News 3/24/23

Top News

ED patient experience software vendor Vital raises $24.7 million in a Series B funding round.

The Atlanta-based company has raised $46 million since its founding in 2019.

Co-founder and CEO Aaron Patzer, MSEE was founder and CEO of money management software vendor Mint, which he sold to Intuit in 2009.

Reader Comments

From Homey D. Clown: “Re: GPT-4. Microsoft’s announcement included a quote from Epic that says the company will be using it.” The Microsoft blog post that announced Azure OpenAI Service quotes Epic SVP of R&D Seth Hain as saying that “we’ll use [GPT-4] to help physicians and nurses spend less time at the keyboard and to help them investigate data in more conversational, easy-to-use ways.” Hain, who joined Epic straight out of college in 2005, has spent the last eight years working on embedding cognitive computing and machine learning into Epic’s software. Health IT software vendors will need to make similar decisions about their financial and technical capabilities to incorporate ChatGPT-like AI into their products as opportunities and user expectations expand.

HIStalk Announcements and Requests

I’ll run my usual online guide of what HIStalk sponsors will be doing at HIMSS23 the week before it kicks off, so send me your details. And since the question comes up every year, we can in fact get a new sponsor onboarded quickly enough to get into the guide, not to mention that they also get 51 more weeks of involvement once we all return home from Chicago. 

I awkwardly put together my first weekly healthcare AI update, not yet confident about content and writing style. Still, I have lined up some good interviews as a result and the more I write, the more I’ll learn.

I have early access to Google’s Bard AI chat tool and found it to be vastly inferior to ChatGPT, even the 3.5 version, as it either gave wildly incorrect responses or declined to answer at all. Its only advantage is that its information is kept current instead of being limited by a training cutoff date, as ChatGPT’s famous knowledge horizon of September 2021. AI will get a lot cooler when it stays current, which may come in the form of merging it with search engines as Microsoft has done with Bing.

Webinars

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

Acquisitions, Funding, Business, and Stock

Primary care operator Oak Street Health, whose $10.6 billion acquisition by CVS is in progress, launches OakWell in joint venture with kidney care management company Interwell Health. OakWell will offer primary care services to patients with end-stage kidney disease directly in the dialysis center, where ESKD patients spend an average of 12 hours per week.

People

Caregility hires Paul Oliver (Cisco) as chief revenue officer.

Announcements and Implementations

Epic integrates Invitae’s genetic testing into its Orders and Results Anywhere network specialty diagnostics suite.

An Intelligent Medical Objects survey of provider leaders finds that 94% plan to implement software to address clinician burnout and a potential recession, while 98% of respondents acknowledge that they need to use data better to confront challenges. Most respondents think that AI is overhyped, yet are adopting it and reporting improvements in clinical quality and administrative functions as a result.

A new KLAS report ranks Epic Community Connect as the top EHR for FQHCs, closely followed by Athenahealth. NextGen Healthcare is the leader in supporting an integrated care model and treating underserved populations. FQHCs express general dissatisfaction with dental management software integration, although NextGen Healthcare customers are content with its Electronic Dental Record integration.

Government and Politics

The Oklahoma Health Care Authority board unanimously votes to implement a statewide HIE and require providers to contribute data to it except for patients who opt out. Mental health providers had marched on the capitol last week over concerns that the personal information of their patients could be compromised, while other providers are unhappy about the $5,000 signup fee.

Other

Former Microsoft HealthVault GM Sean Nolan takes a nostalgic look back at its acquired Azyxxi, which it later renamed to Amalga. He provides some fun backstory – and potentially startup-relevant lessons learned — to the flashy analytics platform that was the hottest thing going for a short time in the early 2000s:

• Azyxxi thought that ETL pre-work is always wrong and not useful for asking new questions, so they loaded data from source systems and relied on heavy SQL processing to transform it as needed.
• The company’s early culture was that users should be able to ask questions themselves instead of dealing with the IT department.
• The product displayed information in an automatically refreshed kiosk-type display in patient care areas. The company’s experts would optimize performance-hogging queries once they saw them being used, which avoided optimizing low-use functions.
• The Amalga team ran into channel conflict at Microsoft, which had salespeople co-selling with third party developers that used Microsoft technologies, meaning that the salespeople “were best buddies with a whole bunch of healthcare data analytics companies that were in direct competition with Amalga.”
• The product was created at Washington Hospital Center by a dedicated team of 40 employees, but prospect hospitals focused on risk avoidance rather than innovation and weren’t motivated to replace an existing, inferior product with one they had to learn.
• Microsoft narrowed its business lines with the hiring of Satya Nadella as CEO in 2014. Amalga was sold to the Caradigm joint venture of GE HealthCare and Microsoft, Microsoft sold its stake, and the company was split into two parts that were sold to Inspirata and Imprivata. He didn’t mention that Microsoft also used the Amalga name on a Thailand-based EHR and RIS/PACS that it acquired from Global Care Solutions (Microsoft later sold that business to Orion Health).

Epic stages a cook-off of its in-house chefs, with Madison magazine offering interesting facts about the company’s massive food service program:

• Epic serves 9,000 made-from-scratch meals per day from three food service buildings and seven culinary venues (soon to be eight).
• The company’s working farm provides some of the produce it uses.
• Several of its recipes are posted online.
• Culinary employees get the same benefits as everyone else, including paid vacations, bonuses, health insurance, sabbaticals, and normal working hours instead of the usual evenings and weekends.
• Epic’s on-campus soda fountain (above) is named after CEO Judy Faulkner’s father Lou, who owned a pharmacy that had a soda fountain.

Sponsor Updates

• CereCore releases a new podcast, “How L1 Support and Hosting Services Made Customers Happy and More.”
• Everbridge CEO David Wagner presides over the opening of the Nasdaq to celebrate the company’s new brand and 20th anniversary.
• The Association of Health Information Outsourcing Services elects HealthMark Group CEO Bart Howe as its new president.
• InterSystems releases a new Health Data Podcast, “Mitigating the Risk of Innovation (ft. Pothik Chatterjee, Lifebridge Health).”
• Meditech releases a new podcast, “Shaping home care and hospice practices at the national level.”

Blog Posts

• CMS Innovation Center: Specialist Incentives for Value-Based Care (Enlace Health)
• 5 Healthcare cybersecurity tips for apps and mobile devices (Fortified Health Security)
• Ensuring Security and Compliance for Life Sciences Data with HITRUST Certification (Healthcare Triangle)
• Medical chart audits: what you need to know (HealthMark Group)
• How EMR Optimization Empowers Your Healthcare Facility’s Top Talent (HealthTech Resources)
• Capitalizing on Tighter EHR-ERP Integration (Impact Advisors)
• The impending crisis in healthcare: Lessons from SVB’s collapse (Nordic)
• What makes clinical terminology so tough to maintain? (Intelligent Medical Objects)
• Communication Breakdown: The Growing Need for Data Integration Services in Community Hospitals (Medhost)
• Preventing Pressure Injuries in Hospitals Takes Best Practices and Technology (Net Health)
• Plans Must Move Upstream to Improve Medicare Advantage Member Outcomes (NeuroFlow)

Contacts

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

EPtalk by Dr. Jayne 3/23/23

People are always asking me how I’m reacting to various things in the news. I was saddened last week to see that Pear Therapeutics is searching for ways to remain viable. They were one of my favorite finds at HIMSS22.

Unfortunately, I don’t think frontline physicians really understand what Prescription Digital Therapeutics (PDT) products are and how they differ from recommending that a patient just download an app. PDTs have to be approved by the US Food and Drug Administration before they can be marketed for patient use. Pear has treatments for substance abuse disorder, opioid use disorder, and insomnia that are clinically proven to provide benefit to patients.

For the technology to make it to patients, however, it has to be prescribed by a licensed clinician, and many clinicians are simply overwhelmed. It’s challenging to get them to learn about new drugs, let alone entirely new paradigms. If someone knows about PDTs, they have to identify appropriate patients, then prescribe the solution. A prescription transmission goes to the PDT company, which then has to fulfill it. In Pear’s case, by providing an access code that allows the patient to download it from Apple or Google Play.

Once the patient begins using the tool, the clinician receives notifications through a prescriber dashboard and can monitor patient progress. It’s not unlike prescribing a medication. The intervention still requires monitoring and follow up by the prescriber, and patient adherence can be an issue. I hope Pear Therapeutics finds what they’re looking for and can continue the good work that they are doing.

I also received some questions about the potential for telehealth use to mitigate the unfolding tragedy in pediatrics, namely, the increase in all-cause mortality for children in the US. A research article published in JAMA last week looked at the increase in child and teen deaths that began pre-pandemic but worsened during last few years. The largest increase in pediatric mortality in 50 years is being led by injuries, which include motor vehicle accidents, overdose, homicide, and suicide. All of them were on the rise prior to 2019, with suicide being on the rise as early as 2007. Even children from ages 1 to 9 had increases in death rates. Infants younger than 12 months were the only ones spared. The article summarizes some of the racial disparities that accompany the rise in mortality, with non-white children being the most impacted.

When talking with people about potential interventions or solutions, everyone says “telehealth” as if it’s a magic bullet. Although telehealth can reduce the burden on families who are trying to get their children help — through easier access, reduced driving, etc., — the reality is that there simply are not enough therapists to go around. Social workers and others who deliver telehealth therapy are leaving the field at an alarming rate. Policy makers need to go deeper and look at the causes of increased mortality. Nearly half of the increase in 2020 was related to firearms deaths, which were the leading cause for children aged 1 to 19 years.

The article points out that nearly all the gains that have been made in pediatric longevity over the past few decades are being erased by “bullets, drugs, and automobiles.” So much for improving outcomes with asthma, vaccine-preventable diseases, premature birth, and the like. I continue to come across parents who bury their heads in the sand about what is going on with their children and who seem shocked when the physicians caring for them suggest that they need to talk to their middle schoolers about sex, drugs, and guns. Frankly, by middle school, it’s a little late for a lot of that, depending on who your kids run with, but as family physicians and pediatricians, we’ll keep trying. We can throw some telehealth at it as well, but it’s a much bigger issue than the majority of people understand.

Several people have also asked for my reaction to “The Match,” which is the National Resident Matching Program. It’s the multi-month mating dance where medical students try to figure out where they will continue their training through internship and/or residency, and where training programs figure out who their workforce will be for the next several years. There were some huge shakeups in Match data this year, with emergency medicine taking a serious hit. It was bad enough that the American College of Emergency Physicians and other organizations issued a joint statement about the specialty’s prospects. It cites “workforce projections, increased clinical demands, emergency department (ED) boarding, economic challenges, the impact of the COVID-19 pandemic, and the corporatization of medicine, among many others” as reasons leading students to choose specialties other than emergency medicine.

I’m not an emergency medicine physician, but I’ve spent the last 17 years of my career practicing alongside EM physicians in the emergency department and high-acuity urgent care settings. The specialty has been absolutely dumped on during the last three years. If you don’t know what ED boarding is, that means that when there aren’t enough beds in the hospital to admit new patients (usually because of nursing or other staffing shortages), those patient stack up in the emergency department. Depending on the facility, often the emergency team has to care for them. Sometimes it’s bad enough that patients are even discharged from the hospital after a multi-day stay without ever going to a regular room.

That’s not what EM physicians signed up for, and it’s not their particular skillset. When primary care practices shut down due to COVID, everyone went to the ED and the urgent cares. Some physicians were seeing 80-100 patients each shift, while other physicians shut down. It was brutal, and the things we saw were horrific. The moral injury from having to ration care still haunts many of us. The sense of powerlessness that most of us felt for weeks grew to months and into years with little relief. Some of us are still coping with the symptoms of post-traumatic stress disorder, and a lot of us have left the profession.

For those frontline healthcare IT folks who have been trying to support the emergency department through all of this, you’ve seen it and understand why students don’t want to choose a career in the emergency medicine trenches. Thank you for your patience and compassion when we were frustrated day after day and the technology seemed like just one more thing causing torment. For those of you who haven’t seen this, or who haven’t been a patient lately, the downstream effects of this Match will ripple through our health systems for years to come. Ultimately patients will continue to bear the brunt of the mess that is the US healthcare system.

Would you encourage your child or loved one to pursue a career in medicine? What about healthcare technology? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 3/23/23

Veterans Affairs shares statement on electronic health records rollout

Mann-Grandstaff VA Medical Center (WA) shares improvements made to the VA’s Oracle Cerner system, and stresses that the VA remains committed to fully implementing the same system as that used by the DoD and Coast Guard.

Mental Health Leader SonderMind to Provide More Personalized Care with Acquisition of Mindstrong Technology

SonderMind, a mental healthcare company that helps match patients with therapists, acquires the technology of virtual mental healthcare provider Mindstrong, which is in the midst of winding down operations.

There in the sky! Not a bird, not a plane, it’s VA’s old VistA system!

The VA will shift its legacy VistA system to the cloud to ensure its functionality and accessibility while the new Oracle Cerner system is optimized and implemented across the department’s remaining facilities.

Healthcare AI News 3/22/23

Reader Note

This is my first weekly healthcare AI news recap, and as such is a work in progress as I learn on the job. I need advice about the topics that interest you, how you would like to see items laid out, and suggestions of individual experts and companies that you follow for healthcare AI news. I’m also interested in interviewing experts. Let me know.

News

Google releases its Bard chatbot to a limited number of users. I got early access and it has a long way to go to catch up even to ChatGPT 3.5, much less GPT-4.

Google is using its Duplex automated calling to contact US healthcare providers to see if their information is correct and to find out if they accept Medicaid, both with the intention of updating Google search results.

Medical device manufacturer Medtronic will incorporate Nvidia’s AI technology into its AI-assisted colonoscopy tool.

Microsoft offers a preview of GPT-4 for customers of its Azure OpenAI Service.

PNC’s treasury management launches PNC Claim Predictor, an AI-powered tool that learns from previously submitted claims to identify future claims that are likely to be rejected. The system integrates with EHRs, including Epic.

The Wall Street Journal looks at startups that are offering AI for healthcare use:

• Abridge AI, which is being implemented at University of Kansas Health System, creates visit summaries from the recorded audio from a visit.
• Syntegra creates validated synthetic patient data that can be used for research when available patient data is limited or when privacy laws limit its use.
• Atropos Health analyzes available anonymized patient records to product observational research.

OpenAI CTO Mira Murati joins the board of Unlearn, which uses AI-generated digital twins of individual patients for work with clinical trials and precision medicine.

Ommyx launches an AI health tracking app and a $15 per month service that integrates data from wearables and sends recommendations about nutrition, activity, and sleep to the user’s calendar.

Pangaea, whose AI technology characterizes patient disease trajectories, predicts the length of stay and morality risk of ICU patients with 85% accuracy. The company says its technology discovers undiagnosed and misdiagnosed patients, reduces treatment costs, and gives drug companies access to provider data in a privacy compliant manner.

France-based startup Nabla announces GPT-3 powered Copilot, a digital assistant that transcribes information from video conversations and generates prescriptions, appointment letters, and visit summary. The tool will initially be provided as a Chrome browser extension and an in-person version will be released soon. The company also sells a tool for patient engagement and secure messaging, video consults, and scheduling, all of which include machine learning.

Research

Researchers find that ChatGPT does a good job explaining myths and misperceptions about cancer, creating summaries that are not noticeably different or less readable than the National Cancer Institute’s answers. The authors conclude that AI chatbots could be useful for people who are seeking cancer information online.

Opinion

Doctors are skeptical that they can trust AI systems that have been trained to think like experts in situations where no single right answer exists, Politico reports. The federal government is pairing AI with expert humans to figure out how they reason on the battlefield or in natural disasters. They are following the model of medical imaging analysis, where AI is defined as successful if its conclusions fall within the boundaries of those offered by radiologists who don’t necessarily agree with each other.

Bill Gates says that AI will be the most important advance in technology since the graphical user interface. He predicts widespread use of Microsoft’s co-pilot technology in Office, controlling computers by writing plain English requests instead of pointing and clicking, and using AI as a personal agent to manage emails and appointments. He foresees AI’s impact on healthcare as helping its workers with repetitive tasks, and in countries with too few doctors, helping patients with basic triage and advice.

An interesting article says that generative AI could fuel a better, more entrepreneurial business model than the Internet’s advertising-obsessed “attention economy” that has killed off newspapers and online content sources.

Resources and Tools

Are you regularly using AI-related tools for work or for personal use? Let me know and I’ll list them here. These aren’t necessarily healthcare related, just interesting uses of AI.

• PromptPal – user-created prompts for ChatGPT and other services.
• Supernormal – records and transcribes Zoom meetings to create notes.
• Engage AI – analyzes the voice characteristics of contact center conversations in real time to give agents suggestions to improve their call quality.
• Futurenda – plans and tracks tasks and time usage.
• Whisper Memos – transcribes recorded phone messages.
• Descript – video editing, podcasting, transcription, and AI voices that can be used for team communication.
• Dall-E 2 – create images from text.
• Branmark – create business logos from text descriptions.
• Synthesia – create videos from text that feature lifelike avatars and 120 language options.
• SlidesAI – create Google Slides from text.
• Yippity – create text or websites into quizzes and flashcards.
• Otter – takes online meeting notes, creates summaries, and auto-join and record meetings from your calendar entry in case you’re late.

Contacts

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

HIStalk Interviews Ed Gaudet, CEO, Censinet

Ed Gaudet is founder and CEO of Censinet of Boston, MA.

Tell me about yourself and the company.

I’m a high-tech entrepreneur. I’ve done 11 startups throughout my career, mostly focused on building products and applying technology and automation to solve customer problems. I’ve done cross industry, everything from finance and energy to healthcare. I entered healthcare in 2010 when I joined Imprivata. I took Imprivata into healthcare, drove marketing and products for them, and then built their cloud platform for communications. We eventually took that company public and then private when Thoma Bravo purchased the company in 2016. 

I  left and attempted retirement, but that didn’t go too well [laughs]. My wife cordially commanded me to go find a job and get off the kitchen table. I started Censinet in September 2017, partnering with investor Keith Figlioli of LRVHealth. We found a syndicate of other investors and launched the company.

Who are your main competitors and what are your differentiators?

I saw while working at Imprivata this requirement to fill out security risk assessments. We used to joke that if you see one assessment, you’ve seen one assessment, because they are all different. They were in different formats, the questions were different, and semantics were different, so it took a lot of time. You could never get really leveraged. When I looked at problems to solve as I was exiting retirement, I kept coming back to this problem. What was interesting to me was looking at all of the alternative solutions that had been out there in the marketplace for probably a decade. Yet the problems — breaches, incidents, and attacks — were getting worse. Whatever we were doing in terms of trying to protect healthcare wasn’t working.

I looked at the problem around risk management in particular. I felt like there was an opportunity to disrupt the market and do something completely different to ultimately move the needle in risk and start to take out risk in healthcare. That was the idea behind it.

Some organizations aren’t what I think of as competition, but they they were providing solutions at the time. They were doing assessments through a combination of technology and services. You had folks like HITRUST with their framework. Then there were a bunch of early-on entrants that were trying to automate the problem through a pipeline approach, a single application, and you couldn’t get leverage.

For example, if Intermountain was using a single application to manage risk, and Cedars-Sinai was using the same application but they weren’t really connected, where’s the leverage? In looking at other markets, technologies, and architectures, I had this epiphany that we should put it on a network. We should think about it as a multi-sided platform. Could we streamline the automation on an exchange, a platform that was connected to the different actors in that process of managing risk information, and ultimately put controls in place to effectively reduce risk over time?

What are healthcare’s risks and how do they compare with those of other industries?

I learned through the Imprivata experience that healthcare is different. It is an ecosystem in and of itself. It’s a large ecosystem. The workflows are different. The requirements are different. The regulations are different. Other competitors or solutions were taking a broad approach to the problem, but I felt like we had to be purpose-built for healthcare. We had to think about the problem through the lens of the CIO and the CISO in healthcare and not worry about other industries, because the problem is so big.

We started with third-party risk. We thought about the vendors and those products and services that they were providing to the health systems. How that could affect risk. At the time, the percentage of third parties that were involved and integrated into the business process of health systems was fairly manageable. But in the past five or 10 years, that percentage has grown exponentially. You’re seeing every business process in a health system directly being run on some type of digital or IT infrastructure or technology.

Cyber risk was mostly in IT problem. Your IT organization would manage the security risk assessments, the process for collecting the data, create the remediations or corrective action plans, and manage that through the business. Cyber risk is now enterprise risk that affects every single department within a healthcare organization. Every business process is affected by cyber risk, because they rely on technology to do their work.

That has made a big impact on our overall strategy and where we’ve taken the product. Where we started with third parties and built the platform, today we have over 34,000 assessed vendors and products in our digital catalog. On the other side of the network, we have over 100 customers across more than 500 facilities. The network is growing, and every new provider we add, every new vendor we add, has a geometric effect. Providers bring new vendors, new vendors bring new vendors and new providers. There’s this flywheel that happens. We get this incredible network effect on our platform, which drives a number of benefits to the participants. 

Part of the vision was that if we’re going to solve this problem around risk and around cybersecurity, we have to take a page out of the bad guys’ playbook. If you think about what they’re doing and why they are so effective, they are organized. They have a cyberattack conveyor belt. They have applied manufacturing principles to cyberattacks. They have this concept of micro services, where each person has a certain role that they manage in the attack. It’s not just one person doing the full stack attack. That organization has made them effective and dangerous, yet from an industry perspective, we haven’t come together. The vision for Censinet was a platform to facilitate that ability to drive that leverage and drive the power of the community to protect itself.

Many recent incidents involved business partners or external technology vendors. What do you look for and what do you provide to the organization that engages with you?

Our history from an organizational perspective is third-party risk. We’ve leveraged that into other areas of risk management. When you think about an initial customer implementation, the customer comes on board and they can easily and quickly start sending out assessments in the platform. They’ll search for a particular vendor or product. They will use the platform to send out an invite that vendor and its products into that process. The analogy is where you want to do an assessment on a vendor and its products and you send out any email with a spreadsheet. We’re automating that workflow and sending out an email with a link to the portal.

The vendor fills out the questionnaire, attaches any supporting evidence or documentation to their claims, and it sends it back to the provider. The provider then has full automation capabilities for things like rating and driving corrective actions or remediations automatically, or they can do it manually in the platform and they can generate all their reporting through the platform as well. That end-to-end process, without us, can up to six weeks the first time time a vendor comes on board. Our SLA guarantee is 10 days or less for that full assessment, which is incredible. The next time that vendor gets asked to do an assessment by somebody else in the platform, it’s a click of a button. The network effect continues to drive that value as more people are added to it. It increases over time and it’s exponential. 

We are doing not just that facilitation. We are also doing those governance functions. We’re driving the curation of the assessment data, the questionnaires based on the regulations that are ever changing, as well as the corrective actions. If a vendor answers in a certain way and risk is generated, then how do we correctively reduce that risk? What do we put in place to move that risk from a certain inherent risk to a residual risk that we can accept as an organization? We do that all on the platform.

Typically without a platform like ours, you do a point in time, set it and forget it. I’m going to purchase this product, I’m going to do risk, and then maybe I’ll be able to do a reassessment at some point, which nobody ever does. With our system, once you do your initial assessment, you’ve got the data in there. You can automatically set up a reassessment for some time, usually a year later. You can tier that vendor into a critical, high, medium, or low tier, which can drive automation on the back end. You have the ability to periodically and continually assess that vendor and their product or products based on maybe a scope change.

For example, if you just set it and forget it, you miss the ability for risk to appear based on some type of scope change. Blackbaud was a donor management that many health systems used a few years ago. On paper. it seemed like it was low risk. No PHI is going to be on this, so we’ll send it through a low risk assessment process. Users changed the scope of usage, and introduced risk, by putting PHI in the application. Because nobody was looking at it, nobody was continually assessing it, they missed it, and it caused a huge breach issue across a number of health systems. 

Having this lifecycle approach is another differentiation that we bring, and an innovation that we bring, to the marketplace. Think about it as a longitudinal record for risk in the same way that the EHR is that longitudinal record of care.

Customers are always faced with the decision of how much they are willing to spend to mitigate whatever risks exist. What framework do they use to evaluate the exposures you call out?

Without a system like this, they are rolling the dice. It’s anyone’s guess. There’s an inability to manage a risk program in a way that can be data driven because the artifacts are scattered. They’re not centrally located, they’re not pulled together, they’re not driven through automation. They might be in emails, spreadsheets, sticky notes, and conversations, so the ability to assess all third parties is difficult without a system like ours.

You have to automate that process. You could have 1,000 vendors with 2,000 products in your environment. You start to apply a solution like ours. Those have to be added to the system. That data has to be captured through maybe a reassessment that can be automatically set, because every day that goes by, someone is buying something new that needs to be assessed.

We often see customers will start with net new vendors and products and quickly realize, wow, we have all these other legacy products that we have three-year contracts with. We need to add them to the system as well. We encourage that, because ultimately you have to understand what that risk is. With a system like Censinet, it doesn’t take a lot of time to do that. There are tools to basically apply tiering to those different vendors and products. Which by the way, people do regardless of whether they have a system or not.

Let’s say they have a handful of products, but they’re doing it manually. What we find is that there’s this tiering that happens a priori before they even do an assessment. They will say, we can’t handle everything, so we’re going to make some judgments. We’re going to stratify artificially these vendors and products into buckets of risk. That’s high, that’s critical, that’s medium, that’s low. But there needs to be a true business impact analysis, where you’re understanding the product and the vendor relationship through the eyes of the business, because ultimately they understand the importance and criticality of that product, not the IT organization. 

There’s this real disconnect with the risk management programs that occurs. Everyone thinks they are doing the right thing by doing these assessments, but there needs to be a broader rubric and a strategic lens to apply across the organization when it comes to risk. Because as you said, you otherwise could be spending a lot of money and getting little benefit. We see that all the time. We see organizations throw point tools at the problem and not think through strategically how to manage risk. Not just today, but in the future.

If you take a tool and you apply it to a terrible process, you’re going to get a terrible result. Vice versa, if you have a great process and you apply a terrible tool, you’re going to get terrible returns. If the tool is good, then the tool should inform the process. The leadership team needs to take that into consideration when they bring these things on board, because they are transforming their organization. They should be open to that. They should be willing to change, because ultimately they’re going to have to change to stay in the game. It’s no longer good enough to throw spreadsheets at this problem. You need a better approach, a more strategic approach, that includes the right resources, the right process, and the right product or technology to move the needle on risk.

What will be important to the company over the next three or four years?

When we first started off with third-party risk, our customers would come to us and say, we love what you’re doing with third parties, but we have another dozen or so risk processes, silos if you will, within the organization. For example, Intermountain said, we have institutional review board processes and we do a number of risk assessments, but we do it in a different product. We are holding this thing together and we have people supporting it. Can you consolidate it on your platform?

We’ve been working with our customers to identify those silos of risk and consolidate them on the platform. We’ve added things like IRB and the ability to do enterprise risk, where the health system can assess its own facility, its own operations, using NIST CSF, using the health industry cybersecurity practices, the HICP framework. Those are being recognized as security practices. In the event of an incident, if you an prove that you’re following the NCSF and applying it, or HICP, and  there’s some type of event or incident, OCR has to take that in consideration as part of some recent regulation. Public law 116-321 provides — I hate to use the word safe harbor, but effectively it’s a safe harbor – if you do the right thing from an enterprise risk perspective. 

We look at M&A transactions, the risk involved with acquiring a new organization, and assessing the risk of that and how you bring that into the platform. If you’re building applications internally or doing integrations, those require assessments as well. You can do that now on the platform. We started off with technical suppliers and technical products, but what about the non-technical suppliers, like a laundry service that may be critical to a health system? The health system is so large that it requires a certain laundry service, and maybe there’s only one that can service them accordingly. What would happen if that laundry service was hit with a cyberattack? That hospital wouldn’t be able to function without laundry. 

Elements of suppliers that are non-technical could have huge impacts to health systems. Maybe the organization is thinking about those, maybe they’re not, maybe they’re in a different system. Medical devices typically are being managed through the biomed team, but there should be some connection with the IT team. Why are they doing it in two separate places? Why are they doing it with two separate processes? We are starting to see the consolidation of all these silos of risk on the Censinet platform, which continues to drive down the unit economics for our customers and deliver interesting, unique value.

Morning Headlines 3/22/23

Nuance and Microsoft Announce the First Fully AI-Automated Clinical Documentation Application for Healthcare

Microsoft-owned Nuance will launch Dragon Ambient EXperience Express, which uses ChatGPT-4 to automatically generate clinical notes, this summer.

Maven Clinic Accelerates Growth in the United Kingdom with Acquisition of Naytal

Maven Clinic, a virtual women’s and family health provider that has raised $300 million, acquires UK competitor Naytal for an undisclosed sum.

Bionic Health raises $3M for its AI health clinic using GPT-4 and other ML models to design better preventative care

North Carolina-based Bionic Health will use $3 million in seed funding to further develop its membership-based “AI health clinic” for preventative care.

Perspectives of Patients About Immediate Access to Test Results Through an Online Patient Portal

A survey involving four academic medical centers finds that nearly all patients appreciate having their test results posted immediately to the patient portal, even if their providers haven’t reviewed them.

News 3/22/23

Top News

Microsoft-owned Nuance will launch Dragon Ambient EXperience Express, which uses ChatGPT-4 to automatically generate clinical notes, this summer.

DAX Express will be included in DAX. It will also be offered as an addition to Dragon Medical One.

DAX Express creates clinical notes using exam room or telehealth conversations with patients.

Nuance will demonstrate the product at HIMSS23.

Reader Comments

From Lloyd Christmas: “Re: DoD’s DEERS personnel system. Hearing that it screws up addresses, pay, and assignments. I imagine it feeds into the Tricare system and probably Cerner.” The Army has also had problems with its IPPS-A human resources system, whose recent problems have resulted in incomplete data that is used for promotions and assignments. Problems in either system are likely to cause problems in Oracle Cerner, although at least the  $600 million IPPS-A system is also from Oracle, based on PeopleSoft.

From Midwest Nice: “Re: Epic. Judy reads HIStalk! Slide shared from March staff meeting.” My goal is that every reader feels as though I’m whispering directly into their ear alone as their guilty pleasure. But I will share one story. Several years ago, some health IT companies were blocking access to HIStalk because they didn’t want their employees to hear the truth (which of course led those employees to simply read after hours from home). I received what I think was my first-ever email from Carl at Epic, which started off with the ominous, “I have a problem with your site.” I nervously continued: “Some of our employees are telling me that they aren’t able to access HIStalk from work. We can’t determine if the problem is on our end or yours. Can you help me out so they can keep reading?”

HIStalk Announcements and Requests

Welcome to new HIStalk Platinum Sponsor Marble. Marble provides a holistic API platform representing the simplest way to get patient authorization and access to a vast data network from 120 million patients and 65,000 healthcare organizations. On the front end, Marble captures and verifies patient identity, obtaining explicit patient consent to access and share patient data and storing that data with FHIR-compliant companies using the Marble API. Developers gain network searchability and data retrieval at their fingertips while meeting HIPAA compliance and other privacy mandates. Thanks to Marble for supporting HIStalk.

Attention ViVE 2023 attendees: check out what HIStalk’s sponsors say they will be doing there next week.

I’m not often a fan of suddenly trendy words and phrases, but this one’s efficiency gets my green light: 3Xing (it works with any number). You 3Xed your revenue, which is the same as tripling it (which is the same as increasing it by 200%, which confounds a lot of people).

Webinars

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

Sales

• UR Medicine Highland Hospital (NY) will use software from Medaptus to manage inpatient physician assignments.
• Mental health system Brook Lane (MD) selects Commure’s Strongline staff safety alert system.
• Northwell Health will implement Epic, with the first go-lives scheduled for 2025.
• Vitas Healthcare will implement WellSky’s hospital and palliative care solution in its 50 hospices.

People

Julia Strandberg, MBA (Pear Therapeutics) joins Philips as chief business leader of its connected care businesses, including enterprise informatics.

KLAS Research promotes Steve Low, MS to president.

Caregility hires Kedar Ganta, MBA (Cisco) as chief product and engineering officer.

Health Data Movers promotes Karla Christopher and Brandon Camp, MBA to VPs of delivery.

Announcements and Implementations

Delaware-based ChristianaCare’s Center for Virtual Health launches a subscription-based, direct-to-consumer virtual primary care service in six states.

Children’s Hospital of Philadelphia develops a remote patient monitoring program for babies discharged from the NICU and an RPM program focused on malnutrition.

Maternity telehealth provider Ouma Health will partner with MedArrive’s field provider network to offer in-home services to pregnant women and newborns, especially high-risk Medicaid beneficiaries. The companies note that Medicaid mothers are often erroneously labeled as non-compliant when they miss appointments because of problems with transportation or taking time off from work.

Gozio Health enhances its mobile platform to support customized experiences by user type.

KLAS interviews a small number of Oracle Health customers about their perception of the company:

• The percentage of clients that see Oracle Health as a long-term partner has dropped significantly, particularly in large health systems.
• Customers say they are losing patience waiting for the company’s RevElate RCM solution, for which communication has been infrequent.
• They also question whether Oracle Health has enough staff left to implement RevElate after several rounds of layoffs.
• While customers think that Oracle Health will execute better than Cerner, they are uneasy about the lack of detail in the company’s plans.

Government and Politics

Politico reports that the FTC decided not to sue to block Amazon’s $4 billion acquisition of One Medical due to the case being considered too hard to win. Questionable negotiations with Lyft just before Amazon Care was shuttered and the One Medical deal announced had raised federal red flags, but the online retailer’s far-reaching tentacles have left lawmakers unable to effectively pinpoint exactly which markets may have been monopolized.

The VA will launch a pilot of its internally-developed Internal Scheduling System this summer, enabling medical support assistants to see available appointment slots for particular providers without navigating five or more windows. The VA is also looking for commercial software “like ZocDoc or Kyruus” to help its providers manage community referrals.

The FTC offers a deep dive into the enforcement actions it took against GoodRx and BetterHelp after they allegedly used pixel-tracking technology to share user health data with third parties for advertising.

Privacy and Security

UC San Diego Health notifies patients that vendor Solv Health used analytics tools that distributed information to third-parties without authorization on the scheduling websites of the health system’s Express Care and Urgent Care clinics.

Other

A survey involving four academic medical centers finds that nearly all patients appreciate having their test results posted immediately to the patient portal, even if their providers haven’t reviewed them. Some of those whose results were abnormal reported being worried and trying to understand what the results meant to their health, but 95% of them wanted immediate access to continue anyway. The authors suggest conducting further studies of pre-counseling — which was not associated with lower levels of worry in the study — and allowing portal users to designate their notification preferences for abnormal results or to hold results until after working hours, perhaps even on a per-test basis based on the patient’s level of concern.

Sponsor Updates

• Lakes Region Mental Health Center (NH) expands its use of Netsmart technology to include the CareFabric platform.
• Meditech, Algonquin College, and Queensway Carleton Hospital in Canada, partner to teach EHR configuration, workflows, collaboration, and security in lab sessions this semester.
• Artera will exhibit at The Beryl Institute’s Elevate PX event March 27-29 in Dallas.
• Azara Healthcare congratulates FQHC customers Community Health Center of Southeast Kansas and Valley Professionals Community Health Center (IN) on being recognized by HHS as 2022 Million Hearts Champions.
• Baker Tilly releases a new Healthy Outcomes Podcast, “Direct-care workers in the post-acute care sector – challenges and opportunities.”
• CereCore publishes a new case study, “An Epic Implementation Story: Fast Tracking Epic Integration for a New Pediatric Facility.”
• Nordic releases a new episode of In Network’s Designing for Health podcast.
• ChartSpan becomes the exclusive chronic care management partner of Arkansas Hospital Association Services.
• Dimensional Insight will exhibit at AMGA 2023 March 28-31 in Chicago.
• CompTIA honors Divurgent SVP of Delivery Rebecca Woods with its 2023 North American Spotlight Award for advancing women in technology leadership.
• CereCore expands its specialized IT staffing services in the Dallas-Fort Worth area to better serve the area’s healthcare and life sciences industries.
• The latest Philips Capsule patient deterioration Surveillance solution receives market clearance from the FDA.

Blog Posts

• The AI Advantage: Complete, Accurate, and Compliant Medical Coding (AGS Health)
• What conditions are causing hospital readmissions? (Arcadia)
• How Virtual Monitoring Technology Improves Patient Safety (AvaSure)
• How encryption can take your data security to the next level (Philips Capsule)
• Managing Post-Acute Care to Improve Quality and Reduce Costs (CarePort)
• Bottom Line: Cost Savings is Why Meditech EHR and AP Automation Make Sense (CereCore)
• A time of growth at Oracle Health (Oracle Cerner)
• Digital Health Companies: Get Ahead of the Cybersecurity Implications of the SVB Collapse (Clearwater)
• How EMR Optimization Empowers Your Healthcare Facility’s Top Talent (HealthTech Resources)
• Improving Health Equity by Understanding the Social Drivers of Health (CTG)
• Top Questions About Hospital-at-Home (Current Health)

Contacts

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

Morning Headlines 3/21/23

Washington prepares for war with Amazon

Politico reports that the FTC decided not to sue to block Amazon’s $4 billion acquisition of One Medical due to the case being considered too hard to win.

RookMotion Raises $1.7M in Pre-Seed Funding to Empower Companies With More Actionable Health Data, Rebrands to Rook

Texas-based wearables data integration and analytics startup Rook raises $1.7 million.

Infinity Announces New Name, Now SimiTree Behavioral Health

Behavioral health IT vendor Infinity rebrands to SimiTree Behavioral Health after being acquired by the RCM, outsourcing, and professional services company SimiTree last year.

HIStalk’s Guide to ViVE 2023

AGS Health

Booth 1619

Contact: Christina Cussimanio, SVP of marketing

christina.cussimanio@agshealth.com

802.777.4084

AGS Health is more than a revenue cycle management company – we’re a strategic partner for growth. With expert services complemented by AI-enabled technologies and high-touch support, AGS Health is the premier revenue cycle partner for leading health systems, physician groups, and academic medical centers in the US. AGS Health employs more than 11,000 team members globally and partners with more than 100 clients across a variety of care settings, specialties, and billing systems. Anyone who is seeking an end-to-end revenue cycle management partner should seek out AGS. We will be hosting a charity event for the Kids In Need Foundation where participants can stuff a pencil case for a child in need.

AvaSure

Booth 911

Contact: Laura Melendez, event manager

laura.melendez@avasure.com

If you are interested in setting up a meeting or talking with AvaSure experts like our Chief Product Officer, Jacob Hansen, you can request a time.

AvaSure provides the leading hospital virtual care platform to systems with nursing and staffing shortages that are challenged to significantly reduce labor costs without sacrificing patient health outcomes. Recently recognized by KLAS Research as the leader in reducing the cost of patient care, AvaSure is the pioneer in providing best-in-class, video-based AvaSure TeleSitter and TeleNurse solutions. As a trusted partner of more than 1,000 hospitals, AvaSure combines remote patient monitors, virtual nurses, and other providers on a single platform to enhance clinical care without placing any additional burdens on existing staff.

Baker Tilly

Booth 2407

Contact: Charlie Cook (charlie.cook@bakertilly.com), Ed Ricks (ed.ricks@bakertilly.com, 843.521.7191)

Baker Tilly is a top eight CPA Advisory firm worldwide. We’d love to have you chat with Ed Ricks, former health system CIO and COO, about how we are helping health systems solve the nursing shortage with an AI platform in conjunction with our change management and analytics services. Helping remove barriers to care delivery, improve patient and clinician satisfaction, and improve the bottom line. Go there. Start here.

Care.ai

Booth 1512

Contact: hello@care.ai

Visit booth #1512 to learn how leading health systems use care.ai’s Smart Care Facility Platform to optimize their processes. Discover how our platform empowers care teams to deliver personalized, quality care leading to better patient outcomes.

CereCore

Booth 2704

Contact: Jillian Whitefield, business development manager

jillian.whitefield@CereCore.net

248.891.5557

CereCore provides IT services that make it easier for hospitals and healthcare systems to focus on supporting hospital operations and transforming healthcare through technology. We partner with clients to extend their team through comprehensive IT staffing and application support; technical, professional, and managed services; IT advisory services; and EHR consulting because we know firsthand the power that integrated technology has on patient care and communities.

Clearwater

Kiosk 1 in the Cybersecurity Pavilion

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, March 28, at 10:30am in the Cybersecurity Pavilion as Clearwater CEO Steve Cagle presents “The Top 3 Questions Health System CISOs Want to Know About the Security of Digital Health Technologies (and How to Satisfy Them).”

Clinical Architecture

Booth 2020

Contact: Jeff Nolan, VP of sales

jeff_nolan@clinicalarchitecture.com

843.521.7191

Schedule time to meet with us at our booth:

Clinical Architecture delivers healthcare enterprise data quality solutions focused on managing vast amounts of disparate data to help customers succeed with analytics, population health, and value-based care. Our solutions produce trusted, actionable data to enable smart decisions that mitigate risk, reduce cost, and improve outcomes. Schedule a meeting with us during #ViVE2023 so we can show you how we’ve helped some of the largest healthcare enterprises overcome their data quality struggles.

Consensus Cloud Solutions

Booth 1020

We will showcase our innovative solutions that streamline workflow processes and enable interoperability across the healthcare ecosystem. Our experts will also be demonstrating our Natural language Processing (NLP) and Artificial Intelligence (AI) solutions at the InterOpNOW! kiosk 13, where attendees can learn how Consensus’ solutions address the industry’s growing need for technology that alleviates the burden of repetitive administrative processes, while helping to reduce staff frustration and enable actionable insights to improve care.

But that’s not all! We hope you’ll join our communication-exchange experts at our booth in a fun, interactive game of Drawful. All participants will be entered into our daily raffle for a chance to win a Nintendo Switch!

Divurgent

Meeting Cube 1258

Contact: Brittany Williams, VP of marketing and communications

brittany.williams@divurgent.com

804.712.1524

Divurgent is your partner in digital acceleration – we’re a solutions provider focused on what matters most to our client partners. We disrupt the typical value equation by using data-infused, flexible, and scalable solutions that demonstrate and quantify value for our partners. We are committed to IT evolution, deploying tailored solutions that help our client partners achieve improved operational effectiveness, financial performance, and quality of customer experience. Learn about our Business Resiliency Tooling and Epic Hyperdrive Solutions – book time with us here.

Ellkay

Booth 1826

Contact: Ajay Kapare, chief strategy and marketing officer

TeamELLKAY@ELLKAY.com

The Team ELLKAY booth 1826 is one stop you don’t want to miss at ViVE! Whether you need your coffee kick in the morning or want to unwind during Happy Hour at night, join us in booth1826 and learn how to declutter your data strategy and make interoperability happen. ELLKAY’s innovative cloud-based solutions address the challenges that hospitals and health systems, laboratories, healthcare IT vendors, health plans, and ambulatory practices face. Schedule a meeting during ViVE with our team of data experts today!

Five9

Booth 1212

Contact: Roni Jamesmeyer, senior healthcare manager

roni.jamesmeyer@five9.com

972.768.6554

We will host a Happy Hour on Monday afternoon in our booth 1212 and have a book signing event during that time giving away free, signed copies of the book, “Blueprint for the Contact Center of the Future.” Come have a drink, meet the author, and grab a book!

Fortified Health Security

Booth 2243, Meeting Room 102B

Contact: Matthew Thompson, community manager

mthompson@fortifiedhealthsecurity.com

615.600.4002 x119

Fortified is Healthcare’s Cybersecurity Partner and we’re coming to ViVE with a full schedule of strategy sessions and social events. Join us in the Fortified Central Command Room (meeting room 102B) for one of these events:

• Crash Central Command: Security professionals cocktail mixer.
• Strategy session: Cyber subsidy strategies and lunch.
• Strategy session: Building a medical device security program and breakfast.
• Ask a VISO: Have healthcare cybersecurity questions? Ask one of our on-site VISOs.
• Introducing a better way to manage your MSSP: Fortified Central Command Group.

Demo Seats are limited. RSVP for any of these events here.

Fortified Health Security is Healthcare’s Cybersecurity Partner – securing data and reducing risk to help ensure patient safety and continuity of care. A two-time Best in KLAS award winner, Fortified works with healthcare organizations to construct client-centric, customized programs leveraging both new and existing solutions. We are committed to building a stronger cybersecurity landscape for both our client ecosystem and the healthcare industry as a whole.

Healthwise

Booth 1028

Contact: Nate Smith, partner solutions, digital health

nsmith@healthwise.org

415.516.9848

Healthwise gets it right every day so you can focus on building your digital health offering. Headlines report changes in medicine every day, but not every headline tells the whole story. Trust our content to be accurate and up-to-date and to reflect the evidence and current standards in medical practice. We stay one step ahead with our comprehensive monitoring, research, writing, review, and update process. Developed to be inclusive, Healthwise content can help you better serve and relate to an increasingly diverse population. Enhanced API documentation makes it easier and quicker for developers to get started with Healthwise APIs.

JTG Consulting Group

We will not have a fixed location. Please feel free to email the team attending (CEO Jamel Giuma and VP of Sales Philip Garrott) at TeamJTG@jtg.group, or schedule an appointment.

JTG Consulting Group offers comprehensive custom consulting services from professionals who have experience in a wide cross-section of industries with deep proficiency in healthcare, healthcare IT, laboratory, and laboratory information sectors. Our scalable offerings are designed to fully compliment and support the plan we build for you, and we provide creative and time-tested solutions to fit the unique needs of your health system. JTG was founded in 2018 by Jamel Giuma. His vision was to create a boutique healthcare IT consulting firm to provide custom IT support and solutions to health systems of all sizes. Our core team of employees is supported by a vast network of consultants from various settings and with a wide range of healthcare IT specialties. Connect with us to experience the JTG Way! Check out our blog post about Overcoming Staffing Shortages in the Lab: Finding the Right Fit Consulting Firm. Read our KLAS Report and see why the JTG team ranked #5 out of 26 in HIT Staffing!

Medhost

Booth 1942

Contact: Samra Khan, senior marketing manager

samra.khan@medhost.com

As a leading provider of electronic health records (EHR) and healthcare IT services, MEDHOST will showcase its clinical and financial solutions and services to help enhance hospital operations and patient care while improving your bottom line. At the MEDHOST booth, visitors can also learn about our mobile apps, digital patient management, and our partnerships with innovative companies such as CommonWell Health Alliance and AWS. MEDHOST is all about increasing your bottom line and helping you save costs, and you can start doing that by stopping at our booth and entering our giveaway for a chance to win a $500 gift card. To learn more or schedule a demo, please email inquiries@medhost.com or speak with a MEDHOST representative at ViVE booth #1942.

Nuance

Booth 2312

Contact: Doug Kaufman, solutions consultant

Doug.Kaufman@nuance.com

781.565.5000

Get ready for Nuance at ViVE! Together, Microsoft and Nuance offer the AI solutions you need to drive better decision‑making, improve physician and patient experiences, create more meaningful connections, and produce tangible results.

Request a meeting or visit the Nuance pod in Microsoft booth #2312 to experience how we help providers engage with patients more effectively at every stage of the health and wellness journey. While you are here, learn more about the launch of DAX Express, a fully automated, workflow-integrated clinical documentation solution that is the first to combine proven conversational and ambient AI with GPT-4, the newest and most capable generative AI.

ReMedi Health Solutions

Contact: GP Hyare, managing director

g.hyare@remedihs.com

ReMedi Health Solutions is a nationally recognized, physician-led healthcare IT consulting firm specializing in peer-to-peer, clinician-centric EHR implementation and training. At ReMedi, 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.

Tegria

Meeting Cube 1265

Contact: Kevin Kutz, VP of external relations

kevin.kutz@tegria.com

608.621.5296

Tegria provides consulting and technology services to healthcare organizations throughout the United States and internationally. Meet with us to learn how our customers are maximizing technology, transforming operations, improving financials, and optimizing care.

Curbside Consult with Dr. Jayne 3/20/23

I was hanging out with one of my favorite computer science students over the weekend and ChatGPT was a hot topic. He has been working on a group project, and someone who didn’t have a partner asked if they could join the group by way of an email that was clearly AI generated. The first couple of sentences weren’t too bad, but then the email started laying it on thick with comments about how hard the new member planned to work and “rest assured I will do my best” type syntax which isn’t typical of the age group.

Since this student has access to better AI toys than I do, I decided to have some fun. A lot of people in my life know that I write for a blog but they don’t read it or really know what it’s about, so I wondered what generative AI thought about my alter ego: 

Tell me what you know about the writing style of Dr. Jayne HIStalk.

Dr. Jayne HIStalk is the pseudonym of a physician who writes a popular blog about healthcare information technology. Her writing style is characterized by a unique blend of humor, wit, and incisive analysis of industry trends.

Dr. Jayne often uses anecdotes and personal experiences to illustrate her points, and she is known for her ability to distill complex concepts into clear and accessible language. Her writing is often critical of the healthcare industry and its shortcomings, but she also offers practical suggestions for improving healthcare delivery and patient outcomes.

Dr. Jayne’s writing is also notable for its use of pop culture references, particularly to science fiction and fantasy, as well as her ability to inject humor into even the most serious topics. Her style has been described as irreverent, thought-provoking, and engaging.

Overall, Dr. Jayne HIStalk’s writing style is distinctive and engaging, and has helped to establish her as one of the most influential voices in healthcare information technology.

I felt like that write up would be useful for the back of a book, should I ever write one. I think it sums up what I’ve been up to for the last 13 years, although it seemed a little schmoozy with the compliments. Since physicians are starting to use ChatGPT to write everything from prior authorization forms that help patients get medications approved to school and work notes excusing absences, I decided to see if I could get it to do my work for me.

Write 500 words in the style of Dr. Jayne HIStalk about the value of telehealth.

Dr. Jayne here, and today I want to talk about the value of telehealth. With the rise of digital technology, telehealth has become an increasingly popular method of providing healthcare services. Telehealth, also known as telemedicine, is the delivery of healthcare services through digital communication technologies such as video conferencing, remote monitoring, and mobile health applications.

Telehealth has become especially important in recent times due to the COVID-19 pandemic. The pandemic has forced many healthcare providers to pivot to telehealth in order to continue providing care to their patients while minimizing the risk of transmission. This has led to a surge in telehealth usage, with patients and providers alike recognizing the many benefits of this approach.

One of the main benefits of telehealth is increased access to healthcare services. Telehealth allows patients to receive care from the comfort of their own homes, eliminating the need to travel to a healthcare facility. This is particularly beneficial for patients who live in rural or remote areas, where healthcare services may be limited. Telehealth also allows patients to receive care outside of traditional office hours, making it more convenient for busy individuals who may not have time to visit a healthcare facility during regular business hours.

Another benefit of telehealth is improved patient outcomes. Telehealth allows for more frequent monitoring and communication between patients and their healthcare providers, which can help identify potential health issues early on and prevent them from escalating. Telehealth can also improve patient education and self-management, empowering patients to take a more active role in their own healthcare.

Telehealth can also lead to cost savings for both patients and healthcare providers. By eliminating the need for in-person visits, telehealth can reduce healthcare costs associated with travel, parking, and time away from work. Telehealth can also reduce healthcare costs associated with hospital readmissions, as frequent monitoring and communication with patients can help prevent complications and ensure timely interventions.

Finally, telehealth can improve provider satisfaction by reducing administrative burdens and improving work-life balance. Telehealth can eliminate the need for providers to spend time on administrative tasks such as scheduling and paperwork, allowing them to focus more on patient care. Telehealth can also provide more flexibility in terms of scheduling, allowing providers to work from home or outside of traditional office hours.

In conclusion, telehealth is a valuable tool for providing healthcare services in today’s digital age. Telehealth offers many benefits, including increased access to care, improved patient outcomes, cost savings, and improved provider satisfaction. As telehealth continues to grow in popularity, it will be important for healthcare providers and policymakers to work together to ensure that telehealth services are accessible, affordable, and of high quality.

Although it’s an accurate essay, it doesn’t seem to incorporate anything specific from a stylistic standpoint that makes this feel like a sassy HIStalk blog versus a middle school essay. I decided to ask it about the pitfalls of telehealth to see if using a less positive topic would allow it to pull in some humor, pop culture references, or particular insight:

Write 500 words in the style of Dr. Jayne HIStalk about the pitfalls of telehealth.

Telehealth has become increasingly popular in recent years as a way to provide medical care remotely. While telehealth has many benefits, including increased accessibility to healthcare, reduced travel times, and greater flexibility for both patients and providers, there are also several pitfalls to consider.

One of the biggest challenges of telehealth is the lack of in-person interaction. While video conferencing and other forms of remote communication have come a long way in recent years, there is still a sense of distance that can make it difficult to establish a rapport between patient and provider. This can be particularly challenging for patients with complex medical needs or those who require a more personal touch.

Another challenge of telehealth is the potential for misdiagnosis or missed diagnoses. Without the ability to perform a physical examination, providers may miss important signs or symptoms that could indicate a more serious underlying condition. In addition, there may be technical issues that could impact the quality of the video or audio, making it difficult to accurately assess the patient’s condition.

Privacy and security are also major concerns with telehealth. While providers are required to follow certain guidelines and regulations to ensure patient confidentiality, there is always the potential for sensitive information to be intercepted or shared inadvertently. In addition, patients may be more hesitant to share personal information over a video call, which could impact the quality of care they receive.

Finally, there is the potential for telehealth to exacerbate existing health disparities. While telehealth has the potential to increase access to care for those who live in rural or underserved areas, there are still many barriers to accessing care, such as lack of reliable internet or computer access. In addition, some patients may not feel comfortable with the technology or may prefer in-person care, which could impact their willingness to seek care remotely.

Despite these challenges, telehealth has many potential benefits and can be a valuable tool for both patients and providers. To mitigate the risks associated with telehealth, it is important for providers to receive proper training and education on the use of telehealth technology, and to be aware of the potential pitfalls and limitations of remote care. Additionally, patients should be informed of the risks and benefits of telehealth and encouraged to ask questions and voice their concerns about the use of remote care. By working together, providers and patients can ensure that telehealth is used in a safe and effective manner, improving access to care and helping to bridge the gap between patients and providers.

I’m wondering if the fact that I used sequential prompts to ask the questions contributed to the fact that it didn’t include a reference to the author or a definition of telehealth. I think it did a good job pulling in some of the concerns that are often voiced about telehealth, but it still felt a bit like a school essay and not anything that readers would find engaging or otherwise different from the dozens of bland articles that pop up in healthcare IT publications. It’s certainly not to a level of sophistication where I can let it write for me, but it was a fun exercise and it was good to hear what someone from another generation and point of view thought about whether generative AI is ready for prime time or not.

I spent the rest of the weekend playing catch up and getting ready for the fact that I’ll be out next week for the ViVE and CHIME meetings. I’m headed to Nashville on Saturday so I can spend some quality time with one of my favorite shoe junkies and see what has happened to the town in the decade or so since I’ve last been there. I’ll be writing my next couple of posts from there, so if you’re in attendance and see any good shoes or wild conference behavior, be sure to send your thoughts my way.

What’s the best way to spend a cold dreary weekend, when ChatGPT isn’t as entertaining as you hoped? Leave a comment or email me.

Email Dr. Jayne.

Readers Write: A Glimpse of Telehealth’s Future: Five Takeaways from ATA 2023

A Glimpse of Telehealth’s Future: Five Takeaways from ATA 2023
By Lyle Berkowitz, MD

Lyle Berkowitz, MD, is CEO of KeyCare of Chicago, IL.

My recent visit to the American Telemedicine Association (ATA)’s annual meeting offered an opportunity to briefly reflect on how far the industry has come, as well as provided a few glimpses of what the future of telehealth might hold.

When ATA was founded three decades ago, broadband internet was a rare commodity and telehealth visits were primarily via phone calls. Fast forward to today and it’s obvious that telehealth is leading healthcare transformation in multiple areas, from urgent care to women’s health needs to lifestyle medications – while pushing how we can use virtual care tools to simultaneously improve the patient experience, quality, and cost.

Here are five of my key takeaways from the ATA 2023 Annual Conference and Expo:

1. The rise of femtech and women’s health. Numerous startups are developing solutions that leverage telehealth to address women’s health issues. For example, Nest provides virtual same-day lactation support and has partnered with several hospitals to improve infant health outcomes. Separately, SimpliFed partners with caregivers before an infant is born to develop feeding plans and delivers support to patients through a virtual breastfeeding provider network.
2. Increased focus on hybrid care. In this context, hybrid models refer to those that offer patients access to telehealth visits which can coordinate with in-person care, based on a patient’s individual care needs. Corporate giants like Amazon, CVS, and Walmart are lurking around in this space, but health systems have the greatest potential to own it. That’s because it is far more straightforward, simple, and cost-effective to add a virtual care partner to a robust office-based health system than to bolt on office-based care to a virtual care company.
3. A new market for hearing aids. Over-the-counter hearing aids are now available to the public, thanks to a ruling by the US Food and Drug Administration last year. As a result, companies like Audicus have jumped into this market to serve customers via telehealth. In this easy and convenient process, a hearing test is performed online, a hearing aid is shipped out, and any adjustments are done via a video visit.
4. The rise of remote patient monitoring. Like telehealth, remote patient monitoring (RPM) technology has been around for decades, and while various startups have different approaches for obtaining data, they all have the same vision in mind. For example, some companies use a wearable patch for continuous monitoring, others use Bluetooth to connect to devices a patient may have, and “device-less” companies use a chatbot that allows a patient to self-enter data. Some may even combine these tools or add others. Then all of this data is sent to a dashboard for analysis and display so that a virtual team can appropriately monitor and engage with patients, and then identify outliers which need to be escalated to office-based providers. However, the real trick is knowing where to apply RPM and align incentives. The post-acute care area has been popular for years; the chronic care space has experienced slow growth but offers strong potential; and the new hot area is clearly hospital at home.
5. Niche products. It has become easier for companies to focus on specific use cases for virtual care monitoring and management. For example, I came across the super niche startup Staling Medical, which has created an at-home urine diagnostics tool that uses a patient’s smartphone microphone to listen to their urine stream, with a goal of improving outcomes for recurrent urinary tract infections, urinary obstructions, and chronic kidney disease.

It’s a fun time to be in telehealth. I’m looking forward to seeing what’s up next at ATA 2024!

Readers Write: Value-Based Care Arrangements: Four Ways Specialty Care Providers Can Prepare for Claims Data

Value-Based Care Arrangements: Four Ways Specialty Care Providers Can Prepare for Claims Data
By Tyler Johnson

Tyler Johnson is VP of strategic partnerships at Ursa Health of Nashville, TN.

Companies that are bringing new specialty care models to market face a big early hurdle when partnering with plans, full-risk provider groups, or self-insured employers: working with claims data. Although lacking some clinical context, clean, well-organized claims data is vital for creating longitudinal patient views and the main fuel for analytics (which of course become even more powerful when supplemented with clinical and other data sources). Trusted analytics, in turn, are the first step toward optimal operations and outcomes, as well as the financial reconciliation between partners that value-based contracts require.

With everything else involved in launching or expanding a new business, specialty care providers (SCPs) may be tempted to put data and analytics planning on the back burner. Those that delay too long, however, could find themselves scrambling to get new partnerships off the ground or to keep up with an ever-changing landscape. In the best-case scenario, late-night heroics save the day but inordinately stress the team. In the worst, lack of planning leads to lost sales, crumbling partnerships, and dwindling rather than growing healthcare impact.

SCPs must ready themselves to consume claims data from their partners in four key ways.

The first concerns the security review. Organizations are very particular about how and where their data gets shared. Convincing business or clinical leadership to try a novel intervention is tough, but convincing security and InfoSec folks that others can be trusted with their most prized possession is another obstacle altogether.

Before any data is shared, an organization will ask its potential SCP partner to submit to a comprehensive vetting process to ensure the SCP’s technical and administrative safeguards are strong enough to meet both internal and HIPAA requirements. To prepare for the review process, the SCP should:

• Create very tight and easy-to-understand documentation around its technical architecture, including where data is going to live and what people, tools, and processes are going to touch it.
• Create an overview document that summarizes its security posture.
• Organize employee business and security procedures for easy reference.
• Devise a system for retaining answers to assessment questions to expedite the next review.
• Consider being HITRUST and SOC2 certified, which can quickly ease the security team’s concerns. Because the level of effort isn’t trivial, working with a technology vendor that is already certified can help organizations that do not have the internal resources to pursue certification themselves.

Second, an SCP needs to prepare is its tech stack. The contracting and security assessment process can feel a lot like hurry up and wait, but the reality is that this is a task in a very long queue, and once the organization assigns resources to complete that task, it will expect a new partner to be ready to roll.

If the SCP can tap into and pull from the organization’s existing infrastructure for hosting data, great. If not, it needs its own secure cloud storage mechanism (e.g., Amazon S3, Azure blob storage) into which data can be dropped, as well as a pre-defined process for granting access to it. In addition to transmission mechanisms, a database/warehouse and any data modeling and transformation tools must be up and ready to use.

The potential partner is also going to expect the SCP to quickly provide feedback and ask questions about the data. If the environment is ready to go in advance, the SCP can spend more time on loading and investigation instead of provisioning cloud resources. It is also extremely helpful to get answers to data questions while the company’s technical resources are still engaged and informed.

As a final note, SCPs should think in advance about how they will assess the quality of the incoming data, both in a general sense (e.g., data completeness) and regarding specific data points or lineage that is important to their analyses.

The third way to prepare is to ensure a scalable approach exists for organizing and analyzing data. Without a proactive approach to a data model, an SCP can very easily stack up technical debt — in the form of silos of logic and code that are custom to analyzing data from a single source — that becomes a nightmare to untangle down the road and will prohibit efficient scaling of its business.

Once it has defined the data model, the SCP should apply transformation logic to all incoming raw data sources to map the data to that standardized structure. Rules and algorithms to interpret data for specific use case(s) should only be authored on top of that standardized data model, an approach called hierarchical data modeling. This approach facilitates scalability while making it easier to marry up claims data with other sources of information: for example, clinical data from the EHR, patient engagement data, and internal product data.

The final way to prepare is to identify how the claims data will be used to provide insight into their operations and business. This planning should occur before any value-based contract is signed, let alone claims data is shared, to help determine whether other sources of data will be needed — for example, other patient data or industry-available supplemental data such as value sets and provider rosters. Armed with a clear understanding of what insights need to be derived, SCPs can more intelligently articulate their needs and the anticipated value to partnering organizations.

Effective partnership in the co-management of patient populations demands a strong data foundation paired with trusted, useful analytics. Bad data in results in bad data out. SCPs embarking on new value-based partnerships can increase their chances of success and make life easier for both parties with some basic preparation. With a solid and scalable data foundation in place, technical resources can shift their attention away from non-strategic data wrangling work and focus on building the special sauce that differentiates it from competitors and adds the most value to its customers.

Morning Headlines 3/20/23

Oracle Cerner appears to have started another round of job cuts

Oracle Cerner has conducted another round of layoffs, according to the social media posts of some employees, which appears to line up with a restructuring plan approved in 2022.

Two Key Players in Ohio’s Health Information Exchange Announce New Partnership

The Healthcare Collaborative exits the HIE business and will transfer its customers – 70 hospitals and 18,000 providers — to Ohio Health Information Partnership’s CliniSync service by the end of 2023.

UC San Diego Health Notifies Patients of Vendor Data Collection Issue

UC San Diego Health notifies patients that vendor Solv Health used analytics tools that distributed information to third-parties without authorization on the scheduling websites of the health system’s Express Care and Urgent Care clinics.

Pear Therapeutics Announces Process Exploring Strategic Alternatives

Pear Therapeutics, which offers prescription-based digital therapeutics, will explore strategic alternatives to avoid reorganizing or liquidating the company.

Monday Morning Update 3/20/23

Top News

Oracle Cerner has conducted another round of layoffs, according to the social media posts of some employees who were affected. Some say they’ve heard that 10% of the company was let go, but Oracle has not confirmed specifics.

Rumored severance was four weeks plus one week per year of service.

Oracle also told office-based employees who were allowed to work remotely during the pandemic that they will need to return to campus full time. Managers will notify workers within 30 days if their jobs will be in-office, flex office with unassigned space, or remote.

Reader Comments

From Yduj’s Hardest Worker: “Re: Northwell moving to Epic. Confirmed – they played the wedding bells at Epic today.” Northwell has 42 Epic jobs posted, so it’s goodbye to Sunrise and other systems there. The health system renewed its contract with Allscripts in 2020 to extend through 2026 and had announced the year before that it would build its own EHR with Allscripts and its Avenel product. That’s a pretty big customer loss for Harris-owned Altera Digital Health, which acquired Sunrise and other Allscripts products in May 2022.

HIStalk Announcements and Requests

Today (Monday) is the first day of astronomical spring in the US, although meteorological spring has already sprung as of March 1.

Poll respondents say that the weakest aspect of in-person conferences is the quality of educational sessions, i.e. the predecessor to social media in which companies sell advertising with unpaid, user-generated content as the hook. I don’t bother with conference education sessions because they are usually dull and stale, especially given the alternative of delivering them virtually so I can bail out or fast-forward, so maybe we’ll see conferences deconstruct themselves into just a big exhibit hall by day and parties by night.

New poll to your right or here: Which technology trend will have the biggest healthcare impact in the next five years? I couldn’t list every possible one, so you can always add a poll comment to support one that I missed.

Webinars

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

Acquisitions, Funding, Business, and Stock

The UK’s merger watchdog raises competitive concerns about the proposed acquisition of healthcare software vendor EMIS Group by a UnitedHealth Group subsidiary.

Pear Therapeutics, which offers prescription-based digital therapeutics, will explore strategic alternatives to avoid reorganizing or liquidating the company. Pear went public via a SPAC transaction in June 2021 at an initial valuation of $1.5 billion. PEAR shares have lost 96% since, valuing the company at $83 million after a 34% drop following Friday’s announcement.

Autism treatment software vendor Spectrum Ai raises $20 million in a Series A funding round.

Stanley Healthcare renames itself to Securitas Healthcare. The company was acquired in July 2022 by security services vendor Securitas.

It’s a sad day for Glassholes everywhere (both of them): Google ends sales of Glass Enterprise Edition, which the company created in 2017 as a pivot from the poor-selling consumer version of Google Glass.

People

Transcarent hires Randy Hawkins, MD (Carrum Health) as chief medical officer. He was formerly a US Navy squadron medical officer, with deployment in Operations Desert Shield and Desert Storm.

Announcements and Implementations

The publisher of New England Journal of Medicine launches NEJM AI and names Harvard Medical School informaticist Isaac Kohane, MD, PhD as editor-in-chief.

Orbita’s Blaze care-finding solution for consumers will incorporate triage algorithms from Isabel Healthcare.

Ohio-based The Healthcare Collaborative exits the HIE business and will transfer its customers – 70 hospitals and 18,000 providers — to Ohio Health Information Partnership’s CliniSync service by the end of 2023.

A new KLAS report on ambulatory and enterprise EHR interoperability grades NextGen Healthcare and Athenahealth highest in ambulatory, while Epic tops the enterprise EHR list. The authors say that Altera Digital Health (the former Allscripts Sunrise), EClinicalWorks, and Greenway Health are falling behind in using external data for transitions of care and analytics.

Government and Politics

A GAO report on the VA’s Oracle Cerner rollout finds that the VA needs to improve its change management practices and to assess user satisfaction. Previous surveys found that around 95% of users disagreed that the system enabled quality care and made them efficient. GAO also found that while Oracle Cerner has reduced the number of old trouble tickets that are unresolved, the overall number of open issues has steadily increased since 2020.

Privacy and Security

Peaceful protesters, many of them mental health professionals, assemble at Oklahoma’s state capitol to object to SB 1369, which requires health plans to submit patient data – including mental health records — to a statewide HIE.

Healthcare security executives Scott Dresen (Corewell Health), Kate Piece (Fortified Health Security), Greg Garcia (Healthcare and Public Health Sector Coordinating Council), and Stirling Martin (Epic) testify at a meeting of the Homeland Security and Government Affairs Committee titled “In Need of a Checkup: Examining the Cybersecurity Risks to the Healthcare Sector.”

Other

NHS England orders trusts to start submitting patient information to a system that is provided by Palantir, which the newspaper article calls an American spy-tech firm. A US technology fairness organization CEO says that while NHS needs to make better use of patient data, he questions the fairness of the procurement and whether NHS should be choosing a partner “mainly known for supporting CIA drone attacks, predictive policing, and deportation raids.” Oracle board chair and CTO Larry Ellison suggested in the company’s recent earnings call that it was, as had been rumored, also a bidder for the Federated Data Platform that would expand access to de-identified patient data.

Medical residency match day last week resulted in a 94% success rate for PGY-1 positions, but 554 emergency medicine went unfilled, a huge increase that was driven by fewer applicants. The most competitive specialties were plastic surgery, internal medicine-pediatrics, OB-GYN, and orthopedic surgery. Nearly all of the 2,685 unfilled positions will be placed in the supplemental offer (SOAP) program. Residency preferences fluctuate significantly every few years as medical students try to guess the future earnings potential and job satisfaction of a specialty in which most of them will spend their entire working lives.

Sponsor Updates

• PerfectServe is accepting nominations for its Nurses of Note awards through April 14.
• Surescripts publishes its “2022 National Progress Report.”
• Premier’s Pinc AI and Fortune name the nation’s top 50 cardiovascular hospitals
• .Relatient’s team in India opens a new Global Capability Centre.
• Talkdesk wins several 2023 Stevie Awards for sales and customer service, and congratulates customer Memorial Healthcare System for winning several as well.
• The HLTH Matters Podcast features Tegria Managing Director Theresa Demeter.
• Volpara Health announces that a new US federal regulation requires mammography facilities to inform patients whether their breasts are composed of dense tissue.
• Vyne Medical publishes a new customer success story, “A Productive Manager’s Choice for Increased Patient Satisfaction.”

Blog Posts

• Clearsense at ViVE 2023 (Clearsense)
• Driving Digital Transformation in Healthcare (Nordic)
• Doctors and Social Media: Unlocking New HCP Engagement Approaches (OptimizeRx)
• Can Healthcare Technology Beat Burnout? Not On Its Own. (PerfectServe)
• Medical librarians use their expertise in healthcare technology to improve clinician satisfaction (Wolters Kluwer Health)
• Reimagining Master Data Management for Healthcare Organizations (Verato)
• 4 Reasons to Switch Online Scheduling (WebPT)

Contacts

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

Morning Headlines 3/17/23

Senators threaten consequences after VA confirms 4 deaths tied to computer system tested in Spokane

VA officials testify before the Senate Veterans Affairs Committee that its Oracle Cerner system has been linked to six incidents of severe patient harm, including four deaths.

Zus Health Closes Financing, Signs Partnership with Elation Health, to Accelerate Growth of its Data Service to Provide Connective Tissue for Healthcare

Interoperability platform vendor Zus Health raises $40 million in funding and announces that EHR vendor Elation Health will integrate Zus Aggregated Profile to allow clinicians to view expanded records.

SpectrumAi Secures up to $20M Series A Investment

SpectrumAi, a healthcare IT company focused on autism care, closes a Series A funding round of up to $20 million.

Electronic Health Record Modernization:VA Needs to Address Change Management Challenges, User Satisfaction, and System Issues

A new report from the US Government Accountability Office recommends that the VA address change management, user satisfaction, system trouble ticket, and independent operational assessment deficiencies within its EHRM program.

News 3/17/23

Top News

VA officials testify before the Senate Veterans Affairs Committee that its Oracle Cerner system has been linked to six incidents of severe patient harm, including four deaths.

Sen. Patty Murray (D-WA), who chairs the Senate Appropriations Committee, threatened to withhold funding for the system’s implementation until problems have been addressed.

Sen. Jon Tester (D-MT) raised questions about why Cerner was awarded a no-bid, $10 billion contract that lacks adequate accountability for patient harm or system downtime. Tester urged the VA to continue its implementation efforts but to renegotiate its contract, which is set to expire on May 17, for more favorable terms. The VA’s top contracting offer responded, “That’s absolutely the plan.”

Sen. Marsha Blackburn (R-TN) said of VA employees, “I have never in my life seen such resistance to modernizing a program. You’ve got a vendor sitting right next to you. They’re making a good faith effort to bring something forward. Why can you not tell employees, ‘This is your job. If you don’t want to do this, go work somewhere else?’”

Reader Comments

From Bread Zeppelin: “Re: AI in healthcare. Would readers other than me like to have that section added to the HIStalk news posts, similar to the COVID-19 news coverage?” Let’s ask them in this poll, which I’ll also post on LinkedIn to see if anyone notices.

HIStalk Announcements and Requests

I’ve decided that LinkedIn will serve my social media needs best, especially given its significant participation by my decision-making readers, so follow the HIStalk page for updates there. Or stick with Twitter since I’m not abandoning it. 

Webinars

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

Acquisitions, Funding, Business, and Stock

Senior care software vendor PointClickCare acquires Patient Pattern, which offers a value-based care EHR and care management platform.

White-label telehealth services vendor OpenLoop raises $15 million in a Series A funding round. It offers provider staffing as well as services to assist with regulatory monitoring and credentialing. Co-founder and CEO Jon Lensing, MD graduated medical school in 2020 and started the company instead of pursuing a residency.

Maribel Health, which offers solutions to support hospital-at-home and community-based palliative care programs, raises $25 million in a Series A funding round.

Interoperability platform vendor Zus Health raises $40 million in funding and announces that EHR vendor Elation Health will integrate Zus Aggregated Profile to allow clinicians to view expanded records.

Microsoft and its Nuance business announce a Copilot AI-powered feature for Nuance Mix Builder that allows teams to build intelligent chatbots with minimal technical skills. In other AI news, both Microsoft and Google announced that they have added generative AI to their Office and Workspace apps, respectively, that will create draft documents from a user’s description of what they need.

Sales

• UR Medicine Highland Hospital will implement Medaptus Assign to manage inpatient physician assignment.
• FQHC Access Family Care (MO) chooses EClinicalWorks EHR and related modules.
• Lakes Region Mental Health Center will expand its 33-year relationship with Netsmart by adopting its CareFabric platform.
• Zuyderland signs a 10-year renewal with Sectra and will move to its cloud-based enterprise imaging solution.

People

Industry long-timer Peter Butler, president and CEO of MDaudit, retires. He will be replaced by COO Ritesh Ramesh, MS, MBA. 

Athenahealth hires Caleb Anderson (Netsmart) as chief sales officer.

Brian White, healthcare partner with LogicSource and long-time health system executive, died Sunday. He was 48.

Announcements and Implementations

Google introduces Open Health Stack to help Android developers create FHIR-based digital health solutions.  

An Urban Institute survey of adults ages 18 to 64 finds that 15% of their families have past-due medical debt, most of it involving hospital bills. About 80% of those with overdue medical bills had insurance when the expense was incurred, and while one-third of them were offered a payment plan by hospitals, few hospitals offered to discount the total owed or offered to help them apply for Medicaid. Overall, 100 million US adults have medical or dental bills that they are paying off over time or that are overdue.

TytoCare receives FDA clearance for its AI-powered wheeze detection for remote diagnosis.

Other

I ran across a testimonial from Laurence Beer, MD, chief clinical officer at Transitional Care Physicians of America, on the company’s use of free Chrome browser productivity extension Magical to boost documentation productivity. He set up variables so populate patient details into the EHR note, saving one hour per day per user. He says that clinicians needed six mouse clicks to use an EHR shortcut to start a physical exam note that says “well-nourished, elderly male in no acute distress” while Magical did it with one. The organization distributed the shortcuts as a team list to standardize documentation.

Denmark-based Be My Eyes – which links mobile-connected volunteers to people with vision problems to complete such as identifying a product or navigating an airport — develops a GPT-4 powered Virtual Volunteer version. The new assistant, which is in beta testing, helps users identify household items, avoid fall hazards, hear a summary of web page and search content, and navigate public transportation.

Sponsor Updates

• Metrigy recognizes Five9 as a Contact-Center-as-a-Software MetriStar Award Winner.
• Fortified Health Security names Melissa Schroeder (Oracle) security compliance advisor.
• GHX recognizes North America’s 2022 50 best healthcare providers for supply chain excellence.
• Healthcare Triangle confirms that it does not hold any cash or maintain any accounts at Silicon Valley Bank.
• InterSystems releases a new Healthy Data podcast, “Clinical Staffing – Patient Ratio & Documentation Burden.”
• Konza National Network will present at the AHIMA Advocacy Summit March 20 in Washington, DC.
• Kyruus will exhibit at AMGA March 28-30 in Chicago.
• Kingman Regional Medical Center (AZ) moves toward eradicating hepatitis C with support from Meditech Professional Services.

Blog Posts

• VBC Can’t Work Without Specialists on Board (Enlace Health)
• High Acuity Patients in Urgent Care: Defining and Solving Acuity Degradation (Experity)
• ‘To Err is Human’ Update Finds Inpatient Adverse Events Still a Challenge (First Databank)
• Inefficiencies in EHR Systems Can Cause Healthcare Worker Burnout (HealthTech Resources)
• How to Improve Care for Spanish-Speaking Patients (Healthwise)
• Innovation, Partnerships Driving Nationwide Interoperability to Address Healthcare’s Top Challenges (Surescripts)
• Oracle Cerner RevElate Common Questions and Implementation Tips (Healthcare IT Leaders)
• Rapidly Evolving and Increasing Cyberthreats: Why You Need an IT Assurance Service Program (Impact Advisors)
• 9 HIT conferences to attend in 2023 (Intelligent Medical Objects)
• MEDITECH continues moving health IT forward (Meditech)
• Advancing Interoperability in the Age of TEFCA: An Interview with CommonWell’s Executive Director, Paul L Wilder: Part 2 (Medhost)
• Myndshft Advocates for Da Vinci Standards in Public Comments to CMS Proposed Prior Authorization Rule (Myndshft)
• The Power of Pairing EHR and MDS Data Together for SNFs (Net Health)

Contacts

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

EPtalk by Dr. Jayne 3/16/23

I’ve been carefully following the Silicon Valley Bank implosion, especially the stories about the electronic transactions that contributed to its death spiral. The most striking data point: customers were attempting to withdraw more than $42 billion within a 24-hour period, which works out to approximately $500,000 per second.

I admit that I’m one of those people who has grown used to being able to transfer money on a timeline of minutes to seconds, but the idea of that much money moving around is nearly unfathomable. The bank failure, along with concerns about other lenders, has led to the flow of more than $15 billion to Bank of America. Other large banks, such as Wells Fargo and Citigroup, have yet to comment on the amount of new money flowing in.

People frequently compare what we’re doing in healthcare IT to the digital revolutions that have occurred in other industries. I enjoyed this article about accounting firm PwC and its plans to use an AI chatbot to help its legal team boost efficiency. More than 4,000 workers will have access to an AI-enabled chatbot provided by Harvey with the expectations that it can assist with tasks such as due diligence and contract analysis. Harvey works with large language models in the legal space and uses OpenAI and ChatGPT technology.

Even though we’re several days past the Daylight Saving Time transition, several people I know are still struggling with sleep/wake cycles, especially where children and pets are involved. There’s plenty of push for making Daylight Saving Time permanent, but the medical establishment isn’t convinced. A recent article in JAMA notes that medical societies such as the American Academy of Sleep Medicine “overwhelmingly” support the continuation of Standard Time if we’re going to stop jumping back and forth. They note that during Daylight Saving Time, “the body’s internal circadian clock, which synchronizes to solar time, is out of step with the social clock, or local time.” This results in higher numbers of motor vehicle crashes, depression, and stroke, not only during the transition period, but throughout the summer. There’s not a ton of research on time changes, though, with the authors noting that only 159 articles have been published since 1962.

The reality is that there’s a finite amount of sunlight each day, and choosing one time paradigm over the other determines whether that extra light is in the morning to help us get going or whether it’s later in the day for after-work and after-school activities.

Interestingly, some of the most prominent research in the field stems from Russia, which instituted permanent Daylight Saving Time from 2011 to 2014 before moving to permanent standard time. In a retrospective study of adolescents and young adults, researchers found that ongoing Daylight Saving Time created a dissociation between social and biological clocks which “potentially exerts a negative influence on adolescents’ sleep habits, mood, and behavior.” People also forget that the US tried year-round DST in January of 1974, resulting in an extended period of dark mornings during the winter when children are headed to school. Standard time was restored by October of that year. There’s plenty of other great information in the article, so if you’re looking for a deep dive, I’d give it a read.

I was interested to learn about proposed legislation that would prevent companies from using health data for advertising and marketing purposes. US Senators Amy Klobuchar, Elizabeth Warren, and Mazie Hirono introduced the Upholding Protections for Health and Online Location Data (UPHOLD) Privacy Act, which would curtail the profits companies generate by using personally identifiable health data for advertising. Where HIPAA focuses on covered entities, this bill takes protections to the next level, allowing patients even more control over their health data when it resides with apps, tech companies, and other organizations. The bill would impact the numerous companies that harvest health information but aren’t regulated by HIPAA and would also ban the sale of location data.

From Igloo Fan: “Re: organ donation. Did you see this article about the donated liver that got stuck due to road closures for a marathon?” I hadn’t seen it, so I appreciate the share. Apparently the liver was stranded by the Philadelphia Half Marathon with 30,000 participants hitting the streets. Dr. Adam Bodzin ran into the field, traveling half a mile to where the van carrying the organ had reached a literal road block. Fortunately, police were able to transport him back to the hospital with his precious cargo. I had the privilege of working on my hospital’s transplant team during training and it was an unbelievable experience, if often surreal. Our team treated each organ procurement surgery with the reverence and awe it deserved and as a surgical subintern I was honored to be left behind to help return the donors to the best appearance possible for their families. Once those cases were complete, we caught up with the team performing the actual transplant procedures, and the sense of awe continued. There’s nothing like watching a donor organ start functioning. If you’re an organ donor, make sure your family knows your wishes. If you aren’t, please consider making it possible to give the gift of life should something unforeseen happen.

I love it when readers send me funny emails, even though I don’t always have time to reply to them. I’ve had some long-term back and forth correspondence with some readers to the point where I feel like I really know them. One of those readers and I have had an ongoing dialogue about virtual workplaces where you’re constantly expected to be on camera. It was the best laugh of the day when I opened a message to read this: “I’m on a Zoom and this woman is casually sipping a bottle of magnesium citrate.” I’m just hoping his co-worker was knowingly drinking a laxative and didn’t have it confused for some other beverage in the refrigerator. March is Colorectal Cancer Awareness Month, so perhaps she was getting ready for a recommended screening test.

What’s the wildest thing you’ve seen on a conference call? Leave a comment or email me.

Email Dr. Jayne.