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Healthcare AI News 5/24/23

News

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

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

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

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

OpenAI launches a ChatGPT app for the IPhone.

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

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


Business

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


Research

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

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


Other

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

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

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

Contacts

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

Morning Headlines 5/24/23

May 23, 2023 Headlines Comments Off on Morning Headlines 5/24/23

Norton Healthcare still reeling 2 weeks after cyber attack

Norton Healthcare in Kentucky works to recover from a cyberattack two weeks ago that is still causing “delays in network-related capabilities” including patient portal messaging; imaging, lab, and test results; and prescription fulfillment.

Medisolv Receives Strategic Investment from BVP Forge

Healthcare quality data management company Medisolv secures an unspecified amount of funding from BVP Forge.

Website Notice of Unauthorized Access to PillPack Accounts

Amazon Pharmacy’s PillPack reports that an unauthorized person logged into its website using individual user credentials that were identical to those shared from other breaches, with 3,600 of those accounts containing prescription information.

Comments Off on Morning Headlines 5/24/23

News 5/24/23

May 23, 2023 News 6 Comments

Top News

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Clinical terminology management and data quality vendor Intelligent Medical Objects acquires Melax Technologies, which specializes in data extraction using AI and natural language processing.

The acquisition, IMO’s first, will help extend its market reach to payer, life science, and pharmaceutical companies.


HIStalk Announcements and Requests

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Welcome to new HIStalk Platinum Sponsor Aridhia Informatics. The Glasgow-based company offers the Aridhia Digital Research Environment (DRE), a combination PaaS/SaaS offering that addresses challenges that are associated with the scale and sustainability of biomedical data science. It is used by research hospitals, pharma, and global consortia across nearly 100 countries. Adherence to FAIR data principles gives researchers and innovators the ability to discover and understand data through dataset search, classification, and efficient metadata browsing capabilities. Researchers can request access to datasets, while data owners get access to configurable and orchestrated data governance while making approval decisions within their own specialized pipelines. Principal investigators can invite team members who can securely upload, access, and analyze project data while taking advantage of an audited environment that is furnished with analytical tools, scalable compute resources, and virtual desktops. All of this is underpinned by comprehensive auditing, secure data management, reliable infrastructure that scales to user needs, and world-class analytics capabilities. The company manages high-level security accreditation, leaving the team to focus on the science using a personalized, next-generation research environment. Thanks to Aridhia for supporting HIStalk.

YouTube has an intro video for the Aridhia DRE.


Webinars

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


Acquisitions, Funding, Business, and Stock

Nuance Communications CEO Mark Benjamin notifies employees of an unspecified number of layoffs as the Microsoft subsidiary adjusts to changing market conditions and a renewed focus on healthcare. Microsoft, which acquired Nuance in early 2022 for $20 billion, announced a separate round of 10,000 layoffs in January.


Sales

  • Fifteen-bed Eureka Springs Hospital (AR) selects Oracle Cerner.
  • Palouse Specialty Physicians (WA) will implement CureMD Oncology’s EHR and practice management software.
  • Tampa General Hospital (FL) will roll out Navina’s AI-powered clinical data summary capabilities for primary care.
  • Atlantic Health System selects NeuroFlow’s caseload management software to support behavioral health screenings within its ACO.

People

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Zyter|TruCare names Joanne Berrios (Salesforce) VP and chief value officer.

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Holly Urban, MD, MBA (Oracle Cerner) joins CliniComp as VP of clinical product design.

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CRISP Shared Services promotes practicing pediatrician Marc Rabner, MD, MPH to chief medical officer.

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Jordan Bazinsky (Cotiviti) joins Intelerad Medical Systems as CEO, replacing the newly retired Mike Lipps.

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Telemetrix promotes Nancy Beale, RN to president.

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Cynerio names Rasu B. Shrestha, MD, MBA (Advocate Health) as board chair.

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Brooklyn Hospital Center promotes SVP/CMIO Sam Amirfar, MD, MS to chief medical officer.

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Avalon Healthcare Solutions hires Pamela Stahl (Sidekick Health) as president.

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Tegria hires Jen Morgan (Senta Partners) as CFO and Prasanna Gunjikar (HTC Global Services) as chief growth officer.

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Aaron Green(Optum) joins OneMedNet as president.

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Lanie Schenkelberg (Spring Health) joins Inovalon as VP of product marketing.


Announcements and Implementations

Gillette Children’s (MN) implements Notable’s automated Registration and Intake Assistant and Scheduling Assistant software across 11 multispecialty clinics.

Garden City Pediatric Associates (MA) implements EClinicalWorks.

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Box Butte General Hospital (NE) goes live on Meditech.

Epic lists 26 of its customers that have pledged to join the TEFCA information sharing framework.

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A new KLAS report on US EHR market share finds that Oracle Cerner saw its first double-digit net gain in hospitals since 2018, but 49 of its 50 wins were in under-200 bed facilities, giving it the biggest drop in total bed count of all vendors. Meditech gained 120 hospitals in 2022 via net-new sales and migrations, more than any other vendor, but still showed a decrease in total beds and total hospitals. Epic was the only vendor that gained both facilities and beds.


Government and Politics

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Mann-Grandstaff VA Medical Center (WA) Director Robert Fischer says the facility will need to reduce staff by 15% over the next several years to make up for an anticipated $35 million budget deficit it attributes to the rollout and use of its Oracle Cerner system. The software’s well-documented deficiencies have hampered the facility’s ability to keep up with patient demand, resulting in decreased funding, while its billing inefficiencies have delayed payer reimbursements. Surges in staffing for the system and pay raises and bonuses to help with recruitment and retention have also contributed to the budget shortfall.


Privacy and Security

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Norton Healthcare in Kentucky works to recover from a cyberattack two weeks ago that is still causing “delays in network-related capabilities” including patient portal messaging; imaging, lab and test results; and prescription fulfillment. Hackers reportedly sent a fax with threats and demands shortly after breaching the hospital network on May 9.

Amazon Pharmacy’s PillPack reports that an unauthorized person logged into its website using individual user credentials that were identical to those shared from other breaches, with 3,600 of those accounts containing prescription information.


Sponsor Updates

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  • AdvancedMD sponsors the Gratitude Gala in Chicago, benefiting The Bette D. Harris Family & Child Clinic.
  • Princeton Brain, Spine & Sports Medicine transitions to EClinicalWorks Cloud.
  • KeyCare pledges to adopt the TEFCA framework.
  • InterSystems launches its HealthShare Health Connect Cloud in the AWS Marketplace.
  • KLAS Research recognizes Availity as a co-recipient of the KLAS Points of Light Award.
  • AvaSure establishes a chief nursing executive advisory board.
  • Azara Healthcare publishes a new case study, “Improving Equity in Healthcare Access through Improved Data Exchange.”
  • Nordic publishes a technical paper titled “A New Horizon for IT Strategy: Prioritizing the Patient Experience Through Digital Transformation.”
  • Bamboo Health will exhibit at AHIP 2023 June 13-15 in Portland, OR.
  • Black Book survey-takers give Xifin top customer and user satisfaction ratings in nine out of 18 RCM KPIs.

Blog Posts


Contacts

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

Morning Headlines 5/23/23

May 22, 2023 Headlines Comments Off on Morning Headlines 5/23/23

Intelligent Medical Objects Announces the Acquisition of Melax Technologies Inc.

Clinical terminology management and data quality vendor Intelligent Medical Objects acquires Melax Technologies, which specializes in data extraction using AI and natural language processing.

Layoffs hit Nuance after Microsoft acquisition

Nuance Communications CEO Mark Benjamin notifies employees of an unspecified number layoffs as the Microsoft subsidiary adjusts to changing market conditions and a renewed focus on healthcare.

VIPC’s Virginia Venture Partners Invests in Kinometrix to Provide Healthcare Workers With Real-Time Risk Assessments

Fall risk assessment software startup Kinometrix secures funding from Virginia Venture Partners.

Comments Off on Morning Headlines 5/23/23

Curbside Consult with Dr. Jayne 5/22/23

May 22, 2023 Dr. Jayne 1 Comment

I’m a big fan of experiential learning, especially after having just finished teaching some Outdoor Classroom sessions for a local youth organization. It’s great to see people use the skills you’re teaching as they interact with each other and try to solve problems. It works best, however, when you have a good blend of instructional time with practical or application time.

Having hands-on time can be great if you at least understand the concepts that are being presented and the goal is to either learn them at a deeper level or become more capable in performing them. I liken it to a surgical skills lab. First, you learn about wound repair, and make sure you understand how skin will heal depending on the repair technique and how different types of sutures will work in different ways. Then, you actually practice either with a simulator, or back in the dark ages, we practiced with pigs’ feet. You don’t just start throwing stitches into live patients without understanding the fundamentals.

I have a couple of certifications on EHR products that I rarely use, but for which I like to stay up to speed. One of the vendors rolled out a new product that I’ve not been certified on. Given my past work with the application, they offered me the opportunity to take the certification classes for the new product.

I was excited about the opportunity and ready to prepare for the classes. Unfortunately, there wasn’t any kind of preparatory work – no pre-class readings or training videos. There was a PDF for the class, but what was in there looked mostly like exercises without any foundational content. I wasn’t sure if I was missing materials or whether it was intentional, but I decided to head to class with an open mind.

I have to say that it was one of the most frustrating classes I’ve ever taken. The entire thing was taught in a hands-on fashion, with no structured presentations or materials that summarized the functionality. Each module was a situational vignette, and after reading it, we were expected to go into the application and figure out how to take the necessary steps.

It was completely frustrating. I knew the general layout of the application and the main menus, but I didn’t know all the shortcuts that this class apparently expected us to not only know, but use. It was made worse by the fact that many of the desired tasks had more than one way for them to be accomplished, but you only deduced this after working through the scenario a couple of times. At no time did the instructor explain why one might want to embrace one workflow over another.

Not having any kind of initial summary or teaching also made it difficult to figure out what the various options were. I felt like I was more focused on writing things down in my notes so I could try to put it together in a cohesive manner rather than trying to understand how to manipulate the different scenarios. Because of that, I found myself missing key information because I was still trying to figure out something that happened a minute or two earlier in the simulation scenario.

Even if I would have been given a one-page summary that listed the different workflow possibilities and explained why a user would select one compared to another, it would have been a significant step up. A handout of the system’s keyboard shortcuts would have been helpful as well. After completing the class, I ended up spending several hours in the system’s demo environment running through common scenarios and seeing if I could figure out how to execute them on the platform.

At the end of the course, there was an evaluation that contained a couple of the question formats I hate the most. The first was what my medical school used to call “multiple-multiple choice” questions, which typically had four answer options (A, B, C, D) but then would have additional options like “A and B” or “A and B and C” and other combinations. Inevitable you’d find more than one thing on the list that was likely to be correct, but you spent excess time trying to psych yourself out about which items to exclude.

The other most hated question format (which unfortunately continues to also be present on my medical specialty board certification platform) is the “choose the best answer” type question. “Best” is really a subjective question, especially when you’re talking about patients and how they might take or not take a medicine. There have been campaigns for many years to get those kinds of questions off the recertification exams, so I’m used to seeing them more rarely. However, those questions were all over this software training, with the problem being that finding the “best” solution depends on many more factors other than just the test taker.

For patient care, the best solution might be one that balances clinical effectiveness with cost and makes it easier for patients to take their medications they way they intended. Best could also mean the treatment that will give a patient the most longevity, or the highest quality of life. But it can also represent treatments that might save your life, but that also might cause horrific side effects and deterioration in your quality of life at the same time.

This can also be true in the healthcare IT side of the house. The term “best” might represent the solution that has the most bang for the buyer’s buck. It could also be the solution that has the lowest risk of patient care errors. Or perhaps the one that takes the least amount of time for nurses to complete their workflows. When you put on your client hat while reading test items like that, one can’t help but overthink them or overanalyze similar decisions you’ve made in the past.

After feeling like I had been led astray but the hands-on training and then burned by the confusing test questions, I was ready to give up. Sure, I could follow the instructor to perform a bunch of different tasks, but I had no idea how the application would help my daily work or benefit my organization. I’m a pretty decent test-taker, so I ended up passing the evaluation step, but I still don’t feel like I know anything as far as being able to operationalize the functionality.

One of my co-presenters at Outdoor Classroom has dyslexia, and working with him made me think about how others would perceive the class. Similarly, people who learn best from reading rather than watching an instructor perform tasks and then try to emulate them might be out of luck. Organizations need to do more thought around different learning styles and need to spend time crafting strategies that will work for the diverse groups of users that their products will certainly encounter.

What are the best and worst types of software training you’ve experienced? Any advice that you’d give those who create the strategies? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 5/22/23

May 21, 2023 Headlines Comments Off on Morning Headlines 5/22/23

Notice of Auction Results for the Sale of the Debtors’ Assets

The assets of bankrupt digital therapeutics vendor Pear Therapeutics fetch $6 million at auction.

Aspirion Announces Acquisition of FIRM Revenue Cycle Management Services, Inc.

RCM vendor Aspirion acquires Firm Revenue Cycle Management Services.

Spokane VA director warns budget trouble caused by computer system is forcing staff cuts

Mann-Grandstaff VA Medical Center (WA) Director Robert Fischer says the facility will need to reduce staff by 15% to make up for an anticipated $35 million budget deficit attributed to the roll out and use of Oracle Cerner software.

Internal Health P.E.I. emails reveal EMR glitch led to 1,770 ‘missed’ referrals

In Canada, a Prince Edward Island review finds that 1,700 patient referrals were missed when clinic staff forgot to fax them as required by the Telus EHR.

Comments Off on Morning Headlines 5/22/23

Monday Morning Update 5/22/23

May 21, 2023 News 2 Comments

Top News

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The assets of bankrupt digital therapeutics vendor Pear Therapeutics fetch $6 million at auction.

The company had raised $409 million in funding. It went public in a SPAC merger in December 2021 in a deal worth $1.5 billion.

The auction proceeds, which must be approved in a court hearing Monday, won’t cover the $32 million that Pear owes to creditors.

Successful bidders were:

  • Click Therapeutics, which offered $70,000 for Pear’s patents. That company offers a variety of digital therapeutics products.
  • Harvest Bio, which bid $2 million for Pear’s patent licenses. I couldn’t find any online presence for the company.
  • Nox Health, which offered to pay $3.9 million for Somryst, which is Pear’s insomnia treatment app. Nox Health offers sleep health solutions.
  • Welt, which will pay $50,000 for Pear’s migraine assets. The Korea-based company offers digital biomarkers and digital therapeutics.

Reader Comments

From Oracular Degeneration: “Re: David Feinberg. Will he leave Oracle Cerner at the one-year mark? It’s coming up.” I’m among many who expect him to leave at the earliest date that won’t jeopardize his $22 million reward for serving as Cerner’s CEO for a few pre-acquisition weeks. The one-year closing date is June 8, and other documents reference a 52-day period that would make it July 30. I don’t know why he would stay or why Oracle would want him to.


HIStalk Announcements and Requests

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Poll respondents have just two real problems with the behavior of their fellow attendees. I’ll side with the person who opines that Q&A pontification is the one item on the list that is insulting rather than just annoying and thus deservers having attendees emulate UK Members of Parliament and shout them down.

New poll to your right or here: Will the VA eventually complete an enterprise-wide rollout of Oracle Cerner?

I thought the once-respected Forbes couldn’t get any more hilariously irrelevant, but they have topped it by tasking a “content creator” (they deem her an “expert”) to compare Cerner to Epic. She helpfully informs us that neither company offers transparent pricing or a free trial, that both offer the “useful feature” of revenue cycle management, and that Epic does not offer third-party integrations. She concludes that in her expert opinion, Cerner is the better choice for “clinical practices and specialties,” while “Epic is our pick for bigger hospitals and care networks.” Should you wish to drink further from her Forbes fountain, check out “How To Make Business Cards At Home” or “How To Get Clients In Release Estate.”


Webinars

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


Acquisitions, Funding, Business, and Stock

RCM vendor Aspirion acquires Firm Revenue Cycle Management Services.


People

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Amwell hires Kathy Weiler, MA (Optum) as EVP / chief commercial and growth officer.

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Today I (accidentally) learned that Care.AI founder and CEO Chakri Toleti – who previously co-founded Galvanon (sold to NCR) and HealthGrid (sold to Allscripts) – is a former actor and Bollywood film director. His brother Raj Toleti, who was involved with those companies along with others in health IT, such as Cytura and PatientPoint, is now founder, CEO, and chairman of Andor Health.


Announcements and Implementations

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Five pharmacies of the Wegmans grocery chain will pilot ScripTalk, an RFID tag for prescription containers that allows the drug’s name, dose, instructions, and warnings to be read out loud on the accompanying audio device or on the patient’s phone.


Privacy and Security

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The Harris County, TX attorney calls for privacy violation action against Texas Children’s Hospital after an unnamed person provided screen shots of the medical records of children to a conservative think tank, which published them in an article about the hospital’s gender-affirming care services.

In England, a judge dismisses a hospital patient’s privacy lawsuit against Google, ruling that Royal Free London NHS Trust’s sharing of patient medical records with Google’s DeepMind Technologies in 2015 did not violate reasonable expectations of privacy.


Other

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In Canada, a Price Edward Island review finds that 1,700 patient referrals were missed when clinic staff forgot to fax them as required by the Telus EHR.

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I found via a LinkedIn mention the “Simple Sabotage Field Manual” that was created by the US’s predecessor to the CIA in 1944 to guide “citizen-saboteurs” of occupied countries as gleaned from European experience. Some that pertain to businesses may still have corporate relevance:

  • Insist that everything go through channels and don’t allow shortcuts that could expedite decisions.
  • Make long speeches that include anecdotes of personal experience.
  • Refer all matters to committees that have at least five members.
  • Bring up irrelevant issues.
  • Revisit decisions made in previous meetings.
  • Recommend caution and emphasize avoiding embarrassment in guiding decision-making.
  • Promote employees who don’t deserve it and complain about achievers.
  • Add layers of required approval and unneeded paperwork.

Sponsor Updates

  • CereCore promotes Bob Gronberg to AVP of Meditech professional services and Clay Posey to AVP of technical services.
  • Black Book releases the results of its analysis of population health data activation platforms and data management systems, based on the responses of 2,539 survey respondents.
  • EClinicalWorks releases a new customer success story featuring Shield Medical Group, “Data-Driven Decisions with Healow Insights.”
  • Wolters Kluwer Health releases the results of its second “Pharmacy Next: Consumer Care and Cost Trends” survey.
  • Nordic will exhibit at Infor Connect 2023 May 22-25 in St. Paul, MN.
  • OmniSys will exhibit at the HCP23 Spring Hospital Pharmacy Conference May 22-24 in Indianapolis.
  • Sonifi Health expands its customer engagements with Children’s Hospital of Philadelphia, Essentia Health, University of Arkansas for Medical Sciences, and Griffin Health.
  • Talkdesk earns TrustRadius Awards in the contact center, call center workforce optimization, call recording, and VoIP categories.
  • Waystar will exhibit at the EClinicalWorks 2023 Enterprise Summit May 22-24 in Boston.

Blog Posts


Contacts

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

Morning Headlines 5/19/23

May 18, 2023 Headlines Comments Off on Morning Headlines 5/19/23

Adonis Raises $17.3 Million, Led by General Catalyst, to Transform Revenue Outcomes for Healthcare Providers Across the United States

RCM automation vendor Adonis raises $17 million in a Series A funding round.

Flagler Health+ Announces Plans to Join UF Health, Elevate and Expand Health Care Services

UF Health will acquire Flagler Health+ (FL), with one of Flagler’s goals being to upgrade its IT systems.

HealthSnap Raises $9 Million Series A for Continued Growth of Remote Patient Monitoring and Chronic Care Management Platform

Virtual care management platform vendor HealthSnap raises $9 million in a Series A funding round.

Startups Wanted: Catalyst by Wellstar Launches $100 Million Venture Fund to Shape Future of Healthcare

Health system Wellstar’s Catalyst venture capital firm launches a $100 million fund to support early-stage healthcare startups working in areas that include digital health; data, analytics, and security; and customer experience.

Comments Off on Morning Headlines 5/19/23

News 5/19/23

May 18, 2023 News 9 Comments

Top News

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The VA and Oracle Cerner complete their scheduled five-year contract renegotiation.

The VA’s next five-year renewal period will be changed to five, one-year terms.

The revised contract will also include stiffer financial penalties if the Oracle Cerner system fails to meet specific performance metrics.


Reader Comments

From MmSEC Observer: “Re: Veradigm. This is how private equity firms steal shareholder value in taking public companies private. They are pillaging companies that misstep software accounting rules. See Avaya.” Publicly traded digital communications vendor Avaya filed bankruptcy a few weeks ago in a deal that allowed two private equity firm lenders to take control of the company, leaving Avaya’s shareholders with nothing. The company’s problems came to light after executive changes and delays in filing earnings reports that followed a previous bankruptcy filing in 2018. A bondholder class action lawsuit accuses Avaya’s board of “massive fraud” in misleading investors. MDRX shares have lost 34% in the past 12 months versus the Nasdaq’s 4% gain, valuing the company at just over $1 billion.


HIStalk Announcements and Requests

Reminder: if your company sponsors HIStalk and is participating in the MUSE conference, give me details for my conference guide.


Webinars

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


Acquisitions, Funding, Business, and Stock

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RCM automation vendor Adonis raises $17 million in a Series A funding round.

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Virtual care management platform vendor HealthSnap raises $9 million in a Series A funding round.

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CVS Health will close the clinical trials business that it launched in May 2021. The service provided technology-drive patient recruitment, real-world data collection, and clinical trial delivery.

A Business Insider piece says that Oracle is “crushing morale” among former Cerner employees since its $28 billion acquisition of the company by these actions:

  • Laying off 3,000 of 28,000 employees.
  • Freezing raises and promotions.
  • Vacating Cerner’s former buildings in Kansas City.
  • Sidelining former Cerner CEO David Feinberg to a “ceremonial” role as chairman of Oracle Health.

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Doximity reports Q4 results: revenue up 18%, adjusted EPS $0.20 versus $0.21, beating expectations for both. Shares dropped 6% on the news to their year-ago price, valuing the physician networking company at $6 billion.

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NextGen Healthcare reports Q4 results: revenue up 18%, adjusted EPS $0.31 versus $0.19, beating analyst expectations for both but sending shares down on the news. NXGN shares have lost 16% in the past 12 months versus the Nasdaq’s 4% gain, valuing the company at $1 billion.


Sales

  • Gundersen Health System will implement cloud-based Visage 7 Enterprise Imaging Platform in its seven hospitals and 65 clinics.
  • SUNY Downstate Health Sciences University will implement Memora Health’s care delivery platform.

Announcements and Implementations

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Executives for Health Innovation, which was known as EHealth Initiative through 2021, will shut down, 22 years after it was founded.

UF Health will acquire Flagler Health+ (FL), with one of Flagler’s goals being to upgrade its IT systems. Flagler chose Allscripts Sunrise in 2011, while UF Health uses Epic.

UnitedHealthcare takes heat for its decision to require prior authorization for colonoscopies starting June 1, a move that left the American Gastroenterological Association “profoundly alarmed and disappointed.” The insurer says approval will be immediate for procedures that follow evidence-based guidelines and within two days otherwise.

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OpenAI launches ChatGPT for the IPhone on the Apple App Store.


Government and Politics

A judge orders Theranos founder Elizabeth Holmes to report to prison to begin serving her 11-year sentence for investor fraud, rejecting her last-minute bid to remain free while she appeals. Holmes and former Theranos COO Sunny Balwani, who is serving a 13-year sentence, were also ordered to pay $452 million in restitution to 12 defrauded investors and former partners Walgreens and Safeway.

An Oklahoma doctor and pharmacist are charged with manslaughter in the death of a 75-year-old rehabilitation center patient from a methotrexate overdose. The physician admitted that he didn’t order correctly, while an investigation found that the pharmacist ignored the computer’s red-letter warning that the prescribed dose of 20 mg of methotrexate daily for seven days – instead of the intended 20 mg every seven days – was excessive.


Privacy and Security

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A proposed Federal Trade Commission order would bar ovulation tracking app Premom from sharing user health data in charging the company with making unauthorized disclosures to third parties when its privacy policies claimed it doesn’t. The company will also pay $200,000 in federal and state fines.

Related to the Premom order, FTC seeks comments on its intention to extend the Health Breach Notification Rule to cover health apps.

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An Oklahoma allergy clinic shuts down permanently following a cyberattack. The clinic’s physician owner says all of the practice’s technology was impacted when she and her husband downloaded an unspecified IPhone app, locking them out of all of its systems even as patients were receiving appointment reminder text messages. The owner says that the FBI, Department of Justice, and Department of Defense are investigating, but the FBI says it has received no reports about the issue. Social media comments claim that the same doctor abruptly shut down other clinics, including a medical spa, for reasons unrelated to technology.


Sponsor Updates

  • Divurgent releases a new episode of The Vurge Podcast, “Digital Mental Health Insights: Breaking the Stigma with Data.”
  • Fortified Health Security names Candace Manning (Lifeway) client success manager.
  • Loyal wins Best Patient Registration and Scheduling Solution in the MedTech Breakthrough Awards.
  • Consensus Cloud Solutions partners with Hyland Software to offer a digital cloud fax solution that integrates with OnBase.
  • AvaSure, which offers acute virtual care and remote safety monitoring solutions, establishes a chief nursing executive advisory board with 10 inaugural members.
  • CereCore will recruit and train hundreds of EHR and clinical informatics staff over the next one to three years to support HCA Healthcare’s deployment of Meditech Expanse.
  • Nordic releases a video titled “The Download: Valuing IT as an Asset to Improve Patient Care.”

Blog Posts


Contacts

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

EPtalk by Dr. Jayne 5/18/23

May 18, 2023 Dr. Jayne 1 Comment

A colleague clued me in about an article that was published in JAMA Network Open last week, “Perspectives on the Intersection of Electronic Health Records and Health Care Team Communication, Function, and Well-being.” The associated qualitative study looked at the habits of more than 70 attending and resident physicians and found that the EHR dominated most inter-office communication.

Although it can be helpful for management of patient-related tasks, they found that communicating through the EHR limited the “rich communication and social connection required for building relationships and navigating conflict.” The authors suggest that “the technology shifts attention away from the human needs of the care team, and interventions to cultivate interpersonal interactions and team function are necessary to complement the efficiency benefits of health information technology.”

Digging into the study design, I found it interesting that the participants in the qualitative interviews were separated in time, with a significant event in the middle with the emergence of the COVID-19 pandemic. The first of the two cohorts was interviewed from March to October 2017 with the other being interviewed from February to April 2022. The authors called this out as a limitation of the study. They also noted that the first study focused on EHR-related distressing events and their role in physician emotions and actions, where the second study focused on EHR use and “daily EHR irritants.”

I would propose that in a post-pandemic world, even the smallest of daily annoyances is felt much more acutely than it might have been in 2017. This is exacerbated by the staffing and financial pressures that have been magnified since the pandemic’s start in 2020. I’d be interested to know what the relative level of staffing was during the two cohorts’ interview periods, since a significantly understaffed practice will yield different sentiments than one that is running with adequate staffing. Interestingly, information on respondent demographics wasn’t collected.

The authors also note that communicating through the EHR was felt to negatively affect team function and team well-being, namely by “promoting disagreement and introducing areas of conflict into team relationships related to medical-legal pressures, role confusion, and undefined norms around EHR-related communication.” There was specific discussion of physicians being expected to manage EHR-related messages across multiple platforms such as in-basket, email, and text.

One interviewee compared this to driving a car before stoplights were developed. “Some of my colleagues text; some of them send it in… email; some of them send it as Epic provider-to-provider messages. What a mess… there’s no sort of manners and rules. Right? Sort of like… before they developed stoplights, and there were starting to be more and more cars. Right? Man, this is nuts. It’s like, ‘Who’s going first. Who’s talking to who?’” I feel that frustration, especially when you look at the fact that different platforms might offer different subsets of functionality that can be confusing.

In some of my experiences with startups, we ran into this with differences in what IOS versus Android platforms would support, and even with IOS, on what might work on iPhone but not on iPad. This is magnified when you’re dealing with a full-feature EHR that people are trying to use from disparate platforms. You can also throw in some desktop support requirements and the Apple Watch and it’s a doozy.

I tend to only perform “real work” on a laptop or desktop, so I can’t imagine the cognitive overhead that people who try to manage on different platforms are experiencing as they try to remember which device will allow them to do what. Especially with portable devices, people are also trying to use EHR-based communication while doing other things, such as attending events with family, which adds a layer of distraction to what might already be some fairly brief communications.

Others in the study noted that “now that I can place an order from anywhere, everyone assumes I can place an order from anywhere, and expects me to do so anywhere, anytime.” In my experience, this blurring of personal and professional time adds to clinician burnout and resentment towards the workplace.

I was saddened to read the part of the article where they discussed the EHR being used to air disagreements, including clinicians who “would document petty, kind of nasty comments in the EHR about residents.” Others noted that concerns about potential litigation may “put people under the bus” in the EHR with documentation about who was paged and when, and whether the response from the contacted clinician was to their satisfaction. There were also the expected comments that delivery of care to the patient has “completely been subsumed in documentation requirements.”

The authors noted that there is a need for greater understanding of optimal EHR use and that “the development and improvement of local work culture is critical and may have a greater influence on physician burnout than EHR improvements alone.” They go on to suggest that “organizations support physicians in implementing small, structured peer-group discussions to enhance team function and individual well-being.” I’m a big fan of the concept of self-organizing teams and the latter comment resonated with me. People need to be able to talk about how they like to be communicated with, and any additional needs they have in processing information, but may not be likely to address these needs unless it’s clear that the workplace is supportive of accommodating them.

I received quite a bit of reader mail about my recent Curbside Consult that talked about May being graduation season. Many readers have graduates in their families and it sounds like there is an even split between those going into technology-related fields and those pursuing careers in the arts and humanities. A couple sent pictures of their graduates and it was great to see the proud parents and the excited faces of the graduates in the photos. One correspondent noted that her daughter is headed to work for Epic, with another sending a child to a public health organization. They’re looking forward to seeing what their children think about the industry after seeing it from another side. I’m sure new entrants to the healthcare field have an entirely different idea of what it will be like than many of us did 10 or even 20 years ago.

What did you think healthcare IT would be like when you first started in the industry? Has it met your expectations or crushed your dreams? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 5/18/23

May 17, 2023 Headlines Comments Off on Morning Headlines 5/18/23

Neura Health Secures $8M in Financing to Support Go-To-Market Expansion to Employers and Health Plans

Virtual neurology clinic Neura Health will use $8 million in seed funding round to expand into enterprise markets.

Ovulation Tracking App Premom Will be Barred from Sharing Health Data for Advertising Under Proposed FTC Order

Easy Healthcare, developer of the Premom ovulation-tracking app, will pay a $100,000 fine for violating the FTC’s Health Breach Notification Rule.

Investing in Hippocratic AI

Andreessen Horowitz’s A16Z invests $50 million in seeding funding for Hippocratic AI, which offers a safety-focused large language model for healthcare.

Comments Off on Morning Headlines 5/18/23

Readers Write: Bringing the Call Center Into the 21st Century

May 17, 2023 Readers Write 2 Comments

Bringing the Call Center Into the 21st Century
By Ben Moore

Ben Moore is chief product officer of PerfectServe of Knoxville, TN.

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Like some of you, I was compelled to dip my toe in the healthcare waters because of a personal experience.  It was over a decade ago, but I still remember it like it was yesterday.

My wife was pregnant with our daughter, who came weeks before her due date. Both my wife and daughter faced serious complications, and my stress level was exacerbated significantly by care delays that seemed almost entirely caused by inefficient communication. Simple questions and follow-ups that should have taken minutes ended up taking hours. These delays put both my wife and daughter’s health and safety at risk. 

For example, to reach the specialist, a nurse would have to call the hospital operator, who then had to manually track down and page the correct specialist on call, which would often start a process of telephone tag among nurses, operators, and physicians. The physicians were, and in some cases still are, carrying one-way pager devices, which would cause lots of disjointed one-way communications.

At that time, we had purchased the first-generation 3G-connected iPad for my wife while she was in the hospital. She was able to instantly text friends and family from her hospital bed and engage in social media. I was perplexed. Why weren’t the care teams in the hospital equipped with similar state-of-the-art communication tools? My wife was able to engage in real-time and media-rich communication, but hospital staff were limited to 140-character alphanumeric pager messages, telephone callbacks, and voicemails. The contrast was stark, and to be frank, seemed a bit ridiculous.

I can tell you that archaic technology and processes like the ones I described above are still prevalent across healthcare today. As just one example, even though over 70% of communications into and out of a hospital run through the call center, these antiquated tools are still, in many cases, a major part of directing that very important traffic. That’s alarming.

By upgrading technology that has its roots in the 1990s, the call center can become a true hub for patient engagement and clinical collaboration. Here are four steps you can take to bring the call center into the 21st century. 

  1. Head for the cloud. Eighty percent of call center systems still use on-premise technology. This is problematic, because you’re only going to reliably connect stakeholders across all sites of care with a cloud-based solution. I once witnessed a fan blow up on a hospital PC server, and it completely knocked out communication with incoming ambulances. With a cloud-based system, this kind of risk is gone. If your EHR is already in the cloud, your call center should be there, too.
  2. Unify clinical and patient communication. Rather than forcing operators to play middleman, go with a system that allows providers to communicate directly with patients. This kind of setup can be achieved within a broader ecosystem that facilitates both clinician-to-clinician and patient-to-clinician communication, meaning all communication is initiated and captured in one platform. This means less complexity for providers, easier access for patients, and greater transparency — especially with EHR integration — for anyone who needs to reference communication history.
  3. Integrate, integrate, integrate. Speaking of integration, I actually think it should be a bigger focus for the call center than things like analytics or standard performance metrics, which you find in most call centers today. A properly executed integration plan can reduce the manual labor of operators by over 80%. Key integrations should include the EHR, patient flow systems, CRM, and scheduling platforms to provide operators with a single pane of glass.
  4. Embrace smartphones. You need a call center platform that embraces smartphones. The vast majority of physicians use them, and integrating them with the call center ecosystem allows for things like time-sensitive communication — say, a team alert initiated by an agent about an incoming hip fracture patient — that can actually be monitored to verify that recipients have received and read all necessary information. No more guesswork! And please, whatever you do, make sure to ditch the pagers. No agent wants the page-and-pray technique to be central to their everyday duties.

Clinical call centers — like hospital switchboards, patient transfer centers, and answering services — can have a tremendous impact on everything from care coordination to patient experience to health outcomes. After decades of neglect, it’s time to give them the modern infrastructure they deserve to unleash their true potential.

Healthcare AI News 5/17/23

May 17, 2023 Healthcare AI News Comments Off on Healthcare AI News 5/17/23

News

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OpenAI rolls out 70 third-party plug-ins for ChatGPT that allow Plus users to access Internet content, retrieve information from specific sites such as Expedia, analyze online PDF documents, and create integrations with Zapier. The Link Reader plug-in, which I tested above, allows ChatGPT to analyze live web pages.

The World Health Organization expresses enthusiasm for using AI in healthcare, but recommends cautious adoption to avoid errors and patient harm due to AI training bias, incorrect or incomplete responses that appear authoritative, and its possible use to generate convincing health disinformation.

Google enhances its Bard generative AI tool with a new version of its PaLM 2 large language model, adds connectivity to a user’s Google apps and services, and provides support for plug-ins.

Google also introduces Duet AI for Google Workspace, which adds AI creation to Gmail and Docs similar to Microsoft’s Copilot for Office 365.

Google’s Med-PaLM 2 is being tested to analyze diagnostic images and answer questions about its summary.


Business

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Andreessen Horowitz’s A16Z invests $50 million in seeding funding for Hippocratic AI, which offers a safety-focused large language model for healthcare. The company says that its model outperforms GPT-4 and uses clinician-validated model training that avoids bias and sources that aren’t evidence based.

BeeKeeperAI announces GA of EscrowAI, which allows HIPAA-compliant research on full PHI without exposing patient data or the algorithm’s intellectual property. The company says it acts as a “middleman and matchmaker between data stewards and algorithm developers” to reduce the effort and cost of data projects by 50%. The company was created at UCSF’s Center for Digital Health Innovation by that organization’s founder, UCSF Health Chief Digital Transformation Officer Michael Blum, MD, who serves as BeeKeeperAI’s CEO.

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BayCare Health System and HealthPrecision will co-develop AI tools for nursing decision support and clinical documentation, where the system will translate nurse dictation into EHR documentation and suggest additional steps. The co-founders are Eyal Ephrat, MD and Sonia Ben-Yehuda, who together created MedCPU and PeriGen.


Research

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Kaiser Permanente will award grants of up to $750,000 to three to five US health systems to study the use of AI and ML to improve diagnoses and outcomes.


Opinion

FDA Commissioner Rob Califf, MD says that large language models appear to be ushering in a fourth industrial revolution that includes healthcare, but they need to be regulated now to avoid society being “swept up quickly by something that we hardly understand,” also adding that methods need to be developed to measure and adjust the operating characteristics of algorithms based on real-life experience.

Physician and author Elisabeth Rosenthal, MD, MA says in an opinion piece that startups are offering apps and devices that address mental health therapy as an alternative to short-supply professionals, but most of them aren’t supported by outcomes research, haven’t been reviewed by FDA, and contain small print that reminds users that they are not intended to provide actual clinical services. Experts say the apps use a workbook-like approach for specific problems, which doesn’t address complexity or offer the empathy between patient and doctor that many therapy types require.


Other

The UK government issues guidance about when sellers of software as a medical device must report adverse incidents to the Medicines & Healthcare Regulatory Agency.


Contacts

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

Comments Off on Healthcare AI News 5/17/23

Morning Headlines 5/17/23

May 16, 2023 Headlines 1 Comment

VA Signs New, Tougher Contract with Company Handling Faulty Electronic Health Records Rollout

The VA signs a one-year contract, renegotiable and renewable for up to five years, with Oracle Cerner to extend its work on the department’s EHR Modernization program

Ambient Intelligence Streamlines Clinical Burden, Patient Safety and Compliance, Black Book Survey Announces Top AI Workflow Solutions

A Black Book survey of health system IT leaders finds that Care.ai is the top emerging ambient intelligence solution.

Laguna Health gets $15M to be a Waze for care transitions

Care management technology startup Laguna Health raises $15 million in a Series A funding round led by SemperVirens and HC9 Ventures.

News 5/17/23

May 16, 2023 News 18 Comments

Top News

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Connected health company Validic acquires Cox Communications subsidiary Trapollo, which offers technology and services that help healthcare organizations care for patients at home.

The companies had previously partnered to support a West Coast IDN’s personalized care program.

Cox will become an investor in Validic as part of the acquisition.


Reader Comments

From Vera Dime-a-Dozen: “Re: MDRX, formerly Allscripts and now Veradigm. Were supposed to restate their 10K on May 8, but it has been postponed to mid-June as the internal audit continues to identify issues.” The company says in a recent SEC filing that it hopes to file the 10-K by June 14, but can’t guarantee it. The company announced on March 22 that the year-end audit and 10-K filing would be extended because of “internal control deficiencies related to revenue recognition.” Veradigm expects the audit to have a revenue impact of $40 million that will require restating its 2021 financials.


HIStalk Announcements and Requests

Gmail suddenly started sending legitimate incoming emails to  spam a few weeks ago, I noticed yesterday, including entries from the Rumor Report and Contact forms. I added some inbox rules that should fix that, but let me know if you didn’t receive a reply that you expected.

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Attention HIStalk sponsors that are participating in the MUSE Inspire conference June 7-10 in Aurora, CO — send me your details and I’ll include them in my online list of sponsor activities there. I see some sponsor names sprinkled among those companies that have booths in the sold-out exhibit hall of the conference’s 40th anniversary.


Webinars

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


Acquisition, Funding, Business, and Stock

Healthcare pricing transparency startup Cascade Health raises $1.7 million in venture funding. It has developed healthcare pricing APIs and an AI-powered chatbot that answers patient questions about procedure pricing and insurance coverage. Co-founders Ana-Maria Constantin and Pulak Goyal hail from Microsoft.


People

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Divurgent CEO Ed Marx announces on LinkedIn that he has left the company after one year and will work as an independent consultant. The company made no announcement, but its leadership page shows that founder Colin Konschak, RPh, MBA, who stepped down from the CEO job in May 2022 but remained board chair, is again serving in both roles.

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Dale Sanders, chief strategy officer of Intelligent Medical Objects, resigns to take a one-year professional break.

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CereCore promotes Peyman Zand, MBA to chief strategy officer.

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HCTec hires Bill Lewkowski (Lewkowski Associates) as VP of strategic client services.

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Rhapsody names Jeff Chiumiento (Rocket Software) as CFO.

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Jason Prestinario, MS (Komodo Health) joins Particle Health as CEO.

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Jane Casey, RN, MS (Humber River Hospital) joins Tampa General Hospital as VP of CareComm Operations, its clinical command center.

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Zyter|TruCare names Kevin Riley, MBA (Salesforce) as  president and CEO.

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John George (Validic) joins Gozio Health as chief sales officer.


Sales

  • Piedmont Healthcare (GA) will launch a remote patient monitoring program using RPM software from Telemetrix and devices, care management, and coaching from Remote Care Partners.
  • The University of Mississippi Medical Center selects remote patient monitoring software, services, and resources from AMC Health.

Announcements and Implementations

CHIME opens registration for its Fall Forum November 9-12 in Phoenix, AZ for its provider members.

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The West Hawaiʻi Region of Hawaiʻi Health Systems will go live on Epic June 1 through a Community Connect partnership with The Queen’s Health System.

Hendrick Health (TX) launches a wayfinding app developed by Gozio Health.

A Connected Health Initiative survey finds that 89 million Americans use a wearable device, with fitness tracking being the most common use followed by sleep and weight monitoring. Nearly all of the users are sharing data with their healthcare provider or are willing to, while 40% of those with a chronic condition say that the device has simplified their health management. More than half of HSA/FSA participants who don’t have a wearable say they would be more likely to buy one if they could fund the purchase from those accounts.


Government and Politics

Minnesota lawmakers are planning make a single exception to the state’s proposed patient-to-nurse hospital staffing ratio regulation for Mayo Clinic, which threatened to pull billions of dollars worth of investments out of the state in protest over the bill and another involving price transparency. House Speaker Melissa Hortmann says the exception is justified because “Mayo is different” and “an asset that is known all over the world.” Draft legislation would exempt hospitals that aren’t in the Twin Cities, that use an electronic nurse acuity system, and that have 40% of patients coming from out of state, requirements that only Mayo in Rochester meets.


Other

Netsmart earns top user satisfaction rankings among behavioral health technology vendors, according to a Black Book survey of 2,847 end-users.

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UF Health launches tele-pharmacy kiosks from MedAvail Technologies at three of its ERs. Newly discharged patients can virtually consult with a pharmacist and pick up medications within about five minutes.

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A Black Book survey of health system IT leaders finds that Care.ai is the top emerging ambient intelligence solution. The company has deployed AI solutions for infection prevention and control, patient and protocol monitoring, workforce optimization, and virtual care in 1,500 organizations.

A researcher warns that companies are rolling out AI-powered search tools for academic databases and research journals without understanding the opportunities and limitations of those tools. The author calls for evidence-based groups to audit individual search tools and publish their suitable uses so that research projects aren’t skewed.


Sponsor Updates

  • Ellkay, which participates annually in the Go the Distance for Autism biking event, seeks donations to help it meet its fundraising goal of $35,000.
  • Artera expands its online learning center, Artera Academy, to include an improved user dashboard, integrated events hub, and more accessible learning resources.
  • Baker Tilly releases a new Healthy Outcomes Podcast, “The current state of cybersecurity in the healthcare industry.”
  • Nordic publishes a podcast titled “Designing for Health: Dr. Adam Wright.”
  • Bamboo Health will exhibit at the Medicare Star Ratings, HEDIS, Quality Assurance & Risk Conference June 5-7 in Chicago.
  • Biofourmis will sponsor the Hospital @ Home Leadership Summit June 5-6 in Boston.
  • CloudWave will exhibit at the NRHA Annual Rural Health Conference through May 19 in San Diego.

Blog Posts


Contacts

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

Morning Headlines 5/16/23

May 15, 2023 Headlines Comments Off on Morning Headlines 5/16/23

Personalized Care Company Validic Acquires Trapollo

Digital health company Validic acquires Cox Communications subsidiary Trapollo, which offers technology and services that help healthcare organizations care for patients at home.

Practice Perfect Acquires an Ownership Stake in Clinical Billing Solutions to Provide Revenue Cycle Management Services

Practice Perfect acquires Clinical Billing Solutions, and will integrate the RCM vendor’s software and services with its EHR and practice management system for outpatient rehabilitation clinics.

Cascade Health Announces Venture Funding Round to Build Intelligent Platform for Healthcare Transparency

Healthcare pricing transparency startup Cascade Health raises $1.7 million to further scale its AI-powered chatbot designed to answer patient questions about procedure pricing and insurance coverage.

Comments Off on Morning Headlines 5/16/23

Curbside Consult with Dr. Jayne 5/15/23

May 15, 2023 Dr. Jayne 1 Comment

May can be a busy time for families who have graduates. When I was in Madison last week, I saw plenty of people who were taking pictures at the state capitol wearing caps and gowns. It was fun to see their excited smiles and to wonder where they are heading next on life’s adventures.

This weekend, I attended a graduation at my state’s flagship engineering and technology school, and it didn’t disappoint. It was inspiring to see so many people going into careers in science, technology, engineering, and math fields. It was particularly gratifying to see the number of women graduating in fields that have been historically male dominated, including geophysics, mining, metallurgy, and explosives engineering.

Due to the size of the ceremony, graduates of various departments were recognized in groups by their majors before coming to the stage individually to receive their diplomas. Although mechanical engineering was dominant at the ceremony I attended, there were quite a few aerospace engineers and a surprising number of metallurgical engineers who had the most stylish hair, shoes, and eyeglasses in the crowd. In addition to computer science and computer engineering, degrees from a new program in information systems and technology were also conferred.

The “best decorated graduation cap” honors goes to the biology major who had three Petri dishes affixed to her cap, along with the metallurgical engineer who had gilded designs on the top of hers. Several of the biology majors had plush bacteria toys dangling with their tassels after being gifted them from their department chair. During the departmental recognitions, the audience figured out that there was a lone economics major among the hundreds of graduates, and he received some extra applause and cheering.

I sat next to the mother of one of the information systems graduates and was learning a bit about the new program and how it was founded as part of a major donation to the university. That funding led to the addition of a college that covers entrepreneurship, information systems, technology management, and more. Although some of those disciplines existed previously as part of the college of engineering, it’s interesting to see them grouped together under a new umbrella.

My assumption is that the new organizational structure also helps ensure that they’re funded in the way that the donor intended, rather than the money being washed through a larger department and potentially sidetracked. Since the new college carries the donor’s name, it also needed to contain actual departments, so I’m sure that was a factor as well. According to his mother, that new graduate interviewed at a healthcare software company, but she wasn’t sure which one it was.

Being well into my career, it’s sometimes easy to forget what those milestones that our younger selves experienced meant to us at the time. I don’t have deep memories of my college graduation other than lining up in the bowels of the basketball arena with other graduates in my department and singing our school song for what would be my last time. (I admit, I haven’t visited since graduation, but I’ll be doing that later this month as part of a milestone road trip with my former college roommate.) I remember my medical school graduation in great detail, especially the processional that involved bagpipers and a parade down a couple of escalators. With the bagpipes and the gowns and hoods and having been through the wringer during the four years prior, it seemed quite surreal at the time.

I also remember the fact that the main speaker failed to follow the program, which led to us not being administered the appropriate oath (in our case, the Oath of Geneva rather than the Hippocratic Oath) during the ceremony. They tried to rectify that after the ceremony concluded, but many of us had already scattered to meet with families and loved ones.

I’ve made use of that fact at least once in my career, when a patient was upset that I wouldn’t give her what she wanted and told me that I had to do it because “you took an oath.” I said very calmly that actually I didn’t take that particular oath, but that wasn’t going to keep me from giving her high-quality, evidence-based care regardless of the fact that it wasn’t what she wanted on that particular day. I think most of us in medicine would agree that the core values we follow are ingrained in us long before any oaths become topics of discussion, and that we don’t need to say prescribed words to do the right thing. Quite a few medical schools allow their incoming classes to write their own oaths during the first year, enabling them to memorialize values and intentions that are important to them.

There are situations where oaths are important, and I was able to experience one of those as well while attending my first ROTC officer commissioning ceremony as part of the graduation festivities. During that ceremony, a military officer administers the Oath of Office to each newly appointed Second Lieutenant, and then family members or loved ones help pin on their ranks. They also receive their first salute from an enlisted service member who has been important to them. It was interesting to see who the cadets chose to perform the different parts of the ceremony. Some of them had relatives who were officers administer the oath, one had a former scout leader who was a naval officer do his, and one woman received the oath from her husband who graduated and was commissioned last year. The most touching was the cadet who had his grandfather, a Korean War veteran, give his grandson the first salute. There were few dry eyes in the house after that one.

It was inspiring to see these young people, most of whom could have headed off to solid careers in engineering or technical fields, commit to serving their country. Instead of following the money, they’ll be supporting our military as cybersecurity resources, civil engineers, logistics coordinators, pilots, and missile operations officers.

The latter job role is one that most people don’t think about. It feels strange to understand that in a world where so many people are focused on what they see on TikTok or Instagram, we have officers underground 24×7 ready to launch what might be world-ending missiles should the order arrive. Knowing that gives me a new perspective on my daily work struggles or the things that some of us think are emergencies on any given day. There’s a lot of uncertainty in the world that these newly minted officers are headed into, but I have high hopes that this generation has leaders among it that can do a better job than what we might be seeing today.

Are you headed to any graduations this spring, and what are your hopes for the futures of these recently degreed individuals? Are graduates gravitating to technical fields or finding their futures in the arts or humanities? Leave a comment or email me.

Email Dr. Jayne.

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