for a lot of digital health startups, as well as a great deal of marketing, but the meaty information tends to get pretty thin when you start to dig into some of them. The article looked to assess clinical robustness along with the claims made by companies.

The authors used data from the Rock Health Digital Health Venture Funding Database, the US Food and Drug Administration, and the US National Library of Medicine. (It should be noted that three of the authors are employees of Rock Health, although the article states that no individuals involved in investments were part of the analysis.) The authors defined clinical robustness using the sum of the number of regulatory filings and clinical trials completed by each company with each having equal weight. For the companies’ claims, the authors looked at company websites. They looked at 220 digital health companies with an average tenure of 7.7 years.

The average clinical robustness score was 2.5, with a median score of 1. Companies specializing in diagnostics had the highest scores, followed by those focusing on treatment and those specializing in prevention. The authors found that 44% of the companies they looked at had a clinical robustness score of zero. There was no correlation between clinical robustness and the number of publicly made clinical claims or between clinical robustness and total funding.

There were some other interesting statistics in the article:

  • More than 1,900 digital health startups have raised more than $2 million in venture capital funding in the US.
  • In total, digital health startups have raised more than $77 billion in venture capital funding.
  • Multiple studies have shown the need for greater clinical validation.
  • Many solutions are not supported by robust clinical evidence.
  • Solutions have mixed results on cost savings and cost-effectiveness.

Additionally, the authors noted that there have been examples of misleading claims in the industry, as well as actions by the Federal Trade Commission and state attorneys general. They note the limitations of using publications as a proxy for clinical impact, especially given that there is often a lag in publications. There were also limitations in that they only looked at venture-backed startups in the US that had raised at least $2 million in funding, which may have excluded early-stage companies as well as larger technology companies. They also note the need for deeper research into the effectiveness of solutions.

I found it amusing that the article noted that “all data were stored in Microsoft Excel,” where the calculations were performed. Excel isn’t always the most sophisticated tool, but it’s gotten the job done for me more often than not.

It would be interesting to do a follow-up study to see how many of the startups that the authors looked at are even here in two, five, or 10 years and what their clinical robustness might look like over time. I suspect we may see some significance between funding and clinical strength or between time in the market and clinical outcomes. In the short term, though, it’s often difficult to demonstrate value beyond individual case studies and client profiles. It’s certainly challenging to wade through some of the content on company websites and to truly know how broadly a solution has been deployed or whether clients are happy with it.

What do you think about the idea of measuring clinical robustness for digital health tools? What markers might you use beyond those selected by the authors? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 7/25/22

July 24, 2022 Headlines No Comments

Statement of Mike Sicilia, Executive Vice President Industries Oracle Corporation Before the U.S. Senate Committee on Veterans’ Affairs Hearing on Examining the Status of VA’s Electronic Health Record Modernization Program

Oracle EVP Mike Sicilia tells the US Senate Committee on Veterans’ Affairs that Oracle will move the VA’s Cerner implementation to the cloud and rewrite Cerner’s pharmacy module, completing both tasks within six to nine months.

Pre-Visit Clinical Intake Automation Company Health Note Nabs $17M in Funding Round

Health Note will use a $17 million Series A funding round to expand its market presence and EHR integrations, and invest in additional research and development.

Ascom acquires French software developer Appliware

Ascom acquires Appliware, a France-based developer of long-term care solutions for patient monitoring and alarming.

London NHS trust cancels operations as IT system fails in heatwave

In the UK, IT and telephone system servers at one of NHS’s largest trusts go down as data center cooling systems fail to keep up with a record heat wave.

Monday Morning Update 7/25/22

July 24, 2022 News 23 Comments

Top News


Oracle EVP Mike Sicilia tells the US Senate Committee on Veterans’ Affairs that Oracle will move the VA’s Cerner implementation to the cloud and rewrite Cerner’s pharmacy module, completing both tasks within 6-9 months. Notes:

  • Sicilia told the committee to consider that Oracle’s acquisition of Cerner gives VA, DoD, and the Coast Guard “a new, vastly more resourced technology partner overnight to augment Cerner.”
  • Oracle says it will shift its top talent to working on the federal government’s Cerner challenges and is running the project from a war room that is staffed by senior Oracle engineers and developers.
  • Sicilia says that Cerner, like its EHR competitors, is running on dated architecture using technology that is up to two decades old, making it hard to manage, support, and scale. Oracle says it will quickly move the Cerner application to a “modern, hyperscale cloud data center,” the same infrastructure that Oracle uses for critical industries in financial services and utilities. That conversion will be performed at no cost to the federal government.
  • Oracle quickly fixed a database bug that caused 13 of the most recent 15 outages once the acquisition was completed and Oracle gained access to Cerner’s source code.
  • The “unknown queue” was designed to account for human error rather than to mitigate it, so it will be redesigned.
  • Sicilia says Oracle will “start over” with the Cerner pharmacy module, rebuilding it as a showcase of a cloud-optimized web application.

HIStalk Announcements and Requests


Most poll respondents aren’t too worried about negative job changes.

New poll to your right or here: Which conferences you plan to attend in person in the next 12 months? A sponsor asked if I planned to create a sponsor guide for conferences other than my usual HIMSS one, so the poll results will help me decide.

It’s an interesting phenomenon that so much of my LinkedIn feed is filled with “I’ve been laid off and need a job” posts, many of them from Olive because it laid off so many employees (450) at once. I’ve laid people off and been laid off myself and the double whammy is that not only are you out of a job, you are competing for a new position along with a bunch of your comparably skilled co-workers, most of them vastly preferring to avoid relocation. Maybe LinkedIn, combined with remote work options, will be effective in reducing the lost time between being marched out of one door (often virtually these days) and waiting for a new one to open.


August 10 (Wednesday) 12:30 ET. “Navigating healthcare’s data quality challenge: An actionable discussion.” Sponsor: Intelligent Medical Objects. Presenters: Alastair Allen, CTO, Better; Dale Sanders, chief strategy officer, IMO. Achieving a consolidated patient record is challenging in an environment of hospital M&A, where EHR rip-and-replace projects are expensive and HIEs and FHIR connectivity haven’t significantly accelerated progress. The underlying problem is that systems don’t speak the same language due to a lack of comprehensive, persistent clinical terminology and data standards adoption. UK-based Better offers a unique, FHIR-based approach to integrating disparate EHR data. The presenters will explore how to improve clinical data quality and how interoperable information can be used to support patient safety, reimbursement, and population health management.

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

Acquisitions, Funding, Business, and Stock

Ascom acquires Appliware, a France-based developer of long-term care solutions for patient monitoring and alarming.

Elevance Health, the former Anthem, says in its earnings call that it will develop solutions that go beyond selling health insurance, touting its Carelon health services offering in which the company’s own providers will coordinate and provide patient care. Carelon offers services for behavioral health and value-based care and operates IngenioRx, an pharmacy benefits management and home delivery pharmacy company. ELV shares are up 20% in the past 12 months versus the Dow’s 8% loss, valuing the company at $110 billion.


  • New York City Department of Health and Mental Hygiene will implement CareMesh’s national provider directory, which is available via FHIR APIs, file uploads, and web app.
  • Hawaii’s Med-QUEST Division awards NTT Data a health analytics contract.



Divurgent hires Collin Jones, MBA (RedZone Technologies) as VP of finance.

Announcements and Implementations

Clearwater launches ClearConfidence, a managed services program covering cyber risk management and compliance.

An Optum consumer survey finds that providers fall short in offering online scheduling for both in-person and telehealth visits, particularly for younger adults who are not satisfied. Half of the respondents missed a scheduled healthcare appointment in the past year, one-third of those because they forgot, suggesting that appointment reminders could help reduce that number.

Three studies show that use of Bayesian Health’s AI technology for sepsis early warning reduced inpatient mortality by 18%. Founder and CEO Suchi Saria, PhD is an associate professor at Johns Hopkins University, where she also runs healthcare AI and engineering groups.


WHO declares monkeypox as a global health emergency as world case counts rise to 16,000. US infections have risen from 200 to 3,000 in the past four weeks.


In the UK, IT and telephone system servers at one of NHS’s largest trusts go down as data center cooling systems fail to keep up with a record heat wave. The UK recorded its highest-ever temperature Tuesday of 104.5 degrees F. Clinicians are recording information by hand and asking patients to bring their own records to appointments. One doctor reports, “We are back to using paper and can’t see any existing electronic notes. We are needing to triage basic tests like blood tests and scans. There’s no access to results apart from over the phone, and of course the whole hospital is trying to use that line. Frankly, it’s a big patient safety issue and we haven’t been told how long it will take to fix. We are on divert for major specialist services such as cardiac, vascular, and ECMO.”

A widely cited 2006 research article on Alzheimer’s is found to contain what appears to be “shockingly blatant” examples of image tampering, leading to speculation that the authors may have altered data to support a hypothesis and thus sending researchers off on wild goose chases for years. In an interesting case of money driving the scientific process, the research was performed by scientists who were associated with the manufacturer of an Alzheimer’s drug, while the neuroscientist who reported the altered images was hired to do so by two other neuroscientists who were short sellers in shares of the same drug company. NIH spends $1.6 billion per year on research of amyloids for Alzheimer’s and scientists report that suggesting other causes of the condition to study pits them against the “amyloid mafia.” The only marketed drug in that category is Aduhelm, which earned the FDA widespread scientific scorn for approving a drug despite unimpressive research results.

Sponsor Updates


  • Azara Healthcare staff train for the Pan-Mass Challenge, a bike race that will raise money for the Dana Farber Cancer Institute. Azara BKRS will ride in honor of colleague Heather Budd, who lost her battle with ovarian cancer last November.
  • Northwest Clinics in the Netherlands adds Agfa HealthCare’s Rubee for AI platform to its Agfa enterprise imaging solution.
  • GHX has grown its technology group by 12% in the last year, and plans to grown another 21% by the end of 2022.
  • Baker Tilly releases a new Healthy Outcomes Podcast, “The rise of CCBHCs and the importance of quality of care measures in behavioral health.”
  • Oracle Cerner releases a new podcast, “Improving health equality and equity through digital innovation.”
  • Clinical Architecture Manager of Research & Strategy Jordan Rose becomes the co-vice chair of the HIMSS Chapter Advocacy Task Force.
  • CloudWave appoints CompuGroup Medical CEO Derek Pickell to its board.
  • ReMedi Health Solutions posts a white paper titled “How a Clinically-Driven Chart Preparation Process Improves the Continuum of Care.”
  • RCx Rules publishes a case study titled “How US Dermatology Partners Achieved Their Highest Clean Claim Rates Despite Staffing Challenges.”
  • Health Data Movers appoints former Bluetree CEO Jeremy Schwach to its Board of Directors.
  • Lyniate announces a referral partnership with Solarity, which has developed an intelligent automation engine for easier use of clinical data.
  • Nuance expands the availability of Dragon Medical One through the Microsoft Marketplace.
  • Nordic Consulting achieves ISO 27001 certification.
  • Pivot Point Consulting publishes a new case study, “A Multi-Pronged Success: AthenaOne EHR Support & Cures Act Education.”
  • PeriGen earns the 2022 Frost & Sullivan Best Practices Product Leadership Award for its maternal and infant care solutions.
  • PerfectServe publishes a case study, “Children’s Hospital & Medical Center Omaha: Centralizing Provider Scheduling Across an Enterprise.”
  • MGMA’s podcast features Surescripts Senior Product Analyst Nicholas Chambers, “How Medical Practices Improve Medication Adherence and Patient Safety.”
  • Vocera publishes a new white paper, “Smart, connected hospital framework.”
  • Wolters Kluwer Health expands its Lippincott portfolio, using open science to support the higher velocity exchange of scientific findings.

Blog Posts


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


Morning Headlines 7/22/22

July 21, 2022 Headlines 1 Comment

Amazon to buy One Medical for $3.9 billion as it expands healthcare footprint

The announcement comes two weeks after reports that primary care operator One Medical, whose share price had dropped by nearly two-thirds in the past 12 months, was exploring its options after reported acquisition interest by CVS Health didn’t materialize.

Internal document reveals more frequent computer problems at Spokane VA than previously known

The Spokane paper says that the Mann-Grandstaff VA Medical Center users have experienced more than 180 episodes of system degradation or downtime since September 2021.

VA’s $16 billion medical records overhaul could triple in cost

VA officials say its Oracle Cerner project could cost $51 billion over the next 30 years when maintenance and staffing are factored in.

Justice Department Seizes and Forfeits Approximately $500,000 from North Korean Ransomware Actors and their Conspirators

DOJ seizes $500,000 from North Korean hackers and returns the $220,000 that two US hospitals had paid in ransomware attacks.

News 7/22/22

July 21, 2022 News 7 Comments

Top News


The VA postpones this week’s planned Oracle Cerner go-live in Boise, ID due to system stability issues that the VA says make it unsuitable for larger-facility use. The VA has no other go-lives scheduled for 2022.

The Spokane paper obtained a document from Mann-Grandstaff VA Medical Center that lists 180 incidents of system degradation and downtime since September 2021, a far larger number than the VA has acknowledged.

Meanwhile, VA officials tell Congress that its implementation will cost $51 billion over the next 30 years, including maintenance and staffing, but it does not expect the $16 billion Cerner contract to run over budget unless the 10-year implementation timeline is extended.

HIStalk Announcements and Requests

Several COVID-careful relatives and friends have come down with the virus in the past week, some of whom have had it multiple times and all of whom were vaccinated. I think the term “pandemic” no longer applies (COVID-19 is now arguably endemic) and the coronavirus is no longer “novel” (most of us have been vaccinated, had COVID-19, or both, which has dramatically dropped hospitalization and death rates). A New York Times viewpoint predicts that by the end of 2022, 80% of the total infection count since 2020 will have happened in 2022 as new variants are popping up every few weeks. Experts predict 100,000 to 300,000 COVID-19 deaths in the US each year indefinitely as higher case counts overcome lower death rates. COVID has killed just over 1 million Americans.


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

Acquisitions, Funding, Business, and Stock


Amazon will buy publicly traded primary care clinic chain One Medical for nearly $4 billion in cash, a 77% premium to ONEM’s closing share price Wednesday. The company has member-only clinics in 16 cities throughout the US. One Medical acquired Medicare-focused provider Iora Health in June 2021 for $2.1 billion. Before the acquisition announcement, One Medical shares were down 63% in the previous 12 months versus the Nasdaq’s 18% loss. Bloomberg reported on July 5 that One Medical was considering its options after CVS Health reportedly expressed interest but ultimately passed.

A CB Insights Q2 report on digital health says that the COVID-era funding boom is receding to 2019 levels, dropping 32% quarter over quarter following a 36% drop in Q1. IPO activity is nearly non-existent and SPAC exits are rare. Funding in the health IT category remained at 2021 levels, however. Telehealth cooled dramatically and digital startups that focus on reproductive health face privacy and security challenges following the Roe v. Wade decision.

Remote patient monitoring system vendor Verustat acquires One Healthcare Solution, which sells software for chronic care management, annual wellness visits, and medication reconciliation.

A recapitalization of Internet Brands values the company at $12 billion. Its health brands include WebMD, Medscape, EDoctors, and Henry Schein One.

Tech-powered online pharmacy Capsule reportedly lays off 13% of its employees.


The twice-yearly health IT investment market review of Healthcare Growth Partners – the only company whose reports I study carefully — notes that an entire generation that was raised on cheap capital and climbing valuations is watching the market come to a screeching halt. It observes that while valuations are falling, they have climbed steadily since early 2018. Points:

  • Valuations remain strong for high-quality companies, although investor criteria for “quality” have stiffened and emphasis has shifted from growth to profit.
  • Fewer investors are buying, but available capital from premium buyers has kept valuations high.
  • The cost of private debt is increasing, as lenders become cautious and raise their quality standards.
  • The industry will consolidate as smaller companies that lose access to capital are acquired by incumbent competitors.
  • HCP believes that multiples are nearing a bottom, but a return to post-COVID levels is unrealistic and sellers need to deal with a market that looks more like 2018-19.
  • Winning sectors are likely to be supply chain management, spend analytics, contract and vendor management, lead generation, and revenue enhancement.


  • MemorialCare Miller Children’s & Women’s Hospital Long Beach will implement Health Catalyst’s Twistle patient, family, and caregiver communication system in pediatric cardiology.
  • Denver community mental health provider WellPower selects Augintel’s NLP solution to extract information from provider case notes.
  • Prime Healthcare adds three hospitals to the surgical care team collaboration and coordination solution of RelayOne.



Matthew Lungren, MD, MPH (Amazon Web Services) joins Nuance/Microsoft as CMIO.

Announcements and Implementations


Apple publishes a report on its healthcare accomplishments and ambitions. Notes:

  • The company’s health efforts are focused on the personal health journey of users (data storage, fitness and health features, support for third-party apps) and medical collaboration (research enrollment, making patient data available to providers, promoting health lifestyles via Apple Watch, and supporting public health and government).
  • The release this fall of IOS 16 and WatchOS 9 will offer features covering 17 areas of health and fitness . These are activity, heart health, sleep, respiratory, mobility, hearing, mindfulness, education, COVID-19, handwashing, safety, women’s health, medications, research, health sharing, data visualization and insights, health records, and third-party apps.
  • The Health IPhone app can store 150 types of health data and tens of thousands of App Store apps use the HealthKit API.
  • The company’s work with Stanford to develop the Apple Heart Study helped it develop capabilities to allow researchers to develop medical studies at unprecedented scale.
  • Healthcare systems are using Apple technology to strengthen the physician-patient relationship and to enable care from everywhere.
  • Providers and insurers are integrating Apple Watch into their wellness programs.

Google Health develops a tool that can reduce the effort and cost of training machine learning systems on chest X-rays. The system, CXR Foundation, converts X-ray images to a numeric representation that allows models to be developed using smaller datasets and less computing power but with no loss of predictive quality. Another benefit is that it works with smaller datasets and allows building a solid model that accommodates underrepresented populations and rare medical conditions.

Oracle and Microsoft announce Oracle Database Service for Microsoft Azure, which allows customers to run applications across the cloud offerings of both companies.

Frederick Health (MD) goes live on Meditech Expanse Genomics in that includes First Databank’s embedded pharmacogenomic decision support, sending orders, and receiving inbound patient-matched results in full PDF form.

Government and Politics

The Justice Department seizes $500,000 from the cryptocurrency accounts of North Korean hackers, which includes ransom paid by hospitals that DOJ returned. A Kansas hospital paid $100,000 to regain access to its systems following a ransomware attack, while a Colorado provider paid $120,000. The incidents drove the federal government’s July 6 cybersecurity threat warning about North Korea-based ransomware hackers who are targeting healthcare and public health organizations.

Privacy and Security

An Atlas VPN review finds that three-fourths of Q1 malware attacks exploited Microsoft Office vulnerabilities, often because users had not applied security updates. Browser exploits are becoming rare because they keep themselves updated automatically.


I’ve read some insightful comments about Amazon’s acquisition of One Medical, which I’ll summarize:

  • Health systems have bought up primary care practices as a loss leader, with their real interest being forcing their owned PCPs to refer their high-profit inpatient procedure work to the health system’s acute care hospitals.
  • Telehealth companies can disrupt that process only so much in the absence of offering the in-office services that patients regularly need.
  • Amazon is gaining a national physical presence with the acquisition. It also gains a respected healthcare name.
  • Amazon’s PCPs can focus on meeting consumer needs rather than making in-organization referrals.
  • The company could also charge for its procedure gatekeeper services or bid the procedure work selectively.
  • Amazon CEO Andy Jassy said in November 2021 that the company will be a “significant disruptor” with its Amazon Care virtual primary care business. Its goal was to be a one-stop shop for health-related transactions via three health arms – Amazon Care (virtual medical advice), Amazon Diagnostics (at-home testing), and Amazon Pharmacy (the former PillPack). Amazon also offers the Alexa Together caregiver support / remote patient monitoring service that runs on Echo devices.


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


EPtalk by Dr. Jayne 7/21/22

July 21, 2022 Dr. Jayne 3 Comments

As I put together my travel schedule for the next year, I’m looking at various conferences. One that caught my attention in email was Becker’s 8th Annual Health IT + Digital Health + RCM Annual Meeting. The attention-getter was its list of keynote speakers including former President George W. Bush, former professional boxer Sugar Ray Leonard, and professional golfer Michelle Wie. It’s certainly an eclectic mix of speakers and I’m not sure how much they individually have to bring to the digital health discussion, but hopefully someone who is willing to pay the $950 admission fee will clue us in.

The costs for conferences keep rising, and it’s not always clear whether attendees receive the value offered. For comparison, the American Academy of Family Physicians charges between $695 and $895 for its Family Medicine Experience (FMX) conference. The National Association of Community Health Centers charges $1,290 for member organizations to attend its annual Community Health Institute & Expo and $2545 for non-member organization attendees. HLTH is pricing registration for in-person admission at $2,295. Typically, an employed physician might have one conference covered by their employer per year, so there are certainly some choices to be made.

I’ve been working with EHRs and consulting with vendors for more than a decade, so it’s been gratifying to see the improved focus on patient safety and greater movement towards standardization. A Viewpoint article published in the Journal of the American Medical Association last week discussed ways that we can continue to improve EHR safety and usability. The authors note that computer-based records have failed to live up to their promise particularly as related to the support of health care providers’ thought processes and that in fact the EHR creates distractions for caregivers.

They state that “…the term electronic health record” is a misnomer… It is not designed primarily to capture and present a patient’s record as efficiently and effectively as practical.” They go on to recognize what we all know – that “…the EHR has many stakeholders, including physicians, health system executives, educators, regulators, and patients whose needs influence EHR capabilities. In the US, requirements for reimbursement, regulatory compliance, and administrative workflow automation often take precedence over clinical efficiency and effectiveness.”

I don’t think anyone who has been working in the healthcare IT space for any length of time would disagree. We’ve all been stymied by EHRs that won’t let us document things the way we need for the patient in front of us. For example, one EHR I worked with didn’t have the capability for the physician to set a default follow up instruction of “within 24 to 48 hours.” The system’s designers insisted that a date be used, which doesn’t necessarily support what the urgent care physician is trying to say when they want a patient to see a specialist quickly but not necessarily on a certain date. As a result, the physician ends up free-texting what they want on every single patient rather than taking advantage of labor-saving features – which costs much more time and money in the long term. There are also organizational impediments to efficiency, such as when EHR decision makers refuse to let clinicians personalize their workflows because of a fear of increased maintenance or support costs.

The Centers for Medicare & Medicaid Services published a final rule stating that hospitals should review their systems using the Safety Assurance Factors for EHR resilience (SAFER) Guides so that they can evaluate usability and safety of clinician systems. The authors call for greater focus on minimizing the cognitive load created by EHR workflows. When there is too much mental effort needed to complete a given task, user performance suffers. The authors propose a SMARTER Guide to improve EHR cognitive support:

  • Synthesizing information and supporting goal-oriented search.
  • Monitoring care decisions, taking patient data and care setting into account, and suggesting better alternatives.
  • Automating routine tasks.
  • Recognizing trends toward or away from idealized patient models.
  • Translating important user actions into documentation.
  • Exposing contextually relevant data; and
  • Reliably and consistently performing these functions.

It will be interesting to see how some of these elements are incorporated into technology over the next few years, and whether technology begins to better serve clinicians or whether it continues to be a distraction.

As an avid outdoor adventurer, sustainability and environmental protection are high on my priority list. I enjoyed this article in the Journal of the American Medical Association that looked at the use of informatics to assess healthcare systems with regard to climate impact and environmental footprint. The authors note that healthcare delivery  — including facilities, pharmaceuticals, and more — accounts for approximately 5% of global carbon emissions and propose informatics efforts to monitor healthcare’s carbon footprint. Other contributors include supply chain (production and transportation of supplies) along with staff travel and waste disposal. The authors propose synthesizing economic activity data alongside life cycle assessment models for products and processes.

Most of the organizations cited in the article are located in the UK or Australia. I would be interested to see how US organizations are looking at the problem. One of the aspects that was mentioned was one that I’ll admit I hadn’t thought very much about in the context of sustainability – wasteful clinical practices. This includes unnecessary imaging, duplicate tests, medication overprescribing, and unneeded surgeries. Many patients in the US feel that greater technology use leads to better outcomes and that medications are a much better solution than more environmentally friendly treatments such as lifestyle modification. Often the decisions made for hospital purchasing are focused strictly on cost without consideration of environmental impact, so there will need to be significant changes in priorities in order to see downstream impacts on climate or the environment.

One of my favorite readers clued me in to this publication on health worker burnout from US Surgeon General Vivek Murthy. He cites Hawaii Pacific Health’s “Getting Rid of Stupid Stuff” initiative as an example of identifying and mitigating workflows that staff felt were unnecessary or poorly designed. The effort led to a savings of 1,700 nursing hours per month across the organization.

A specific example of burnout-generating work is the prior authorization process. Although I understand the need to reduce ordering of unneeded treatments and tests, I’ve long proposed some kind of golden ticket for those of us who order judiciously. In my time as a traditional family physician, I never had an order that failed to be authorized, which meant I was following guidelines. With years of that kind of track record under their belts, why should physicians be subjected to unneeded scrutiny? To be certain, all those unwarranted prior authorization process cost the payers more money than they saved.

Should providers who follow guidelines and control costs be rewarded by reduction in administrative burdens? Would such a move serve as an incentive for clinician behavior? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 7/21/22

July 20, 2022 Headlines No Comments

How Apple is empowering people with their health information

A new Apple report proclaims the company as “an intelligent guardian for [consumer] health and safety,” dividing its products between health and fitness (the Health app and the Apple Watch) and medical community collaboration (ResearchKit for study recruitment, Health Records to give patients access to provider data, Apple Watch for health system integration, and the company’s work in building COVID-19 apps and features).

Simplified Transfer Learning for Chest Radiography Model Development

An article published in the journal Radiology describes how Google Health has used advanced machine learning methods to pre-train chest X-ray networks that convert images into numerical vectors, which allows high-quality models to be created from 600-fold less data that can detect abnormalities and perform better in underrepresented populations and rare conditions.

Invitae to Lay Off Over 1,000 Workers Amid Restructuring, Leadership Transition

The medical genetic testing company will lay off 1,000 of its 2,900 employees, restructure, eliminate non-core operations and geographies, focus on profitable business lines, and shuffle its executive leadership and board.

VA scraps last EHR go-live date in FY 2022, amid IG accounts of patient harm

The VA postpones its last remaining 2022 go-live on Oracle Cerner, saying that the system isn’t ready to be used in larger facilities because of stability issues.

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