News 8/23/23

August 22, 2023 News 8 Comments

Top News

Waystar is reportedly considering an IPO that could value the healthcare payments business at $8 billion.

The company, formed in 2017 through the merger of Navicure and ZirMed, was valued at $2.7 billion when EQT and Canada Plan Pension Investment Board acquired a majority stake in the company two years later from Bain Capital.

Reader Comments

From Offline Opie: “Re: UGM 2023. The biggest news item from Day 1 was that the WiFi was down most of the day and Verizon service was similarly spotty.” Attendee attentiveness was likely improved, so that might have been a plus. I would pay extra to visit a theater, performing arts center, or restaurant that has implemented a cone of electronic silence to prevent phone addicts from serving as mood-piercing lighthouses. It baffles me why people take the effort to go somewhere, but then yield to the dopamine call of electronic fantasyland (see: a couple staring down at their respective phones in a restaurant).

From Kirin: “Re: Veradigm. It is not new accounting software that is preventing them from filing SEC reports, it’s that the finance team can’t figure out exactly what products they have, with multiple and sometimes overlapping solutions with multiple names, acronyms, and leadership changes. They also had M&A activity and didn’t really know what they were buying or selling. Executives thought they had 150 products, but it’s closer to 220, and the various lists weren’t reconciled before the divestiture to Harris and prior to moving to new accounting software. The auditors aren’t able to contact the people who know the history. The extension deadline is less than a month a away.” Unverified. Veradigm just announced that it can’t guarantee that it will file its annual report, as well as the two following quarterly reports, by the September 18 deadline for Nasdaq de-listing.

From Tippi: “Re: [company name omitted.] Speculation has it that the president has stepped away from company operations and will leave once terms are agreed on.” Unverified. I’ve omitted specific details that were provided since it’s not fair to name names without an official announcement.

HIStalk Announcements and Requests

Signs that your press release is poorly written and thus likely to be ignored:

It leads off with the word “today.”
The headline doesn’t summarize the content that few people will actually read.
It contains nothing newsworthy, such as the eye-rolling “momentum” announcement that pointlessly recaps (and in some cases rewrites) history.
It fails to clear the “why you should care” bar, providing information that would interest only company insiders and perhaps existing customers.
It fails to describe what the company sells in a single sentence, instead vomiting up overwrought, unintelligible corporate gibberish to make its work seem loftier.
It doesn’t list a press contact, thus simultaneously seeking media attention while discouraging it.

I haven’t seen many photos from Epic UGM (maybe because connectivity there has been limited), but here’s my favorite, as Availity gets into the “Castaway” theme.

Webinars

August 24 (Thursday) 2 ET. “RCM analytics in action: How to use your data to drive decisions + revenue.” Sponsor: Waystar. Presenter: Laura Tungate, solution strategist team lead, Waystar. This webinar will describe how to use RCM analytics to take control of your data even if you use outdated or multiple tools. Attendees will learn how to target improvements, describe the KPIs that are key to revenue cycle leaders, prioritize dashboards that spotlight organizational goals and build alignment, and how and when to apply RCM analytics to go from analysis to action faster.

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

Acquisitions, Funding, Business, and Stock

Claims payment and editing software company Lyric raises nearly $91 million. The company, formerly known as ClaimsXten, was sold by Change Healthcare to TPG Capital last October for $2.2 billion as a condition of Change’s $13 billion acquisition by UnitedHealth Group’s Optum business.

Five9 will acquire Aceyus, which offers customer experience analytics.

Sales

HIE San Diego Health Connect will implement 4medica’s enterprise master patient index.
Michigan Health Information Network Shared Services selects Smile Digital Health’s data exchange and interoperability software.
The Norfolk and Waveney Acute Hospital Collaborative in the UK will implement Meditech across its three hospitals.
UAE’s Kanad Hospital chooses InterSystems TrakCare.

People

Kipu Health names Carina Edwards, MBA (Quil) CEO.

Lisa Nelson, MBA, MMI (MaxMD) joins ADVault as SVP of enterprise integrations.

Jefferson County Health Center (IA) names Tim Belec (Owensboro Health) CIO.

Blanchard Valley Health System (OH) hires Gulshan Mehta (Oracle) as chief digital and information officer.

Donna Robinson, MFA (Change Healthcare) joins TeleVox Healthcare as chief commercial officer.

Mark Michalski, MD (Amazon) joins Northwell-created healthcare AI company Ascertain as CEO.

Emory Healthcare promotes Scott Smiser, MBA to CTO.

Digital wound care technology vendor Swift Medical hires Neil Sharma, MBA (Sword Health) as chief commercial officer and Joseph Filippoli, MBA (Tabula Rasa HealthCare) as CIO.

Announcements and Implementations

Moffitt Cancer Center McKinley Hospital (FL) implements Pcare’s interactive patient care and engagement system within its new inpatient surgical facility.

In Australia, the Illawarra Shoalhaven and Sydney Local Health Districts deploy Sectra’s enterprise imaging software.

A new KLAS report looks at how advanced users of next-generation digital fax solutions are moving toward extracting discrete clinical data from faxes using NLP or OCR. Most of the users say that digital fax is a key part of their interoperability strategy since they use it to ingest data, order, and bills. They say that “faxing is here to stay” and predict that even paper-based faxing will see increased use because of its ease of use and inherent security.

Sponsor Updates

Findhelp publishes a new whitepaper, “Consumer Privacy and Consent: Implications for Social Care and Social Drivers of Health in the United States.”
The Connecticut Institute for Communities deploys population health solutions from EClinicalWorks.
Ascom releases a new report, “Clinical Decision Support Systems (CDSS), A Clinical Safety Net, Drives Tomorrow’s Brighter Healthcare Outlook.”
Bamboo Health will host a Headshot Studio at the NACHC CHI & Expo August 27-29 in San Diego.
CHIME releases a new Opioid Action Center Podcast, “Interoperability & Data Sharing at the Speed of Trust.”
Clinical Architecture celebrates its sixteenth anniversary.
Nordic posts a new episode of its podcast, “Designing for Health: Interview with Matt Sakumoto, MD.”
Current Health publishes a new case study, “Keeping High-Risk Heart Failure Patients Out of the Hospital.”

Blog Posts

Contacts

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

8 Comments

Morning Headlines 8/22/23

August 21, 2023 Headlines Comments Off

Healthcare software firm Waystar eyes $8 bln valuation in U.S. IPO

Waystar reportedly considers an IPO that would value the healthcare payments software vendor at $8 billion.

Looks like KOP-based AI healthtech company Lyric raised $90.9M

Lyric, a claims payment and editing software company formerly known as ClaimsXten, raises nearly $91 million.

UnisLink Extends its Revenue Cycle Management Leadership with the Acquisition of AQREVA and Doctors’ Resource Specialists

RCM and population health management company UnisLink acquires competitors Aqreva Medical Billing and Consulting and Doctors’ Resource Specialists.

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Curbside Consult with Dr. Jayne 8/21/23

August 21, 2023 Dr. Jayne 1 Comment

One of my favorite practice administrators has worked her way up through her health system and is now the head of human resources for the organization. We were catching up the other day and talked about some of the challenges she is facing in her new role.

Of course, recruiting is a major focus, especially in direct patient-facing roles such as nursing and social work. They’re also having challenges in recruiting respiratory therapists and child life specialists, the latter being more important as they’re trying to grow their presence in the pediatric hospital space.

However, retention is the largest issue she is facing, describing it as an arms race between competing care delivery organizations that serve the same markets. She’s finding more frontline healthcare workers who are willing to move from one health system to another over a few dollars in hourly pay than was common in years past, which is causing a lot of undesired turnover.

Hospitals and health systems shouldn’t be surprised by this. For some time, employees have been increasingly feeling like loyalty is a thing of the past. This sentiment was exacerbated by the things that happened during the height of the COVID pandemic, when caregivers were treated as expendable and were not supported with adequate personal protective equipment or adequate time to recover from the horror they were experiencing on a daily basis.

In my area, we saw hundreds of nurses leave a given hospital to become travel nurses at a hospital across town, making up to three times the pay. Now we’ve arrived at a new normal where salaries have adjusted and most of the travel nurses are gone, but healthcare workers are still voting with their feet. Hospitals may continue to argue that they’re working on slim margins and don’t have the money to keep up with their competitors, but I’m seeing them become increasingly creative with strategies to retain people.

My colleague’s organization is banking on the fact that AI might help augment staffing in more task-based departments such as the central billing office, credentials verification office, and even within her own human resources department. Not surprisingly, the story they’re telling is that as AI takes on tasks that require lower-level skills, they will be able to move those employees to other roles, including cross-training them to work in clinical spaces.

I think there is some level of wishful thinking in this regard. Not everyone has the temperament to work with patients who are often going through some of the worst things they can imagine. Some of the best workers I’ve encountered in clinical areas view their work more as a calling than as a job, and you can tell easily which employees are which when you encounter them as a patient.

She noted that one of her most pressing challenges will be changing attitudes about workers taking time off. She’s made it a point of engaging directly with workers to understand how they feel about the organization, and not just relying on surveys, which may not fully explain what’s going on with a workforce. She has found that some of the nurses feel guilty about taking time off, because it creates additional load for their co-workers.

Other workers, such as those in technology support and other departments, feel like they’re perceived as not being team players when they take all the time off to which they’re entitled. The organization buys back unused blocks of paid time off and has no minimum on how much employees have to take during the year. She’s been starting to socialize the idea that workers should have to take a minimum amount of time off in order to encourage them to recharge.

She’s also floating the idea of paid hours to be used for volunteering in the community, which is an idea that I really like. She’s trying to get approval for a relatively small number of hours to start, four hours every six months. In a large organization, however, that’s a substantial commitment, so it will be interesting to see how that effort plays out. I suspect that many of their employees are already supporting community organizations, so for them it would be additional compensation for things they are already doing, but for others it might be a way to encourage employees to engage in a way they haven’t done.

Given recent attention to student loans, she’s also considering expanding the organization’s loan repayment efforts. That might be attractive to younger workers, but won’t mean much to older workers. It will be interesting to see what she comes up with to balance that out across other employee segments.

I’m excited for her and enjoyed seeing her enthusiasm for her new role. Only time will tell how much support she’ll receive from her organization and whether other members of the leadership will see the proposed changes in the spirit in which they are intended. I’ve seen a fair amount of turnover in human resources roles in the last few years, so I hope she has success in this endeavor. I can imagine it might be easy to burn out if she doesn’t get the support she’s expecting, and a burned-out human resources leader isn’t going to be in the best position to help her co-workers.

With the Epic User Group Meeting this week, lots of informatics folks and health system executives have descended on Madison, Wisconsin. According to one of my friends who is a local but not affiliated with Epic, it’s “when we hunker down and don’t go anywhere, because the traffic is terrible and all the restaurants are packed.” Traffic in Madison is nothing to sneeze at normally, so I don’t blame folks for laying low when the big show is in town.

To increase my knowledge about the area, he sent me this article about the “great butter and cheese fire of 1991,” which is burned into the memories of many locals. The fire, which took more than a week to fully extinguish, was ultimately attributed to a malfunctioning forklift battery. The fire’s intensity was fueled by burning insulation and more than 12,000 tons of butter and cheese along with 5,000 tons of hams, hot dogs, cranberries, and baked goods. Firefighters on the scene described at “river of butter” that flowed when the building collapsed and described five-foot-deep pools of butter.

Firefighters were hampered by a “moat” of dairy products that kept fuel trucks from reaching the ladder trucks, leading to the need for people to hand-carry buckets of diesel fuel to keep the trucks running. Personnel from the Department of Natural Resources were on hand to protect local streams and lakes from the flood of butter. Retention ponds were used to contain butter that was flowing faster than it could be pumped into the sewer system. Several dams were built to control the torrents of butter. Ultimately firefighters had to discard most of their personal gear due to contamination and ongoing rancid smells. Here’s to hoping that we never see another event like this in our lifetimes, and that everyone headed to Madison has uneventful travel.

Are you attending the Epic User Group Meeting, and what are your favorite parts of the event? Leave a comment or email me.

Email Dr. Jayne.

1 Comment

Readers Write: What’s Needed to Resolve the Medicaid Redetermination Crisis

August 21, 2023 Readers Write Comments Off

What’s Needed to Resolve the Medicaid Redetermination Crisis
By Carrie Kozlowski

Carrie Kozlowski, OT, MBA is co-founder and COO of Upfront Healthcare of Chicago, IL.

More than 90 million Americans, including children, the elderly, people with disabilities, and veterans rely on Medicaid for their health coverage. Many of them are now losing that coverage with the expiration of the COVID-19 relief laws this spring.

According to the Kaiser Family Foundation (KFF), as of mid-July, more than two million people have lost Medicaid coverage since April 1, 2023, with most of them removed from state rolls for technicalities, such as missing the deadline to complete their forms or to file certain required documents. The Centers for Medicare and Medicaid Services’ (CMS) also found that 31% of renewals resulted in someone dropping Medicaid or Children’s Health Insurance Program (CHIP) benefits, with an alarming 79% of the beneficiaries losing coverage due to procedural reasons, not because they no longer qualified due to income or changes in family arrangements.

In total, KFF estimates that 15 million people will be dropped from Medicaid over the course of the year under this “Medicaid unwinding” process. The result? Healthcare enterprises will experience a gap in compensation for care, operational efficiency will suffer, and patients will get sicker during this post-pandemic Medicaid redetermination period.

The federal government is stepping in to try to stem the crisis. On July 19, CMS reported that it has intervened with several states, requiring them to pause procedural terminations and reinstate individuals. Moving forward, the CMS will be closely tracking state data and fielding complaints to identify problems early with renewals and take corrective action, according to the fact sheet “Returning to Regular Medicaid Renewals: Monitoring, Oversight, and Requiring States to Meet Federal Requirements” released by the agency.

More efforts are needed, however. Basic lack of awareness about the changes in the laws is a key part of why the Medicaid unwinding process is turning into a crisis in many states. A Robert Wood Johnson Foundation survey, “Awareness of the Resumption of Medicaid Renewal Processes Remained Low in December 2022,” revealed that approximately 64% of Medicaid members had heard nothing at all about the enrollment requirements, leaving them vulnerable to losing their coverage.

All this is a significant concern, not only from a population health and health equity perspective, but it also because it has far-reaching financial implications for health systems and medical group that are already facing slim to negative operating margins. With declining enrollees, they risk further negative financial impacts and may need to increase staffing to facilitate point-of-care enrollment, adding to the costs and inefficiencies.

It is crucial for health systems to keep patients enrolled in Medicaid, not just for the sake of their health, but for the financial stability of their own operations. Keeping them enrolled ensures that they can continue to receive preventative care, which leads to improved health outcomes, protected reimbursement, and reduced overall healthcare costs.

From an operational standpoint for health systems, it is also in their best interest to keep Medicaid patients covered so they do not lose access to primary care providers, causing delayed time to treatment and sicker patients admitted to hospitals, flooding intensive care units, and causing backlogs in emergency departments that can reverberate through the hospital and can delay elective surgery schedules.

Alarmed by the numbers of people losing insurance, some states are taking a more proactive approach to notifying and educating people about the new verification process for maintaining coverage. But a one-size-fits-all approach will not be effective in communicating with this diverse audience. Connecting with these different populations requires understanding their unique needs and preferences and delivering culturally sensitive content in multiple languages. Digital health solutions are well positioned to help states and providers achieve their shared goal of engaging Medicaid patients.

Combining digital communications with human efforts is critical to achieving this daunting task. Trust plays a role as well, as more people with Medicaid express wariness about their providers. The report “A Two-Way Street: Building Trust Between People with Medicaid and Primary Care Doctors” published by Public Agenda found that four in 10 say doctors need to earn their trust. Communicating with these patients in culturally sensitive and health literate language should be central to the strategy for engaging them to play a more proactive role in their healthcare.

By leveraging patient data and insights, technology can help personalize the content and optimize the outreach by channel, ultimately improving effectiveness and ensuring that patients do not get lost, while building a greater bond of trust between them and their providers.

As states continue to unwind the Medicaid continuous enrollment provision, there are opportunities to promote continuity of coverage among enrollees who remain eligible by implementing a patient engagement strategy that leverages digital communications along with human efforts to reach, educate, and activate patients.

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Readers Write: The Illusion of EHR Interoperability

August 21, 2023 Readers Write 2 Comments

The Illusion of EHR Interoperability
By Pawan Jindal, MBBS

Pawan Jindal, MBBS, MHI is CEO of Darena Solutions of Chesterfield, MO.

Isn’t EHR interoperability great?

It would be, but there is a huge gap between the published standards and the reality. Sharing data among healthcare providers, health plans, and patients was supposed to be much easier now that EHR interoperability through FHIR-enabled apps is the universal standard. Developers should have been able to integrate their SMART on FHIR apps with virtually any EHR and have the resulting integrations work seamlessly across multiple platforms. Sadly, it is not working as intended.

In Q1 2023, the Office of the National Coordinator for Health Information Technology (ONC) reported that 95% of certified health IT developers met the December 31, 2022 compliance deadline to enable access to information through application programming interfaces (APIs) “without special effort.” However, our experience with FHIR app developers, providers, and EHRs shows that true EHR integration remains elusive, despite ONC’s claims.

Out of the nearly 300 EHRs certified by ONC to be interoperable with FHIR-enabled apps, only a few allow developers to integrate apps with their EHRs. By enforcing the Cures Update requirement only on EHR vendors, ONC is not penalizing providers, the ones who seem to be refraining from information sharing. Out of the total 763 claims of information blocking filed so far with the ONC, 85% of the claims (646) are against providers. This problem is further exacerbated by the fact that provider education on the benefits of information sharing from ONC is severely lacking.

The Information Blocking provisions of the Cures Act currently only mandate making data available to patients upon request. The EHRs have geared up to allow providers to honor these requests. However, if you ask providers, they say, “No one is asking for it, or I send them to the patient portal, or I ask them to fill out a request form to obtain a hard copy of their records.”

Most providers aren’t aware of the requirement to provide data to patients in an app of their choice. If healthcare is ever to achieve a reality that includes easily integrated apps facilitating the seamless sharing of patient data between organizations, it must actively engage providers in information sharing.

Healthcare has been working toward interoperability for a while through the creation of rules and standards. It’s been three years since the Centers for Medicare and Medicaid Services (CMS) adopted the interoperability rule, removing many barriers that prevented patients from accessing their health data. The rule also issued version 1 of the US Core Data for Interoperability (USCDI v1) standard that EHR vendors must meet for ONC certification.

An information blocking provision went into effect in 2021 requiring EHR vendors, providers and others to share the data specified in USCDI v1. That rule was expanded in 2022 to include even more types of data. Last year, ONC also published the Trusted Exchange Framework and Common Agreement (TEFCA), which sets a nationwide standard for interoperability and establishes the process for health information networks to become Qualified Health Information Networks (QHINs), a sort of “super network” for sharing data.

FHIR (Fast Healthcare Interoperability Resource) is the standard developed to enable this data exchange. It can be used on its own and with existing standards, like the USCDI and billing-related data elements used in EHRs. FHIR-based apps are designed to be used with any FHIR-capable EHR. It is important to note that the TEFCA agreement is meant to establish a minimum standard for performance across the healthcare continuum. Based on that, FHIR is on the map for future phases and is not required out of the box.

So why does widespread EHR interoperability remain an illusion despite ONC claims?

Glitches are to be expected any time there is development and adoption of a new technology standard, particularly one that must integrate with older EHR platforms. Companies, sometimes unwittingly, fail to disclose all the ins and outs of their products and capabilities. Take for example, NextGen Healthcare’s agreement this summer to pay a $31 million fine to settle claims that the company misrepresented its software’s capabilities and paid users kickbacks for their endorsements. Similar cases have resulted in settlements with other EHR vendors, including EClinicalWorks, Practice Fusion, Greenway Health, and Modernizing Medicine.

Even when considering glitches and a few bad actors, it’s become obvious that ONC certification alone doesn’t necessarily guarantee successful app integration in the field because developers, EHR vendors, and healthcare systems continue to struggle to achieve interoperability.

For its Health IT Certification Program, the ONC includes a Real World Testing annual requirement. According to the website, “The purpose of this Condition and Maintenance of Certification requirement is for Certified Health IT Developers to demonstrate interoperability and functionality of their certified health IT in real world settings and scenarios, rather than in a controlled test environment with an ONC-Authorized Testing Lab.”

Anyone with experience in IT development (or any complicated technology, for that matter) knows that what works well in the lab can fail in the field. That’s because real-world conditions and demands can be more challenging than what designers anticipated. This highlights the need for more realistic real-world testing from the ONC in addition to tests conducted by independent entities. Currently, each EHR tests its own application in the field. Unsurprisingly, they all seem to replicate the certification testing. We need a Consumers Reports-style impartial review for health IT.

In the meantime, app developers and other stakeholders can work with third-party experts who can guarantee EHR integration.

2 Comments

Morning Headlines 8/21/23

August 20, 2023 Headlines Comments Off

After cyber breach, Point32Health suffers financial losses

Point32Health, the second-largest insurer in Massachusetts, reports a six-month loss of $103 million that its CFO attributes almost entirely to a security breach at Harvard Pilgrim Health Care.

Veradigm Inc. Receives Nasdaq Notice Regarding Delayed Form 10-Q Filing

Hospitals at home: Doccla hopes virtual wards can solve healthcare woes

London-based virtual hospital startup Doccla, which works with NHS, acquires remote patient monitoring platform vendor Open TeleHealth to expand into nine additional countries in Europe.

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Monday Morning Update 8/21/23

August 20, 2023 News 4 Comments

Top News

Point32Health, the second-largest insurer in Massachusetts, reports a six-month loss of $103 million that its CFO attributes almost entirely to a security breach at Harvard Pilgrim Health Care.

Harvard Pilgrim discovered the ransomware attack on April 17, 2023. Its website and online member accounts were offline for more than two months.

The hackers gained access to the protected health information of 2.5 million people, which was exfiltrated from its systems.

Reader Comments

From Cosmos: “Re: Meditech. Has quietly shut down its professional services division. Their website was just scrubbed of any mention of this service.” Confirmed, at least the “scrubbed from the website” part. The company hasn’t replied to my inquiry from Friday or the one from mid-May when a reader first told me that the service was being eliminated, four years after it was announced. UPDATE: Meditech re-sent a response from my May inquiry that I didn’t receive, with this update:

MEDITECH will continue to offer services for analytics and quality initiatives to further the widespread adoption of these expert-based solutions across our customer base to ensure customer success. We are in the process of defining all of these services and will release more details on our website as they become available. Going forward, customer requests for large-scale, full implementation project work will be directed toward MEDITECH-certified consulting firms. All existing contracts will be honored to ensure customer success.

From Baffle; “Re: HIStalk search. Could you add a function that returns pages with links?” The existing search function at the top of each page does that, although it’s really just a Google site search. Everybody would like to be able to search with sorting or filters by date range, but I’ve spent money several times on custom search engines and WordPress plug-ins that failed to work ideally. A viable company will eventually develop an affordable ChatGPT-powered chatbot search tool that will help catalog the treasure trove of industry information that is contained in the 16 years’ worth of HIStalk content — I didn’t save information from the old site host from the first four years – and I’ll be excited to implement that. Everything here has already cleared the bar of being both newsworthy and concise, so powering that with ChatGPT-type access would be powerful for market research and learning from the past.

HIStalk Announcements and Requests

Most poll respondents would like having their UTI treated via telehealth, but with a doctor or health system they are familiar with rather than someone from a national telehealth service.

New poll to your right or here: Do you think it’s good that hospitals are consolidating into huge health systems? I set up the poll, the choices of which are admittedly clunky by necessity, to allow you to answer in your multiple roles as a consumer, taxpayer, and health IT employee.

Listening: 90s-style grungy indie rock from Blondshell, which is actually just LA-based Sabrina Teitelbaum under a far more marketable brand along with a backing band that can rock hard. The concept of “band” is fading fast in favor of one-shot collaborations and solo artists hiring other players to retain career flexibility, revenue, and the benefit of independent solo craftsmanship.

The industry seems to be thawing out again and competitors are repositioning themselves after a year of hunkering down, so this is for their marketing folks. Current HIStalk sponsors get free spotlights and text ads, while prospective ones can talk to Lorre about the benefits of full-year exposure. Startups and former sponsors might even get a lagniappe. Lorre also has a single Top Spot banner for companies that are seeking maximal exposure and the satisfaction of always seeing their ad atop those of competitors. Sponsors get zero influence over news and opinion, but that’s to their advantage since decision-makers will bail quickly on thinly veiled pay-for-play and inexpert babbling.

Webinars

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

Acquisitions, Funding, Business, and Stock

Nasdaq notifies Veradigm that the company remains non-compliant with its listing requirements and faces de-listing for its failure to file its FY2022 and Q1/Q2 financial reports, which the company blames on software it implemented to meet new accounting standards. Veradigm says it hopes to file the reports before the 180-day exception period ends on September 18, but can’t guarantee it.

A good article in Behavioral Health Business reviews the digital therapeutics market following the bankruptcy of substance abuse app vendor Pear Therapeutics:

Insurers are reluctant to pay for digital therapeutics products, although state Medicaid plans and the VA have been more active in covering them.
Those Medicaid programs are concerned that other companies will follow Pear’s example in failing to stick around long enough to deliver value.
Programs that require provider workflow changes and education are less likely to succeed.
Companies are trying to establish a foothold with employers instead of treating their offering as a pharmacy benefit.
Insurers are particularly reluctant to pay for software-only products, so companies are expanding to bundle coaching and clinical oversight as a virtual-first service.

Sales

West Tennessee Healthcare engages Nordic to support its transition from Oracle Health to Epic.

Announcements and Implementations

London-based virtual hospital startup Doccla, which works with NHS, acquires remote patient monitoring platform vendor Open TeleHealth to expand into nine additional countries in Europe.

MUSC Health Orangeburg will go live on Epic on December 7, replacing Oracle Health.

Other

Epic UGM runs Monday through Wednesday this week. I always appreciate getting attendee reports. Verona is under a heat advisory (isn’t everybody), with highs Sunday through Wednesday of 92, 85, 95, and 95 versus barely 80 degrees last year. Cling to those memories of huddling by the first-night’s campfire in the crisp air, but at least be glad it’s not on Thursday, when the high will hit 100 degrees.

Sponsor Updates

EClinicalWorks releases a new customer success story, “How healow Self-Scheduling Helped a New Practice Fill 400 Appointment Slots.”
SeamlessMD’s Digital Patient Podcast features Meditech EVP and COO Helen Waters.
NTT Data becomes a Microsoft Global System Integrator partner.
Ronin publishes a new whitepaper, “Clinician Experience: The Missing Link Between High-Efficiency and High-Tech Healthcare.”
Visage Imaging posts a case study titled “Optimizing Enterprise Imaging in the Cloud Using Visage 7 PACS Platform on AWS with Allina Health.”
Sectra announces that a US-based health system will expand its use of the company’s technology to include the Sectra One Cloud enterprise imaging cloud subscription service for diagnostic imaging.
Verato will exhibit at the Civitas 2023 Annual Conference August 21-23 in Maryland.
Waystar will exhibit at the HFMA North Carolina HFMA Summer Conference August 23-25 in Myrtle Beach, SC.
Wolters Kluwer Health will present at Rise West 2023 August 29 in Dallas.

Blog Posts

How Meditech is driving AI innovations in health IT (Meditech)
Amplifying Success: Integration Drives Positive Patient Experience (NeuroFlow)
Lights Out: Defeat Digital Darkness (Optimum Healthcare IT)
How Integrated Is Your Omnichannel Strategy? Here’s a Quick Guide (OptimizeRx)
How Better Communication Improves Revenue Cycle Management (PMD)
Leapfrog Rapid Response: Interventions to Improve Your Healthcare Ratings (ReMedi Health Solutions)
IOT Sensing-as-a-Service Enriches Hospital Food Service (SmartSense by Digi)
What Is the CMS GUIDE Model: A Paradigm Shift in Dementia Care (Trualta)
Healthcare Transformation Series: Why Incorporating Digital Mental Health Solutions Makes Sense (Zynx Health)

Contacts

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

4 Comments

Morning Headlines 8/18/23

August 17, 2023 Headlines Comments Off

Orbita Acquires Wellbe Assets

Smart virtual assistant and workflow automation vendor Orbita acquires the assets of Wellbe, which offers patient journey automation software.

Figur8, the market leader for measuring musculoskeletal (MSK) health and injury recovery, secures $25M Series A-1 financing

Musculoskeletal health measurement technology vendor Figur8 raises $25 million in a Series A funding round.

The Plan to Better Protect US Hospitals From Ransomware

The Advanced Research Projects Agency for Health within HHS launches the Digital Health Security project as a means to discover new cybersecurity tools for healthcare.

Visana Health Raises $10.1 Million Seed Round to Bring Comprehensive Virtual Healthcare to Women Nationwide

Minneapolis-based virtual women’s health clinic Visana Health raises $10.1 million in a seed funding round.

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News 8/18/23

August 17, 2023 News Comments Off

Top News

Patient intake software vendor Phreesia acquires Access EForms, which specializes in electronic forms management and automation.

Webinars

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

Acquisitions, Funding, Business, and Stock

Smart virtual assistant and workflow automation vendor Orbita acquires the assets of Wellbe, which offers patient journey automation software.

Babylon files Chapter 7 liquidation bankruptcy in the US, with the COO noting in filings that the company has no money available to pay unsecured creditors. The company, whose market cap peaked at $8 billion shortly after going public via a SPAC merger in 2021, lost $221 million on revenue of $1.1 billion in 2022.

Musculoskeletal health measurement technology vendor Figur8 raises $25 million in a Series A funding round. The company began as a sports medicine technology project of MIT, Mass General, and the Boston Red Sox.

Oregon Health & Science University announces its intention to acquire Legacy Health, creating a 10-hospital, 32,000-employee system in the Pacific Northwest.

Blue Shield of California will replace its pharmacy provider CVS Health with Amazon, Mark Cuban Cost Plus Drugs, and other companies, sending shares of pharmacy benefit manager owners CVS, Cigna, and UnitedHealth Group down.

People

Colleen Watson (FinThrive) joins Divurgent as VP of sales management and operations.

Announcements and Implementations

Vanderbilt University Medical Center pilots a virtual nurse program in which dedicated virtual nurses will initially focus on created admitting and discharge documentation.

Abridge, whose app turns doctor-patient conversations into transcripts and visit summaries, becomes the first member of Epic’s Partners and Pals integration program.

Ellkay announces LKOasis, an enterprise-wide data management platform that expands its LKArchive data archive.

Government and Politics

A new Florida law requires Medicaid-accepting hospitals to add an admission form item asking patients if they are a US citizen or lawful visitor and to submit their aggregated information to the state quarterly. Florida is the only state with that requirement.

The Department of Defense and the VA work together to solve IT integration problems at Chicago’s Captain James A. Lovell Federal Health Care Center, the only facility that serves both DoD and VA patients. Health center employees have struggled with file sharing, printing, and collaborating using Microsoft Teams, problems that the organizations hope to resolve by the end of the year.

Other

Bondholders of Mercy Iowa City ask a judge to investigate the hospital’s bankruptcy, its acceptance of what critics call a lowball University of Iowa offer to buy it for $20 million, and rumors that UI wants the hospital only to convert it to a behavioral health facility. The bondholders also want an examiner to review the hospital’s EHR migration to Allscripts Sunrise in 2021, which they call an “inferior platform” that caused the hospital to lose millions of dollars.

The American Medical Association examines the myth that all electronic prescriptions require two-factor authentication. It notes that the DEA requires two-factor authentication only when prescribing controlled substances and that Ohio has eliminated previous requirements for non-controlled outpatient orders. AMA recommends checking with the state medical society or board of pharmacy, noting that Cleveland Clinic alone saves 12,000 physician hours per year after AMA worked with Epic to notify Ohio CMIOs.

Non-profit CommonSpirit Health paid its CEO $35 million in its tax year ending in June 2022, as called out by Stat. The company’s federal filings indicate that the organization, which was formed with the 2019 merger of Catholic Health Initiatives and Dignity Health, paid 36 executives more than $1 million that year, including $3 million to its chief information and digital officer. Among its top paid contractors are Conifer Health Solutions ($574 million) and HCL Technologies ($26 million). Two of its executives are lobbyists, one of whom was paid $2.4 million.

The future of Amazon’s Alexa devices is questioned as its top executive leaves the company amidst poor consumer adoption, a shift of interest to ChatGPT, and reported losses by the unit of $5 billion per year with little progress toward the intended goal of boosting Amazon’s overall sales. Bloomberg’s commentary:

For most, Alexa became little more than an overly-sophisticated kitchen timer, or a decent-enough smart speaker for those who were not audiophiles. Amazon’s attempts to remind consumers of different “skills” Alexa had became intrusive and irritating. Developers, initially intrigued by the possibilities of a voice-first platform, came and went when they realized engagement was low. Ambitions of Alexa within cars made way for the more full-featured offerings from Apple’s Car Play and Google’s Android Auto. And then ChatGPT arrived. In the space of a few weeks — maybe even days — ChatGPT wowed more consumers with its intelligence than Alexa has managed in its entire lifetime.

Sponsor Updates

Findhelp publishes a new case study, “Enhancing Social Care Coordination: How findhelp Partners with 211 & United Way.”
Healthcare Triangle publishes a new whitepaper, “The Future of Healthcare Infrastructure: An In-Depth Look at the Infrastructure as a Code (IaaC) Landscape.”
Black Book Market Research behavioral health survey-takers recognize Netsmart for its top-performing technology solutions and services.
Lucem Health releases a new This Week in Health Podcast.
Nordic posts a new episode of DocTalk titled “The future of health through widespread precision medicine.”

Blog Posts

Prisma and Healow – The Miller Family Medicine Group (EClinicalWorks)
CX Summit: Five9 Partners Showcase the Power of People, Our Partners, and Technology (Five9)
Change Management Tips for Large-Scale Medical Group Implementations (Impact Advisors)
The Importance of Support & Training When Choosing an EHR Provider (Medhost)

Contacts

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

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EPtalk by Dr. Jayne 8/17/23

August 17, 2023 Dr. Jayne Comments Off

Many companies are talking about the work they are trying to do using artificial intelligence, but some of the writeups I see range from overly vague to downright nonsensical.

I was intrigued to see an email from Tripadvisor inviting me to “kick-start your planning” by trying the company’s new AI trip planning product in a pre-launch version. It promises to use the answers to four questions about a proposed trip to “sift through over one billion traveler reviews and opinions.” From there, the user is supposed to get a custom daily itinerary based on their interests, and it’s supposed to be sharable with others. I decided to check it out and see how a more consumer-facing offering behaves compared to the healthcare-centric products I usually look at.

I ran the AI trip builder against a trip I had recently planned to a city where I’ve wanted to go, for which I have already compiled a list of recommendations. The solution asked me where I wanted to go (city and state) as well as proposed dates and whether I was going solo, with a partner, with friends, or with family. From there, I was asked to choose attractions, hidden gems, museums, history, culture, food, outdoors, wine and beer, arts and theater, or adventure and sports as the ways I would want to spend my time.

After about a minute, it put together an itinerary, tagged as “powered by AI,” for five full days of sightseeing. I was pleased to see that two of the restaurants on my list matched the Tripadvisor list. However, there was a lot of detail lacking. For example, there was no input for how I preferred to get around – would I have a car, or rely on public transportation? Based on the distances between recommended activities, I suspect it made the assumption that most travelers in the US have a car.

The way that different locations was grouped together didn’t make a lot of sense. I would have expected that AI should be able to use addresses and directions to put things together in a way that makes more sense. Given the amount of data available to the system, it could also have generated some other useful information, such as a forecasted budget per day and a total for the trip. It didn’t ask any information about cost, and also didn’t include any lodging options, which for me is a big part of planning any trip.

Hopefully more bells and whistles will come in the released version. But overall, it didn’t feel like there was much difference between this and other itineraries I’ve seen in travel magazines that I read while researching my trip.

I ran it again against a trip I took earlier this year and the results were even more erratic. It sent me to the same historic district on three different days, recommending that I visit adjacent properties separately even though they were within a block or two of each other. I double-checked the sites’ operating hours to make sure that wasn’t a factor, but they were all open all of the days. It also included the Cracker Barrel Old Country Store, which isn’t necessarily what I think of when I’m looking for great food on a vacation, although I do always like biscuits and gravy.

Maybe some additional functionality could include an understanding of where the trip is in relation to where you reside, whether you’ve been to the area before, and if so, what you did last time. To truly take it to the next level, it could ask if you want to eliminate options that are also available within 10 miles of your home location.

Alas, I’ve spent enough time in this industry to understand the concept of the Minimum Viable Product, so if they were looking at providing something with features that might draw in an early adopter type user or might help validate a product idea, they’re on their way. Unfortunately, there wasn’t any way to provide feedback, so I think that’s a missed opportunity for the Tripadvisor development team. Hopefully they are doing some additional testing where they’ll actually get user feedback. In my experience, that’s the best way to evolve a product.

From All Work, No Pay: “Re: HIMSS selling its conference. It sounds like there might be financial troubles, since the organization is not making good on honorarium payments for CIOs and others who participated in focus groups at the HIMSS23 conference. Staffers have cited the conference’s transition as a reason for the delay.” These focus groups are usually hosted by HIMSS Corporate Members, who pay a hefty fee in exchange for the opportunity to either pitch to or pick the collective brains of various healthcare executives. Attendees usually receive a gift card in addition to lunch. I’ve been to HIMSS meetings where it’s hard to find lunch without waiting in a huge line, so I can see the draw of making the trek to one of the private meeting rooms, which are usually in the basements of the convention centers. A sandwich and the opportunity to rest your feet for an hour can be a draw on its own, not to mention the possibility of seeing something new that a vendor might be preparing to debut. Hopefully HIMSS will get its act together and make good on its agreements if indeed there’s a problem.

I’m always looking for a feel-good story, but unfortunately I ran across this one a few years too late. The Swedish Number was a campaign by the Swedish Tourist Association that allowed callers to dial Sweden and “get connected to a random Swede and talk about anything.” It was launched in 2016 to celebrate the 250th anniversary of a law to abolish censorship. It generated nearly 200,000 calls in the 79 days it was open. Callers from the USA were responsible for 32% of its volume. Swedes could register as ambassadors, and when calls came in, they were randomly routed to participants until someone answered.

It’s a great idea to generate interest in your country, and I like the idea of people just wanting to connect with someone in another part of the world. With all that we’ve collectively been through over the last three years, maybe it’s time for another feel-good moment. Which country wants to give it a go?

If you could call and talk to a random citizen of a given country, who would you want to talk to? Leave a comment or email me.

Email Dr. Jayne.

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Morning Headlines 8/17/23

August 16, 2023 Headlines Comments Off

Abridge Becomes Epic’s First Pal, Bringing Generative AI to More Providers and Patients

Abridge, whose app turns doctor-patient conversations into transcripts and visit summaries, becomes the first member of Epic’s Partners and Pals integration program.

Tausight Announces Additional $6 Million in Financing

Healthcare data security company Tausight raises $6 million, bringing its total funding to $26 million.

Digital Health Company Babylon Files for Bankruptcy In US, Will Liquidate

Babylon Health will liquidate the assets of two of its US subsidiaries as part of Chapter 7 bankruptcy proceedings.

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HIStalk Interviews Sean Cassidy, CEO, Lucem Health

August 16, 2023 Interviews Comments Off

Sean Cassidy is co-founder and CEO of Lucem Health of Raleigh, NC.

Tell me about yourself and the company.

I’m an old enterprise software guy, going back to the early 1990s. I’ve been in digital health since about 2004. I’ve worked mostly on big platform type products sold to healthcare providers, such as data integration, data management, and analytics.

The idea for Lucem Health originated within Mayo Clinic a little over three years ago, Mayo Clinic, like a lot of academically oriented healthcare providers that were doing research in AI and machine learning, was struggling to figure out how to deploy AI at scale so that they could deliver real value and impact in the clinical workflow. They went looking for platforms that could be Swiss army knives, for lack of a better term, for the deployment of a broad set of clinical AI type solutions. They didn’t really find anything, so they made the decision to fund the start of a company which later became Lucem Health.

How do health system executives decide when to jump in or experiment with AI among the daily flurry of AI announcements or research results?

It’s important to have a perspective on what the potential value and impact of AI could be to your organization. But primarily, I would orient yourself — as health system leaders are doing these days – to the real problems that are vexing you; for which solutions exist in the market that are novel, unique, and different from what you have seen before; and that can be deployed against those problems and be force multipliers. When you are inquisitive about that, you will find that there is AI at the center of a lot of those solutions.

However, it’s important to note, and this is our perspective, that AI is not a panacea. An algorithm is not a solution. It may deliver a strong and accurate predictive output, but if it can’t be delivered to stakeholders in the right context, right place, and right time, then it’s all for naught. It can’t deliver any meaningful value and it can’t solve for those problems that a healthcare provider may be facing.

Are health systems looking for a turnkey solution to address one specific problem or do they want tools and assistance that can help them develop their own expertise?

I actually think that they are looking for both. It depends on the context.

There is a certain class of provider, large providers that do a lot of research and development in a variety of areas, who are struggling with the bench-to-bedside problem. Their problem is not necessarily a technology-oriented problem, but it turns out that they need technology to solve for that.

But let’s take a provider organization that doesn’t have a data science team and is not doing research and development. They see, as they are exploring the market, that there is value in opportunity and solutions that may have AI at the center. They are telling us that they would prefer not to invest in point solutions or a fragmented set of underlying technology platforms, but would rather buy or deploy on a consistent and uniform infrastructure.

How hard is it for connect those external AI systems to their underlying data and work around issues with interoperability and terminology?

As your readers know, in healthcare, that’s a pervasive, it’s always an issue that there is heterogeneity in the operating environment, but the data can be represented in different ways and can be semantically different. AI solutions are no different from any other solution that is trying to leverage data that already exists, whether it comes from an EMR or some other modality. There is a curation process that has to occur in order to optimize the data so it can be served to the AI and provide the appropriate context to a broader AI solution so that it can be delivered effectively.

What are the steps involved in talking to a health system that has defined a problem and thinks AI can help solve it?

Leaving aside the business case for deploying it, what we find today is that providers are looking for a clinical and financial yield, an ROI, that is significant. Otherwise, it’s difficult to gin up yet another project to try to optimize data infrastructure that they have already invested in. But in terms of connecting into infrastructure, we deploy what I would define as narrow AI. These are not large language models or generative AI. These are very specific hammers for very specific nails. Their data requirements are not terribly broad. They are fairly narrow. There are, for example, plenty of ECG-based models that are powerful in terms of being able to detect cardiovascular disease. Generally speaking, virtually no optimization and curation is required on that signals data to be able to feed it into most of the models.

There are a number of really interesting models that are using EMR data. Fairly simple stuff, like demographic data plus usually one or two lab values that can identify risk of certain kinds of diseases. Again, there’s a little bit of work that has to be done to do some curation on that data, but because the dataset is relatively narrow, it’s straightforward.

If they have FHIR connectivity available in their EMR, which they should have, we can get those EMR-based models up and running quickly without a lot of effort. FHIR as a standard is starting to take hold, and it’s incredibly useful. It’s a bigger lift if we have to go into their PACS and pull CT images. It’s a bigger lift if we have to go to Philips or GE to get enterprise class 12-lead ECGs, but it’s doable. We are finding that health system integration teams have sophisticated integration tools and are really good at being able to tap into the data that’s needed to make AI sing and dance in the real world.

A new survey found that health system executives believe that AI is ready to address some of their issues, yet few of them have developed an AI plan. Is that because they are looking at specific solutions rather than AI in general?

There is an impedance mismatch. I’ve seen those surveys too. When you poll forward-thinking CIOs, CMIOs, and clinical leaders, they are familiar with the opportunity for AI. Of course they to say that they believe that there’s value here, but when it comes down to brass tacks to actually investing in deploying these solutions, their mindset shifts away from the notion of AI as a technical capability to finding solutions that they can deploy. The tip of the spear for them is the solution and the value of the solution over the technology. We think a very high percentage of people feel that way.

How do you position an AI company in a constantly changing environment?

We talk about that a lot. We have to be solution oriented and solution focused. When we package and position what we are taking to market, we are trying to confront real-world problems. The fact that AI is part of the equation is, to a large degree, incidental. We are in conversations with healthcare providers where AI barely comes up. We’re talking about how to identify undiagnosed diabetics, how to get people into the clinic for overdue screening colonoscopies, and how you deal with undiagnosed or undetected breast cancer from mammographies.

The other thing that we talk about a lot is that the solution matters. What we mean by solution is not just the ability to connect with data and to deliver a novel, powerful insight into a clinical workflow. How do you set up infrastructure? How are you capturing telemetry or instrumenting the process so that you can understand whether the thing is delivering the value and impact you expect? Do you have facilities in place to actually make improvements to that over time?

Every provider organization is different. They are different culturally. They are different in terms of the patients they see. They are different in terms of their affinity for technology and their ability to change or not change workflows. All of those things matter. A solution that can be highly optimal at XYZ health system may not be working very well at ABC. Why is that? How do we detect and understand that? How do we make the necessary adjustments to ensure that it does ultimately deliver value? Everything that I just said puts the solution at the front of the conversation and puts the technology in the background.

How are health systems involving physicians as they consider the potential of AI?

I have two thoughts on that. One is that we are trying to frame the conversation in such a way — and this is not a bromide, this is truth — that clinicians feel at the end of it that it’s going to help them practice better medicine. We think it is important that they are left with that impression, and that is their ultimate reality.

The other thing is that we believe that changing clinical workflows, trying to change how clinicians are using EMRs when they are already frustrated by their EMRs, is not the way to go. We are trying to bring solutions into clinical workflows that deliver impact that don’t require any modifications to workflows. They may make those workflows more efficient, but certainly won’t make them inefficient. They won’t pop up more alerts or fill their inboxes with more junk. We help them practice better medicine and practice it the way they have been doing it in the past without requiring radical change.

Your website says that you don’t make algorithms or applications. What technologies to bring to the table?

I want to be clear that our solutions have AI at the center, so we work with AI innovators. The best analogy that I can come up with is that we are car makers, not engine makers. We work with engine makers, and these engines are immensely powerful. They have a lot of horsepower. They can spin really fast. They can deliver a lot of impact. But if they are not dropped into a car, they can’t get very far down the road and actually do any good in the world. We have optimized our assembly line to make it easy for us to build a lot of different kinds of cars. We can build an ECG-based solution, an EMR-based solution, an image-based solution, and everything in between. That’s core to what we do, and it’s like breathing to us.

We use the phrase “AI solution ops” to distinguish from MLOps, which is a term that is fairly well established in the industry. What we do is relatively straightforward, and I’ve hinted at it already. So what is the car? The car is the ability to connect to a broad set of data sources, specifically to support the needs of AI. We are not a general purpose integration platform. That’s not what we are trying to build. To provide mechanisms to support the deployment of many kinds of AI, a broad set of capabilities to interpret the output of the AI in a way that’s human interpretable, human readable, and human understandable, and then to provide robust options, including an application framework for delivering AI insights to clinicians, clinical staff, or to supporting staff so they can benefit from those insights. Underneath the covers, all of that measurement of value and impact, continuous improvement stuff that I mentioned. All of that is the car for us.

What are your goals for the company over the next few years?

Not surprisingly, like a lot of companies at our stage, we are focused on growth. We think that we have established a product-market fit. We think that we have established that what we are offering to the market is something that the market actually wants. We know who our buying personas are and we know what market segments we should be engaging with. We are focused on trying to get more and more customers to hear that story and to sign up with us and to deploy our solutions.

When we look three to four years out, our goal is to have a broad portfolio of powerful, impactful, practical, and responsible AI solutions that are confronting the hard clinical problems that are facing providers. Today we are talking about cancers, chronic diseases, and areas where there are existing solutions that have not necessarily delivered the goods that providers expected when they made original investments.

The other piece to the business is that we want to be working with a significant number of large provider organizations who are trying to do AI research and deliver AI impact to the front lines of care within their organizations and potentially even beyond, but are struggling with the bench-to-bedside problem. That’s where we intend to be.

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Healthcare AI News 8/16/23

August 16, 2023 Healthcare AI News Comments Off

News

Abridge, whose app turns doctor-patient conversations into transcripts and visit summaries, becomes the first member of Epic’s Partners and Pals integration program. The company also announced that Emory Healthcare will deploy its solution.

Piction Health launches a dermatology virtual clinic in Massachusetts in which patients complete an online intake questionnaire, attach at least three pictures of their area of concern, and then receive a dermatologist’s evaluation – supported by AI image analysis and comparison to its own image database — within two days. The company says that two-thirds of patients receive a treatment plan without an in-person visit. The service is available for patients in New Hampshire, Connecticut, Massachusetts, and Florida and is covered by some insurances or costs $80 otherwise.

Business

Morgan Stanley lists four areas in which it expects AI to create significant investment opportunities:

Drug discovery, manufacturing, and physician-patient engagement.
Earlier detection of disease, more efficient patient access, claims processing, supply chain management, and helping patients use their insurance and prescription benefits effectively.
Support for advanced diagnostics that combine EHR, genomic, and imaging data to gain disease insight and to personalize treatment.
Enhance monitoring by analyzing data streams from medical devices such as sensor-equipped implants, continuous glucose monitoring, and cardiac monitoring.

Research

Vanderbilt University Medical Center researchers develop an NLP algorithm that analyzes EHR data to identify patients who need lung cancer screening, improving existing methods that look only at EHR smoking flags. The team found that nearly half of the documented smokers are missing discrete EHR data related to pack years and quit dates, but the NLP analysis of clinical notes delivered 96% accuracy.

Taiwan’s National Cheng Kung University creates AI-powered software to detect age-related muscle loss (sarcopenia) from CT scans. The government has approved the software for sale to other hospitals, although the creators suggest that hospitals perform screening of cancer patients for free since they already have their CT images. Sarcopenia, which increase fall and fracture risk in older patients and those undergoing chemotherapy, can be improved through diet and rehabilitation if caught early.

Carnegie Mellon University is using AI, ML, and NLP to analyze YouTube videos that offer patients information on conditions or treatments for accuracy, comprehension level, trustworthiness, and delivery of actionable guidance. They hope to create filters that give doctors a short list of videos that can be reviewed and then prescribed as needed.

Newly developed, AI-powered “smart socks” will allow people with dementia to live at home, where the wearable tracks heart rate, sweat levels, and motion to determine when the wearer is in distress. The socks look like real socks, are machine washable, and do not require charging.

Other

In Canada, a report warns that successful use of healthcare AI will be limited by the healthcare system’s reliance on fax machines, handwritten notes, scanned files, and paper recordkeeping.

Veterinary chain Banfield Pet Hospital offers customers a free AI-powered device – developed by Whistle Health, which like Banfield, is owned by candy and dog food maker Mars — that attaches to a dog’s collar to track caloric intake, scratching that could indicate skin problems, and other health data, with an app that allows chatting with a veterinarian. An enhanced version allows tracking the pet’s location.

An AI expert notes that AI-created influencers – realistic, computer-generated characters – will increase mental health issues and suicides among followers who can’t function in the real, imperfect world. He says that mental health was already threatened by the false perfection of Photoshopping and plastic surgery. An AI-generated influencer who portrays a young woman from Finland has thousands of followers on TikTok and Instagram, while another influencer created an AI-powered “virtual girlfriend” version of herself using ChatGPT that she expects to generate $60 million per year in subscriptions from an audience that is 98% male.

Contacts

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

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Morning Headlines 8/16/23

August 15, 2023 Headlines Comments Off

HGP Advises Access eForms in Sale to Phreesia

Patient intake software vendor Phreesia acquires Access EForms, which specializes in electronic forms management and automation.

Luna Announces Luna Labs, a New Artificial Intelligence (AI) Division Working on Enhancing Care Delivery

Home-based physical therapy provider Luna creates an AI division to develop new AI-based solutions, including enhancements to its Auto Charting technology and a chatbot designed to help patients with inquiries related to scheduling and billing.

Hospitals are dialing back on venture capital investing

Hospitals are cutting back on their venture capital investing, shutting down or downsizing their splashily announced investment arms.

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News 8/16/23

August 15, 2023 News Comments Off

Top News

Urgent care technology vendor Experity acquires cloud-based, teleradiology-focused OnePACS for an undisclosed sum.

HIStalk Announcements and Requests

My five-year-old, 32 GB IPad has been beset with performance problems that are individually quirky and collectively infuriating. I was about to fling it across the room like a Frisbee last night when I noticed that Apple is offering a new 64 GB Generation 9 version from 2021 at just $250 via Amazon. It arrived less than eight hours later, and pairing it up with its older sibling and copying everything over took just a handful of clicks (that ecosystem convenience is why I’m willing to be slightly extorted by Apple). The new one is snappy, with a nice display and a ton of available memory for a non-power user like me. The old one was too, back in its day, when it cost me $329. It feels like I got a decent deal and acceptable annualized cost both times.

Webinars

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

Acquisitions, Funding, Business, and Stock

Italian investment firm Exor becomes the biggest investor in Philips, acquiring a 15% stake in the company for $2.8 billion. Shoe aficionados may be interested to know that Exor, run by the powerful Agnelli family, also has a hefty stake in the French footwear house of Christian Louboutin.

Healthcare market intelligence firm Definitive Healthcare acquires provider data and analytics startup Populi.

European IT company Cegeka will acquire Computer Task Group, a global, multi-vertical digital transformation consultancy, in a take-private deal valued at $170 million.

Hospitals are cutting back on their venture capital investing, Stat notes, shutting down or downsizing their splashily announced investment arms.

Sales

The Veterans Health Administration will offer veterans access to digital educational medical content from Mediflix.
Nashville General Hospital (TN) will implement Oracle Health’s CommunityWorks EHR.
SSM Health (MO) selects diagnostic imaging technology and support services from Siemens Healthineers.
The Health Plan Alliance chooses 1upHealth as its preferred vendor for interoperability solutions and services.

People

Cathy Donohue, MBA (Commure) joins CodaMetrix as SVP of product.

Annexus Health names Sarah Provan (PointClickCare) VP of operations.

Bridget Bell (Nordic) joins Cardamom Health as VP of business development.

David Singer (East Tennessee Children’s Hospital) returns to LCMC Health (LA) as CIO.

Announcements and Implementations

Lakewood Health System (MN) goes live on Epic.

London Northwest University Hospital will go live on Oracle Health later this week.

Williamson Medical Center (TN) implements interactive patient engagement technologies from Sonifi Health throughout its new postpartum unit and renovated emergency department and lobby areas.

Other

A ProPublica report describes how insurance companies used a CMS staffer turned lobbyist to convince the federal government to allow them to charge providers up to 5% to receive electronic payments, in essence charging doctors and hospitals fees to get paid the money that is owed to them. An MGMA poll found that large medical practices pay up to $1 million per year in fees, while AdventHealth says it pays $1.8 million. The report concludes,

The shift from paper to electronic processing, which began in the early 2000s and accelerated after the Affordable Care Act went into effect, was intended to increase efficiency and save money. The story of how a cost-saving initiative ended up benefiting private insurers reveals a lot about what ails the US medical system and why Americans pay more for health care than people in other developed countries. In this case, it took less than a decade for a new industry of middlemen, owned by private equity funds and giant conglomerates like UnitedHealth Group, to cash in.

Vanderbilt University Medical Center describes how it has reduced physician inbox message volume with changes to Epic MyChart. Some of them are:

Clinicians are no longer notified when a patient hasn’t read a message within 48 hours, which was generating 60,000 notifications per month.
Patients are told that they can expect a response within two business days and that messages aren’t read on weekends or holidays.
The “read receipt” timestamp was removed from patient view since it triggered when anyone looked at the message, not just the physician.
The message character limit was reduced from 1,500 to 1,000.
Patients are allowed 14 days to reply to an existing message threat instead of the previous 60 days, at which time they must enter a new message.
A MyChart information banner suggests that patients add common VUMC phone numbers as contacts so they will know to accept those calls.

Cooper University Health Care (NJ) will include an area akin to an Apple Genius Bar within its new facility at Moorestown Mall. Dubbed Cooper Connect, the area will have staff on hand to answer anyone’s questions about the health system’s app, as well as any health and wellness app. The renovated Sears department store is slated to open in November.

Sponsor Updates

Clinical Architecture staff sort and label 3,050 cans at Gleaners Food Bank of Indiana.
Virginia Eye Institute transitions to EClinicalWorks V12.
Dimensional Insight will co-host a community hike August 29 in Concord, MA with HIT Like a Girl to promote women in health IT.
Ascom publishes a new report, “Clinical Decision Support Systems (CDSS), a Clinical Safety Net, Drives Tomorrow’s Brighter Healthcare Outlook.”
Baker Tilly releases a new Healthy Outcomes Podcast, “Navigating the 340B Drug Pricing Program for healthcare providers.”
Clearwater publishes a new case study, “Fortifying At-Home Wellness Screenings: Reperio Health Teams Up with Clearwater to Safeguard Security.”
Nordic released a video titled “Craig Joseph, MD, and his journey to Verona.”
Current Health releases a new case study, “Care-at-home program keeps high-risk heart failure patients out of the hospital.”
Spok announces that 20 of the 22 adult hospitals and seven out of the 10 children’s hospitals named to the latest US News & World Report Best Hospitals Honor Rolls use the company’s secure healthcare communications solutions to facilitate care collaboration and support exceptional patient care.

Blog Posts

High-Quality Clinical Data Increases Risk Score Accuracy for Health Plans (Availity)
The Role of Intelligent Automation in Relieving Staffing Burdens in Healthcare (Access)
Are you tracking how often patients visit your practice? (AdvancedMD)
Mastering the Revenue Cycle: Navigating a Four-Stage Journey to Transformation and Maturity (AGS Health)
Identifying the right patients at the right time (Arcadia)
Automation Saves Thousands for Meditech Expanse Implementation (Time is Money) (CereCore)
Changes are Coming for the NIST Cybersecurity Framework: What Do They Mean for Healthcare and How Can You Prepare for Compliance? (Clearwater)
Improving Clinical Documentation: Simplifying Fax Processing for Healthcare Providers (Consensus Cloud Solutions)
Strengthening Healthcare Security: Moving Beyond Traditional Risk Assessments (CloudWave)

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Morning Headlines 8/15/23

August 14, 2023 Headlines Comments Off

Experity Acquires OnePACS, the Leader in Teleradiology PACS

Urgent care technology vendor Experity acquires cloud-based, teleradiology-focused OnePACS for an undisclosed sum.

Agnelli family’s Exor buys $2.8 bln stake in Philips

Italian investment firm Exor becomes the biggest investor in Philips, acquiring a 15% stake in the company for $2.8 billion.

Definitive Healthcare acquires Populi

Healthcare market research firm Definitive Healthcare acquires provider data and analytics business Populi.

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Curbside Consult with Dr. Jayne 8/14/23

August 14, 2023 Dr. Jayne 1 Comment

Many physicians enjoy seeing antique medical equipment or visiting care delivery sites that aren’t your standard brick and mortar medical office building, and I’m no exception. One of my favorite museums is the Mütter Museum at The College of Physicians of Philadelphia, whose mission is to help the public “understand the mysteries and beauty of the human body and to appreciate the history of diagnosis and treatment of disease.” Its collections include items such as a surgeon’s kit from the American Civil War, which not only makes me glad to practice medicine in the current era, but also reminded me that some of the tools used during amputation of a limb haven’t changed much since that time.

I recently spent some time visiting friends in Virginia and was amused to see a 17th century ear cleaning tool found during the archeological excavations at Historic Jamestowne. Those who set out to establish the first permanent English settlement in North America may have struggled for survival, but at least they planned to maintain hygiene standards. We also spent a day at Colonial Williamsburg, which illustrates a time period where healthcare had evolved a bit.

I was looking forward to visiting the Apothecary and learning more about the apprenticeship they would go through, the medications that would have been available at the time, and more. Unfortunately, that particular living history exhibit was closed on the day I visited, so I had to settle for an online tour. Some of the treatments haven’t changed in hundreds of years, including calcium carbonate for heartburn and camphor for strained muscles.

The most modern healthcare delivery setting we visited was aboard a battleship museum, where you could see what shipboard dentistry was like. Not only was that part of the ship nicely restored, but it also featured recorded dental drill sound effects, which probably was a bit traumatic for some visitors. It was interesting to think about medical recordkeeping on a battleship, with the need to keep hundreds of sailors healthy and ready to support complex military operations on a moment’s notice. Unfortunately, the ship’s sick bay wasn’t accessible to visitors, so it will remain a bit of a mystery.

The ship I visited served from World War II to the Gulf War, so physicians aboard would likely have completed their documentation using a range of methods, from index cards to paper charts, but since it was decommissioned in the 1990s, I doubt it had much in the way of electronic recordkeeping. I chatted with some military folks at HIMSS and CHIME earlier in the year, and learned a bit about the additional complexity of military clinical informatics beyond what you would expect in a typical care delivery organization. It’s definitely a subspecialty of its own, and I am grateful for those who serve in that capacity.

One of my funniest reads this week was on the NordPass website. The solution is a password manager that I admit I hadn’t heard of until a friend pointed me to the site. Independent researchers who were examining cybersecurity practices used data from the company to look at the password habits of the C-suite, including CEOs, CMOs, CTOs, CFOs, and others. They found that passwords with sequential numbers (the proverbial “123456” that every cybersecurity training warns us about) remain as popular with executives as they do with other classes of users. Names were popular, with Tiffany leading the race.

Looking at some other articles on the site, I found some interesting statistics. In data from breaches, 20% of passwords were the name of the company or some variation thereof; “vacation” is a popular password in the healthcare industry; and “password” remains one of the most popular passwords across all sectors. In digging into the top 50 on the C-suite list, however, I found these gems:

Welcome
DEFAULT
Letmein

For some of those, it’s clear that IT departments need to beef up their rules for password complexity at least a little bit. You can’t blame those entirely on the end users.

My heart goes out to the people of Hawaii given the recent wildfires and devastation. I can only imagine how taxed the healthcare resources are in the affected communities right now. I’ve heard that first responders and other critical workers are being housed at scout camps and it sounds like everyone is simply exhausted.

I was impressed by the speed at which the Department of Health and Human Services declared a Public Health Emergency. The Centers for Medicare & Medicaid Services quickly followed with an announcement of additional resources and flexibilities for hospitals and providers. Some of the supports announced include addressing the availability of dialysis services for patients needing treatment and working to ensure patients have equal access to emergency services including language access. CMS is also temporarily waiving certain limits on the replacement of durable medical equipment and supplies, which is going to be critical for people who lost their prosthetics or other devices in the fires.

In talking to some of my colleagues who have been involved in major disasters, they reminded me that it’s not just patients with fire-related needs entering an already stressed system. There are also people with everyday health events like motor vehicle accidents and heart attacks who were impacted, such as patients who might have needed helicopter transport who couldn’t be reached due to the high winds, or those who couldn’t be reached by ambulance due to downed power lines. Pharmacies burned down, medications were destroyed, and supplies will need to be brought in from other parts of the state, from the continental US, or from international sources.

Looking beyond the next month or two, there will also be long-term healthcare consequences, such as lung disease from wildfire smoke. We can’t even begin to quantify the impact on mental health, especially the trauma experienced by those who were directly impacted by the fire as victims or as first responders.

For readers who might have more inside knowledge about the needs on the island or what the healthcare IT community can do to help support those impacted, please leave a comment or email me.

Email Dr. Jayne.

1 Comment

House lawmakers should have bought a squirrel ;-)

Poor portal design has lots to blame for messaging issues. In the portals that I have used, the patient can…

Thanks, appreciate these insights. I've been contemplating VA's Oracle / Cerner implementation and wondered if implementing the same systems across…

This is speculation, but it's informed speculation. There are trouble spots to look out for that are likely involved: 1).…

I hear, and personally experience instances where the insurance company does not understand (or at least can explain to us…

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