News 1/20/23

Top News

Bayer acquires Scotland-based Blackford Analysis, which offers radiology and imaging AI tools.

The companies worked together previously in developing Bayer’s Calantic medical imaging AI platform.

Reader Comments

From Jobber: “Re: position seekers. Would you consider sharing a link to the LinkedIn profile of health IT people who are looking for jobs?” I might be willing to do that in a weekly roundup or something, but only for people who explicitly ask me to share their names, previous job, and sought-after position in the briefest of tables along with a link to their LinkedIn that contains all their other information. But first, a question – would this provide value to those who are listed and to readers, or would I just be creating another pointless task for myself?

From Oracular Degeneration: “Re: Oracle Cerner. Mike Sicilia assured the Senate in late July 2022 that the company would move the VA’s implementation to the cloud and rewrite its pharmacy module within six to nine months. We are at six months now, so is it just about done?” I haven’t heard anything about the self-imposed April 2023 deadline.

From Epic TS: “Re: HIMSS. All Verona-based Epic employees will have the opportunity to attend HIMSS this year, so it might have quite the large population of 22-24 year olds.” Interesting, if this report is accurate. It would seem hard to justify opening up conference attendance to 10,000+ vendor employees.

From RunFromThis: “Re: vendor exec pleads guilty. See attached court record.” [Name redacted], senior partner of [health IT consulting company name redacted], was arrested on March 4, 2022 (at the Fontainebleau Hotel in Miami at the start of ViVE-CHIME) and charged with being captured on surveillance video punching the company’s EVP of sales in the nose at 2:00 in the morning at the hotel bar. The information is public record, but I’m still not entirely comfortable running his name and that of his company over a misdemeanor battery charge. However, should you want to read more, enter citation # 202200018175 on this page. The executive-slash-puncher was 6’2” and 300 pounds, according to his arrest report, and the punchee reports on LinkedIn that the blow required emergency surgery that was followed by a quick exit from the company.

HIStalk Announcements and Requests

The biggest challenge in system implementations or upgrades, at least in some hospitals, is working up the nerve to actually pull the trigger to bring the change live knowing that while some things won’t work right, at some point you have to stop maintaining two systems. That feeling arose with my recent HIStalk server upgrade, where I fully expected issues after dozens of applications and endless custom coding so it would work with new server and database software (the term “deprecated function” comes up a lot). Most everything has been upgraded and/or fixed; web scripts and programming have been modified to work with new versions of PHP, MySQL, and server OS; the virtual firewall is finally working properly; and the new server is faster with more capacity.

Webinars

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

Acquisitions, Funding, Business, and Stock

Teladoc Health lays off 300 employees, 6% of its headcount, as part of a cost-saving restructuring. TDOC shares have lost two-thirds of their value in the past 12 months versus the Nasdaq’s 26% loss.

Real-time benefits tools vendor Arrive Health (formerly RxRevu) acquires medication adherence tools from UPMC Enterprises and has received an investment from UPMC.

Sales

• Highland Rivers Behavioral Health chooses Findhelp to help its clients to connect with local social care resources.
• Eudora Medical Center implements EClinicalWorks Cloud EHR.
• MultiCare Health system acquires Yakima Valley Memorial Hospital and will spend $100 million to replace its Cerner system with Epic.
• Cleveland Clinic will implement Palantir’s Virtual Command Center.

People

Hicuity Health hires Young Ahn, MD (Jiahui Health) as chief medical officer.

Clarus Care hires Rick Stevens (SoftServe) as vice chair and head of strategic accounts.

Announcements and Implementations

St. Bernards Healthcare (AR) upgrades to Meditech Expanse, assisted by the company’s professional services team. It replaces Meditech’s legacy system, three ambulatory systems, and a patient portal. (Questioning: since the health system is named after St. Bernard Tolomei, why does it incorrectly omit the apostrophe from its name?)

Fortified Health Security publishes its healthcare cybersecurity report for 2023.

Socially Determined partners with Datavant to offer patient-level social risk data to life sciences companies.

My favorite health IT market review is from Healthcare Growth Partners, which just released its annual report, whose masterfully concise and authoritative writing style always makes me a little bit jealous. Tidbits:

• Market sentiment is showing a glimmer of rebound as the Fed attempts to steer the economy to a soft landing with a resilient labor market. Health IT market activity has been falling, but remains at a healthy level historically.
• The rising cost of capital and concerns about a recession have reduced the risk tolerance and thus acquisitive interest in investors, but seller interest remains strong and an economic uptick could create significant deal flow.
• Investor pullback in health IT is not being driven by company or sector fundamentals, but rather hospital financial pressure (which is easing) that elongated sales cycles.
• High-quality growth companies continue to command premium valuations, while buyers will find relative bargains in acquiring sound companies and those with strong bookings and recurring profits.
• Health IT sectors with the strongest valuations, as reported publicly, are analytics, revenue cycle management technology, and telemedicine. 
• Companies have three valuation inflection points – proof of concept, growth scalability, and mature scalability.
• Notable take-private transactions as public market valuations plummeted include Cerner, Change Healthcare, Vocera, Tivity Health, Convey Health Solutions, Castlight, and SOC Telemed.

ECRI lists its “Top 10 Health Technology Hazards for 2023”:

1. Communication challenges when medical device manufacturers notify users of recalls.
2. A concerning number of defective single-use medical devices.
3. Inappropriate use of automated dispensing cabinet overrides.
4. Undetected dislodging of hemodialysis venous connections.
5. Failing to manage the cybersecurity risks of cloud-based clinical systems.
6. Inflatable pressure infusers for IV bags delivering air emboli.
7. Cross-contamination in cleaning ventilators.
8. Improper use of electrosurgical units.
9. Overuse of cardiac telemetry on non-cardiac patients, which causes alarm fatigue, clinician cognitive overload, and unrecognized critical events.
10. Underreporting of device-related issues.

Government and Politics

The State of Georgia’s proposed budget calls for $105 million for Medical College of Georgia to implement Epic. The college is part of Augusta University, which is negotiating the transfer of its assets to Epic customer Wellstar. I think the August University Health hospitals are using Cerner. The top reason given by the health systems for partnering was to expand digital health offerings to improve access to care and care personalization.

Privacy and Security

A ProPublica investigation finds that online pharmacies that sell abortion pills are sending potentially identifiable website user data to Google’s tracking tools, potentially exposing customers to prosecution in some states.

Other

A case study describes how Brigham and Women’s Hospital uses an electronic handoff tool when transferring patients from ED to inpatient, yielding high clinician utilization and a reduction in clarifying calls to ED clinicians from 51% of admissions to 10%.

Sponsor Updates

• PeriGen supports a Virtual Learning Day for perinatal and neonatal nurses titled “Partners in Practice: Uncovering Solutions and Strategies for Staffing and Reproductive Justice” on January 26.
• Netsmart achieves ONC Health IT Cures update certification for its human services EHR solutions.
• Ascom Americas expands its partnership with reseller Newtech Systems so that its clinical workflow solutions are available to hospitals in Ohio and Pennsylvania.
• EClinicalWorks publishes a new customer success story, “Brookhaven Heart & MD365: Streamlining Patient Engagement and Intervention with RPM.”
• The Authentically Successful Podcast features Get Well CEO Michael O’Neil.
• Censinet publishes a research report titled “The Impact of Ransomware on Patient Safety and the Value of Cybersecurity Benchmarking.”
• GHX will present at the Contract Administration Conference February 6 in Cape Coral, FL.
• Healthjump earns NCQA’s Validated Data Stream Designation.

Blog Posts

• Tips for Payer Reviews: How to Handle Pre-payment, Post-payment, and Probe (Experity)
• 7 Clinical Guidance Innovations to Empower Retail Pharmacists (First Databank)
• Igniting a Positive Human Experience in Healthcare (Get Well)
• Real Risks Involved with Blockchain Technology (HealthTech Resources)
• Disrupting Healthcare Through Innovation (InterSystems)
• RxNORM 101: What you need to know for clinical documentation (Intelligent Medical Objects)
• How do you decide which Staffing Model is Right for You?  (Optimum Healthcare IT)
• Helping Consumers Find a “Provider Like Me” and Why It Matters (Kyruus)
• Better Outcomes, Lower Costs: How Innovative Partnerships Are Overcoming Rural Staffing Shortages (Medhost)
• Engaging your patient population through care programs (Meditech)
• See a Mumpsimus? Stop a Mumpsimus! (Nordic)
• How Prior Authorization Software Takes Your Patients’ Intake Experiences to a New (Nicer) Place (Myndshft)
• Reporting All Medical Director Hours for SNFs: Why It Matters (Net Health)
• Key Benefits of Mental Health Treatment in Primary Care (NeuroFlow)
• Three trends that will define the future of healthcare (Nuance)

Contacts

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

EPtalk by Dr. Jayne 1/19/23

Most workers in the healthcare IT trenches are familiar with the US Meaningful Use program and its successor, the Medicare Merit-based Incentive Payment System (MIPS). A new study in the Journal of the American Medical Association says that MIPS gets it wrong by penalizing physicians who care for patients with complex medical needs. Researchers from Weill Cornell Medical College noted that “MIPS scores were inconsistently related to performance on profess and outcome measures, and physicians caring for more medically complex and socially vulnerable patients were more likely to receive low MIPS scores even when they delivered relatively high-quality care.”

If there’s one thing I learned as a CMIO, it’s that the team needs to be top notch at collecting the right measurements, which may or may not align with what is really important to patients and their care teams.

I’ve watched patients be treated in ways that aren’t necessarily appropriate for their situation, in the name of satisfying measures. I’ve seen physicians trying to maintain tight control of blood sugar in elderly diabetic patients because they didn’t understand how to exclude them from the measures and the physicians didn’t want to get dinged on their clinical quality metrics. The sometimes-mindless devotion to metrics just illustrates how misaligned the incentives in the US healthcare system can be.

For the love of all those elderly patients who are being overtreated due to poorly implemented clinical decision support in the EHR, if you’re in clinical informatics, please make sure your clinicians know how to properly exclude a patient to whom the recommendations do not fully apply. It will be interesting to see what comes after MIPS – I know clinicians are sick of it and primary care practices waste countless hours on the program every year.

Speaking of primary care physicians, many of my colleagues have come together for regular conversations about how to prevent burnout and promote wellbeing among physicians and office staff. When I started in solo practice, I had 2.5 full time support staff just to run the office, and I paid for a central business office to handle the back end of the revenue cycle. Most of the primary care physicians in my area are employed by one of three large health systems or a large investor-owned provider group, so they’re no longer in charge of their own destinies.

Due to the staffing crisis everyone is seeing, most of them are down to 1:1 support with a medical assistant. One of the doctors I recently spoke with is allocated 40% of a medical assistant’s time to support her 3,000-patient primary care panel. It’s frankly absurd, and she’s looking to leave when the school year is over. She has to give 90 days’ notice, so she will be resigning soon, and I can’t imagine how they are going to be able to recruit a replacement if they let the candidates visit the office and see what’s happening.

She has one child in college and one who has been in the workforce for a couple of years. One of the hot topics with her family over the holidays was the idea of a “slow work” mindset. Her eldest child works at a company that has adopted a four-day work week, which evolved after a couple of years of “focus Fridays,” where employees were encouraged not to have meetings but to give their effort to priority projects or personal development. At that employer, meetings have been either compressed into 20-minute check-ins or expanded into multi-hour collaboration session where people are encouraged to get the work done as a team rather than individually push things along an inch at a time.

Her youngest is interviewing with companies that have been deliberate in their communications about workplace flexibility and how they don’t want to be in the business of babysitting their employees. Despite stories in the media announcing the death of remote work, it seems like a lot of companies are still offering it. I know from experience that I’m more productive in a remote environment. I have fewer interruptions and can use break time productively, whether it’s rotating loads of laundry, baking a loaf of bread, or knocking out a little yard work on my lunch break. Once I’m back at my desk, I’m more focused and it seems like time flies compared to when I was in an office and had constant face-to-face interruptions from co-workers. Sure, there are interruptions, but I can manage a Slack message and respond in 1-2 minutes when I’m finished with my current train of thought versus having to immediately turn to an in-person contact and let that train run right off the tracks.

I get a ton of unsolicited emails and calls, mostly from people trying to sell me services I don’t want or need. Pro tip for those folks responsible for composing corporate communications: starting your email with “Dear Dr. HIStalk,” will at least keep me reading, where “Hey Jayne,” is going to be a direct trip to the “Block Sender” button. Sales and marketing people everywhere, please take a look at your templates and let’s all agree to make professional communications a part of general business discourse again.

Frankly, the Girl Scouts coming to my door with their much-awaited cookie order forms are doing a better job than some of the sales reps who’ve approached me lately. If you’re wondering, Samoas (Caramel deLites ) are my favorites, followed by Tagalongs (Peanut Butter Patties). Depending on which baker services your region, names may vary. And if you’re interested in appropriate wine pairings for your cookies, may I suggest this handy guide.

Several of my friends are in academics, and we recently got into a discussion about sabbatical leave. I was telling them about the sabbatical programs at some well-known tech vendors and they were surprised that sabbaticals exist outside the university world. It’s an interesting idea for companies that want to differentiate themselves and who want to make a clear statement that they want employees to be with them for the long haul. A recent opinion piece talked about the lesser-known effects of sabbaticals, including providing an opportunity for coworkers and teams to shine. The author had spent 10 years at a marketing agency and received an eight-week paid sabbatical upon reaching that milestone. She notes that in addition to providing “a proactive hedge against employee burnout, an antidote for attrition, and a protection from career wanderlust” her time away made her more passionate about her work and workplace than before.

In observing that those who managed her workload while she was out, the writer found that upon her return, those co-workers had increased confidence and willingness to provide leadership for projects. Experts agree, and she cites several studies that have reaffirmed the benefits of sabbaticals. Proponents of the practice find that sabbaticals are an investment in employee wellbeing. According to sources cited in the article, only 5% of employers offered paid sabbaticals with 11% offering unpaid leaves. When you consider how much it would cost to replace a valued employee, two months’ salary seems a relatively economical investment.

There’s a lot of discussion about the value of time away from work, particularly with recent announcements from Microsoft that it is expanding its unlimited time off policy to all US-based employees. For many, such a policy makes it tempting to take days off here, which may lead to fewer employees taking longer vacations. Research from the travel industry indicates that many individuals need at least three days away from work to de-stress, which is nearly half of the traditional week off. For most of my friends, having several four-day holiday weekends in close succession made people feel a little spoiled, and it will be hard to have only two-day weekends for a while.

Does your employer offer sabbatical leave? How has the experience been, not only for the person on leave but those left behind? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 1/19/23

Arrive Health Creates First-of-Its-Kind Medication Access Solution with Acquisition of Pharmacy Technology from UPMC Enterprises

Arrive Health, which specializes in medication cost and benefits coverage data, acquires patient engagement and automation technologies from UPMC Enterprises and the UPMC Pharmacy Network.

Teladoc Health cuts 300 jobs to shave costs

Teladoc Health cuts 300 non-clinical jobs as it refocuses business development efforts on primary care, chronic conditions, and online counseling services.

Microsoft is laying off 10,000 employees

Microsoft, which acquired Nuance in 2022 for $18 billion, will lay off 10,000 employees through March in anticipation of slower revenue growth.

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Morning Headlines 1/18/23

VCU Health launches Home Hospital, the first hospital-at-home program in central Virginia

VCU Health develops a hospital-at-home program that will offer acute care patients the ability to receive care at home via video, remote patient monitoring, and house call visits from care teams.

Ferrum Health Raises $6 Million to Bring Artificial Intelligence into Healthcare

AI-powered healthcare analytics startup Ferrum Health raises $6 million.

Apps want to be your new doctor’s office. Is that a good idea?

The Washington Post looks at the use of smartphone apps that collect patient clinical measures and send them to doctors, concluding that if the AI/ML they use requires doctors to interpret the results, the apps can’t really solve access and cost issues.

News 1/18/23

Top News

Definitive Healthcare will lay off 55 employees, about 6% of its workforce, as part of a restructuring plan that is intended to boost profits.

An email to employees from CEO Robert Musslewhite says the company must address its cost structure since the economy has slowed and companies are purchasing more cautiously.

Webinars

January 19 (Thursday) 2 ET. “Supercharge Your Clinical Data Searches.” Sponsor: Particle Health. Presenter: Paul Robbins, MSMBA, VP of product, Particle. Particle’s team will preview the exciting results of Specialty Search, a new condition-specific record locator service. This webinar will review how to collect patient records from top Centers of Excellence across the entire country; how healthcare organizations of all types are benefiting from Specialty Search capabilities, using Particle’s simple API; and why a focused search of chronic condition data — in oncology, cardiology, endocrinology, orthopedics, and more — has an outsized impact on care outcomes.

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

Acquisitions, Funding, Business, and Stock

Home care and staffing company Viemed invests $2 million in ModoHealth, which offers value-based care and patient management software. Viemed will join Modo’s provider network and use its technology.

Sales

• The San Francisco VA Health Care System will implement CareView’s Patient Safety System with help from Decisive Point Consulting Group.

People

Michael Hawkins (Patient Discovery) joins Axuall as CTO.

CalvertHealth (MD) promotes CTO Melissa Hall, RN to CNO and VP of clinical affairs.

Michele Norton, RN, MSN, MS (MobileSmith Health) joins Avalon Healthcare Solutions as SVP of product marketing.

CereCore promotes Craig McCollum to VP of Meditech International services.

EVisit promotes Sachin Agrawal, MSc to CEO. He replaces co-founder Bret Larsen, who will move to executive board chair.

InnovAge hires Cara Babachicos, MHA (South Shore Health) as CIO.

Lisa Castanzo (Oracle Cerner) joins Elsevier as VP of software engineering, clinical solutions.

Sean Lara (Akasa) joins Censinet as chief revenue officer.

CHOC Children’s promotes Steven Martel, MD to VP/chief health information officer.

Fred Sheffield (HealthPay24) joins TeleVox Healthcare as chief revenue officer.

Announcements and Implementations

Lightbeam Health Solutions announces GA of Radian, a clinical and social data analytics tool designed to help providers with health equity projects.

Persown uses analytics from SAS to develop a Sepsis Monitoring and Alerting System for Hospitals and Homes (SMASH-H).

Other

The Washington Post looks at the use of smartphone apps that collect patient clinical measures and send them to doctors, concluding that if the AI/ML they use requires doctors to interpret the results, the apps can’t really solve access and cost issues.

Safety officials in Bonner County, Idaho attribute a spike in unintentional 911 calls to skiers and snowboarders on local Schweitzer Mountain whose Apple Watches and Iphones automatically called emergency services when their fall-detection technology kicked in.

Sponsor Updates

• Ascom Americas Managing Director Kelly Feist receives a 2023 BIG Innovation Award from the Business Intelligence Group.
• Baker Tilly publishes a new case study, “Medical practice company implements cloud financial management platform to support evolving needs.”
• The Fixing Healthcare Podcast features Oracle Cerner Chairman David Feinberg, MD, “How leadership can fix healthcare.”
• Nordic releases another episode of its “In Network” podcast, “Designing for Health: Dr. Zafar Chaudry.”
• The American Medical Informatics Association elects Clinical Architecture CEO Charlie Harp the 2023-24 chair of its Informatics Partnership Council.

Blog Posts

• E-Signature 2.0 to 3.0 & the Progression of Patient-centric Solutions (Access)
• Data Reconnaissance: Understanding your practice’s data landscape (AdvancedMD)
• Industry Collaboration Day 2023 (Agfa HealthCare)
• Accounts Receivable: A Healthy Approach (AGS Health)
• How to Establish a Digital Patient Engagement Committee (Artera)
• Understanding the Impact and Importance of School-based Health Centers (Azara Healthcare)
• Taming the trouble from too much noise (Philips Capsule)
• How a Nurses-First Model Ensures Chronic Care Management Success (ChartSpan)
• The Intersectionality of Technology, Industry Growth, and Patient Outcomes: Clearsense 20/20 (Clearsense)
• Leveraging Agile in Testing – What You Need to Know (CTG)
• How Healthcare is Going Google (Divurgent)

Contacts

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

Morning Headlines 1/17/23

Viemed on the rise following $2M investment in ModoHealth

In-home medical device and post-acute respiratory care company Viemed invests $2 million in ModoHealth, which offers value-based care and patient management software.

Why We Became a Public Benefit Corporation

Independent primary care practice management and optimization company Aledade transitions to a public benefit corporation.

Alabama medical billing company pays to resolve false claims allegations

Medical billing company Amvik Solutions will pay $153,000 to settle federal allegations that it improperly billed Medicaid for applied behavior analysis services on behalf of customer Helping Hands Academy.

Readers Write: Social Care Help Shouldn’t Come at Social Cost: Why Dignity and Ease Should Be at the Heart of Modernizing America’s Safety Net

Social Care Help Shouldn’t Come at Social Cost: Why Dignity and Ease Should Be at the Heart of Modernizing America’s Safety Net
By Jaffer Traish

Jaffer Traish is COO of Findhelp of Austin, TX.

The Safety Net

Social safety nets are different in each country. Some focus on poverty alleviation, economic mobility, or disaster relief. The World Bank has estimated that safety net programs have helped 36% of the poorest in the world escape extreme poverty.

In the US, we have seen federal administrations strengthen and weaken safety net funding over decades. The history of social safety nets in the US has been shaped by voluntarism, the notion that the voluntary actions and agreements undertaken by private charity and industry are preferable to state-mandated social welfare programs.

Nonetheless, the US has tens of millions of vulnerable people looking for services. 

This is a breakdown of healthcare specific needs after analyzing 10% of searches from a population of 16 million Americans. 

COVID-19 placed a spotlight on the vast array of needs. Our public benefit data mirrors what we heard and saw of the struggle for individuals and families.

Policy Winds

With the increasing awareness of social disparities and impact on health, we now see many major policy changes:

• ACO REACH Model. This model began on January 1 and includes focus areas on equity, access, and community health. There are reimbursement calculations and withholdings related to the area deprivation index (API) and SDoH quality measures.
• Joint Commission. New rules in effect January 1 include identifying a system leader who is accountable to address disparities in the patient population, as well as social needs screening and the sharing of community resources.
• NCQA. They released new HEDIS measures, including the SNS-E measure related to assistance for plan members needing food, housing, and transportation.
• CMS guidance letter. CMS issued a guidance letter on January 4 to state Medicaid Directors related to ILOS (In Lieu of Services) for Medicaid Managed Care, which relates to the Cal-AIM California waiver and many future waivers. The guidance strongly emphasizes the importance of measuring utilization and impact of non-traditional services such as social supports.

Private Company Technology is Accelerating Modernization

With any emerging market, we’ll see some companies taking advantage for short-term profit, multi-million dollar software costs, and a story of hype that fades post contract signature.  We will see others that aim to maximize funding going to communities, to capacity building, and to community health worker staffing. Government and private sector buyers must be well educated to avoid the expensive shiny object that doesn’t deliver.

The good news is that healthcare leaders have long had a vision for what’s possible, including Judy Faulkner and Epic, where social services digitization is found in her original business plan.

SDoH is in the spotlight, with 80 bills proposed in Congress and $90 million of requested funding by states related to social care. Requests fall into several categories,including Medicaid waivers and federal match money.

We have the opportunity to build private-public partnerships that align on key principles. Education of key stakeholders is essential.

Influence 

People go to helpers to get help. Those helpers might be a librarian, a pastor, or a neighbor. Those helpers may also be care coordinators, social workers, and hospital discharge planners.

State government can heavily influence the funding for services. Medicaid directors, Health and Human Services secretaries, commissioners, and deputies control how money is spent through Medicaid waivers, MCO contracting, non-profit capacity grants, and more. There are tough decisions to make, and there is incredible respect for people in these roles who are lobbied heavily by industry.

A large influence on these decisions is improving overall health and driving down the cost of healthcare. We all know over the last two decades of electronic health record implementations that technology alone is not the answer. Technology enables us to work more efficiently and more collaboratively, though it doesn’t solve governance, community engagement, or equitable service delivery.

State agencies want to understand the needs of their populations, where people are going to receive help, the services delivered, and when possible, the correlations with healthcare cost and clinical outcomes.

Some vendors promise a panacea of results via a top-down monopoly that goes something like this:

• Mandate use of a specific, single technology system.
• Force communities to use one system.
• Force non-profits into a contract.
• Force a per-user license model so the vendor makes more money with every user whether they adopt or not.
• Force a one-time consent so the vendor owns data sharing.
• Restrict federal dollars being used outside of this system.

This sounds like a good way to make a vendor rich and to skirt consumer privacy, interoperability, and non-profit autonomy.

The Choice

Procure one technology system with a hand in the face of private sector procurement or empower the community and health systems to choose the tools that make the most sense for them. Require that they report the data using standards and even certifications as the Office of National Coordinator (ONC) has supported for years.

Dignity and Ease

At the heart of this work is privacy. Imagine that you signed a single consent form for your healthcare provider to put your information into a system to facilitate a referral to a local food pantry or domestic violence shelter. But with that one action, you’ve granted more than 120 non-profit organizations the ability to access all of the personal financial, social, and medical data you reported. This is happening today because social care privacy standards haven’t kept pace with healthcare. People expect that their sensitive information will only be visible to the organizations and people they choose. Too many are blindly forced into one-time, all-in consent models in exchange for getting the help they so desperately need.

Healthcare, government, and non-profit leaders must improve safeguarding personal information by building a consumer-directed privacy approach to social care technology. Last year, the State of New Hampshire adopted a first-in-the-nation privacy protection law that established a policy framework to prioritize a person’s right to informed consent when seeking social services.

The Future of the Safety Net

• Imagine a future where applying for state benefits is a dignified, fast, digital process, not a paper process with a custom system.
• Imagine a future where a person in need can log in to a patient portal and see covered benefits, whether value-added, supplemental, community bank funded, or other non-profit led.
• Imagine a future where payers can see member needs and where their member has received help (with permission) anywhere in the country, and (with permission), intervene to prevent costly chronic or other clinical adverse events.
• Imagine a future where social workers, discharge planners, and other helpers simply use their EHR or care management system to make referrals and orders without worrying about which vendor is powering the SDoH network, a true API network model.

This is all possible. We should not be asking governments to pick winners and then learning too late about the risks to privacy and dignity taking place behind a curtain.

With network effects, community engagement, and trust building, the outcomes that we all want to see are possible. We can enact policies that do not create data silos or create monopolies with false promise. The right interoperability policies will create innovation in health and human services that are ubiquitous in every other sector.

Readers Write: What Health IT Companies Can Expect in 2023

What Health IT Companies Can Expect in 2023
By Jodi Amendola

Jodi Amendola is founder and CEO of Amendola Communications of Scottsdale, AZ.

My crystal ball says tighter budgets, LinkedIn, and more targeted, integrated campaigns.

The beginning of a new year provides an irresistible temptation to make predictions. Unlike the ancient Romans, we don’t look to the flight patterns of birds to foretell the future, but base our predictions on what we see in the industry and the economy, what we hear from clients, technological developments, etc. Here are my predictions for what to expect this year in healthcare/health IT.

A tumultuous economy

Economists have been arguing for months about whether the US is headed toward a recession and, if so, how severe it will be. I don’t pretend to know the answer, but I do expect 2023 to be challenging for the healthcare and health IT industry given the challenges faced by providers and payers. Hospitals are still recovering from the COVID-19 pandemic and coping with rising expenses, ongoing staffing shortages, and continuing capacity constraints. In response, health systems have restricted services, laid off employees, closed departments, and even shut down entire hospitals.

However, systems are also investing in new digital technologies that allow them to operate more efficiently and expand care models, such as remote and virtual care, in the face of these challenges. The vendors who sell these products and others that support the digitization of healthcare are ramping up marketing and PR efforts to position themselves as the solutions to help systems clear these barriers.

To best reach their target audiences, what I am seeing for healthcare and health IT companies are budget considerations, such as whether to invest heavily in trade show marketing or if those dollars should be reallocated to more targeted account-based marketing (ABM), digital marketing, or integrated marketing programs.

Twitter down, LinkedIn up

I think 2023 will be a critical year for Twitter as an advertising vehicle and, quite possibly, as a viable social media platform. The uncertainty over Elon Musk’s takeover, the departure of so many staff, and Musk’s controversial decision to largely stop moderating tweets and to welcome back accounts that had been banned for misleading or false content has made brands understandably wary of being associated with Twitter.

According to a recent Media Matters report, half of Twitter’s top 100 advertisers have stopped promoting on the platform, brands which have accounted for nearly $2 billion in advertising since 2020. Some publicly announced their break with Twitter, while others have quietly stepped away. And Musk’s myopic claim that companies who choose not to advertise on Twitter are somehow engaging in censorship or violating free speech principles is not the way to woo them back. Brands have every right to avoid unnecessary and unwelcome controversy when choosing where to advertise.

By contrast, we’re seeing heightened interest among clients in LinkedIn as a marketing and advertising platform. The oldest of the social media platforms, LinkedIn has evolved from a glorified jobs board to a place where companies — including healthcare providers and payers — research vendors, network, and promote themselves.

LinkedIn content is becoming richer and more interesting as well. Yes, there are still plenty of photos of people sitting in hotel ballrooms captioned: “Excited to be attending the annual Widget Trade Show in Walla Walla,”, but creative brands are using it to tell stories and connect with target audiences on a deeper level. To encourage this, LinkedIn is adding content-friendly features, such as Creator Mode, Auto Embed, and image templates.

As LinkedIn becomes more important and versatile, brands would be wise to re-evaluate their approach to the platform with an eye toward expanding their content to engage target audiences beyond what they’ve traditionally posted.

Marketing and PR integration

It’s long been a good idea to integrate PR and marketing, but at many health IT companies, they are still separate silos. With tight budgets for both likely in 2023, it’s never been more important that they work closely together to achieve shared goals, measured using agreed upon performance metrics.

Comprehensive, integrated marketing programs that include webinars, events, digital marketing, and account-based marketing, in addition to media relations, social media, and thought leadership activities, will deliver better returns than separate, disjointed campaigns and help rise above the noise.

That also supports another 2023 trend: companies focusing more on strategic messaging and marketing to reach specific prospects. In a tough economy, it makes sense for businesses to focus on satisfying their most important accounts and landing the whales that could make the difference in a difficult year. Making the best use of tight resources and budgets through integrated marketing and PR campaigns can make all the difference.

Marketing resolutions

January is a great time for making resolutions, as well as predictions. In anticipation of what is likely to happen this year, here’s what healthcare and health IT companies should do:

• Look for new ideas and partnerships that work within their budgets while continuing to deliver great ROI.
• Integrate marketing and PR. Synchronizing efforts delivers a greater punch than pursuing separate tracks. If 2023 does prove to be a difficult year economically, it’s even more important to deliver a strong, coordinated message.
• Take creative risks. One of the great things about marketing and PR is that it’s not static; there’s always a new medium, platform or strategy to explore. This is going to be a good year to go exploring.

Whatever your resolutions, I hope you achieve them. Here’s to a happy and fulfilling new year.

HIStalk Interviews Michael O’Neil, CEO, Get Well

Michael O’Neil, JD, MBA is founder and CEO of Get Well of Bethesda, MD.

Tell me about yourself and the company.

I started GetWellNetwork 22 years ago following a personal cancer experience while I was in school getting a JD/MBA degree at Georgetown. I started the company with a simple mission to make it better for the next person. I had spent way too much time going through surgeries, chemotherapy, and coming in and out of hospital beds and clinics. I thought that these amazing people who were delivering my clinical care needed some help in delivering the kind of patient and family experience that could enhance not only my attitude, but also my outcome. I started the company to help hospitals leverage technology to engage patients and families more effectively in their care, and in turn, help clinicians and improve outcomes.

The original concept was somewhat limited, focusing on in-room patient entertainment and education. How did you broaden the company’s reach to include everything from pre-acute to post-care and even remote monitoring?

I look at this as two acts to a play with an intermission in the middle. Act I was long, 15 years of trying to improve a two-day, four-day or 12-day hospital stay. We met a patient at admission and we said goodbye to them at discharge. We we were in many ways proud of transforming the hospital experience at the point of care for the patient, family, and nurse.

A bit before COVID – and COVID certainly accelerated this — we began to invest, both in organic R&D and in some acquisitions. We knew that the impact that we could have on both our customers and people and their health journey, which had become nine or 10 million people in a year. Their journey was not just that two, four or 12 days – it was a lifelong journey, a 30-day journey, a surgery, or what have you.

We had this intermission period where we doubled down on investing in R&D. We bought a couple of companies and that helped us accelerate to build Act II for the last 18 to 24 months. That involves enterprise engagement, navigation, and retention. We have a chance to help organizations wrap their digital arms around either members or patients at scale, but do it with intimacy that is required in healthcare. We are excited about today and what lies ahead.

Patient engagement seemed to align well with value-based care, which has had perhaps less impact than everybody expected on health systems, and now the imperative involves patient recruitment and retention. What are the primary motivators of health systems to improve patient engagement?

It’s actually straightforward , and there is a triple purpose on this. The industry is littered with tiny niche consumer engagement solutions. It doesn’t have many true platforms at scale. When we talk to health systems, payers, and managed care organizations, we are talking about what we would call Get Well Anywhere. The value proposition is threefold. They need to drive their business because these organizations have been through the grinder the last three years. If you can’t claim, stand behind, and share risk in the ability of your consumer engagement solutions to drive business, we don’t think you can do a lot of business in today’s health system world.

Number One is these AI-driven outreach tools that we have now, the ability to navigate people back into their primary care, to help them navigate into a mammogram or a care gap or something like that. It is driving direct revenue when it comes to fee-for-service organizations. But a lot of times, those same organizations also have value-based pockets. They have taken on full inpatient risk in a certain market.

The powerful thing is that the same platform, the same workflows, the same what we call Get Well Navigators — who have been trained to help people in vulnerable moments leverage technology and then pick them up when they can — these same things work to make sure that we are guiding patients to the appropriate and oftentimes lower-cost point of care, or doing self-care. The number one value prop and number one driver of people investing in this now is business, whether you are in fee-for-service or you’re in risk.

The second reason, and I don’t say this lightly, is that loyalty and patient love are more important than ever. We have an internal Slack channel at Get Well called Call Patient Love, and all day long our navigators are streaming comments from our thousands of patients every day who have interacted with one of our navigators, who interacted with a nurse, or who interacted with a physician who has touched them in a certain way. It matters. This kind of patient loyalty and patient love is the second piece. It’s a little softer in its ROI approach but it’s not unimportant.

The third thing is that workforce challenges are everywhere. This isn’t a temporary thing. This has been going on for a long time. How can you leverage the power of the patient and their family caregivers to help drive efficiency of your incredibly precious workforce?

That is our three-part value prop. I will tell you pretty bluntly that we are driving at Number One. We are going at a lot of risk for this. If you have 800,000 dormant patients, we know we can convert them back to activated. They need care, and that care will also drive revenue. Let’s share in the risk of that. Let’s make sure they get the care they need. That allows us to then make other investments alongside of our partners in things that they want to do.

Insurers are making significant inroads into becoming providers, while providers are sometimes taking on the role of payvider. How does this affect your business?

On the payvider side, a lot of our large complex health systems have partnered fairly meaningfully and financially with local, regional or national payers. In those partnerships where they are taking on risk, they of course are terrific partners for us. We are doing a lot of innovative stuff. You are managing 12,000 mothers on Medicaid and you are responsible for their full cost, so we are running a Mothers on Medicaid navigation program that was a feature at the White House last December. We think there’s a way to really help these incredibly important people in our communities have the very best care and have a healthy pregnancy. In that case, you have an aligned payer and provider delivering great care and the solutions match that way.

In a world where you have payers who are starting to invest in direct care as you alluded to, they also need tools. You know from using your employer’s portals and digital tools that nobody uses them. The trust relationship and the navigation is light. We are partnering more and more these days with some folks on the managed care side, because we now have 20 years of data on when people are in this vulnerable spot, what are the interactions? How frequently should we be interacting with them? How can we recruit and hire local navigators who are in market who understand the communities, understand the local vernacular? How do you build trust on behalf of a health system or a payer? Those managed care companies have struggled for a long time with that, and we think we can help. We have shown some data to be able to help that as well.

How did your business change with the pandemic?

In all transparency — as you have built your entire organization around directness and transparency, which those of us who get to read it love — it was challenging. The most challenging thing for us was we lost touch with the clients that we work with day in, day out, month in, month out, quarter in, quarter out. We work closely with chief nurses, chief experience officers, CIOs, and nurse directors on an ortho unit that is doing a certain pathway for post-knee replacement patients and how they are going to navigate through their discharge. This is work that we do all the time. We have a lot of clinicians in the company. That changed. We had to figure out how to support them without being able to be with them, and that’s a difficult challenge.

On the other side, it tested the dynamism of our solutions and platforms. We gave a solution called GetWell Loop. It’s a library of 300 digital care plans. I was at a fellowship in Colorado when COVID broke out. When I got home, w4e met as a team. Within three weeks, we had built five COVID loops. We deployed them over the next six weeks in 200 command centers across the US at no cost to our provider partners. We ended up touching and helping over a million patients stay safe at home, and helped ER beds free up so they would stay available for the sickest people. It challenged folks to support our clinicians in a way that we are typically supporting them.

Thirdly, ironically enough, it gave us a little bit of room to double down on R&D and transformation. We contracted with this amazing firm in the UK to design a completely new consumer-grade UX that we just launched late last year. We built a BYOD version of our inpatient solution that we are deploying now across lots of hospitals without capital investment. We acquired a business that does AI outreach and navigation, which has been amazing.

We doubled down on our government investment. We spent quite a bit of time and resources on getting FedRAMP approval for our cloud-based solutions in the government. We do a lot of work across 70 or so VA medical centers and now we are able to bring our loops and our navigation stuff into those communities for our vets. That is a source of pride and drive for the company as well.

The interest in AI tools such as ChatGPT has been unprecedented. How will AI technology be applied to patient engagement?

We have a front row seat. We were admittedly a little bit slow on the organic R&D in AI. We just didn’t have the bandwidth to get ahead of it. We acquired a company whose foundation is in AI and chat. One of the elegant things that we liked about this was that it has an ability to interject AI and live chat simultaneously. You are building real-time profiles of patients and how they are interacting with the content and our people.

As an example, we are working on a large project in California, where we had close to a million dormant patients. We were given a file from their EHR company. They had not been in to see a primary care physician in over 18 months because of the pandemic. We used our AI to reach out to them. To give you a sense of this, you’re talking about 2.6 million AI-driven, text-based bidirectional interactions coupled with 40,000 supplemental live interactions from our navigators.

The good news is that we are seeing the AI work and people respond to it. But we also would tell you that the realization in healthcare is to think that this stuff will be done exclusively without people. We believe that human interactions in your biggest state of vulnerability will require people to make sure they are monitoring, looking, and attaching in highly personal, delicate, and intimate ways in times of need. We have combined AI with a high-touch approach as well. We are seeing some great results that we are excited about.

How do the areas of patient engagement and patient-reported outcome measures overlap?

This is where things get fairly complicated among the EHR and its capabilities; a large CRM platform and its capabilities; and tools, solutions and platforms like ours.

We are seeing that a large health system will often default to the large enterprise EHR or CRM. We don’t fight against those platforms at Get Well. We spend as much time on programs as we do on platforms, meaning that these platforms are only as good as highly discreet programs that help an individual or a micro population of people navigate through their incredibly individual journey.

It sounds cliché, but you had better be able to integrate into core EHRs in a deep, API-driven, and oftentimes more so these days, FHIR kind of fashion and have SMART apps and things like that. You had better be able to pick up on a broader campaign from a CRM outreach. But in our world, you had better be able to put on top of those two platforms some individualized and personalized programs. Because if not, we are going to see engagement rates just like we saw the portal for 20 years. That’s not good enough. People need help.

How does the company’s history of acquisitions and funding activities change with the current business environment?

It’s been crazy. At HLTH, the buzz wasn’t just patient engagement and health equity, but also the cash burn of companies that have spent a lot of money on marketing knowing that their solutions are fairly niche and are not scaled. I don’t envy being in that kind of startup, early stage, cash-burning mode.

Get Well was not an overnight success. This stuff takes a long time to get  right and to get to scale. But we are fortunate. We have a lot of customers. We have positive cash flow. We are able to invest our own money in things that we actually want to pursue. We will be working this year on an important youth mental health project in Mississippi. We can take our own money, which we actually make, and invest in things that we think are projects of purpose.

The funding environment has changed dramatically, literally over 90 days, because there was a lag. The private markets stayed relatively hot until August and September and then they started to cool. That has been a significant change.

As a company that has been around for a while that has some scale, these are opportunities for us. We are thinking about our strategy. We are thinking about how we might accelerate our own R&D efforts with other companies that might be willing and excited about partnering with us to do something bigger together versus smaller on our respective owns. We spend a bunch of time talking to the ecosystem and staying connected. Honestly, I’m rooting for all of them. Everyone that is doing good work in patient engagement means that somebody on the patient end is impacted.

I hope they all succeed, but they won’t. It’s tougher because there are fewer buyers out there, as health systems consolidate and become fewer and fewer prospects. It is difficult not only that there are so many vendors, but so few customers. It’s a double whammy for the small niche players. Fewer customers, and those fewer customers have a hard time adopting, integrating, and implementing tiny projects that don’t have the security measures and integration depth that these multi-billion dollar, multi-state organizations expect. You have pressure on that side to work with larger, more stable, more comprehensive solutions. Secondly, there’s a big movement at the CIO level to consolidate suppliers.They can’t manage 14 different consumer-facing tools or whatever.

This is not to say that I don’t believe in innovation. Our industry always needs people who have identified a pain point and are going after it in a creative, innovative, new way. However, these entrepreneurs need to spend as much time honing their business models as they are honing their elegant solutions, because too often these amazing solutions can’t get scale on the revenue side, and there’s not a lot of forgiveness out in the market right now for that.

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

One is what I will call Get Well Anywhere. That is, finding our way into relationships where we become that third core solution. You have an EHR, you’ve got a CRM, and you have an engagement, navigation, and retention platform with the depth, the credibility, and the security to make sure that they can deal with these two behemoth solutions while also having the rare ability to deliver digital intimacy that those big platforms lack. We want to find our way into more of these Get Well Anywhere partnerships that are large, where we are sharing risk, and where we can drive business, patient love, and workforce efficiency at scale. We are excited about the progress there.

The second thing for us is that we will continue our work and we are doubling down in the government space. We have had such success in impacting US veterans. We are doing more work these days as well in active duty military clinics and facilities. We are excited about the impact that consumer engagement and navigators can do with the folks that we cherish. We have 30 or 40 veterans on our  cohesive, amazing, and focused team. We are doubling down on their success to make sure that we can impact veterans in active duty military moving forward.

The third thing is that we have primarily been dealing with health systems for 20 years. There are school systems, payers, and other organizations that have a vested interest in engaging constituencies in their health. We need to get outside our comfort zone and help populations do food as medicine, navigating to treatments, and doing self-care. These are the kinds of things that give us great purpose and that we are excited about.

Curbside Consult with Dr. Jayne 1/16/23

As a CMIO, one of my primary responsibilities is to make sure the EHR is configured in a way that makes it easy for clinicians to do the right thing. This involves everything from determining the content and display order of an order set to creating documentation templates and workflows that make sense for a given specialty, subspecialty, or particular type of visit.

In a large healthcare organization, managing this content can be complex. It can seem like we never have enough money, time, or personnel to do everything we want to do. We have to juggle priorities and manage conflicting requests from teams that might be in conflict with organizational priorities. Some days are easier than others, but when the going gets tough I’m glad that I have my “village” of fellow CMIOs that I can reach out to for advice.

During a recent call, one of them brought up this study that was recently published in the Journal of the American Medical Informatics Association. The title was eye-catching: “Behavioral ‘nudges’ in the electronic health record to reduce waste and misuse: 3 interventions.” The authors, working with the EHR team at an academic medical center, identified three workflows that might be driving users towards medical errors, waste, and misuse. They modified the system to try to nudge providers towards high-quality outcomes. but with varying degrees of success.

They had a couple of strategies for how they updated the EHR. “By changing the direction of these nudges – in one case, via making the less appropriate order more difficult to find and use; in the second case, by making the more frequently desired imaging easier to find; and in the final case, by presenting an easy to find alternative – we attempted to nudge providers toward reduced waste and misuse.”

The first situation dealt with a blood test. There were several variations of the test available and having an alphabetical order display that placed the least-desirable option higher on the list was likely contributing to erroneous orders. The modification removed the less-appropriate option, replacing it with an order panel that included educational content to help the provider make a better choice, including pre-checking the more desired test.

The second situation addressed the issue of providers erroneously ordering a CT scan of the abdomen when it was more likely that they wanted to order a CT of the abdomen and pelvis. The researchers assumed that alphabetical placement was an issue here as well. They reordered the list to place the more desired option higher in the list.

In the third situation, the authors looked at prescriptions of benzodiazepines that are given to help patients with anxiety during medical procedures. Prior to the intervention, the default quantity for the medication order in the EHR was what one would prescribe for a patient who was taking the medication on a routine basis rather than just taking it before a procedure. This led to prescriptions for more pills than would be appropriate for the situation. The team created a new order that made it clear that the intent was for pre-procedure use. It dispenses two pills with no refills and includes an additional comment that it is to be used as needed for anxiety prior to a procedure.

The authors noted some challenges in determining how effective the nudges were. For the anxiety prescription, there was a very short baseline, so it was difficult to determine the level of improvement. They also commented that the benefits of changes to the system have to be balanced against the cost of implementing them. There was a fairly dramatic difference in the time needed to create each solution: six hours for the blood test, three hours for the imaging order, and 16 hours for the anxiety medication order.

The changes were presented to end users as part of general educational guidance that is released with monthly EHR updates. In my experience the uptake of monthly update documentation can be variable, so there’s a good chance that some users simply stumbled upon the changes in the system. It would be interesting to look at how different specialties interacted with the new orders. For example, whether they made more of a difference among physicians in a specialty that interacted with the orders at a higher frequency than those who ordered the tests less frequently.

In the article’s discussion, I was interested to learn that “as compared to interruptive alerts, nudges in the EHR literature have not been as well described.” That’s an interesting point, because alerts that interrupt the workflow have become general annoyances for many clinicians, where nudges can be embedded in the design to the point where users might not even perceive them as having been deliberately placed. I wasn’t aware of the “Nudge” group at the University of Pennsylvania, but I’ll definitely be keeping an eye out for writeups of their work.

I also hadn’t thought of some of the work I recently incorporated into my own EHR as being nudges, but in hindsight, they are. I got the idea from a presentation I saw from one of the nation’s premier children’s hospitals and extrapolated a piece of it to the work that our clinicians do. It hasn’t been live long enough for me to know how well it’s been received, but I’m looking forward to finding out.

Another interesting dynamic to explore would be whether there were any specific complaints from end users about the incorporation of the nudges. For items that appear in a list, changing the order or removing an item can interfere with muscle memory and will feel bothersome to those who had adapted to finding the right choice in the list in their own way. It can take time for those users to re-adapt to the new presentation. For items that appear as part of a search, changing those can be less bothersome.

Since the study was done at University of California, San Francisco (UCSF) Health, I’d be interested to hear from anyone who was on the team responsible for the changes or from end users who experienced it.

What user-facing nudges or interventions are you working on for 2023? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 1/16/23

GAO rules Booz Allen has no conflict in $860M VA award

The Government Accountability Office rejects bid protests involving the VA’s selection of Booz Allen to continue managing its Oracle Cerner implementation for another five years.

Definitive Healthcare lays off 6% of staff despite revenue growth

Healthcare market intelligence company Definitive Healthcare, which went public in 2021, will lay off 55 employees as it struggles to balance hiring and expenses with revenue.

Owensboro Health and Optum Launch Comprehensive Partnership to Enhance Patient Care and Experience in Western Kentucky and Southern Indiana

Owensboro Health (KY) outsources revenue cycle management and IT to Optum, which will take on 575 health system employees.

Monday Morning Update 1/16/23

Top News

The Government Accountability Office rejects bid protests involving the VA’s selection of Booz Allen to continue managing its Oracle Cerner implementation for another five years.

Unsuccessful bidders Cognosante and Pro Sphere Tech said that Booz Allen has an organization conflict of interest because the $860 million contract will allow it to steer work under a different VA task order to its subsidiary Liberty IT Solutions, which it acquired in June 2021 for $725 million.

GAO dismissed a similar year-ago protest by a Liberty IT Solutions competitor, determining that Liberty and Booz Allen are performing different kinds of work that is managed by different VA offices.

Reader Comments

From Cron: “Re: disruptors. Does any company actually disrupt anything?” Rarely in healthcare, since those companies that would be disrupted are usually entrenched, well funded, and politically connected. Expectations are misplaced that scrappy startups will somehow fix our healthcare non-system for us since politicians won’t. The job of a startup is to survive, grow, and make money, and tangling with huge insurers, health systems, and vendors isn’t a great way to do that.

HIStalk Announcements and Requests

Poll respondents are mixed on assigning responsibility to the VA’s struggling rollout of Oracle Cerner.

New poll to your right or here: Which social media service have you used in the past seven days?

Several folks have reached out about the death of industry long-timer Frank Pecaitis. His family has started a GoFundMe to establish a scholarship in his name.

Welcome to new HIStalk Platinum Sponsor RxLightning. The New Albany, IN-based company enables physicians to accelerate patient access to their preferred specialty therapies. Its MedAccess platform was designed for physicians and their clinical team to re-imagine the entire specialty medication experience without paper forms or fax machines, supporting over 1,200 specialty medications across all therapeutic specialties. Ninety-four percent of patients get access in less than one hour and 99% in less than one day. Its proven approach simplifies the historically cumbersome process of specialty medication access by providing visibility into the entire patient journey through a digital platform, which acts as a single source of truth for all stakeholders. This MedAccess Ecosystem optimizes the patient journey from enrollment to fulfillment and makes the disconnected, connected. Thanks to RxLightning for supporting HIStalk.

Thanks to these companies that recently supported HIStalk. Click a logo for more information.

January 19 (Thursday) 2 ET. “Supercharge Your Clinical Data Searches.” Sponsor: Particle Health. Presenter: Paul Robbins, MSMBA, VP of product, Particle. Particle’s team will preview the exciting results of Specialty Search, a new condition-specific record locator service. This webinar will review how to collect patient records from top Centers of Excellence across the entire country; how healthcare organizations of all types are benefiting from Specialty Search capabilities, using Particle’s simple API; and why a focused search of chronic condition data — in oncology, cardiology, endocrinology, orthopedics, and more — has an outsized impact on care outcomes.

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

Acquisitions, Funding, Business, and Stock

Not directly healthcare related, but interesting. JP Morgan Chase sues Charlie Javice, the 30-year-old founder of student loan signup platform vendor Frank, which it acquired for $175 million in September 2021 and has since shut down. Executives of Frank allegedly hired a data science professor to create 4.25 million phony user accounts versus its actual 300,000 users who used the service to apply for school loans. The company came under Congressional scrutiny in 2020 on suspicions that it was misleading students and  selling their personal information to advertisers. JP Morgan discovered discrepancies when it asked for a customer list so it could begin marketing its own offerings to students, then found that three-fourths of test emails were undeliverable and only 1% were opened.

Jingyun Fan, MS, founder and CEO of app-based insomnia coaching startup Shuni, lists the lessons she learned that resulted in shutting the company down after three years:

1. Founders must manage their egos in balancing the many naysayers while still listening to legitimate feedback.
2. First-time founders focus on “build it and they will come” instead of the real challenge of distribution. They should learn about marketing and sales and split their time equally between product and growth.
3. Operational excellence is easily copied and just doing something better isn’t enough to provide the returns that venture capital seeks.
4. Startups should not focus on building a services business, which is operational excellence that incumbents can copy given their capital and reputation.
5. Don’t try to sell platform technology into healthcare since better technology is a nice-to-have that may never result in a sale, and it’s hard to disrupt Epic or Oracle Cerner.
6. For behavioral health offerings, focus on direct-to-consumer growth rather than pursuing academia-grade outcomes data that would interest only employers and insurers.
7. Cost-of-acquisition is high in behavioral health and marketing strategies should focus on long-form content written by authentic personalities as brand representatives, making YouTube as the primary channel because you can speak directly to target clients, has good discoverability, and is good for search engine optimization.
8. Make sure as a founder that the problem you are addressing is worth dedicating a major part of your life to.
9. Venture capital isn’t right for every business. Capital comes with timeline expectations and what startups need is time.
10. Ignore these lessons. People do the impossible all the time, doing meaningful work and transforming their own lives.

Sales

• Two hospitals on the border between France and Belgium choose Sectra for digital pathology in a joint project.
• Owensboro Health (KY) outsources revenue cycle management and IT to Optum, which will take on 575 health system employees.

Government and Politics

ONC publishes Draft Version 4 of USCDI.

Sponsor Updates

• Current Health publishes a new case study, “UMass Memorial Health Builds Leading Hospital at Home Program.”
• EClinicalWorks releases a new customer success story, “Value-Based Care Achieved Through PCMH and HEDIS.”
• Relatient publishes a new case study featuring One Pediatrics, “Activating Patients Through Targeted Messaging and Segmentation.”
• West Monroe appoints TED Conferences CEO Jay Herratti to its board.

Blog Posts

• Are You Compliant? New CURES Act Rules in Effect (Pivot Point Consulting)
• How Bedside Manner Improves Patient Recovery (PerfectServe)
• How The Bellevue Hospital is Transforming their Supply Chain – and Maximizing Savings (Premier)
• Your guide to the average speed of answer in a call center (Talkdesk)
• 2023 Top Healthcare Cybersecurity Threats (TigerConnect)
• Upfront Healthcare 2022 Year in Review (Upfront Healthcare)
• 4 Tips to Boost Physical Therapy Documentation Training in Your Clinic (WebPT)
• The Cost of Doing Nothing (VisiQuate)
• Carequality & EHealth Exchange Annual Meeting Highlights (Zen Healthcare IT)

Contacts

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

Morning Headlines 1/13/23

Censinet Secures $9M in New Funding to Accelerate Third Party Risk Management in Healthcare

Healthcare risk management company Censinet raises $9 million in new funding, bringing its total raised to $22 million.

Talent Group Acquires Queen Consulting Group

IT staffing company Talent Group acquires Queen Consulting Group, which specializes in pharma and healthcare IT, including EHR implementations.

Alpine Investors Announces Partnership with Leading Revenue Cycle Management Provider, Medusind

Alpine Investors acquires RCM, practice management, and analytics company Medusind from HIG Capital.

News 1/13/23

Top News

Alphabet’s Verily health sciences unit will lay off 240 employees, 15% of its workforce, as the company tries to bolster its financials to reduce reliance on its parent.

The company will end early-stage projects that involved remote patient monitoring and microneedles for drug delivery.

Reader Comments

From High Vibration Go On: “Re: J.P. Morgan Healthcare Conference. You should ask your readers for their assessment and any zingers, predictions, etc.” Readers who attended JPM, what thoughts do you have?

HIStalk Announcements and Requests

The migration to the new, more powerful server overnight went mostly OK, with a few errors due to permissions, security certificates, and the “contact us” online forms (still working on those). Let me know if you see anything that is irritatingly broken.

Webinars

January 19 (Thursday) 2 ET. “Supercharge Your Clinical Data Searches.” Sponsor: Particle Health. Presenter: Paul Robbins, MSMBA, VP of product, Particle. Particle’s team will preview the exciting results of Specialty Search, a new condition-specific record locator service. This webinar will review how to collect patient records from top Centers of Excellence across the entire country; how healthcare organizations of all types are benefiting from Specialty Search capabilities, using Particle’s simple API; and why a focused search of chronic condition data — in oncology, cardiology, endocrinology, orthopedics, and more — has an outsized impact on care outcomes.

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

Acquisitions, Funding, Business, and Stock

Censinet raises $9 million in new funding.

Talent Group acquires Queen Consulting Group.

Sales

• C By Precision Care chooses EClinicalWorks, Healow, and PRISMA.
• Meditech UK chooses CloudWave’s OpSus Cloud Services to deploy its cloud-based Meditech Expanse implementation at two NHS trusts.
• Eye Health America will implement NextGen Patient Experience Platform and NextGen Pay powered by InstaMed.
• Jefferson County Human Services (WI) chooses Eleos Health’s natural language understanding technology to interpret behavioral health conversations and reduce documentation time.
• Transcarent will offer expert second opinions from specialists at The Clinic by Cleveland Clinic, which is a joint venture between Cleveland Clinic and Amwell.
• Nicklaus Children’s Hospital will implement the ActX Genomic Decision Support platform.

People

Life sciences medical intelligence company Dr. Evidence hires Rose Higgins, RN, MPM (HealthMyne) as CEO.

DrFirst promotes G. Cameron Deemer to CEO. He replaces founder James Chen, MS, who moves to executive chairman of the board. The company also promotes Anthony Brooke to chief technology and innovation officer.

ModMed hires Jody Beaverson (Change Healthcare) as chief people officer.

Industry long-timer Frank Pecaitis — who held executive roles at QuadraMed, Medsphere, GE Healthcare, PatientSafe Solutions, Agfa HealthCare, and most recently at Philips in a 30-year career — died December 24 at 59.

Announcements and Implementations

A trigger method adverse event study of 11 hospitals in Massachusetts finds that nearly one-fourth of admissions included an adverse event, of which about 1% were both serious and preventable. The most common type of events involved drugs (39%), surgeries or procedures (30%), nursing care (15%), and healthcare-associated infections (12%).

Northwell Health releases a pregnancy chatbot for its patients that offers education and triage with escalation.

Sponsor Updates

• Nordic posts a new episode of DocTalk titled “The two sides of digital health.”
• Healthjump earns Validated Data Stream designation in the new NCQA Data Aggregator Validation Program.
• EClinicalWorks customer Children First Pediatrics reports successful process automation, increased patient compliance, and general cost savings using the company’s Healthcare Effectiveness Data and Information Set (HEDIS).
• Ellkay hosts a virtual blood drive through the Red Cross in support of National Blood Donor Month.
• Fortified Health Security names Ayinde Mitchell (Cognoa) regional sales director.
• HCTec sponsors five families as part of Operation Stand Down Tennessee’s holiday program.
• Impact Advisors announces that is has been recognized as one of the top leaders in Canada in the KLAS Canada EMR Consulting Services 2023 report.
• Kyruus reports a landmark year in 2022, serving over 100 health systems, 500 independent medical groups, and 100 health plan brands.

Blog Posts

• Customer-Centric Healthcare Tech Commercialization (Get-to-Market Health)
• Digital Innovations Behind the Future of Life Sciences Industry (Healthcare Triangle)
• How Technology is Affecting Hospitals From the Top Down: The Role of Today’s CIO (HealthTech Resources)
• How Patient Education Can Increase Compassion in Healthcare (Healthwise)
• Unlocking the power of digital healthcare solutions in three steps (InterSystems)
• A history of home healthcare payment models (Intelligent Medical Objects)
• Meltdown: Why Resiliency Programs Alone Can’t Reverse Physician Burnout (Medhost)
• 4 essential factors to a successful, multi-year, phased implementation project (Meditech)
• How NeuroFlow Prioritizes User Experience to Improve Digital Mental Health (NeuroFlow)
• An In-Depth Q&A with Cathy Thomas Hess, Chief Clinical Officer of Wound Care (Net Health)

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EPtalk by Dr. Jayne 1/12/23

I volunteer with a couple of community organizations. Although I find the work gratifying, it can also be frustrating for those of us who are used to workplaces where time is seen as precious and communication is key.

One of my organizations keeps sending out “friendly reminder” emails telling recipients that “if you haven’t taken care of XYZ yet, please do so, but if you have already done it, disregard this message.” I’ve certainly seen this approach in business situations as well, so those who are guilty should be on notice. For those of us in fast-paced situations who tend to juggle way too many balls, it can be difficult to know if you did it or not – especially if the original request was some time ago. Sending the email only to the people who actually need to take action would be more useful and would avoid wasting other people’s time.

From Jimmy the Greek: “Re: telehealth. Check out this company that will set you up with a video chat with a doctor, and then sell you a bunch of prescription meds to keep on hand  ‘just in case.‘” Duration Health describes itself as “a mission-driven organization with a deep belief in patient autonomy.” Following a consultation, they prepare a customized kit from their list of 60 medications so that you can have the good stuff on hand in the event of trouble in the backcountry, natural disaster, or all civil unrest. They note that their formulary “contains the medications most prescribed at urgent cares for acute, non-emergent conditions, along with a select set of potentially life-saving medications for emergent scenarios where help is limited.” The list includes such favorites as antibiotics, antifungals, antimalarials, steroids, epinephrine, antihistamines, laxatives, altitude sickness treatments, emergency contraception, and anti-nerve gas agents. They focus their sales on those who anticipate traveling outside the US, into the backcountry, to an area at risk for natural disasters, or to a medically underserved area as defined by HRSA. Their OFFGRID promo will net you a hefty discount if you’re interested.

Here’s some good news for those of us who spend a lot of time at our desks. A recent study published in Nature Medicine shows that even short bursts of vigorous activity as part of daily life can help reduce the risk of death. Activities might include climbing stairs, brisk walks during a commute, and more. Participants wore wrist-based accelerometers that helped measure the amount of vigorous intermittent lifestyle physical activity (VILPA). More than 25,000 people aged 40 to 69 years participated in the study and wore the devices more than 16 hours a day for at least three days during a weeklong period. The “nonexerciser” group said they didn’t exercise during leisure time and they didn’t walk more than once weekly for recreation. The researchers compared mortality rates between those nonexercisers who did and did not have spurts of VILPA recorded by their devices. They also looked at data from another 62,000 research subjects who self-reported that they exercised regularly. The subjects’ health outcomes were tracked for approximately seven years.

The study found that even in nonexercisers, having engaged in bursts of vigorous activity was associated with a nearly 50% decrease in mortality from cardiovascular disease. Although the study can’t show causality, it’s hopefully interesting enough to help set a framework for additional investigations. The authors noted some limitations of the study. Only about 6% of people invited to participate actually accepted, so the subjects might not represent the general population. Additionally, some bursts of activity such as carrying something heavy like a shopping bag might not have been accurately captured by wrist-based devices.

It looks like every bit of movement during the day counts, so I’ll keep that in mind when I’m racing to the laundry room to rotate a load of towels in between conference calls or scurrying down the driveway to bring the recycle bin in before one of my neighbors calls the city inspector for leaving it out past dusk.

Of no surprise to anyone: MyChart message volumes decreased at UCSF Health after the organization began billing for them, even though the number of messages that actually generated charges were small. A research letter published in the Journal of the American Medical Association found that although charges occurred about 2% of the time, the overall number of messages declined from 59,648 to 57,925. The authors propose that the decline was likely due to “awareness of the possibility of being billed.” Interestingly, they found no significant changes in the numbers of scheduled visits or unscheduled telephone calls. They note that “future research should investigate overall costs under different payment models and the effect of billing for messaging on outcomes, health equity, and patient and clinician satisfaction.”

In speaking with my peers around the virtual water cooler, it doesn’t seem like patients understand the burdens that primary care physicians are facing including the deluge of messages that has happened since COVID appeared. Patients are unaware that a majority of primary care physicians are taking work home with them and continuing to manage phone messages, insurance preauthorizations, and visit notes well into the evenings. As I coach physicians on trying to make documentation more efficient, I keep hearing themes about not only lack of office staff, but lack of highly qualified staff, which pushes more work onto the physicians.

One physician I spoke with recently has had to perform all patient care tasks in his office, including patient intake (history updates, vital signs, etc.) because his medical assistant is on medical leave and the health system employer claims they can’t find anyone to serve as a temporary replacement. He’s thinking about resigning because he can’t get caught up and other physicians in the practice are unwilling to share their staffing capacity. I know that my former clinical employer still has a percentage of its locations closed because it can’t staff them, so I’m not surprised about any hiring crises I hear about.

Is your organization charging for messages, and how are patients receiving the change? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 1/12/23

Array Behavioral Care Secures $25 Million from CVS Health to Help Address National Mental Health Crisis through Virtual Care

Telepsychiatry provider Array Behavioral Care raises $25 million in a Series C funding round led by CVS Health, which will look for ways in which Array’s capabilities can complement its own healthcare delivery services.

OpenLoop Acquires Reliant.MD Practice Group, Expanding Services and Strengthening Position in Insured Care Market

OpenLoop, a white label telehealth services company focused on payers and employers, acquires Reliant.MD’s practice group.

Alphabet to cut staff of health sciences unit Verily by 15%

Verily will lay off 240 employees and shutter several product lines, including remote patient monitoring for heart failure, in an effort to streamline operations and achieve financial independence from parent company Alphabet.

Morning Headlines 1/11/23

LeanTaaS Acquires Hospital IQ to Create AI Innovator for Hospital Operations Optimization

Capacity management and patient flow software vendor LeanTaaS acquires Hospital IQ, which offers hospital automation solutions.

Avel eCare Announces the Acquisition of NightWatch to Expand Pharmacy Telemedicine Services

National telemedicine provider Avel ECare acquires after-hours remote pharmacy service NightWatch.

20 Ontario Hospitals Transition to Meditech Expanse as Members of the ONE Shared Service Organization

In Canada, 23 hospitals form a shared services IT organization as they implement a shared instance of Meditech Expanse.