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Morning Headlines 10/26/20

October 25, 2020 Headlines 1 Comment

VA marking milestone with initial EHR rollout, but long-term road ahead still unclear

Mann-Grandstaff VA Medical Center (WA) goes live on Cerner as the VA’s first implementation site.

Symplr To Acquire TractManager

Healthcare governance, risk management, and compliance software vendor Symplr acquires TractManager, which offers solutions for contracting, sourcing, and provider management.

ChristianaCare Builds One of the First Alexa Skills in the U.S. Exclusively for Home Health Patients

ChristianaCare’s Health & Technology Innovation Center develops Home Care Coach, an Alexa skill patients can use to access custom care plans developed by their physicians.

SOC Telemed and HCMC Announce Customer Commitment to Invest in PIPE

Bon Secours Mercy Health will make a private investment in the business combination that will take acute care telemedicine provider SOC Telemed public in early November.

BridgeHealth Merges with Transcarent; Completes $40 Million Series A Funding

BridgeHealth, which guides employees of self-insured companies to cost-effective surgery providers, merges with healthcare consumer information platform vendor Transcarent as part of its $40 million Series A funding round.

Monday Morning Update 10/26/20

October 25, 2020 News 6 Comments

Top News

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Mann-Grandstaff VA Medical Center (WA) goes live on Cerner as the VA’s first implementation site.


Reader Comments

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From Chris Stenrud: “Re: Teladoc Health. Your headline doesn’t reflect reality. Our chief product officer, chief data scientist, and chief medical officer for product and analytics all come from Livongo.” A recap of the SEC filing: (a) five Livongo executives will leave following the acquisition; (b) seven of eight of the CEO’s direct reports will come from Teladoc; (c) two of six R&D executives will come from Teladoc; (d) seven of nine commercial organization executives will come from Teladoc; and (e) one of five executives in the US Group Health segment will come from Teladoc. Chris is Teladoc’s VP of communications. My point is that Teladoc is paying $18.5 billion for Livongo but isn’t bringing over Livongo’s founder and executive chairman, CEO, president, CFO, and SVP of business development as announced so far, while other Livongo execs aren’t mentioned as either coming over or not.


HIStalk Announcements and Requests

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Nearly two-thirds of poll respondents haven’t taken a consumer DNA test, but 50% of those who have done so received surprising results about their known or unknown close relatives. Peter says it has been a pain since he and his wife took a test for fun –his wife started getting hits for half-siblings from all over the world because she was unknowingly fathered by a sperm donor instead of her legal father, which her parents refuse to acknowledge. Peter suggests leaving the test’s “family” features turned off.

New poll to your right or here: As a patient, when have you encountered scribes in the past one year? It occurs to me that I don’t know if it’s legally or ethically OK for a clinician to have a remote scribe listening in without telling the patient – thoughts? I’ve only been in one encounter with a scribe – the doctor introduced her and she didn’t say anything other than quietly responding to the doctor’s questions or instructions as she worked from within the EHR, leaving him free to focus on me. It was a good experience, although it probably wouldn’t work with a PCP who would need look more frequently at the EHR or share its contents.

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I listened to the rehearsal for Bright.md’s Thursday webinar, which will be in the form of an interview with Ries Robinson, MD, SVP/chief innovation officer of Albuquerque-based Presbyterian Healthcare Services. It’s a no-BS description of how the health system ramped up technology to respond to COVID needs and what that experience taught them for redesigning care going forward. Interviewer Ray Costantini, MD of Bright.md was so careful to avoid any hint of doing a company pitch that we had to urge him to at least give a one-minute overview of the technologies the company offers and that PHS uses. One thing I learned — Ries talked about how it’s no easier for doctors to stay on schedule with fixed-length telehealth visits than with in-person visits, but patients hate waiting online and are quicker to give up than when they’ve driven into the office and are already sitting in the room, so technologies can help with pre- and post-visit work to keep the physician on schedule. My first question in reviewing a webinar’s content is, will someone whose employer doesn’t own the sponsor’s product still learn something useful? In this case, the answer is yes, and I enjoyed the no-slides conversational format.


Webinars

October 27 (Tuesday) noon ET. “Don’t Waste This Pandemic (From a Former Healthcare CEO).” Sponsor: Relatient. Presenter: Monica Reed, MD, MSc, former CEO, Celebration Health. Some healthcare organizations are trying to get back to the normalcy of 2019, but tomorrow’s leaders are accelerating even faster in 2020. Two- or three-year roadmaps were accomplished in six months, so what’s next? The presenter will describe how technology was changing before COVID-19, how the pandemic accelerated plans, what we can expect to see as a result, how leaders and providers can adapt, and what healthcare’s digital front door looks like going forward and how it can be leveraged.

October 28 (Wednesday) noon ET: “How to Build a Data-Driven Organization.” Sponsor: Newfire Global Partners. Presenters: Chris Donovan, CEO and founder, Adaptive Product Consulting; Harvard Pan, CTO, Diameter Health; Jason Sroka, chief analytics officer, SmartSense by Digi; Jaya Plmanabhan, data scientist and senior advisor, Newfire Global Partners; Nicole Hale, head of marketing services, Newfire Global Partners. The panel of data experts will discuss the opportunities that data can unlock and the challenges involved with becoming a data-driven organization. Attendees will learn why having a data strategy is important; how to collect, manage, and share data with internal and external audiences; and how to combat internal resistance to create a data-driven culture.

October 29 (Thursday) 1 ET. “How Presbyterian Healthcare Services Is Preparing for a Post-Pandemic Future Using Digital Care Tools.” Sponsor: Bright.md. Presenters: Ries Robinson, MD, SVP/chief innovation officer, Presbyterian Healthcare Services; Ray Costantini, MD, MBA, co-founder and CEO, Bright.md. Presbyterian Healthcare Services changed the way New Mexico patients access healthcare with its pres.today digital front door, which has given patients easy access to care during a global crisis. The health system’s digital care strategy goes beyond simply offering virtual visits and instead makes every episode of care — regardless of where it is delivered — better by streamlining clinical workflows and by directing patients to the most appropriate venue of care. The presenters will describe how Presbyterian has continued to meet patient needs during the pandemic, how it is deploying digital tools to tackle the combined COVID-19 and flu seasons, and how the health system is innovating care delivery to prepare for a post-pandemic future.

November 11 (Wednesday) 1 ET. “Beyond the Firewall: Securing Patients, Staff, and the Healthcare Internet of Things.” Sponsor: Alcatel-Lucent Enterprise. Presenter: Daniel Faurlin, head of network solutions for healthcare, Alcatel-Lucent Enterprise. The biggest cybersecurity risk for healthcare IoT isn’t the objects themselves, but rather the network door they can open. This webinar will address meeting the challenges of security, management, and monitoring using ALE’s Digital Age Networking, a single service platform for the network infrastructure that includes an autonomous network, onboarding and managing IoT, and creating business innovation with automated workflows. Specific use cases will be described, including COVID-19 quarantine management, locating equipment and people, and ensuring the security of patients.

November 12 (Thursday) 5 ET: “Getting Surgical Documentation Right: A Fireside Chat.” Sponsor: Intelligent Medical Objects. Presenters: Alex Dawson, product manager, IMO; Janice Kelly, MS, RN, president, AORN Syntegrity; Julie Glasgow, MD, clinical terminologist, IMO; Lou Ann Montgomery, RN, BSN, nurse informaticist, IMO; Whitney Mannion, RN, clinical terminologist, IMO. The presenters will discuss using checklists, templates, the EHR, and third-party solutions to improve documentation without overburdening clinicians. They will explore the importance of surgical documentation in perioperative patient management, the guidelines and requirements for surgical documentation and operative notes, how refining practices and tools can improve accuracy and efficiency, and the risks and implications of incomplete, inconsistent, and non-compliant documentation.

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


Acquisitions, Funding, Business, and Stock

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NextGen Healthcare reports Q2 results: revenue up 4%, EPS $0.30 versus $0.24, beating Wall Street expectations for both. NXGN shares are down 13% in the past one year versus the Nasdaq’s 42% rise. From the earnings call:

  • RCM and EDI business volumes are at 93% and 95%, respectively, of their pre-COVID levels.
  • 20% of its business came from winning competitive situations.
  • Quarterly spend was reduced by $0.04 per share via short-term cost reductions, but those savings won’t be repeated.

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Healthcare governance, risk management, and compliance software vendor Symplr acquires TractManager, which offers solutions for contracting, sourcing, and provider management.

BridgeHealth, which guides employees of self-insured companies to cost-effective surgery providers, merges with healthcare consumer information platform vendor Transcarent as part of its $40 million Series A funding round.

Bon Secours Mercy Health will make a private investment in the business combination that will take acute care telemedicine provider SOC Telemed public in early November.

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Tech Mahindra’s US subsidiary will acquire a 6% equity position in VitalTech Holdings for $3 million, with an option to invest an additional $5 million through January 2021. VitalTech offers telehealth and remote patient monitoring technology, while Tech Mahindra owns healthcare consulting firm The HCI Group.

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Former Microsoft executive Terry Myerson forms Truveta, which he describes vaguely as working with large amounts of health data to extract insights that will improve patient care. The website lists 19 employees so far, including two physicians, and job openings for bioinformatics engineers, software engineers, clinical informatics and data managers, and marketing and communication VPs.


People

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Amanda Hundt (WE Communications) joins Health Catalyst in the newly created position of VP of corporate communications.

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OptimizeRx promotes Karen Lauer to VP of product development.


Announcements and Implementations

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Relatient releases Broadcast Messenger, which allows health systems to send text, email, and voice call messages to many patients and groups at once.

OmniSys announces Encounter-Rx, a cloud-based solution that allows pharmacies to integrate data and services to support expanded pharmacist roles such as point-of-care testing, disease counseling, and immunizations.

Four large Illinois health systems will exchange patient information with Blue Cross and Blue Shield of Illinois by joining Epic’s Payer Platform, which will launch later this year. The payer-provider system can exchange information about ED visits, tests, lab results; support priority authorization and claims payment; and apply care management strategies.


COVID-19

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The US reported a record-breaking 84,000 new COVID-19 cases on Friday and again Saturday, with experts predicting that daily new case counts will hit six figures soon and deaths will spike over the next 3-4 weeks. State governments say the primary spreader events aren’t reopened schools, but rather social and religious gatherings.

President Trump tells attendees at a Wisconsin rally that “doctors get more money and hospitals get more money” in the US if they classify deaths due to other serious conditions and terminal illnesses as being caused by COVID-19, artificially inflating our death counts because “this country and their reporting systems are really not doing it right.”

FDA approves Gilead’s remdisivir for COVID-19 treatment, surprising many experts who note that the drug doesn’t have a long tracked and its only proven effect is to shorten hospital stays rather than improve survival or reduce ventilator use.The drug has been available since May under FDA’s Emergency Use Authorization.

Vice-President Pence, who had five close staff members test positive for COVID-19 over the weekend, will ignore CDC guidelines and continue his campaign travel and public rallies because he is “essential personnel,” according to White House Chief of Staff Mark Meadows. Meadows told reporters Sunday that the US is “not going to control the pandemic” and instead will focus developing on vaccines and treatments.

The Wall Street Journal reports that HHS’s controversial $250 million “defeat despair” coronavirus ad campaign has been cancelled. It notes that part of the campaign would have given early COVID-19 vaccine access to performers who portray Santa Claus, Mrs. Claus, and their jolly elves as essential workers. The disappointed chairman of the Fraternal order of Real Bearded Santas told WSJ that “this was our greatest hope for Christmas 2020, and now it looks like it won’t happen.”


Other

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A genetic counselor sends DNA samples to consumer genetics testing company Orig3n for childhood development analysis, extracting one sample from her dog and the other from her kitchen faucet. The report failed to notice the non-human origins, but advised that the tap water will need longer to develop language skills. The company is also facing CMS sanctions for its COVID-19 tests, which have produced least 383 false positive results this year.


Sponsor Updates

  • Change Healthcare offers ICAD’s ProFound AI platform as part of its Mammography Plus solution.
  • SOC Telemed announces new board nominations ahead of its merger with Healthcare Merger Corp.
  • Pure Storage releases a new podcast, “Tales from the Ransomware Crypt.”
  • Spirion wins multiple Globee International and One Planet Awards for its privacy and security product, customer deployments, and its COVID-19 company response.
  • Summit Healthcare publishes a new use case featuring Galway Clinic, “Solving Complex Interoperability Needs with the Latest in Integration Technology.”

Blog Posts


Contacts

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

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Weekender 10/23/20

October 23, 2020 Weekender No Comments

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Weekly News Recap

  • Tibco will acquire Information Builders.
  • Teladoc Health announces that several Livongo executives will leave once the acquisition has been completed.
  • LabCorp uses the capabilities of two recent acquisitions to connect patients to drug company remote clinical trials.
  • Patient safety solutions vendor RLDatix acquires provider credentialing software company Verge Health.
  • A new report from Center for Connected Medicine and KLAS finds that the surge in telehealth will end if emergency payments go back to pre-COVID levels, as 80% of health systems say they will stop doing them.
  • Allscripts files a trademark lawsuit against telemedicine and urgent care company CarePortMD, saying the name is too similar to that of CarePort Health, which Allscripts is selling to WellSky.

Best Reader Comments

HIMSS relevant to CIOs? Not for years. CHIME is on the same path. (Justa CIO)

21st Century Cures Act has been a all-hands-on-deck issue for us for the past couple of months. We were already in a good place interoperability-wise and the deadline was a good excuse to review all our data-sharing policies and settings in our system. Since in Massachusetts, children are considered medically emancipated at 12, we have had to review our proxy settings and our patient portal setup in general. As far as our providers go, they have been complaining about the notes transparency and results release changes that the Cures Act brings with it. Unfortunately a mandate is a mandate, so there is not much anyone can do to push back against the impending regulation. (Craig Molway)

In my experience, staying after resigning invariably alters the relationship with your employer and you will never be fully trusted again. Additionally, this situation will certainly leak to your peers and other workforce members who will also look at you thru a different lens. (Festus)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. M in Alabama, who asked for headphones for her kindergarten class. She said in late February, “We are so grateful for your donation. We have increased our use of the rolling computer lab and increased our on task time for our weekly target. Your generous donation has helped students focus more on their own screen. The headphones have minimized noise distractions. The students are more engaged in completing their learning lessons. Four of my students have even increased their pass rate while engaged in their lessons. The success rate can only go up from here. It has been a game changer. We couldn’t have done it without your help!”

A former chief of prosthetics and orthotics at Walter Reed National Military Medical Center pleads guilty to accepting money, travel, and sporting events tickets from a company to which he steered $25 million in equipment business. Federal agents asked him about unexplained cash bank deposits, which he inconsistently claimed came from selling bicycles at swap meets, moonlighting, and selling moonshine.

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A New York pediatric otolaryngologist who also serves as a county legislator, an opioid addiction prevention advocate, and an ordained minister is arrested in a sting operation where be planned to swap oxycodone for sex with a prostitute with whom he has had a long-term relationship. The married father of three thought he was texting with the sex worker he has been seeing for two years, unaware that she had recently died of a heroin overdose and that she had also been working as a police informant. Undercover agents used her phone to set up meetings in several sting operations, with a least one other doctor being arrested.

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Seven South Carolina hospital nurses form an honor guard to watch over the caskets of deceased nurses in funeral homes and to provide a Florence Nightingale Tribute at their funerals.

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A $7 million donation to Novant Health by former NBA star and current Charlotte Hornets majority owner Michael Jordan has supported the opening of two Charlotte, NC family medical clinics that bear his name.

In India, ENT surgeon Arup Senapati cheers up hospitalized coronavirus patients by dancing to a Bollywood movie song on his seventh consecutive day of COVID duty before he began mandatory quarantine.


In Case You Missed It


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Morning Headlines 10/23/20

October 22, 2020 Headlines No Comments

TIBCO Announces Agreement to Acquire Information Builders, Inc.

Analytics vendor Tibco Software will acquire competitor Information Builders, parent company of data analytics business Omni-HealthData, for an undisclosed price.

Loyal Announces $12.5 Million Round Led by Concord Health Partners

Chatbot and provider search technology vendor Loyal raises $12.5 million in a Series A funding round.

Senior leadership announcement

Teladoc Health announces the team that will run the company following the completion of its acquisition of Livongo, all but one of them coming from Teladoc.

Cohere Health Closes Additional $10 Million in Funding to Accelerate Delivery of Patient Journey Platform for Better Healthcare Quality and Outcomes

Cohere Health raises $10 million in a Series A funding extension, increasing its total to $20 million.

News 10/23/20

October 22, 2020 News 4 Comments

Top News

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Analytics vendor Tibco Software will acquire competitor Information Builders for an undisclosed price.

The healthcare offerings of Information Builders include Omni-HealthData data analytics.


Reader Comments

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From Morris the Cat: “Re: HIMSS IT Exec Community. What do you make of this email? It’s the second one from Hal Wolf in as many weeks and reeks of desperation to keep HIMSS relevant to CIOs.” Hal’s VIP-only invitation to become a free member of the new group pitches year-round programming, thought leadership opportunities, and peer-to-peer exchanges. I bristle when I see that “luminary-level” folks get perks that we underachievers don’t, even though I know they indirectly pay the bills in the “ladies drink free” arbitrage model in which high-paying vendors buy access to low-paying prospects. Still, I pay as much or more in member dues and registration fees, so why am I made to feel less important by HIMSS itself? Meanwhile, if HIMSS21 actually happens, you can find the CIOs and apparently now vendor C-levelers segregated in their luminary-only area whose air is lightly tinged with the intoxicating scent of thought leadership, where attentive service teams keep their onsite meals and snacks refreshed to fuel their higher-level creative energies while we lesser mortals charge down to the food court mosh pits seeking a day-old, $15 Caesar salad to eat sitting on the floor.

From I’m Onedering: “Re: One Brooklyn Health. They named Ron Goldman CIO and I can’t find information about his experience or qualifications. Anyone know where he came from?” His name is on a bid from March, so he must have been there awhile, maybe as interim. I found two dormant, skeletal LinkedIn IT manager / director profiles for that name under Brookdale Hospital and Medical Center and Wyckoff Heights Medical Center, both of which are part of One Brooklyn Health. Neither listed education or job history.


HIStalk Announcements and Requests

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I’ve had at least three CEO interview subjects miss our scheduled call because Gmail inserted a unhelpfully presumptuous calendar link to its own Google Meet, which my recipient then clicked instead of following the less-pushy conference line dial-in instructions.


Webinars

October 27 (Tuesday) noon ET. “Don’t Waste This Pandemic (From a Former Healthcare CEO).” Sponsor: Relatient. Presenter: Monica Reed, MD, MSc, former CEO, Celebration Health. Some healthcare organizations are trying to get back to the normalcy of 2019, but tomorrow’s leaders are accelerating even faster in 2020. Two- or three-year roadmaps were accomplished in six months, so what’s next? The presenter will describe how technology was changing before COVID-19, how the pandemic accelerated plans, what we can expect to see as a result, how leaders and providers can adapt, and what healthcare’s digital front door looks like going forward and how it can be leveraged.

October 28 (Wednesday) noon ET: “How to Build a Data-Driven Organization.” Sponsor: Newfire Global Partners. Presenters: Chris Donovan, CEO and founder, Adaptive Product Consulting; Harvard Pan, CTO, Diameter Health; Jason Sroka, chief analytics officer, SmartSense by Digi; Jaya Plmanabhan, data scientist and senior advisor, Newfire Global Partners; Nicole Hale, head of marketing services, Newfire Global Partners. The panel of data experts will discuss the opportunities that data can unlock and the challenges involved with becoming a data-driven organization. Attendees will learn why having a data strategy is important; how to collect, manage, and share data with internal and external audiences; and how to combat internal resistance to create a data-driven culture.

October 29 (Thursday) 1 ET. “How Presbyterian Healthcare Services Is Preparing for a Post-Pandemic Future Using Digital Care Tools.” Sponsor: Bright.md. Presenters: Ries Robinson, MD, SVP/chief innovation officer, Presbyterian Healthcare Services; Ray Costantini, MD, MBA, co-founder and CEO, Bright.md. Presbyterian Healthcare Services changed the way New Mexico patients access healthcare with its pres.today digital front door, which has given patients easy access to care during a global crisis. The health system’s digital care strategy goes beyond simply offering virtual visits and instead makes every episode of care — regardless of where it is delivered — better by streamlining clinical workflows and by directing patients to the most appropriate venue of care. The presenters will describe how Presbyterian has continued to meet patient needs during the pandemic, how it is deploying digital tools to tackle the combined COVID-19 and flu seasons, and how the health system is innovating care delivery to prepare for a post-pandemic future.

November 11 (Wednesday) 1 ET. “Beyond the Firewall: Securing Patients, Staff, and the Healthcare Internet of Things.” Sponsor: Alcatel-Lucent Enterprise. Presenter: Daniel Faurlin, head of network solutions for healthcare, Alcatel-Lucent Enterprise. The biggest cybersecurity risk for healthcare IoT isn’t the objects themselves, but rather the network door they can open. This webinar will address meeting the challenges of security, management, and monitoring using ALE’s Digital Age Networking, a single service platform for the network infrastructure that includes an autonomous network, onboarding and managing IoT, and creating business innovation with automated workflows. Specific use cases will be described, including COVID-19 quarantine management, locating equipment and people, and ensuring the security of patients.

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


Acquisitions, Funding, Business, and Stock

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Teladoc Health announces the team that will run the company following the completion of its acquisition of Livongo, all but one of them coming from the Teladoc side of the “merger.” Livongo’s Michelle Bucaria, Zane Burke, Jennifer Schneider, Lee Shapiro, and Steve Schwartz will wriggle happily on their newly acquired mountains of cash instead of joining Teladoc Health, which will be run by this group:

  • Jason Gorevic, CEO (Teladoc)
  • Arnnon Geshuri, chief human resources officer (Livongo)
  • Mala Murthy, CFO (Teladoc)
  • David Sides, COO (Teladoc)
  • Dan Trencher, SVP of corporate strategy (Teladoc)
  • Drew Turitz, SVP of corporate development (Teladoc)
  • Adam Vandervoort, chief legal officer (Teladoc)
  • Stephany Verstraete, chief marketing and engagement officer (Teladoc)
  • Yulan Wang, interim R&D (Teladoc)

Patient safety solutions vendor RLDatix acquires credentialing Verge Health.

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Cohere Health raises $10 million in a Series A funding extension, increasing its total to $20 million. Its website is unhelpful in describing exactly what the company does beyond slinging lofty buzzwords like “paradigm shift” and “collaboration,” but it seems to primarily offer prior authorization of treatment plans, peer review, provider quality analytics, and optimizing value-based payment. I truly don’t understand why companies feel that it is limiting or demeaning to just say what they’re selling.

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Chatbot and provider search technology vendor Loyal raises $12.5 million in a Series A funding round.


Sales

  • Humana chooses Cohere Health’s collaboration platform for managing prior authorization for musculoskeletal treatments.
  • Telemedicine platform vendor Bluestream Health will implement EHR integration from Redox.

People

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Dan Nigrin, MD, MS (Boston Children’s Hospital) will join MaineHealth as CIO in January. He has been at Boston Children’s for 25 years, including SVP/CIO for 19 of those. His Defective Records electronic music label will survive the relocation, Dan says, and you can check out its latest retrospective release, which to me would make a fine playlist for doing focused work or exercising.

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Conversational AI vendor Gyant hires Justin Graham, MD, MS (Anthem) as chief medical officer.


Announcements and Implementations

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T-System, a CorroHealth company, launches an app store for solutions that complement its EDIS.

Edwards County Medical Center (KS) goes live on CPSI Evident’s clinical and financial systems and RCM solutions from sister company TruBridge.

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A new KLAS report finds that Epic is steadily improving its pharmacy offerings to the point that customers are considering replacing third-party software, although hospitals get less hand-holding from Epic and more of the initiative must be taken by the health system’s Willow analysts. Willow performs well out of the box in medication inventory, but customers report having to do more work to implement wholesaler integration, waste and expiration tracking, and medication shortage management. Basic integration with third-party systems is good, but customers would like to see improvements (both from Epic and from those vendors) for order returns, controlled substance inventories, sizing conversions, purchase tracking, 340B ordering, and drug pricing. Users of IV Dispense Prep for barcode scanning, remote verification, and photo capture verification report above-average satisfaction, but would like to push further with gravimetric verification, guided workflows, hard stops, recommended substitutions, and custom reporting, all of which are challenging because Epic doesn’t manufacture clean room hardware. KLAS concludes that Epic’s pharmacy functionality offers breadth but not depth, as solutions and the customer base’s usage have not yet reached maturity


COVID-19

CDC expands its “close contact” definition of coronavirus exposure, from a continuous 15 minutes within six feet of someone infected to a cumulative 15 minutes over a 24-hour period, which will have a significant impact on schools, workplaces, and other group settings where multiple brief encounters with a COVID-positive individual are more likely.

Politico reports that HHS Secretary Alex Azar is seeking White House permission to fire FDA Commissioner Stephen Hahn, MD, angered that his high safety standards for COVID-19 vaccines will prevent President Trump from delivering on his promise to have a vaccine available before Election Day.

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Analysis by Columbia University’s National Center for Disaster Preparedness says 130,000 to 210,000 US deaths from COVID-19 could have been prevented with better leadership and earlier response from the federal government, specifically in lagging the world in testing, reporting of inconsistent state data, inadequate contact tracing, delayed interventions and lockdowns, lack of mask-wearing guidance or mandates, and the White House’s open hostility toward CDC and WHO and mocking of basic mitigation strategies.

Drug companies, public health officials, and hospitals are preparing to hide and secure COVID-19 vaccine shipments to prevent theft, to the point that the manufacturers will track shipments by GPS and will send out dummy trucks to confuse would-be thieves.

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Two new studies find that deaths of hospitalized COVID-19 patients have dropped sharply as clinicians have learned how to treat them more effectively and to recognize problems faster. Mortality has dropped from 25.6% of those hospitalized to 7.6% even after adjusting for risk, which is important since older, frailer patients were hard hit early but hospitalization of younger patients has increased since. Authors add that survival rates are higher when hospitals aren’t fighting a surge, making mitigation strategies even more important.

Puerto Rico closes its 911 call centers when employees at both locations test positive for coronavirus.

CDC says the government will issue “vaccine cards” on which people who get the first dose of a COVID-19 vaccine will bring the completed card back to make sure they get the correct second dose. It’s low tech, but probably the best anybody can do given urgently short timelines and the need to support people who don’t go back to the same location for their second shot.

The Washington Post looks at the increasing number of nursing home COVID-19 deaths one month after the on-campus return of partying students to the three colleges in La Crosse, WI. City nursing homes went from never having lost a resident to COVID-19 to 19 deaths, aided by successful county-level blocking of state orders that closed bars and required wearing masks. Public health officials can’t say for sure how the virus is spreading since few patient samples have been genetically sequenced, but they suspect that it moves from nursing home employees to residents who otherwise have minimal outside contact.


Other

Southeast Health (MO) went back to paper for two days last week when its network was taken down in response to a high load of external Internet traffic that was apparently caused by a hacking attempt, preventing access to its remotely hosted Cerner system. The hospital also went on ED diversion.

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London-based virtual visit provider Vala Health urges competitors to join it in ending their Facebook advertising until the company improves its protections for the mental health of young people. The action was triggered by the late 2017 suicide of a seemingly stable 14-year-old girl who committed suicide after looking at disturbing suicide images and videos on Facebook-owned Instagram.

Doulas are using Facebook to warn each other about people who falsely claim to be pregnant to engage their services, either because they are role-playing a parental fantasy or acting out what one calls “a creepy fetish.”

In England, a patient dies of a raptured aortic aneurysm after being discharged by an ED doctor who was unknowingly looking at another patient’s CT scan. The coroner says doctors at the hospital seem to be confused by its “unwieldy” computer systems, which are scheduled to be replaced next year, Meanwhile, the hospital’s radiology department will now call doctors directly for a discussion when a scan is abnormal instead of just letting them know that a patient’s report is available.


Sponsor Updates

  • Everbridge featured President George W. Bush speaking on leadership and critical event management, as well as CNN’s Dr. Sanjay Gupta as keynoters during its COVID-19: Road to Recovery Symposium.
  • RxCap’s patient-facing mobile app will feature educational content from First Databank’s Meducation solution.
  • Halo Health publishes a new case study, “Mobile Clinical Communication Ecosystem Supports Asante’s Award-Winning Patient Care.”
  • Hayes achieves HITRUST CSF Certification to manage risk, improve security posture, and meet compliance requirements.
  • Optimum Healthcare IT publishes a case study titled “Leading a Virtual International Epic Go-Live Through a Pandemic.”
  • HIStalk sponsors exhibiting at the HIMSS Prioritizing Healthcare Information Technology for an Unpredictable Tomorrow virtual conference November 12 include Dimensional Insight, Healthcare Triangle, InterSystems, 314e, Arcadia, Bluetree, CloudWave, and Nuance.
  • Impact Advisors receives high marks in the latest KLAS implementation leadership report.

Blog Posts


Contacts

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

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EPtalk by Dr. Jayne 10/22/20

October 22, 2020 Dr. Jayne No Comments

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Continuing its ongoing slide towards irrelevance, HIMSS issues its call for proposals for the 2021 conference, which is slated to take place in Las Vegas in August.

There are quite a few places I’d rather be during the summer than there, so I’m rethinking my plan to attend. Part of me wants to see what the stripped-down version of HIMSS looks like, but I’d rather save my desert trips for the winter months. For those of you interested in presenting, proposals are due by November 2, meaning the material will be nine months old by the time you take the podium. Speakers receive complimentary registration, but then again, most of the rest of us are also receiving “free” registration since they refused to refund our fees for the canceled 2020 conference.

The Journal of the American Medical Informatics Association publishes a review on “Physicians’ electronic inbox work patterns and factors associated with high inbox work duration.” Looking at primary care physicians, they quantified the time spent on inbox management while looking at use patterns to identify which types of messages took the most clinician time. They found that PCPs spent an average of 52 minutes managing the inbox on workdays, with 19 of those minutes occurring outside work hours. Most time was spent on patient-initiated messages and results management. The authors conclude that interventions targeting these two areas would help reduce inbox workload.

I’ve long been a promoter of having support staff assist physicians in managing the inbox, but there continue to be barriers in this regard. Some organizations think there is too much medico-legal risk to have staff screen or triage messages, but others are supportive of the approach. Most employed physicians I’ve worked with seem reluctant to push back, since their employers don’t want to spend money on qualified support staff and they feel like it’s a losing battle. Many physicians feel like they’re in captive employment situations, and you can bet employers take advantage of this, knowing they’re not likely to vote with their feet.

Despite promises of coverage for the expenses of COVID patients, patients are starting to see surprise medical bills arrive in their mailboxes. Patients who don’t have a documented positive test due to testing shortages or those who end up seeking care out of their insurance network seem to be the most at risk. These examples further demonstrate the brokenness of our US healthcare system, where people routinely delay in seeking care because they’re worried that they won’t be able to pay for it.

I treated an elderly patient recently who needed a cardiac workup to confirm whether her symptoms were being caused by a heart attack. There’s not a lot we can do in the urgent care to definitively make the call. Because her home country has a nationalized health service, she was resisting a transfer to the hospital because she had heard of the exorbitant cost of hospital visits in the US. Ultimately she agreed to go, but declined an ambulance transfer. Since our local hospitals routinely block independent physicians from receiving follow-up information, I’ll never know if she made it there or not or what her outcome was.

The ongoing pandemic is a huge stressor to patients and healthcare workers alike. Some companies are offering virtual therapy and meditation apps to try to help their workers cope. Kaiser Permanente is offering the Calm meditation app to millions of its members, and other payers have been bolstering their mental health service offerings as well. My primary clinical practice recently suffered a devastating loss as a staffer died at the site. Given the age distribution of our employees and their engagement with technology, I suspect they’d be more apt to engage mental health services through an app rather than having to pick up a phone and call the employee assistance program.

The Joint Commission issues a “Quick Safety” bulletin covering “the optimal use of telehealth to deliver safe patient care.” They seem a little late to the dance since it’s October and most organizations have been using telehealth services since the spring, often with great success. They include some good pieces of advice, including the need to develop protocols for virtual care to reduce variation between providers. They also note that staff roles and responsibilities need to be defined.

The latter is something I still see organizations struggle with, as they make the assumption that virtual visits need to be 100% the responsibility of the provider. The most efficient telehealth platforms allow for a similar flow to the in-person visit, with staff performing pre-visit and post-visit tasks so that the physician can focus on the parts of the visit that require their specific attention.

The American Medical Association, which controls the CPT codes used in medical billing, has released two new codes for COVID testing this week. Both of them address use of combination tests that look for Influenza A and B along with COVID-19.

Academic medical centers and other large institutions have been developing their own tests for this, but what we really need is mass quantities of a rapid test that covers these pathogens and can be administered and resulted at the point of care. My state continues to be in a surge, and it’s become painfully obvious that the only thing that is going to keep some people home is having an actual positive test result. Many are clear about their intentions to continue “living their lives” in the absence of a positive result, regardless of their symptoms or exposures.

It’s certainly a disheartening time to be a physician. My community just lost another physician to suicide this week. We’re also seeing COVID take a toll on our providers who have other health issues but who have been trying to “power through” due to the extreme need in the community. Two of my colleagues are on bedrest for pre-term labor and two more have taken unspecified medical leaves.

There’s also an emotional toll. We are expected to just keep going regardless of what we’re seeing around us. While hospitals typically have post-event shakedowns after tragic Code Blue or major trauma events, there’s not a parallel for most of us in the ambulatory realm other than just trying to look after one another. No one’s clapping and cheering for the healthcare providers any more, but some of us are working harder than we have since the initial spring peaks. I’m definitely seeing some unhealthy coping behaviors, so keep an eye on your friends and family if they’re in the clinical trenches.

What is your organization trying to do to bolster morale ahead of flu season? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 10/22/20

October 21, 2020 Headlines No Comments

Oula Launches with $3.2 Million in Seed Financing to Build a Modern Maternity Center

Maternity care company Oula will use $3.2 million in seed funding to open a prenatal clinic and birthing center, and develop and offer collaborative care models as well as app-based virtual coaching and monitoring.

RLDatix Acquires Verge Health, Creating Largest Safety-Led Compliance and Credentialing Software Platform Specifically Designed for Healthcare

Patient safety solutions vendor RLDatix acquires provider credentialing software company Verge Health for an undisclosed amount.

Austin-based Verifiable raises $3 million for its API toolkit to verify healthcare credentials

Verifiable raises $3 million to further develop its API that automates real-time credentialing verifications and compliance monitoring for more than 50,000 healthcare providers.

HIStalk Interviews Darren Sommer, DO, CEO, Innovator Health

October 21, 2020 Interviews No Comments

Darren Sommer, DO, MBA, MPH is founder and CEO of Innovator Health of Jonesboro, AR. He is also an assistant professor in the Department of Clinical Medicine at NYIT at Arkansas State University, a lieutenant colonel in the US Army Reserves, and served two combat tours in Afghanistan in Operation Enduring Freedom as brigade surgeon for the US Army’s 82nd Airborne Division, 2nd Brigade Combat Team, where he earned the Bronze Star, Combat Medic Badge, and Combat Action Badge.

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Tell me about yourself and the company.

I’m an internal medicine physician. My origins in the telemedicine space came after deploying to Afghanistan in 2007. I had trained at a suburban hospital in the Tampa Bay area, but was then exposed to some unique pathologies being in a third-world country. The Army had a very good communications infrastructure that allowed me to connect with people around the world.

I used that as the foundation for thinking about how we can use telemedicine to serve and support our rural communities here in the United States. It was a glaring gap for me that the main telemedicine systems that are in existence today, and definitely those at that time, were created for another purpose and then repurposed for healthcare. It was difficult enough to have a conversation in the room with a patient about a diagnosis of cancer, HIV, or Mom’s dementia. It was almost impossible to do that with the existing technology. 

We set out to create a platform that would allow us to be at the patient’s bedside, in life-sized form, in 3D, and with direct eye contact, so that the patients felt like we were there with them. That was the origin of Innovator Health.

Now that we’ve quickly broadened experience with telehealth, how can doctors approach video visits in a way that is more acceptable to patients?

It’s funny, because if you ask 10 doctors how they define telemedicine, you’ll probably get 11 different answers. Most physicians look at telemedicine as just a two-way video conversation. Many of the health systems during COVID used basic Zoom-like technologies to connect with patients. When I talk about telemedicine, I talk about patients in a hospital environment, using medical instruments for diagnosis and treatment, access to the electronic health records, and sophisticated care delivery for telemedicine services. It’s different than how the rest of the market is looking at it.

Does clinician personality type play a role in their success in virtually connecting with their patients?

Good bedside manner is important, regardless of where you are in relation to the patient. I can be physically present in the room with a patient, not look them in the eye, not answer their questions, look at my watch, not allow them to feel at ease, all while being physically present. That’s not going to be a good experience for the patient.

On the contrary, I can be on the screen, be attentive, focus on their questions and answers, interact with their families, provide them the help they need, and have a great interaction. I’ve had many patients provide exceptional comments on the satisfaction that they’ve received from the care we’ve delivered through the telemedicine system in ways that I’ve rarely seen colleagues get in person. So I think it’s much more about how you interact with the patient as opposed to where you’re interacting from.

How do rural areas address the issues of having few doctors and limited connectivity?

My interest in the rural community is because it’s the area that has the greatest need. Look at the evolution of healthcare over the last 40 or 50 years. If I had graduated from residency in 1970 and moved to rural community, I most likely would have been able to do almost anything in that community — minor surgeries, delivering babies, primary care, and a host of things. Over the last 40 or 50 years, as we’ve evolved clinically as a profession, we’ve gone from just a few specialties to almost 100 specialties, and the ability to provide a broad range of services has become more limited. Hospitals don’t have the range of services they did 20 or 30 years ago. That means people in rural communities have to actually physically leave the local community and drive to an urban area to receive care from a specialist.

Many of these services could be provided virtually. Even take surgery as an example. You could have a preoperative visit, where the surgeon talks you to them about your case. You could make a trip into the city, let them examine you, figure out exactly what’s going on, have a follow-up visit before your surgery, have your surgery in the city, and then do post-op visits back in the local community. I look at it as a spectrum of capabilities that exist in combination.

These rural community hospitals are extraordinarily important. They are typically the largest employers. They bring in a lot of revenue. From an economic perspective, most businesses are not going to invest in putting plants or businesses in rural communities if there’s not access to healthcare for their employees.

We have about 1,500 of them across the United States. They make up about 25% of all the hospitals in the US. Without them, our healthcare would be in a worse shape than it is today. Having access to these hospitals is important. I feel like it’s our mission see what we can do to bring high-quality healthcare.

From a strategy perspective, as it relates to the low bandwidth, we understood early on that bandwidth is going to be limited regardless of where you are. There are always limits in bandwidth. It’s less of an issue in big cities and big hospitals, but if we’re going to make a difference in communities, we had to make sure that the communications interactions are going to be good. 

We focused on creating a low-bandwidth system, and the team at Metova was excellent in helping us create that. That has served us well, because as we have conversations with health systems, some outside of the geographic United States, one of their main issues in being unable to provide telemedicine services for COVID patients is limited bandwidth. That’s as much a part of what we do as the interpersonal parts.

The patient’s experience is also driven by factors that are outside the provider’s control, such as the device form factor, bandwidth, their location, and falling back on audio-only visits because of technical limitations. How can those be managed?

Anybody who is looking at setting up a telemedicine program that will serve rural communities or people in their home has to take that into account. They have to recognize that you may go into a 75-year-old widow’s home in a rural community that doesn’t have fiber broadband connection and that may have only one cell phone provider in their community. Recognize that if you really want to make a difference for that patient in that community, you’re going to have to take those things into account. Hopefully the vendor partner that they work with will help them to work through those types of ideas and thoughts. 

One of the things I noticed very early on in this industry was that there are a lot of telemedicine systems out in rural hospitals that aren’t being used. It was like a treadmill. Someone says, I want to get in shape, so I’m going to buy a treadmill. They take it home, set it up, put on their athletic clothes, and they start walking or jogging. They got hot, sweaty, and tired and they realize it was a lot more work than they thought. They fold the treadmill up, and then a year from now, it’s a clothing rack. Many hospitals have dusty telemedicine systems sitting around that have not been used since they were rolled into the room. A lot of it has to do with not being aware of some of the challenges that exist, which include bandwidth for providing these services to patients.

Why have telemedicine visit volumes dropped after lockdowns ended?

A lot of the telemedicine that was being done during the lockdowns was really just Zoom calls. They were not full-fledged telemedicine exams. I think a lot of it has to do with the fact that physicians still want to be able to not only see their patients, but be able to take vital signs, do exams, and listen to heart and lung sounds. That really wasn’t in play a whole lot during COVID. The other part of it is that there is still some lack of clarity as to the volume of visits that are being done today. I’ve seen varying numbers. 

People are still trying to learn and figure out how best to do it. They’ve made some headway in using telemedicine, but there’s still a lot of resistance. If we talked about telemedicine last year at this time, only about 25% of physicians in the United States were doing any form of telemedicine, and less than 1% of all visits in the US healthcare system done last year were done by telemedicine. So there is still a strong lack of real knowledge and understanding about how to put a program together, and what we are really saying when we say we’re doing a telemedicine visit, going back to whether it involves full diagnostic capabilities or just two people talking about their health issues.

What is your reaction to investor enthusiasm about telemedicine-related vendors?

Telemedicine was first listed in the medical literature in 1974, if I remember correctly. It has been around a lot longer than people think. Companies like Teladoc and Doctor On Demand have been able to commoditize a service that has always been available to most people. Ten years ago, if you had a family doctor and weren’t feeling well on a Friday night, you had the ability to call the office. The on-call doctor would talk to you, ask you about your symptoms, and call you in a prescription for an antibiotic. If you didn’t have a doctor, you didn’t have access to that service. 

Having a Teladoc or Doctor On Demand allows everybody to have that capability, so that when they need something, they can make that phone call. They found a way to turn that into a business, but that’s a very small percentage of all the healthcare service that we are providing today. Acute care is about 20 to 25% of the total visits being provided in the US healthcare system, and there’s only so much you can do when you’re just having a conversation with a patient about their healthcare. You can’t get vital signs. You can use the camera to look at a rash or at the back of somebody’s throat, but there’s a lot of variability in lighting, motion, and distance. 

If we’re being honest, most visits, even through those types of companies, are probably being done without the use of video. The vast majority of those are done just by having a conversation with the patient, understanding what their complaints are, and then talking about how to manage it.

Are you concerned as a physician that primary care, especially in young adults, has turned into episodic, as-needed encounters via video or urgent care centers?

The market will have to correct itself on that. People will overuse this capability, bad outcomes and customer dissatisfaction will result, and people will steer away from it or demand a better service or outcome. That will drive the change. That’s probably natural and inherent in all types of businesses and economies.

For me personally, I’ve always tried to focus on the clinical standard of care. If we can provide that through telemedicine technology, then we will, and if we can’t, then we won’t. We’re not going to do anything that won’t deliver the same level of care and service virtually that we would expect in person. Having that as a standard has served us well.

For quite a long time, we were the only physician-led telemedicine company in the country. Most all of these other companies are led by some type of executive that’s not healthcare oriented. In many companies, if you go and you look at their “about us” page, even in the telemedicine space, you’ll scroll down quite a way until you find an actual physician on their leadership team. That has a big part of the problem that we’re seeing

I was struck by a statement you made to an interviewer in which you said, “”In the Airborne, they drop you in behind enemy lines and you find a way to succeed or you expect to die.” How does the Army select or train soldiers who can succeed in that paradigm, and how has that influenced how you practice medicine and business?

The Airborne has evolved since its founding right before World War II. It created a legacy for itself about who and what they did that has extended through generations. Not everybody who’s in has the same mindset, and sometimes somebody is assigned to a unit who may not want to be there. But for the most part, the esprit de corps that exists within the 82nd Airborne Division is of the mindset that they understand that that’s their mission. Either you go in behind enemy lines and you succeed , or you face death. Having that experience and having the opportunity to work with warriors that have that same mindset changes the way that you focus and look at managing problems.

Now in my life, failure is not really an option. I focus on what the mission at hand is, and then any way that I need to go about it to succeed. Starting a company six years ago … you hear the stories of how hard it is and how challenging it is. I don’t think there’s any way to help anybody understand what that really means, because it’s a personal journey, but it is one of the hardest things I’ve ever had to do in my life. If it wasn’t for that experience and  training in that mindset, I might have given up. I’m very thankful for having the tenacity to tackle this without any thoughts of giving up.

Where do you want the company to be in the next 3-5 years?

We are not focused on gratuitous growth. We are completely privately funded. We have very deep relationships with our clients. We help them. Most of our growth has come internally from existing clients, doing a good job and then growing the company.

I still think the market is very immature. Although COVID has pushed us towards an acceptance of telemedicine, I see a lot of people still doing it incorrectly. We are in a phase right now where people are going to get the opportunity to try to do some telemedicine and they’re going to fail. They’re going to look to companies like Innovator Health to say, we hadn’t done telemedicine before COVID. We tried it during and after COVID. It hasn’t gone really well. We see the success that you’re having with a lot of these other health systems. Can you help us? We will be right where we want to be during that time to help them.

I’m quite comfortable being the biggest company that nobody’s ever heard of. Our focus is on making sure that health systems have the ability to reach out and connect with communities. We don’t want it to be about us. We want it to be about the relationship between the patient and the provider.

Do you have any final thoughts?

I appreciate the opportunity to share what we’re doing. People really don’t understand the capacity of what we have the ability to do until they actually see it. If someone says, this is interesting but I don’t think it’s right for us, then I would say they should definitely reach out and let’s talk.

From a “if I knew then what I know now” perspective about telemedicine, I always encourage people to try to do something. People talk about doing a telemedicine program, they try to set something up, then they try to do too much at once and they don’t wind up doing anything. Start a small project, learn and grow from that. You’ll see that in time, small projects will turn into something large and successful, as long as you take the leap of going out there and trying to get something done.

Morning Headlines 10/21/20

October 20, 2020 Headlines No Comments

LabCorp Transforms the Clinical Trial Experience And Streamlines the Drug Development Process

LabCorp will use the capabilities of its recently acquired mobile nursing provider GlobalCare and remote clinical trials software vendor SnapIoT to connect patients with its Covance drug development contract research organization business.

Netsmart Acquires Tellus: Adds Seamless Electronic Visit Verification Capabilities and Enhancements to the Netsmart Population Health Management Offering

Netsmart acquires Tellus, an electronic visit verification and claims processing company that is focused on home health, long-term care, and human and state services.

eVisit Closes $14 Million in Series A Funding Led by TVC Capital

Virtual care company EVisit wraps up a $14 million Series A round of financing led by TVC Capital, bringing its total raised to just over $25 million.

News 10/21/20

October 20, 2020 News 3 Comments

Top News

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LabCorp will use the capabilities of its recently acquired mobile nursing provider GlobalCare and remote clinical trials software vendor SnapIoT to connect patients with its Covance drug development contract research organization business.

Covance will offering tools that include consents, patient-reported outcomes, clinical outcomes assessments, telehealth, connected devices, and digital mobile nurse visits and sample collection.

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LabCorp says its technology platform will reduce administrative tasks, improve trial resiliency, and maintain drug study continuity to improve patient-centric trial experiences. 

LabCorp’s clinical trials design includes direct-to-patient recruitment, telemedicine, and access to its 2,000 patient service centers and its contact center.


Reader Comments

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From Slightly Advanced Member: “Re: HIMSS. Looks like they need money — they are selling certificate frames.” HIMSS is offering advanced members expensive frames for their HIMSS certificates. Those with inflated egos must be the target audience since I can’t imagine putting a HIMSS-issued certificate on an “I’m so proud of me” wall, with or without a $150 frame. Selling frames via a partner is common for schools and member organizations, however, and I don’t have a problem with them doing so since the market will validate the idea.

From You Do You: “Re: HIMSS. I’m going to demand that HIMSS refund my three HIMSS2020 registrations since I don’t think they’ll have another conference soon, and even if they do, I’m not sure that my employers or I will want to attend. I’m already out hotel fees (due to the poor communications from HIMSS) and airfare for all of us. I’ve had no luck with anyone at HIMSS, so I’m wondering if other vendors or attendees would be interested in a class action suit?” HatchMed filed a class action lawsuit in June, but that covered only exhibit hall costs. I’m out two HIMSS20 registrations as well (for Dr. Jayne and me), but I guess we’ll need to attend HIMSS21 to cover it even if it looks unpromising.

From HLTHISNOTHIMSS: “Re: HLTH conference. It’s crazy to call HLTH another HIMSS-type of conference. It would be more appropriate to call it another JPMorgan conference or even Health 2.0 (which I guess technically HIMSS owns now, too). There is a slight overlap with the main HIMSS conference, but not really. The comparison is just not there. As to the event, the sessions were fine, but pretty bland. Take for example John Halamka, who could do a great talk, but ended up just announcing the new Mayo partnership. Disappointing. I guess you could set up meetings, but the interface for that was kludgy and the motivation virtually to do so was tough. Otherwise, the meeting lacked any sort of attendee engagement which was sad since that’s where 80% of the conference value lies.”

From CareManagerIT: “Re: HLTH conference. Our sales team saw the most value in the 1:1 meetings, with the caveat that there were some logistical hurdles in terms of coordinating rescheduled meetings. It would have been nice to incorporate some SMS messaging that sends notifications to the meeting requestor’s phone when changes happened rather than having to check the portal continuously and risk missing important scheduling updates. I also think the virtual booth was more of an asset that was helpful in allowing our meeting targets to check us out, but not very useful by itself because there were so many exhibitors and attendees likely prioritized the agenda sessions and meetings over actually taking the time to see who had a booth. Scheduling and rescheduling should have some sort of feature that makes both parties agree on a meeting time. Having an SMS feature sounds like a great idea. There really is no way of knowing when someone reschedules or cancels a meeting without accessing the portal constantly. Meetings ended abruptly, followed by immediately starting another session. Five-minute intermissions between some time blocks for bathroom breaks, water, food, etc.”

From IANAL: “Re: Olive’s use of the term cybernetics. Olive and other operational improvement companies (like SAP) have to market this way. Who is the buyer of Olive? Managers. What does Olive do? Work around bad process or existing implementation at healthcare organizations. Who is responsible for the process or implementations being bad? Managers. Bad managers generate bad process and are susceptible to buzzword-based initiatives, so Olive’s marketing cleanly targets both the people who have the need and are able to buy. It’s like how scammers leave typos in their emails – they only want to catch the dumb ones.”


HIStalk Announcements and Requests

Listening: Miley Cyrus, covering “Zombie” by the Cranberries in a virtual fundraiser for Save Our Stages. I was listening to the original as I occasionally do and ran across this new version by accident, which along with her “Black Mirror” appearance makes me appreciate Cyrus even more. She can definitely belt it out and I appreciate that she didn’t feel the need to personalize the original with her own embellishments (see: the B-list musicians who murder “The Star-Spangled Banner” before sporting events, where its appropriateness was already in question).


Webinars

October 27 (Tuesday) noon ET. “Don’t Waste This Pandemic (From a Former Healthcare CEO).” Sponsor: Relatient. Presenter: Monica Reed, MD, MSc, former CEO, Celebration Health. Some healthcare organizations are trying to get back to the normalcy of 2019, but tomorrow’s leaders are accelerating even faster in 2020. Two- or three-year roadmaps were accomplished in six months, so what’s next? The presenter will describe how technology was changing before COVID-19, how the pandemic accelerated plans, what we can expect to see as a result, how leaders and providers can adapt, and what healthcare’s digital front door looks like going forward and how it can be leveraged.

October 28 (Wednesday) noon ET: “How to Build a Data-Driven Organization.” Sponsor: Newfire Global Partners. Presenters: Chris Donovan, CEO and founder, Adaptive Product Consulting; Harvard Pan, CTO, Diameter Health; Jason Sroka, chief analytics officer, SmartSense by Digi; Jaya Plmanabhan, data scientist and senior advisor, Newfire Global Partners; Nicole Hale, head of marketing services, Newfire Global Partners. The panel of data experts will discuss the opportunities that data can unlock and the challenges involved with becoming a data-driven organization. Attendees will learn why having a data strategy is important; how to collect, manage, and share data with internal and external audiences; and how to combat internal resistance to create a data-driven culture.

October 29 (Thursday) 1 ET. “How Presbyterian Healthcare Services Is Preparing for a Post-Pandemic Future Using Digital Care Tools.” Sponsor: Bright.md. Presenters: Ries Robinson, MD, SVP/chief innovation officer, Presbyterian Healthcare Services; Ray Costantini, MD, MBA, co-founder and CEO, Bright.md. Presbyterian Healthcare Services changed the way New Mexico patients access healthcare with its pres.today digital front door, which has given patients easy access to care during a global crisis. The health system’s digital care strategy goes beyond simply offering virtual visits and instead makes every episode of care — regardless of where it is delivered — better by streamlining clinical workflows and by directing patients to the most appropriate venue of care. The presenters will describe how Presbyterian has continued to meet patient needs during the pandemic, how it is deploying digital tools to tackle the combined COVID-19 and flu seasons, and how the health system is innovating care delivery to prepare for a post-pandemic future.

November 11 (Wednesday) 1 ET. “Beyond the Firewall: Securing Patients, Staff, and the Medical Internet of Things.” Sponsor: Alcatel-Lucent Enterprise. Presenter: Daniel Faurlin, head of network solutions for healthcare, Alcatel-Lucent Enterprise. The biggest cybersecurity risk for healthcare IoT isn’t the objects themselves, but rather the network door they can open. This webinar will address meeting the challenges of security, management, and monitoring using ALE’s Digital Age Networking, a single service platform for the network infrastructure that includes an autonomous network, onboarding and managing IoT, and creating business innovation with automated workflows. Specific use cases will be described, including COVID-19 quarantine management, locating equipment and people, and ensuring the security of patients.

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


Acquisitions, Funding, Business, and Stock

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I missed this previously: Google Glass-powered remote scribe service Augmedix secures $25 million in private placement financing and completes a reverse merger with Malo Holdings, which will rename itself to Augmedix, Inc. and list shares on the OTCQB market for early-stage companies. The San Francisco-based company has raised $107 million since launching in 2012. Here’s some interesting analysis by Kevin O’Leary:

Augmedix, the startup that uses Google Glass for medical documentation, is going public via a reverse merger that includes a $25 million investment into the company. The Form 8-K filed as part of the detail is full of interesting details on Augmedix’s business and the medical documentation space in general, if it’s your jam. The business overview starts at page 8 of this SEC filing. The filing highlights how hard it is to build digital health companies – Augmedix has been working on this company for eight years and it currently has 510 providers on the platform (as of June 2020). Average revenue per doc currently sits at $30k – they did around $14 million of revenue in 2019. Their gross margin is only at 33% for 2019 as they’re paying other vendors to do the remote documentation services. What started off as a super cool tech story (Google Glass for AI scribing!) has become a very human labor intensive service (remote medical scribes). It appears they’re currently in a precarious financial spot as their debt obligations exceed cash reserves.

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Netsmart acquires Tellus, an electronic visit verification and claims processing company that is focused on home health, long-term care, and human and state services. Netsmart will incorporate its EVV capabilities into the CareFabric population health management portfolio.

Clinical services telemedicine provider SOC Telemed, which will be going public in a Special Purpose Acquisition Company merger and begin public trading on November 2, says 2020 bookings will increase 100% year-over-year to $12.5 million. The SPAC transaction values the company at $720 million.


Sales

  • Five orthopedic groups choose MedEvolve for revenue cycle management and workflow automation.

People

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Stephanie Reel (recently retired from Johns Hopkins University) will serve as interim CIO of Washington University in St. Louis.

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Matt Dinger (Central Logic) joins Solutionreach’s SR Health business as VP of professional services.

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Zac Jiwa (Zeem Consulting) joins Olive as EVP/GM.


Announcements and Implementations

Cerner is seeking health systems to help test its Nuance-powered Voice Assist technology for clinician EHR interaction, joining St. Joseph’s Health and Indiana University Health. 

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A report by the Center for Connected Medicine and KLAS finds that eased regulations and increased reimbursement have made telehealth an increased priority for health systems, jumping from 26% of them pre-pandemic to 49% now. Nearly all respondents say their telehealth ramp-up fully met demand, but also exposed integration weaknesses, especially when their chosen technology was not purpose-built for healthcare. Respondents say they will continue to focus on telehealth in 2021, but post-pandemic regulation and payment remain as obstacles — only 20% of health systems say they will continue doing virtual care if reimbursement returns to pre-COVID levels. Volume of use is the top metric being used to evaluate telehealth programs. The pandemic has also increased interest in AI, with clinical decision support and dictation being the most common use cases. Respondents said that revenue cycle management is the area that is most in need of disruption and innovation, especially in the areas of coding and billing and accounts receivable, and new efforts will revolve around increasing telehealth revenue, allowing more employees to work remotely, and using technology to monitor revenue cycle data.


COVID-19

CDC says that the pandemic has seen 285,000 more deaths than the historical baseline from February 1 to September 16, two-thirds of those caused by COVID-19 and the rest from other causes. The 25-44 age group had the largest excess death rate of any age group at 26.5%.

President Trump said in a campaign call Monday that, “People are tired of hearing from Fauci and all these idiots” and toyed with the idea of firing him. He also told attendees of his political rally that CNN is “dumb bastards” for continuing to cover the pandemic, adding that CNN’s intention is to keep people from voting. Meanwhile, National Institute of Allergy and Infectious Diseases Director Anthony Fauci, MD was almost simultaneously receiving the National Academy of Medicine’s Presidential Citation for Exemplary Leadership, which also issued him its 2020 leadership award for his “deft, scientifically grounded leadership in shaping an effective response to the COVID-19 pandemic.”

A Kansas nursing home reports that all of its 62 residents have tested positive for COVID-19, of which 10 have died and one is hospitalized. Some staff members have also tested positive.

Several Southern California health systems refused or delayed COVID-19 patient admissions because of their insurance status, a Wall Street Journal report finds, adding to the strain of the hospitals that were already overrun.

KFF and Epic Health Research Network say that hospital admissions dropped one-third during the peak COVID week in mid-April, with the total decline from March through August representing 6.9% of the total expected admissions for 2020. Admissions for patients under 65 dropped only 10% from the expected number, while those involving patients 65 and older dropped in half during March and April. Hospitalization numbers bounced back to 94% of that expected by mid-July.

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The UK government awards pharma contract research organization Open Orphan a contract to develop a model for a COVID-19 human challenge tests, in which people who have received vaccines that are being developed will then be injected with small amounts of coronavirus to see how well the vaccines protect them. Open Orphan’s HVivio operates FluCamp, where paid volunteers are studied in a two-week residential program for cold, flu, COVID-19, and other viral respiratory infections.


Other

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The University of Virginia Health System makes news once again for its debt collection practices. The health system, which made headlines last year for suing patients 36,000 times over six years, continues to rely on property liens to collect on old bills. Though liens in the state expire after 20 years, UVA Health often renews them, giving it the ability to seize properties through 2039 for bills dating back to the last century.

Dickinson County Healthcare System in Michigan recovers from a ransomware attack over the weekend that compromised access to some of its computer systems.


Sponsor Updates

  • Cerner shares insights from its first virtual healthcare conference.
  • Change Healthcare exhibits at MGMA’s virtual Medical Practice Excellence Conference through October 21.
  • CloudWave and Neptuno partner to deliver cloud services to hospitals using Meditech in Puerto Rico and the Caribbean.
  • PatientPing commends its community of MSSP ACOs for generating over $527 million in shared savings – a 20% improvement over last year.

Blog Posts


Contacts

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

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Morning Headlines 10/20/20

October 19, 2020 Headlines No Comments

WhiteSpace Health Announces Plans to Accelerate Growth and Expand its Product Offerings

WhiteSpace Health will use an undisclosed amount of new funding to further scale its RCM and practice analytics offerings and expand its sales and marketing team.

Tampa General Hospital Uses BMC Automated Data Solution to Collaborate with Hospitals and Fight COVID-19

Tampa General Hospital uses software from BMC to provide a dashboard view of real-time, COVID-19-related data from 51 hospitals through the Florida West Coast Regional Data Exchange.

Twentyeight Health Raises $5.1M to Expand Access to Reproductive Healthcare for Underserved Communities

Birth control prescription delivery startup Twentyeight Health raises a $5.1 million seed funding round led by Third Prime.

HIStalk Interviews Feyi Olopade Ayodele, CEO, CancerIQ

October 19, 2020 Interviews No Comments

Feyi Olopade Ayodele, MBA is co-founder and CEO of CancerIQ of Chicago, IL.

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Tell me about yourself and the company.

I started CancerIQ when making the transition from the world of finance into healthcare. I joined healthcare with an amazing co-founder, my mother, Dr. Funmi Olopade. She’s not only a great mom, but she’s a MacArthur Genius Award winner for her work in understanding the relationship between cancer and genes.

I was motivated to start the company after working with her at the University of Chicago and realized that her vision was for genetics to be part of routine care, but that was really only possible in some of the academic centers that have those resources. I’m all about democratizing access to what we believe is the most cutting-edge version of care. That’s why I left the University of Chicago to start CancerIQ.

To what extent can cancer be predicted using genetic profiles?

To a great extent. In fact, the first cancer gene that was identified was the BRCA gene. Despite us having known for 30 years that the BRCA gene causes breast and ovarian cancer, there has been unfortunately limited adoption of genetic testing. About 10% of patients who should be tested, even for the BRCA gene, have been tested. What’s also exciting is that they can not only understand your risks, but there are also well-defined clinical protocols that have been validated to help you reduce your risk, or eliminate that risk altogether.

Many oncology treatments aren’t pursued because of insurance or other financial issues. Does insurance cover the cost of genetic screening?

Absolutely. The insurance companies have done the math. It’s expensive to treat a patient, only to have them come back with a secondary cancer that you could have known about earlier. It’s also very expensive to treat somebody who has a predisposition and is going to get a more aggressive cancer, or get it earlier than standard cancer screening age, so payers have been willing to cover this testing.

What has held providers back is knowledge, workflow, and time. We’re solving those with CancerIQ.

What is involved in doing the screening and what kinds of providers can offer it?

Risk assessment starts off with the cheapest genetic test available, and that’s your family history. While it costs nothing to evaluate your cancer history, if you’re like me and have 31 first cousins, it could take a provider a whole lot of time. That’s one of the initial barriers that holds people back from this process. It’s time-consuming to see who meets the criteria for genetic testing, but it’s also time-consuming to fill out all the insurance paperwork to get coverage for it. 

In terms of the types of providers who can perform the screening, genetic testing was initially incurred in specialty care. Genetic counselors were given this responsibility, but unfortunately, millions of patients need this service and we have only 700 cancer genetic counselors. A number of professional societies encourage doing this kind of genetic evaluation, ranging from oncologists to OB-GYNs, who have been on the forefront of doing this in preventative care.

Can the screening be performed in a telehealth visit?

Absolutely, and that’s where we have seen the biggest traction, during COVID, when people are anxious about going in for their cancer screenings, CancerIQ is a mechanism by which providers can evaluate their patients remotely and give them peace of mind on whether or not they can afford to delay their cancer screening or determine if they must be prioritized to be screened earlier rather than later.

What would the trigger be that would suggest that an individual is a candidate for screening?

Pretty much every patient should get a CancerIQ at some point in time. What we see as the future of healthcare is being proactive and preventative. If we could know everyone’s risk by the age of 21 in the future, it could help with better, more personalized, or precision health recommendations so that people can get ahead of cancer.

Is there psychology involved in telling that 21-year-old that they are genetically predisposed to get cancer decades down the road?

I would say that 21 is probably a little early because there aren’t too many established guidelines that would change the way you’re managed at the age of 21. But that depends on your risk. If you are at an elevated risk and many people who have these predispositions will get cancer under the age of 30, then you should start some of these screenings under the age of 30. I don’t want to opine on when you should start, but what is exciting about the future of healthcare is that you could get a genetic evaluation at a certain age, and through CancerIQ, your provider can monitor and manage you over time.

An individual’s genetic makeup doesn’t change over time, but new research findings about the health implications of DNA are ongoing. How do you collect those new findings and reapply them to existing genetic profiles?

You hit the nail on the head. While your genetic data will not change, the interpretation of that data and the recommendations on how to address that predisposition will change all the time. In fact, they change almost quarterly. That’s why CancerIQ has a great, purpose-built use case alongside the EHR. At the end of the day, we are a content engine that can help interpret that information, not only for the provider, but to make sure that patient is getting the most up-to-date care.

What elements of patient engagement are involved in regularly reapplying that new knowledge to someone’s profile and then communicating any new concerns?

That’s where CancerIQ has differentiated ourselves as a solution that will manage a longitudinal relationship with the patient. We not only have provider features that provide clinical decision support, but we also have cutting edge patient engagement features that allow them to receive reminders and updates through the CancerIQ platform. Eventually we will make it so the patient can carry their CancerIQ from one place to another.

What are the typical steps in a patient journey in interacting with your system?

I’ll use the BRCA case because that’s probably the easiest for people to picture. When you check in to a provider visit from the comfort of your own home, you provide your family history. It’s a lot easier for you to recall the cancer in your family than for your provider to interview you to find it out, so we take that burden off the provider. If you are at elevated risk, we will generate some patient education for you and your provider will have a discussion about the need for genetic testing. That’s where your provider will be able to use the test platform to order testing from a number of our embedded genetic testing partners, where CancerIQ will ultimately facilitate the ordering of that test.

As I mentioned before, providers are being held back by filling out the insurance documentation paperwork. Patients who go through the CancerIQ experience are going to be working with providers who have a streamlined, easy way of making sure it’s covered by their insurance. They have peace of mind that they won’t really need to pay much out of pocket. When they get their test results back, they’ll get a personalized action plan based on their genetic testing results.

Some of those action plans could be things like getting a breast MRI in addition to a mammogram. In the COVID context, it could be that you were at the top of a priority list for someone who needs the breast cancer screening because of your level of risk and ultimately that early detection strategy isn’t something that happens once. As a patient, you’ll get a reminder every year that you need to get that breast MRI. Should the guidelines change, where they say, “Maybe we need to do one of those really cool blood detection cancer tests in the future,” CancerIQ will communicate that to the patient so that they ultimately have not only the most clinically valid options, but the best options for detecting cancer early or preventing it altogether.

Consumer DNA test results often surprise people whose blood relatives don’t necessarily match what they have believed, with unknown siblings or different parents than they were raised with. How useful is the self-reported family history compared to actually testing someone’s DNA?

The future of healthcare is going to be genome-first. Family history is what we had in place and is the earliest form of risk assessment. We of course continue to support that. But part of the real value in CancerIQ, and where we see the healthcare ecosystem heading, is that we will be able to do genetic testing on people, and we may reach to that first. But as we reach to doing the testing first, what will become more important is the interpretation of the testing, the clinical decision support, and a lot of the intelligence layers that CancerIQ offers. If you don’t know your family history, CancerIQ can still interpret that genetic data to get you the right preventative health care plan.

Most investors are older white men who, consciously or subconsciously, tend to fund startups that are led by founders who are like a younger version of themselves. How do you pitch the company for funding knowing that’s the case?

I always pitch my company in the way I know it will resonate with an investor. I started my career in finance and used to be an investor. To get over the hurdle of them looking for a younger version of themselves, I’ve always shown them data on the value of our company and the traction that we’ve made. We have demonstrated that we are extremely valuable to some of the best health systems in the country. We are data-driven in showing how we can increase their downstream revenue, detect cancer early, and even improve their cancer screening rates. I’ve always had to lead with data to overcome some of those biases. Once they see the incredible performance and traction of CancerIQ, it typically gets me to the next meeting.

What do you see happening with the company over the next 3-5 years?

I see the market growing, primarily driven by the science. We understand the correlation between cancer and our genes, but we’re also starting to learn a lot more about cardiac diseases and other chronic conditions. I see the company in the next 3-5 years meeting that need and expanding from CancerIQ to CardiacIQ and ultimately being able to support full genome-based care.

I also see this moving from something that is done only in specialty care to becoming part of a primary care visit. Decision support technologies and things that can offer artificial intelligence will be a huge part of what we do in the future.

Do you have any final thoughts?

CancerIQ is partnering with a number of the available HIT solutions. We started off point-to-point integrations to make sure that our data gets into the EHR. But we are excited, given that we are managing content and data information that changes, by FHIR interfaces and allowing the provider to feel like they are not leaving the EHR, but are still getting the benefits of CancerIQ in their workflow.

Curbside Consult with Dr. Jayne 10/19/20

October 19, 2020 Dr. Jayne 1 Comment

There has been a tremendous amount of anxiety in the virtual physician lounge this week. One of the local hospital systems announced that they are going to start releasing all physician notes to patients via their MyChart implementation. Apparently, there was very little information provided about how confidential information will be addressed, particularly among teenagers, and physicians are concerned about the repercussions.

I’ve been watching the conversations, trying to get a feel for how the situation looks to physicians who aren’t informaticists and don’t have a full understanding of why this is happening. Some of the comments underscore the need for education and highlight the opportunity that hospitals have to make sure their medical staff members are all on the same page and understand the background:

  • Why are all the hospitals jumping on this bandwagon? Seems like just another patient engagement trend.
  • It’s an absolute mandate from CMS.
  • It’s a Medicare thing. I’m just going to do my Medicare patient notes on paper and scan them in.
  • I’m going to make a smart phrase now to explain that I’m no longer using MyChart.
  • Patient notes are for me and my colleagues, not for the patient.
  • This contradicts state law, I’m not doing it.
  • I’m just going to make my notes very sterile, generic, and useless in order to avoid patients freaking out about things they don’t have the training to understand.
  • There’s a $1 million fine if you don’t do it.
  • X health system has an option to “not share the note.” I assume this is going away.
  • Y health system just implemented an option to “not share,” I guess this is due to the new requirement.
  • No patient ever needs to see the back and forth messages between my staff and me, whether it’s in their chart or not.
  • I’m just going to make shadow charts on all my patients.
  • I hope they take this into account with the patient satisfaction surveys. Patients are going to hate seeing the real truth about themselves.

To be honest, I was surprised by how bitter and angry some of the comments were. It made me a bit embarrassed to be part of the physician community in my area.

At least there were a couple of physicians who chimed in who had previous experience with OpenNotes, trying to reassure people that it won’t be as bad as they are anticipating. Another pointed out a positive experience with patients who claim they were never advised of various parts of the treatment plan, but it was clearly documented in the notes they received after the visit, which led to some good discussions with patients who could benefit from taking charge of their health.

It was a very different conversation than the one going on among my clinical informaticist peers, who have been detailing their plans in various informatics forums. It sounds like there is a strong consensus on only releasing ambulatory notes and test results after they have been signed by the responsible physician, and only releasing inpatient documents after discharge, but that’s where the consensus ends. However, there has been some good discussion around the fact that the regulations are somewhat vague and it’s not clear whether “progress notes” includes all progress notes (such as nursing, physical / occupational / speech therapy, social work, etc.) or just physician notes.

Some health systems are running full speed ahead for a November 1 go live, but others seem to be biding their time hoping that there will be a delay in enforcement. Although I see the value of patients having access to their notes, most health organizations are pretty strapped right now, what with the pandemic and all. Many of my independent physician friends are barely keeping their heads above water, with another one deciding to retire at the end of the calendar year. I think there are quite a few of them who wish that a health system would acquire them, but it doesn’t seem like there’s a lot of available cash for practice purchases these days.

How is your organization preparing for the upcoming mandate? Do you think your physicians understand what it’s all about? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 10/19/20

October 18, 2020 Headlines No Comments

Allscripts Software, LLC v. CarePortMD, LLC

Allscripts files a trademark lawsuit against telemedicine and urgent care startup CarePortMD, claiming the market could confuse its name with CarePort Health, which Allscripts is selling to WellSky.

HST Pathways, healthcare software provider, approaches sale

Sources report that ambulatory surgery center software vendor HST Pathways is nearing a sale of the company.

Surgical Information Systems Secures Growth Investment from Accel-KKR

Private equity firm Accel-KKR makes a majority investment in Surgical Information Systems, which offers anesthesia information management systems and perioperative software to hospitals and ASCs.

Monday Morning Update 10/19/20

October 18, 2020 News 1 Comment

Top News

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Allscripts files a trademark lawsuit against telemedicine and urgent care startup CarePortMD over its name. Allscripts says CarePortMD is confusingly similar to the name of CarePort Health, which Allscripts is selling to WellSky, and the healthcare market will be confused.

CarePortMD changed its name from ER at Home in September 2018. CarePort Health earned its trademark in early 2013.

Googling “CarePort” returns Cascade Pacific Action Alliance, whose Community CarePort does basically exactly what CarePort Health’s software enables. That program was launched in late 2018.


Reader Comments

From Mighty Boosh : “Re: HLTH conference. I’m wondering if readers could share their reviews and recaps about how it went virtually? I’ve always thought it was silly to have another HIMSS-type conference, but the speaker lineup this year looked great even though I didn’t muster up the $700 to register.” I would be interested in knowing myself. Any attendees want to jot down their thoughts?

From Hospital CIO: “Re: today was a good day. It was boss day and our administrative team put together a nice spread of goodies. A team member who has struggled with the impact of their behavioral self-awareness send me a note thanking their manager for their patience and guidance through a difficult time. In corporate news, Allscripts told employees they will pay back those who were affected by temporary salary reductions during COVID and HCA said it will return its $6 billion in government COVID funding. Good news should lift the spirits of all of who who are dealing with COVID and its related impact on our jobs and personal lives. It might even influence others to do something for the ground troops.”

From Stretched Spandex: “Re: cybernetics. Olive hired executives for jobs with cybernetics in their title. Does that actually mean anything?” Cybernetics is a fancy term for creating a device or system that controls a process automatically using a feedback loop, like a thermostat or self-driving car. Olive describes its Olive Helps as “using cybernetics to provide real-time intelligence while they’re [human workers] handling their most critical tasks.” Its examples are less lofty that the term used to collectively describe them — checking insurance coverage, pushing work lists to nurses, standardizing OR preference cards, and dynamically adjusting materials inventory and ordering. The bottom line is that if it can do that work as well as humans without the cost that humans bring with them, it should be useful, at least if hospitals are willing to use it and to offset the expense by reducing headcount. But you could say that with most any healthcare software.

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From Undulating Wave: “Re: [vendor name omitted]. I resigned to take a higher-paying job. They have offered to match the offer I received. Should I stay where I am, which would result in less family disruption?” I would take the new job. Buy-backs rarely benefit either the employee or the employer. You had reasons to leave a company that has failed to pay you the market value that you command, so why would you want to stick around? And why should they give you more money now when you’ve already proven yourself to be available to the highest bidder? It is true, however, that employers rarely make an effort to compensate people according to their contribution or value, so someone’s paycheck often reflects (a) less than they would get if they shopped their skills elsewhere, thus they will need to move out to move up, or (b) they are overpaid or have low-demand, easily replaceable skills and should do they can to keep the job they have. I’m a Maslow’s Hierarchy guy and would say that money should be a motivator only to the extent you earn enough of it to be comfortable, which then leaves belonging, esteem, and self-actualization, which is asking a lot of the company that is buying your time. You gain skepticism of the employer-employee relationship once you’ve been marched off their property while carrying a shockingly small box of your now-pathetic personal effects.


HIStalk Announcements and Requests

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Presentation style is what keeps webinar attendees engaged, poll respondents say. Don’t be boring or read your slides, don’t rehash material the audience already knows, and don’t present content that fails to deliver what the abstract promises (I usually see that when someone other than the presenter writes the abstract and learning objectives). I’m sure those presenters are torn in making their slides (a) detailed enough for non-attendees to review standalone afterward, versus (b) not so detailed that the speaker’s presence is superfluous because everything they have to say is right there on the slide. I suppose that leads to a more philosophical question – how can a webinar (or a podium presentation, for that matter) add value over just writing an article instead? I think the answer probably involves answering attendee questions, unless the presenter is to enthused and personable that the written word alone can’t do their content justice.

New poll to your right or here: Have you taken a consumer DNA test such as AncestryHealth or 23andMe? I have heard countless stories about people whose test results indicated that a parent or sibling wasn’t genetically connected or that they had brothers or sisters they didn’t know about. Most interesting is that those services invite you to make a connection with those strangers whose DNA you share as a previously unknown parent, child, or sibling. The most common surprise seems to be men who fathered children unknowingly or people who raised someone else’s child as their own. My conclusion: it may not be as useful as we think to ask patients about their family medical history when the social and DNA versions of “family” aren’t the same.


Webinars

October 27 (Tuesday) noon ET. “Don’t Waste This Pandemic (From a Former Healthcare CEO).” Sponsor: Relatient. Presenter: Monica Reed, MD, MSc, former CEO, Celebration Health. Some healthcare organizations are trying to get back to the normalcy of 2019, but tomorrow’s leaders are accelerating even faster in 2020. Two- or three-year roadmaps were accomplished in six months, so what’s next? The presenter will describe how technology was changing before COVID-19, how the pandemic accelerated plans, what we can expect to see as a result, how leaders and providers can adapt, and what healthcare’s digital front door looks like going forward and how it can be leveraged.

October 28 (Wednesday) noon ET: “How to Build a Data-Driven Organization.” Sponsor: Newfire Global Partners. Presenters: Chris Donovan, CEO and founder, Adaptive Product Consulting; Harvard Pan, CTO, Diameter Health; Jason Sroka, chief analytics officer, SmartSense by Digi; Jaya Plmanabhan, data scientist and senior advisor, Newfire Global Partners; Nicole Hale, head of marketing services, Newfire Global Partners. The panel of data experts will discuss the opportunities that data can unlock and the challenges involved with becoming a data-driven organization. Attendees will learn why having a data strategy is important; how to collect, manage, and share data with internal and external audiences; and how to combat internal resistance to create a data-driven culture.

October 29 (Thursday) 1 ET. “How Presbyterian Healthcare Services Is Preparing for a Post-Pandemic Future Using Digital Care Tools.” Sponsor: Bright.md. Presenters: Ries Robinson, MD, SVP/chief innovation officer, Presbyterian Healthcare Services; Ray Costantini, MD, MBA, co-founder and CEO, Bright.md. Presbyterian Healthcare Services changed the way New Mexico patients access healthcare with its pres.today digital front door, which has given patients easy access to care during a global crisis. The health system’s digital care strategy goes beyond simply offering virtual visits and instead makes every episode of care — regardless of where it is delivered — better by streamlining clinical workflows and by directing patients to the most appropriate venue of care. The presenters will describe how Presbyterian has continued to meet patient needs during the pandemic, how it is deploying digital tools to tackle the combined COVID-19 and flu seasons, and how the health system is innovating care delivery to prepare for a post-pandemic future.

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


Acquisitions, Funding, Business, and Stock

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Sources report that ambulatory surgery center software vendor HST Pathways is nearing a sale of the company.

The UK Space Agency provides funding for Apian, which was founded by two medical students who are also NHS Entrepreneurs to create a nationwide NHS Air Grid to support COVID-19 related lab sample and supply delivery. The company has created a healthcare drone API to simplify adoption. The company launched its first drone, which can carry 4.4 pounds of cargo for up to 60 miles, on Saturday.


Announcements and Implementations

Blue Shield of California saves $10 million in prescription costs over two years by using Gemini Health’s drug cost transparency tool, which integrates with the EHR to give clinicians prescription cost information and alternatives at the point of prescribing.

PatientKeeper announces GA of Charge Aggregator, which allows central billing offices to reconcile and process charges generated across facilities, specialties, and systems.


COVID-19

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The tough COVID-19 winter and third surge are getting an early start, as new US cases top 55,000 per day and hit 69,000 on Friday, 14 states are recording their highest-ever new case counts, and hospitalizations are steadily rising. Some states are warning their residents that hospitals are full. Test positivity exceeds 20% in ID, IA, SD, and WI. IHME projects 181,000 more deaths by February 1, which would take the US death count to 400,000.

The 2020 federal deficit hits a record $3.1 trillion from pandemic spending, more than 2.5 times the previous record from 2009, exceeding the gross domestic product for the first time since World War II. Both presidential candidates have proposed trillions of dollars of additional debt should they win. The total US government debt is at $27 trillion.

ProPublica ponders how the CDC — the agency that defeated smallpox globally and polio in the US – is widely perceived as being ineffective during COVID-19. The publication concluded after speaking to former and current employees that: (a) the White House meddles in its work by emphasizing politics over science; (b) CDC’s top leadership is ineffective and caves under White House pressure; (c) CDC fumbled the early rollout of COVID-19 tests, allowing the pandemic to spread unchecked; (d) CDC’s budget was reduced, which forced it to reduce its global involvement; (e) the White House blames Director Robert Redfield, MD for China’s lack of COVID transparency; (f) CDC has been sidelined as the president publicly rejects science with inaccurate claims and the touting of unproven cures; (g) CDC ceded to White House demands to downplay public health concerns about testing, cruise ships, school re-openings, and religious gatherings, which forced CDC to reverse its publicly announced guidelines; and (h) the White House shut down CDC’s hospital data tracking system and turned it over to TeleTracking.

A New York Times article reminds that no test can determine whether someone who has had coronavirus is still contagious, even as recently recovered politicians and football coaches return to public gatherings claiming that their negative tests prove they can’t infect anyone. A physician commenter also notes that one of the many things that nobody knows about coronavirus is how much viral load is needed to be infectious. Studies are beginning to shore up the argument that higher levels of viral load drive poorer outcomes, but not the level of infectiousness or the severity of symptoms.

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Twitter removes a tweet in which White House coronavirus advisor and neuroradiologist Scott Atlas, MD made misleading claims that masks are ineffective for reducing coronavirus spread, citing a libertarian think tank’s article. Atul Gawande, MD, MPH listed studies on Twitter that prove the effectiveness of masks. Atlas also said in a Thursday interview that COVID-19 testing should be used only to protect vulnerable populations, that large-scale testing and isolation programs infringe on civil liberties, that testing people without symptoms is “destroying the workforce,” and that herd immunity will be reached once 20-40% of Americans are infected. He previously said that increased testing is “a fundamental error of the public health people perpetrated on the world.”

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In the UK, NHS updates its COVID-19 tracing app following user complaints that it gives them an exposure warning that simply disappears when pressed with no further instructions. NHS says the message is coming from IOS and Android security. The update cause a second message to pop up that says to ignore the first one.


Other

A Texas man who was angry at a surgeon — whose practice charged him $115 for a copy of his medical records after cancelling his surgery because he hadn’t followed pre-op instructions — is indicted for online impersonation for posting the doctor’s cell phone number in Craigslist ads. The man initially admitted only to calling the doctor’s cell phone at odd hours with caller ID blocked, but he later later told detectives that he posted ads that were either sexually suggestive or that offered free Doberman puppies, in both cases specifying that calls and texts would be accepted only after 10 p.m. Craigslist records indicated that he had used the platform to complain about the doctor’s business and to ask female readers to send him nude pictures.


Sponsor Updates

  • The VA has used the Nuance Dragon Medical One speech-recognition cloud platform and PowerMic Mobile microphone app since the start of the pandemic to help physicians document care through its expanded telehealth services.
  • RxRevu’s SwiftRx Direct real-time prescription benefit solution is now available within Athenahealth’s EHR.
  • The Chartis Group names Greg Benton (Grant Thornton) ERP practice leader within its informatics and technology practice.
  • Redox releases its latest podcast, “Getting Paid from Medicaid with Rachel Dixon of Prime Health.”
  • Relatient adds new partners for print and mailing statements to expand RCM services.
  • Ludwig-Maximillians-Universitat in Germany implements Visage Imaging’s Visage 7 Enterprise Imaging Platform across all of its radiology and subspecialty imaging departments.
  • Waystar will present and exhibit at MGMA’s virtual Medical Practice Excellence Conference October 19-21.

Blog Posts


Contacts

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

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Weekender 10/16/20

October 16, 2020 Weekender No Comments

weekender


Weekly News Recap

  • Private equity firm JLL Partners acquires analytics solution vendor MedeAnalytics from Thoma Bravo.
  • Digital check-in vendor Clearwave acquires Odoro.
  • Allscripts announces plans to sell its CarePort Health care coordination business to WellSky for $1.35 billion.
  • Providence forms Tegria, a healthcare services business comprised of nine companies that the health system has invested in or acquired.
  • HealthStream acquires ShiftWizard.
  • Online texting-only mental therapy provider Talkspace tells providers it will cover their legal costs if they are caught providing services in states where they aren’t licensed.

Best Reader Comments

Just wondering. What happened to blockchain as the savior of IT? (Former CIO)

The DOD,VA, and USCG connecting to CommonWell FEELS like it should be big news (five years late notwithstanding), but reading the press release and the word Cerner is nowhere to be found. Are the federal legacy systems live on CommonWell before the flagship? Will any of them ever turn on Carequality, so they’ll have someone on the other end to exchange with? (vaporware?)

CarePort was the combination of three different Allscripts companies Allscripts acquired. ECIN (a company Glen Tullman company with Jeff Surges as CEO), Canopy (acquired by A4 prior to Allscripts acquisition), and CarePort (acquired by Allscripts). If you sum up the values of all three companies at their acquisition price, it isn’t as crazy a price. Still a good transaction, just not as good as it appears at first glance. (OhMDRX)

Wow that is way more than I thought Allscripts would be able to get for CarePort. The other sellable assets seem to be Veradigm and 2bprecise. Would 2bprecise stand up to an acquiring firm’s due diligence? As far as the core business goes, does Cerner has the appetite to buy and gut the whole company? I can’t think of a way that one of Allscripts EHR or EHR-adjacent software assets could be peeled off and sold separately. Practice Fusion could potentially go with Veradigm. (IANAL)

As an IT director working to launch one of the major telehealth platforms at our healthcare organization, I have been flabbergasted to find that their system is not a certified EHR and is unable of sending out industry-standard CCDs (e.g. lack the ability to include regular data set of problems, discrete medication data, allergy data, etc.) back to our EHR. They really only use the CCD as a vehicle to send over nicely formatted PDFs, which are a pain for clinicians to navigate and view to in our EHR to get the gist of what happened during the encounter. (Caveat Emptor)

t would be great if the telehealth / retail health / urgent care style practices would plug into an HIE or something, but that only benefits the PCPs,, health systems, or whoever can capture the referral. The margins in tele / retail / urgent are much thinner so there has to be a strong business case for interoperability before something gets done. Maybe PCP / health systems could pay Teladoc / Walgreens / big urgent care chain for the integration. Otherwise, these places didn’t take MU money, so they can only be incentivized with the stick when the stick comes down on everybody. (LowlyITworker)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. C in Washington, DC, who asked for three laptops for her kindergarten class. She reports, “Thank you for helping us with our technology. It really hard to get more tech for our students. This is very helpful and beneficial to my students and me during testing. My students are going to be super excited and these are right on time. We recently had computers that the sound went out on. So having replacements makes it even better. Thank you for being the reason my students smile when opening new laptops.”

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A London hospital installs a vending machine that dispenses vegan meals for employees, the first of 500 such machines that vegan meal subscription company Vibrant Vegan will install in NHS hospitals by 2023. The meals, which cost $6.50, can be microwaved or heated inside the machine in four minutes.

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Jaines Andrades started working at Baystate Medical Center in 2010 at 19 as a custodian cleaning the ORs, graduated as a nurse four years later, then became a nurse practitioner in trauma surgery.


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Morning Headlines 10/16/20

October 15, 2020 Headlines No Comments

WiserCare closes $3.6M financing round, led by UnityPoint Health Ventures

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Trump Administration Drives Telehealth Services in Medicaid and Medicare

CMS expands the list of telehealth services that Medicare will pay for during the pandemic.

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Text-based telemedicine company 98point6 raises $118 million in a funding round led by L Catterton and Activant Capital.

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Reader Comments

  • AnInteropGuy: I would hope that we have better medicine and science than we did 67 years ago. Our understanding of virus mechanisms ar...
  • Angela C. Witt: Most of the suggestions you have to improve order management in the EHR are features available in current vendor product...
  • masterblaster: I was intrigued by your statement of "Because they so tightly control access to the vendor’s documentation, I have no ...
  • IANAL: In spite of AMA lobbying, regulatory changes in the early 2000s allowed pharmacists to give flu shots. Costs fell, acces...
  • Brian Too: My theory is that telehealth is a bigger benefit for the patient than it is for the clinician (though there are clinical...

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