News 6/16/23

Top News

Oracle conducts another round of layoffs in the former Cerner business, according to employee reports on Reddit and LinkedIn. Federal business groups, specifically teams involved in the VA’s now-paused implementation, were most often mentioned.

The company also reportedly rescinded some job offers.

Oracle CEO Safra Catz said of the Cerner business in this week’s earnings call, “You will be seeing some more significant changes, and we have legal entity combination imminently and that actually gives us a lot more flexibility regarding the way we operate the business. We are just at the very beginning of it. Their margins are nowhere close to the way we run our company.“

Oracle has reportedly laid off 3,000 of Cerner’s 28,000 employees in the year since the $28 billion acquisition.

Meanwhile, the stock market likes what it heard this week and has pushed ORCL shares to record highs, valuing the company at $342 billion and the wallet of CTO and Chairman Larry Ellison at nearly $150 billion. Shares rose another 3.5% on Thursday.

Webinars

June 22 (Thursday) 2 ET. “The End of COVID Public Health Emergency is Here. Is Your Rev Cycle Ready?” Sponsor: Waystar. Presenter: Vanessa L. Moldovan, commercial enablement + insights program manager, Waystar. This webinar will describe the proactive steps that are needed to avoid increased rejections and denials. It will cover regulatory waivers and flexibilities, major shifts in telehealth, changes to reimbursement, and the impact of the end of the PHE on Medicaid coverage.

July 12 (Wednesday) 2 ET. “101: National Network Data Exchanges.” Sponsor: Particle Health. Presenter: Troy Bannister, founder and CEO, Particle Health. It’s highly likely that your most recent medical records were indexed by a national Health Information Network (HIN). Network participants can submit basic demographic information into an API and receive full, longitudinal medical records sourced from HINs. Records come in a parsed, standardized format, on demand, with a success rate above 90%. There’s so much more to learn and discover, which is why Troy Bannister is going to provide a 101 on all things HIN. You will learn what HINs are, see how the major HINS compare, and learn how networks will evolve due to TEFCA.

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

Acquisitions, Funding, Business, and Stock

Nasdaq gives Veradigm another extension to submit its annual and quarterly reports, with the company expecting to file Form 10-K on September 18, 2023 rather than June 14. The former Allscripts announced at the end of February that audits internal had uncovered revenue recognition problems that would force a 15-day delay in filing its report that was due March 1. The company then announced on March 22 that it had fallen out of Nasdaq compliance by failing to file its 10-K by the revised date. It was given another 60 days to file the report. Nasdaq issued a delisting notice for MDRX shares on May 18 for failing to file its reports on time. MDRX shares have lost 35% since January 1 versus the Nasdaq’s 30% gain, valuing the company at $1.3 billion. 

Nasdaq retracts its delisting warning for shares of Healthcare Triangle, determining that it made a mistake in calculating the company’s per-share value following its May 26 reverse stock split.

Healthcare staffing company Aya Health acquires Flexwise Health, whose software forecasts hospital staffing needs.

BurstIQ acquires the business intelligence solution of Olive AI.

Sales

• Health risk management firm Captive Health will offer its covered members KeyCare’s virtual care services, accessed from MyChart and Captive Health’s mobile app.

Announcements and Implementations

A new KLAS report on population health management technology vendors finds that Epic and Innovaccer stand out, and along with Arcadia, are most often considered. Customers give high partnership marks to Azara Healthcare, Relevant Healthcare, and Salient Healthcare.

Government and Politics

Human Rights Watch calls for the US government to protect Americans from aggressive billing and debt collection by non-profit hospitals, which the organization says is interfering with their other human rights such as housing, food, and education. It concludes that the US model of giving tax breaks to privately operated hospitals and hoping they will reciprocate by delivering charity care isn’t working, making the US a big outlier in medical debt. The report says the government should require hospitals to provide as much charity care as they receive in tax subsidies, for the IRS to set national standards for hospital financial assistance, and for the Consumer Financial Protection Bureau to require debt collectors to make sure that patients have been screened for financial assistance eligibility before pressing them for payment. 

Sponsor Updates

• Team Ellkay raises over $35,000 for the Alpine Learning Group during its annual Go the Distance for Autism cycling event.
• Vyne Medical publishes a new case study, “How to Establish Proof of Patient Authorizations to Overturn Denials.”
• A new report from Forester recognizes InterSystems as a strong performer among top data management and analytics vendors.
• Redox publishes a new report, “Uncovering hidden data roadblocks of cloud and AI adoption in healthcare.”
• Black Book lists the top-ranked payer technologies category leaders exhibiting at AHIP this week. HIStalk sponsors include Wolters Kluwer Health (member and consumer education solutions) and Optum (end-to-end payer RCM outsourcing, payer analytics outsourcing).
• Wolters Kluwer Health and Laerdal Medical launch VRClinicals for Nursing to enhance nurse training with realistic, multi-patient scenarios using virtual reality.
• Konza National Network’s interoperability platform earns certified status by HITRUST for information security.
• Direct Recruiters parent company Starfish Partners acquires Global People and cybersecurity-focused NinjaJobs.
• Fortified Health Security names Katarzyna Parzonka conference and event coordinator.
• Healthwise wins six Digital Health Awards.
• Loyal names Matt Gove (Summit Health/CityMD) senior advisor.

Blog Posts

• How to Maintain a Thriving Healthcare System Despite Inflating Costs (Vyne Medical)
• How Analytics Can Transform Interoperability (Dimensional Insight)
• The Hidden Benefits of Staff Augmentation in Healthcare (Divurgent)
• EClinicalWorks Day is Back – and Coming to Your Area (EClinicalWorks)
• Doctor’s Urgent Care Sees Immediate Improvement to Revenue Potential by Switching EMR (Experity)
• EHR Implementation: How to Achieve Successful Change Management (HealthTech Resources)
• Proceed with caution: Why code crosswalks are built to fail (Intelligent Medical Objects)
• Unique Challenges of Healthcare Application Testing: Why It Is So Different (Keysight)

Contacts

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

EPtalk by Dr. Jayne 6/15/23

I recently took a smaller version of The Great American Road Trip and made it a point to visit some historical roadside attractions. In the 1950s, it was all about seeing the USA in your Chevrolet (or equivalent) and families might have stopped at various quirky museums or points of interest.

One of the places I visited had a collection of antique cars. I was struck by the idea of this 1960s era Amphicar. In some ways it’s a solution in search of a problem, which is something we see often in the world of healthcare IT. I have so many vendor emails hit my box each week promising to solve problems that I didn’t even know I had that I can’t keep track of them all.

The Amphicar was innovative, but didn’t make it big, ceasing production only four years after it began. Sounds like a lot of the products I see out there.

A group of organizations including AstraZeneca, Elevance Health, Geisinger, and UCSF have come together to publish a framework for evaluating digital health products. The goal is for care delivery organizations, health insurers, and trade groups to use it to determine whether digital health products are evidence based. The authors examined 70 frameworks that were created to assess the evidence around digital health intervention, determining that the existing frameworks lacked the specificity needed by healthcare organizations.

Sometimes people forget that digital health interventions can be as important and useful to patients as medications and surgeries. For example, an appropriate intervention to help patients stop smoking can prevent lung cancer. Digital coaching to manage body weight can lead to reductions in heart disease and stroke. The authors identified certain requirements as being potentially non-negotiable for organizations depending on their needs: HIPAA compliance, FDA clearance, and ability to be understood by patients with a fifth-grade reading level were examples.

Organizations are instructed next to use existing evidence assessment frameworks that have been defined for non-digital interventions. Following that, they should apply the new framework’s 21-item supplementary checklist for considerations specific to digital health. These may include elements such as assessing an intervention for selection biases, looking at data gaps, or ensuring that underserved patients were included in the product’s clinical trials.

According to the article, there are 300,000 health apps and 300 wearables in the marketplace, so being able to determine quality of an intervention is key. I wonder how much traction this approach will get, especially when we’re already struggling to make use of evidence quality in non-digital interventions. One of the hottest topics among physicians in my area is the surge in providers offering non-evidence-based hydration and vitamin infusion services. Comments such as “the patients want it, and I don’t see the harm” win the day, along with the potential for revenue. I’ll be watching closely to see how the world of evidence for digital interventions plays out.

Mayo Clinic is planning a $1 billion expansion and its new clinical spaces will incorporate data from patient wearables. Clinicians will have the opportunity interact with patient data elements such as pulse, steps, and sleep. I got a chuckle out of the fact that the article specifically called out Mayo’s “marble-filled lobby” since so many hospitals are overly proud of their non-patient-care spaces while patients may struggle to have basic needs met.

I also found it interesting that it mentioned the tension between Mayo’s lobbyist and Governor Tim Walz over the potential for penalties against hospitals that have excessive cost growth. The project is part of Mayo’s plans to transform the city into an international medical hub. The system has pitched the state, county, and city for $500 million in public funding for campus-serving infrastructure improvements. The new expansion will impact several blocks in downtown Rochester and is intended to make the campus more streamlined and modern, eliminating wayfinding confusion and harmonizing the patient experience. Construction is slated to begin in 2024.

Northwell Direct has inked a deal with the US State Department to offer telehealth consultations to patients seeing Department of State medical professionals around the world. The offering will apply to US government employees and their families posted outside the US. Consultations will be available 24 hours a day, seven days a week and requests will be triaged for assignment to the appropriate Northwell provider staff in more than 100 specialties and subspecialties. Those providers will also provide medical clearance services before employees are sent outside the US, as well as clinical case reviews. Northwell Health also partners within the US with Teladoc for additional virtual care delivery services, so it’s not entirely clear how this will all fit together.

Speaking of government, the Surgeon General of the United States has issued an advisory about the impacts of social media on adolescent and child mental health. The report notes that social media use is nearly universal in those ages 13 to 17 with nearly two-thirds reporting daily social media use and one-third reporting use of platforms “almost constantly.” It goes on to conclude that “social media presents a meaningful risk of harm to youth” with those spending more than three hours daily facing double the risk of mental health problems as others who spend less time on social media.

The long and short of it is that “we cannot conclude social media is sufficiently safe for children and adolescents” and lists steps that can be taken to reduce the risk of harm in those groups. These include: reaching out for help for those negatively impacted by social media; creating boundaries to balance media use; being selective about what is posted and shared online; and addressing cyberbullying. A short summary is available or you can view the full advisory.

Many of my family physician colleagues are still trying to figure out how to balance their use of telehealth within the context of traditional primary care practice. A recent report from the University of Washington Center for Health and Workforce Studies showed that while there was limited data about how medical assistants participate in the telehealth setting, those staffers can transition to virtual roles following additional education and training. Unfortunately, I think a lot of organizations just try to throw people in a role without fully thinking it through. We saw this a decade ago, when practices decided they would just turn their medical assistants into scribes but didn’t think through how to create an appropriate training program or how that role transition might otherwise impact office dynamics.

More on the topic of transitioning historically in-person tasks to virtual caregivers. I was talking with some CMIOs earlier this week about whether they think virtual nursing is going to solve some of their staffing issues. Systems such as Washington-based Providence and Arkansas-based Mercy have already rolled out programs and labeled them as successful, preparing for expansion. Among the group, several were enthusiastic about the idea, and one said their system was in the process of rolling it out using internal resources. However, another said her system was about to sunset the concept because it hadn’t yielded the savings it anticipated. Although that organization’s efforts did dramatically reduce its dependence on travel nurses, those savings were countered by expenditures for hardware and third-party staff management.

Has your organization dipped its toes into the waters of virtual nursing? How is it going? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 6/15/23

BurstIQ Acquires Business Intelligence Platform from Olive AI

Healthcare analytics vendor BurstIQ acquires Olive AI’s business intelligence solution, now known as LifeGraph Intelligence.

Hackensack Meridian Health Invests in Canary Speech, Company with AI Software to Assess Anxiety, Wellness in Spoken Words

Hackensack Meridian Health (NJ) invests in speech analysis technology startup Canary Speech through its Bear’s Den accelerator program.

Apixio and ClaimLogiq Merge to Create a Leading Connected Care Platform

Healthcare analytics vendor Apixio acquires ClaimLogiq, which offers health plan claims technology.

Healthcare Triangle Maintains Compliance with Nasdaq Listing Requirements as Nasdaq Resolves Delisting Determination Error

Healthcare Triangle regains its Nasdaq compliance after the financial services organization determined the health IT vendor had been de-listed in error.

Healthcare AI News 6/14/23

News

The American Medical Association’s House of Delegates considers a resolution that would urge doctors to educate patients about the risk of large language models. It also directs AMA to work with the federal government to protect patients from inaccurate, AI-generated medical advice.

Dartmouth launches the Center for Precision Health and Artificial Intelligence.

In England, the British Labour Party recommends that the UK create a mandatory licensing model for companies that do AI work.

A UK pathologist who pioneered the use of AI to diagnose prostate cancer is advocating the use of similar AI pathology tools to diagnose breast cancer within three days and help finalize treatment recommendations within a week. He says that diagnosing cancer isn’t hard, but it takes more time to review biomarkers to determine optimal treatment, creating patient uncertainty and straining staff resources.

Business

Healthcare analytics vendor BurstIQ acquires Olive’s AI business intelligence solution.

Healthcare analytics vendor Apixio acquires ClaimLogiq, which offers health plan claims technology.

The CEO of drug manufacturer Sanofi says it will be the first pharma company that is powered by AI at scale, using AI and data science to discover drugs, design clinical trials, and improve manufacturing and supply chain processes.

Accenture will spend $3 billion to double its AI-focused employee headcount to 80,000, incorporate generative AI in its client work, and help customers use the technology.

Opinion

A Health Affairs opinion piece predicts that AI will set interoperability back, as providers will use technical and legal tools to prevent large competitors from using their data to train large language models to create competing consumer medical services.

Research

Researchers test ChatGPT’s ability to provide venomous snakebite advice to consumers, finding that it gives accurate and useful responses, including recommendations to seek medical care when appropriate, but with limitations involving outdated knowledge and lack of personalization.

Other

Peter Lee, VP of OpenAI investor Microsoft, says he was “alarmed” to learn that within the first three days of the release of ChatGPT, doctors were not only using it, but were asking it to help them communicate with patients more compassionately. A former physician executive at Microsoft says that he was “blown away” by ChatGPT’s ability to help him communicate empathetically with a friend with cancer, but observes that doctors don’t evangelize its use because that would require admitting that they aren’t good at talking to patients.

A health technology firm creates Lifesaving Radio, an AI-based radio station whose playlist of hard rock music is optimized to get surgeons “in the zone” of relaxed high efficiency during surgery. The playlist was developed using Spotify’s AI DJ analytics technology to find songs with the ideal tempo, key, and loudness for surgeons. It features an AI-powered DJ that calls out the surgeons and team members by name. The channel’s first music set is an AC/DC-inspired collection called “Highway to Heal,” which includes parodies such as “You Sewed Me All Night Long.”

Contacts

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

Morning Headlines 6/14/23

American College of Gastroenterology and American Gastroenterological Association Invest in Oshi Health to Accelerate Adoption of Hybrid Digestive Health Care

Shortly after the close of a $30 million funding round, virtual digestive care provider Oshi Health announces investments from the American College of Gastroenterology and the American Gastroenterological Association’s GI Opportunity Fund.

Oracle beats on top and bottom lines as cloud revenue jumps

Oracle reports Q4 results: revenue up 17%, adjusted EPS $1.67 versus $1.54, beating Wall Street expectations for both and sending shares to an all-time high.

Penn State Health enhancing access to primary care through subscription-based virtual service

Penn State Health launches a subscription-based virtual primary care service, initially available to employees and Penn State College of Medicine students and their dependents.

News 6/14/23

Top News

Oracle reports Q4 results: revenue up 17%, adjusted EPS $1.67 versus $1.54, beating Wall Street expectations for both and sending shares to an all-time high. From the earnings call:

• Total cloud revenue was up 55%.
• The Cerner business contributed $1.5 billion to the company’s $13.8 billion of total revenue that was up 18%.
• The company is partnering with Nvidia to build the world’s largest high-performance computer, which will run AI at 16,000 GPUs.
• CTO and Chairman Larry Ellison says that cloud usage is charged by the minute, making Oracle half the price of competitors because it runs twice as fast. He adds that a new Oracle version of MySQL is 1,000 times faster than Amazon Aurora.
• Ellison says Oracle loves Java for building applications, but the company uses Apex for a tenfold developer productivity gain, which he says is why the company believes that it can rewrite Cerner’s entire suite in a “very, very short period of time.”
• Ellison says that the company will earn many healthcare wins because of Oracle’s application breadth, also noting that competitors say they are “cloud” when they are actually “hosted.”
• Ellison adds, “We not only have all the Cerner healthcare apps for hospitals, we’ve specialized our ERP system for hospitals, we’ve specialized our HCM for managing the hospital workforce. We’ve done a bunch of things around the healthcare industry. One of the things we want to do is, you know, we’re the largest provider of clinical trial software. But the clinical — the results of the clinical trial goes to a government regulator. And we’re now working with the government regulators to develop the software that allows them to take the clinical trial output in digital form and get it through the regulatory process much faster at a much lower cost. So, we’re looking at the entire healthcare ecosystem and trying to automate both sides of the transaction.”
• CEO Safra Catz says “we’re still at the beginning” with the Cerner business, as Oracle has been focused on stabilizing the operation, but work remains to increase Cerner’s profit margins and to move its products to Oracle Cloud.

Reader Comments

From Apex: “Re: Elation Health. We were notified that our implementation manager is no longer with the company, apparently part of a structured RIF. Not sure how big, but it was a sign of companies hunkering down for the recession and the lack of non-AI investor capital.” Unverified, because I couldn’t find a press contact on their site to confirm the non-anonymous report.

HIStalk Announcements and Requests

Welcome to new HIStalk Platinum Sponsor Ronin. The San Mateo, CA-based company’s advanced data science and human-centered interfaces embedded in the EHR help clinicians make more precise, confident, and personalized patient care decisions while enhancing the patient and care team experience. Intuitive display of the patient journey: More efficiently and more confidently guide patient care using a reimagined dashboard within the EHR that presents all available patient data in a single click. Efficiently rendered data reduces clinicians burden and supports data-driven decisions. Actionable data insights for personalized care: Preempt adverse events and improve treatment effectiveness using predictive insights delivered at the point of care in the patient chart to accelerate informed, individualized decisions about patient care. Real-time symptom monitoring for effective intervention with PROs: Identify and proactively course-correct at-risk patients for fewer adverse events and emergency department visits through EHR-integrated capture of patient reported outcomes, remote monitoring, effective patient management, and intelligent alerting. Thanks to Ronin for supporting HIStalk.

Webinars

June 22 (Thursday) 2 ET. “The End of COVID Public Health Emergency is Here. Is Your Rev Cycle Ready?” Sponsor: Waystar. Presenter: Vanessa L. Moldovan, commercial enablement + insights program manager, Waystar. This webinar will describe the proactive steps that are needed to avoid increased rejections and denials. It will cover regulatory waivers and flexibilities, major shifts in telehealth, changes to reimbursement, and the impact of the end of the PHE on Medicaid coverage.

July 12 (Wednesday) 2 ET. “101: National Network Data Exchanges.” Sponsor: Particle Health. Presenter: Troy Bannister, founder and CEO, Particle Health. It’s highly likely that your most recent medical records were indexed by a national Health Information Network (HIN). Network participants can submit basic demographic information into an API and receive full, longitudinal medical records sourced from HINs. Records come in a parsed, standardized format, on demand, with a success rate above 90%. There’s so much more to learn and discover, which is why Troy Bannister is going to provide a 101 on all things HIN. You will learn what HINs are, see how the major HINS compare, and learn how networks will evolve due to TEFCA.

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

Acquisitions, Funding, Business, and Stock

A new survey of C-level health system executives by marketing intelligence firm Panda Health looks at the “Churn Index,” as digital health contracts that health systems signed during the pandemic will start expiring, forcing customers to evaluate whether their renewal is cost effective. Telehealth and remote patient monitoring solutions have a potentially high Churn Score due to moderate levels of dissatisfaction.

Forbes questions why Andreessen Horowitz led a recent $50 million seed funding round in healthcare startup Hippocratic AI even though its founder came from a Medicare Advantage broker with a history of debt, laid-off employees, and unpaid invoices.  Several Health IQ co-founders and executives, including CEO Munjal Shah, MS, moved to Hippocratic AI, angering the small companies – mostly lead generators and call center operators — that are stilled owed millions by Health IQ.

People

Will Weider, MS (PeaceHealth) joins Aspirus Health as SVP/CIO.

UCSF promotes Julia Adler-Milstein, PhD as chief of its clinical informatics and digital transformation division.

Spencer Korn (Salesforce) joins League as SVP of sales and business development.

PatientNow hires Bethany Little, MA (Community Brands) as CEO.

Curt Thornton, MHS, MBA (Anatomy IT) joins Linus Health as chief growth officer.

AvoMD hires Mark Citrone (Doximity) as chief commercial officer.

Announcements and Implementations

Artera launches Artera Harmony to unify and streamline patient messaging from across the enterprise.

KLAS reports that as health system acquire independent oncology practices and care centers, more are being moved to Epic and Oracle Health, with Epic users reporting satisfaction with the company’s development roadmap but noting that the system’s complexity creates a user learning curve. Oracle Health users say that PowerChart Oncology is customizable and well integrated, but development is slow and the system is hard to learn.

Government and Politics

Former Theranos CEO Elizabeth Holmes says she can’t afford to pay $250 per month toward the $452 million that she and former COO Sunny Balwani have been ordered to pay as restitution to defrauded investors. Holmes says she will spend the rest of her working life trying to pay her legal bills, although her attorneys did not object to starting a payment plan from prison at $100 per year. 

Privacy and Security

St. Margaret’s Health (IL) will cease operations this week after failing to overcome staff shortages, the lingering effects of the pandemic, and a 2021 ransomware attack on parent organization SMP Health that prevented it from submitting claims to payers for nearly three months.

Other

Bon Secours Mercy Health (OH) develops a Community Health Data Hub for public health research.

Allina Health will re-examine its recently exposed policy of withholding services from patients who have accrued $4,500 in medical debt. The Minnesota-based nonprofit will not, however, restore care for those who are already flagged as debtors.

Sponsor Updates

• Five9 publishes a demonstration video titled “Five9 Helps with Medicaid Redetermination.”
• AssociatesMD (FL) increases patient engagement after implementing Healow technology from EClinicalWorks.
• Waystar enhances its healthcare payments platform for improved transparency, efficiency, and accuracy.
• Baker Tilly releases a new Healthy Outcomes Podcast, “Navigating challenges in 2023 and beyond for healthcare provider organizations.”
• Nordic releases an episode of its In Network podcast titled ““Making Rounds: Turning data into insights with managed services”
• Bamboo Health names Amelia Burnett and Laura Reese software engineers, David Antosh cloud engineer, and Bill Alderson senior payroll specialist.
• The local business paper honors Care.ai with a 2023 Fire Award in the Fresh Faces category.
• CHIME releases a new Trailblazers Podcast, “Digital Future Optimization, Efficiency, Process – Where Do We Start?”
• AGS Health, Amenities, Arcadia, Availity, CereCore, Current Health, Medhost, Nordic, Nym Health, Optum, Sphere, VisiQuate, and Waystar will exhibit at HFMA June 25-28 in Nashville.

Blog Posts

• How to Transition from Meditech Legacy EHR to Expanse (CereCore)
• Rising costs of prescription drugs could drive alternate options (Wolters Kluwer Health)
• We Surveyed Our Customers on Mental Health Issues. Here’s What We Learned. (AdvancedMD)
• Preventing Revenue Leakage with Integrated Financial Clearance and Patient Access (AGS Health)
• Value-based care and ROI: Connecting an Allen wrench to healthcare analytics (Arcadia)
• The Top 5 Takeaways from Artera’s First-Ever Customer Conference, Heartbeat. (Artera)
• Getting to grips with chronic disease management (Nordic)
• Improving the Patient Experience Through Technology (Ascom)
• From Challenge to Opportunity: Exploring Clinical Data Acquisition and Integration in the Healthcare Ecosystem (Availity)
• Utilizing DRVS Tools to Address Social Drivers of Health in Your Community (AGS Health)
• 5 ways patient engagement can improve outcomes (CarePort)
• FHIR-side Chats with Clearsense (Clearsense)
• Recent OCR and State Attorney Generals’ HIPAA Enforcement Actions Stress the Critical Importance for Asset-Based Risk Analysis of All Systems with EPHI (Clearwater)
• The Danger Within: How Unpatched Vulnerabilities Leave Your Hospital Open to Cyberattacks (CloudWave)
• A Roadmap to Successful Application Modernization (CTG)

Contacts

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

Morning Headlines 6/13/23

An Illinois hospital is the first health care facility to link its closing to a ransomware attack

St. Margaret’s Health will close its doors this week after failing to overcome staff shortages, the lingering effects of the pandemic, and a 2021 ransomware attack that prevented it from submitting claims to payers for nearly three months.

Oracle beats quarterly revenue estimates on cloud services demand

Oracle attributes its 17% increase in Q4 revenue to demand for cloud products by companies deploying AI, coupled with the boost its Cerner acquisition has given it against competitors like Microsoft and Amazon.

Iowa invests $1.5 million in innovative Centers of Excellence to boost rural health care access

The State of Iowa’s Centers of Excellence program offers providers the opportunity to qualify for grant funding that will enable them to invest in new technology.

Curbside Consult with Dr. Jayne 6/12/23

I was intrigued by a recent study published in in JNCI Cancer Spectrum that looked at how capable ChatGPT is when asked questions about common cancer myths and misconceptions. The study, performed with the Huntsman Cancer Institute, compared ChatGPT output against social media.

I understand the premise. Many patients are getting their information from social media, friends, family, and people they know on a personal basis rather than being able to learn key information from their care teams. Sometimes this happens because people may be receiving cancer diagnoses via their patient portal accounts due to immediate-release results policies stemming from governmental regulations. Other times it happens because patients are unable to reach their care teams when they have questions or they don’t feel that their team is listening to them.

Cancer is also a condition that leads people to leave no stone unturned as far as investigating treatment options and potential outcomes. It’s one of the scariest diagnoses you can receive, and even as healthcare professionals, we are rarely prepared for it. There can be a lot of uncertainty about treatment plans and sometimes even about diagnoses, and patients often seek additional information or alternative treatments as a way of trying to maintain control of their own health and lives.

Generally, physicians appreciate working with engaged and involved patients who want to understand the pros and cons of various treatment options. But a number of industry forces create pressure on that scenario, including time pressures, insurance limitations of treatment options, and availability of options in a particular geographical area.

In fairness, the study was performed shortly after ChatGPT became widely available, so it may not be entirely applicable today. Researchers used a list of frequently asked questions that they sourced from the National Cancer Institute’s “Common Cancer Myths and Misconceptions” website. They found that 97% of the time, the answers from ChatGPT were in agreement with the responses provided by the National Cancer Institute.

In contrast, approximately one-third of social media articles contain misinformation. Distrust of medical institutions and medical professionals has grown exponentially since the beginning of the COVID pandemic, and patients may decide not to pursue standard treatments based on information they’ve heard from friends or family or might have found online. This can lead to negative outcomes for patients, who may expose themselves to increased mortality rates when selecting unproven treatments.

Even when considering medical professionals as a source of information, I’ve seen instances where misinformation can be spread. Sometimes patients consult neighbors or friends who might be physicians, but who are in specialties nowhere near the patient’s area of need. I’m not even an old timer, but I know that the treatments for various cancers have progressed exponentially since I last cared for patients with those diagnoses. I’m always careful to refer patients back to their oncologists, hematologists, or surgeons, but not everyone does that. I’m part of several Facebook groups that have exclusive physician membership, but we still see bad answers circulating when physicians who are patients themselves pose certain questions.

For physicians who are actively caring for cancer patients, knowing that patients might receive medical misinformation can increase their feeling of burden in delivering care. One of my colleagues feels she can never disconnect from managing patient portal messages because she feels that if she doesn’t answer the patient’s questions promptly, they will be more likely to go down the proverbial internet rabbit hole, leading to greater stress for the patients and their families. When we discussed having boundaries around these kinds of interactions so my colleague can have a break, she said she’s thought about it, but feels that correcting the misinformation later actually requires more work and emotional effort than just being continuously available to field questions. It’s a difficult spot for clinicians to be in when they feel called to serve their patients so broadly.

The study involved a blinded review of the answers to the questions, grading them not only for accuracy , but looking at word count and Flesch-Kincaid readability grade level factors. Answers from both sources were less readable than recommended by most health literacy advocates, but the responses from ChatGPT tended to use more words that led to a perception of hedging or uncertainty. The questions evaluated were striking, and included items such as:

• Is cancer a death sentence?
• Will eating sugar make my cancer worse?
• Do artificial sweeteners cause cancer?
• Is cancer contagious?
• Do cell phones cause cancer?
• Do power lines cause cancer?
• Are there herbal products that can cure cancer?
• Do antiperspirants or deodorants cause breast cancer?

I have to say that I have heard at least four of these questions from friends and family members in the last month or so,  and I am not surprised that they made the question set. The issue of antiperspirants and breast cancer risk comes up often in some of my social media channels, as to the questions about eating sugar and using herbal remedies.

Full documentation of both the National Cancer Institute answers and the ChatGPT answers are included in the article, in case you’re curious.

In addition to the question of accuracy, there’s also the question of specificity. Researchers noted that while the ChatGPT answers were accurate, they were also more vague than the comparison answers from the National Cancer Institute. This could lead to patients not thinking the answers were valid, or to them asking additional questions in clarification.

There was also concern about patients who might ask ChatGPT questions about cancer that are less commonly asked, and which might not have a large body of knowledge to form a training database. The study was also limited to the use of English, which has an impact on its applicability to broad swaths of the US and the world. As a patient and knowing what I know about the propensity for ChatGPT to hallucinate, I don’t think I’d want to go there for my medical information.

Given the newness of the technology when the study was performed, it would be interesting to see how newer versions would perform in the same circumstances. There are a couple of possibilities. It could become more accurate, or it could go completely off the rails as we’ve seen it do with some queries. Additionally, the content used for the models typically only runs through 2021, so current data might influence the results. I hope researchers continue to look at how ChatGPT might be useful as a healthcare adjunct, and where it might serve patients best.

What do you think about ChatGPT as a debunker of medical misinformation? Will it tell patients to inject bleach to kill viruses, or declare it to be an insane strategy? Leave a comment or email me.

Email Dr. Jayne.

Readers Write: Automation’s Role in Patient Engagement Strategies

Automation’s Role in Patient Engagement Strategies
By Lew Parker

Lew Parker, MSIS, MBA is CTO of Arrive Health of Denver, CO.

Thanks to ChatGPT, there’s no shortage of content on the topic of AI and automation’s impact on the future of the workplace. You don’t have to be a technology professional to understand that we’re approaching — if not already in — a pivotal moment that will change how we all do work, much like how the IPhone changed our everyday lives.

While AI may feel like a daunting new topic, the reality is that automated solutions have been widely adopted within all industries for quite some time. Healthcare is no exception, with AI-driven tools commonly being used to make the revenue cycle more efficient.

A prime opportunity within healthcare is bringing AI-driven solutions from the back office and using them to create better patient experiences and outcomes. If we can leverage AI-driven automation tools to drive engagement throughout the patient journey while also alleviating administrative burden for overworked providers, why wouldn’t we invest in tools that do that? The key is determining when and where within patient engagement strategies to implement automated approaches, and how to do so in a thoughtful way that preserves data security and protects patient PHI.

Medication adherence presents an ideal opportunity to enter the waters. According to the World Health Organization, medication adherence can directly impact patient outcomes more than a specific treatment itself. But traditional methods to drive adherence — including relying on staff to conduct massive amounts of personalized outreach once a script has been selected – leave room for improvement, as evidenced by one in five prescriptions never being filled and burned out pharmacists, providers, and care teams.

One factor contributing to non-adherence is the engagement gap that exists from the time a provider writes a prescription to when the patient arrives at the pharmacy counter. A lot can occur during that period to prevent a patient from picking up the prescription. AI-driven solutions, specifically patient outreach tools to connect with patients during this time in a more natural and ultimately human way. Anyone who has worked with traditional chatbots or robocalls can attest to the frustration of both patients and implementers when the conversation strays outside the boundaries of what computers could handle. That has fundamentally changed, and now we can bridge the gap to support patient engagement and medication adherence by:

• Reducing significant volumes of manual and repetitive tasks by automatically sending information over text messaging about topics such as onboarding, medication information, and refill reminders.
• Creating additional patient touch points along the medication adherence journey while reducing the overall cost of outreach.U
• sing AI to identify which patients have barriers to adherence and then prioritizing them for personalized pharmacist outreach. This will allow pharmacy staff to focus on high-value, high-touch care.

It’s impossible to expect pharmacists and providers to conduct the level of personalized outreach needed across all populations served without the help of technology. There are simply not enough hours in the day. However, using AI-driven tools as described above will drive better patient experiences, engagement, and outcomes while also helping an already overburdened healthcare workforce. As IT leaders, it’s our job to encourage innovation while also supporting responsible and impactful use of AI in new ways, including bringing these tools to patient engagement strategies.

Morning Headlines 6/12/23

A Message From Our CEO: Cityblock’s Next Chapter

Cityblock Health, a tech-enabled primary and behavioral healthcare provider serving Medicaid and Medicare patients, will lay off 155 employees.

Pomelo Care collects $33M for maternal and newborn VBC

Pomelo Care, a virtual clinic specializing in pregnancy and newborn care, raises $33 million.

23andMe to cut roughly 9% of workforce, or about 75 employees

Consumer genetics and research company 23andMe will eliminate 75 jobs in early 2024 as part of a restructuring plan it estimates will save $13 million.

Monday Morning Update 6/12/23

Top News

Madison, WI-based news site Isthmus questions whether Epic’s non-compete agreements limit Dane County’s entrepreneurial growth as compared to Microsoft’s startup influence in the Seattle area.

A former Epic employee says that it’s nearly impossible for people like him to launch a startup given the two-year non-compete that involves the 4,500 banned companies that Epic lists as competitors and its “all efforts” pledge that prohibits part-time, professional, or teaching work while working for Epic.

The article also notes that Epic requires independent consulting firms, vendors that are listed in its app marketplace, and its customers to incorporate the same two-year non-compete terms.

Some of the former employees who were interviewed say they took jobs that seemed unrelated to Epic, but were terminated by their new employers when Epic inquired.

The FTC is reviewing its proposed ban on non-compete agreements, which is almost certain to be legally challenged.

HIStalk Announcements and Requests

A surprising number of poll respondents say their phone has driven life-changing improvements, with some examples being Pokémon Go leading to exercise, Reframe for sobriety, Apple Watch’s three-ring activity tracker, Strava for exercise, exercise trackers and monitoring, and calorie tracking.

New poll to your right or here: Has a non-compete agreement that you previously signed ever had a negative impact on your search for a new job?

My fascination with ChatGPT has been replaced by annoyance at the hucksters who are carpet-bombing LinkedIn and Twitter with dull, formulaic, and probably ChatGPT-generated drivel that practically begs for followers and newsletter sign-ups. They will disappear in a few months as they fight each other to be top-of-mind for short attention span crumbs, but meanwhile it’s getting tedious being swamped with repetitive content from self-proclaimed experts:

• Pithy “ChatGPT for business” editorializing from people who have never held a real job beyond self-promotion and who have no documented education, experience in AI, or success in running a company.
• Soulless, pointless one-sentence-per-paragraph eye-rolling insight haikus on LinkedIn.
• Recirculating low-value lists of ChatGPT tools, prompts, and screenshots.
• Making lists of predictions of companies or industries will be rendered obsolete by ChatGPT.
• Posting the non-clever results of the “I asked ChatGPT and here’s what it said” type.
• Folks, many of them in marketing and writing, who don’t realize that any leverage they get from ChatGPT will be quickly adopted by everyone else, erasing any temporary competitive advantage.

Webinars

June 22 (Thursday) 2 ET. “The End of COVID Public Health Emergency is Here. Is Your Rev Cycle Ready?” Sponsor: Waystar. Presenter: Vanessa L. Moldovan, commercial enablement + insights program manager, Waystar. This webinar will describe the proactive steps that are needed to avoid increased rejections and denials. It will cover regulatory waivers and flexibilities, major shifts in telehealth, changes to reimbursement, and the impact of the end of the PHE on Medicaid coverage.

July 12 (Wednesday) 2 ET. “101: National Network Data Exchanges.” Sponsor: Particle Health. Presenter: Troy Bannister, founder and CEO, Particle Health. It’s highly likely that your most recent medical records were indexed by a national Health Information Network (HIN). Network participants can submit basic demographic information into an API and receive full, longitudinal medical records sourced from HINs. Records come in a parsed, standardized format, on demand, with a success rate above 90%. There’s so much more to learn and discover, which is why Troy Bannister is going to provide a 101 on all things HIN. You will learn what HINs are, see how the major HINS compare, and learn how networks will evolve due to TEFCA.

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

Acquisitions, Funding, Business, and Stock

A Business Insider article predicts a startup “mass extinction event” for startups in late 2023 through 2024 that may have already started, although with low visibility since “most startups die quietly and slowly” since they aren’t publicly traded. The result could be asset sales, recapitalization at lower valuation, acqui-hires in which companies are bought simply to poach their employees, and low-visibility shutdowns.

A researcher in Australia says that employees value work-from-home options because of – in addition to time spent commuting — poorly designed corporate offices that stifle inspiration and creativity with cookie-cutter furnishings, high noise levels, and interruptions, also noting that companies tout serendipitous conversations and collaboration that usually doesn’t happen just because employees are forced to sit in a room together. She says the return-to-office push is being driven by Theory X managers who think lazy employees need to be observed and controlled as well as economic concerns about commercial property values.

Sales

• The New York State Office of Mental Health chooses NTT Data to provide Independent Verification and Validation (IV&V) services for the Child Support Workstream of the Integrated Eligibility System (IES) Program.

People

Cedars-Sinai hires James Jones, MHA, MSN, RN (UW Medicine) as its first CNIO.

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

CommonSpirit Health promotes Karen Hunter, DNP, RN to system VP of clinical informatics.

Industry long-timer Michael Kendzierski died May 26 at 61. He retired a few months ago from DrFirst and had held executive sales jobs with Spok, Vocera, CareFusion, Initiate Systems, Eclipsys, and Spacelabs.

Announcements and Implementations

Orbita launches CallDeflectAI, a conversational virtual assistant for provider websites that answers common patient questions using only provider-approved documents and web pages. The company offers a 30-day free trial and promises a one-day launch.

Medhost will offer its partners the Sentri7 antimicrobial and sepsis surveillance suite of Wolters Kluwer Health.

Sponsor Updates

• EClinicalWorks releases a new podcast, “Prisma: Enhancements & Benefits for Clinicians.”
• Tegria will host a LinkedIn Live discussion June 21, “Demystifying Cloud Misconceptions for Healthcare.”
• AdvancedMD publishes a new e-book, “The Private Equity M&A Playbook: A Guide for Private Practices.”
• Meditech publishes a new whitepaper, “Insights on the evolution and implications of healthcare workforce challenges.”
• NeuroFlow releases a new Bridging the Gap Podcast featuring Stephen Klasko, MD of General Catalyst.
• Nuance will present at AHIP 2023 June 14 in Portland, OR.
• Netsmart will present at the I2I Center for Integrative Health Spring Conference June 12 in Raleigh, NC.
• A new KLAS report highlights the success PerfectServe’s customers have experienced with its clinical communication solutions.
• Sectra will exhibit at SIIM 2023 June 14-16 in Austin, TX.
• Volpara Health issues a statement on the new USPSTF breast cancer screening recommendations.
• Waystar will exhibit at the FL AAHAM Annual Conference June 21-23 in Daytona Beach Shores.
• Optum, Availity, Bamboo Health, Surescripts, West Monroe, Ellkay, First Databank, Intelligent Medical Objects, InterSystems, Trualta, and Wolters Kluwer Health will exhibit at AHIP 2023 June 13-15 in Portland, OR.
• Medhost offers customers access to Wolter Kluwer Health’s Sentri7 surveillance suite with turnkey regulatory reporting.
• Zen Healthcare IT’s Stargate IHE Gateway achieves EHealth Exchange Validated Product designation.

Blog Posts

• EHR Implementation: How to Achieve Successful Change Management (HealthTECH Resources)
• Mount Sinai South Nassau (MSSN): One Teaching Hospital’s Journey to Adopting a CC&C Solution (Mobile Heartbeat)
• What You Need to Know: Revolutionize Your Rehab with Digital MSK (Net Health)
• Addressing the Rising Risk of Complex Behavioral Health Care on Our Healthcare System (NeuroFlow)
• A Window Into the State of Medical Coding in the US (Nym Health)
• Nurses of Note 2023: The Interim Director and Nurse Development Leader (PerfectServe)
• The Advantage of a Revenue Cycle Management Partner in Claims Denial Management (PMD)
• Honoring Breakthrough Healthcare Technologies at Premier’s Annual Innovation Celebration (Premier)
• Revenue Cycle Company Brings Medical Practices Live 66% Faster While Continuing to Grow Their Revenue (RCxRules)
• Proprietary new research is live – how Redox is exposing some of the hidden data roadblocks of cloud and AI adoption in healthcare (Redox)
• The Didi Davis Clinical Interoperability Showcase (Surescripts)
• Bringing generative AI to healthcare through the contact center (Talkdesk)
• Demystifying Cloud Misconceptions for Healthcare (Tegria)
• Leveraging Cerner Millenium EHR for a comprehensive Well Baby Program in Qatar: Integrating care processes and promoting early intervention (Oracle Cerner)
• Top 5 Reasons Caregivers Call Healthcare Providers: Insightful Guide for Health System Executives (Trualta)
• How to Purchase Therapy Equipment on a Budget (WebPT)

Contacts

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

Morning Headlines 6/9/23

Carta Healthcare Secures $25 Million in Series B Funding with Additional Investments from Memorial Hermann Health System and UnityPoint Health

Carta Healthcare, which offers registry data abstraction and analytics, closes a $25 million Series B funding round.

Loopback Analytics Announces Strategic Growth Investment by PSG

Specialty pharmacy analytics vendor Loopback Analytics secures funding from PSG Equity.

US medi-tech firm plans ‘major UK campus’ on edge of Bristol

Epic will build a campus in Bristol, England to house its 350 employees there along with others in the UK.

No staff cuts at Spokane VA due to budget deficit, regional director says after visiting Mann-Grandstaff

Mann-Grandstaff VA Medical Center will not be required to reduce staffing or services to address its expected $35 million budget shortfall that was mostly caused by its problematic implementation of Oracle Cerner.

Laudio Announces $13 Million Series B for its AI Solution that Drives Productivity and Reduces Burnout in Health Systems

Healthcare workforce software vendor Laudio raises $13 million in Series B funding, brining its total raised to $25 million.

News 6/9/23

Top News

Primary and urgent care chain Carbon Health launches hands-free, AI-powered EHR charting across all of its clinics and providers.

Audio recordings of patient visits are analyzed with AWS Medical Transcribe, then processed with GPT-4 to generate an EHR-ready notes document. The company say that chart completion time is reduced from 16 minutes to four.

Carbon Health  is reviewing options to license the technology. It cut 200 jobs and ended several key initiatives in January 2023, shortly after opening conversations about licensing its EHR and days before announcing a $100 million Series D funding round led by CVS Health Ventures.

Reader Comments

From CTDeveloper: “Re: [company name omitted]. Fired 450 employees over the last three weeks. Was acquired by a private equity firm last year.” I’ve left off the company’s name while waiting on a response to my inquiry. The company and most of its employees are based in India.

Webinars

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

Acquisitions, Funding, Business, and Stock

Wolters Kluwer Health acquires Invistics, which offers AI-enabled software to detect drug diversion in hospitals and ambulatory surgery centers.

Carta Healthcare, which offers registry data abstraction and analytics, closes a $25 million Series B funding round.

Sales

• Curana Health, which offers primary and post-acute care to senior living communities, chooses Netsmart’s CareFabric for consumer engagement, value-based care, and management of high-risk populations.

People

William Crawford, MS, MBA (Medically Home) joins Newfire Global Partners as CTO.

Announcements and Implementations

HIMSS will move its global headquarters to Rotterdam, Netherlands this summer, after which its Chicago facility will be known as its Americas headquarters. HIMSS first announced the opening in September 2022.

A new KLAS report on clinical communication platform adoption finds that PerfectServe Telmediq and Stryker Vocera are closest to having comprehensive deployments that address customer strategies.

Epic will build a campus in Bristol, England to house its 350 employees there along with others in the UK.

University of Pennsylvania receives a $10 million gift to establish a fund for student healthcare entrepreneurship.

Bankrupt weight loss center operator Jenny Craig will sell its Australia and New Zealand online business to Eucalyptus, which sells medical products online for weight and hair loss, erective dysfunction, menopause, fertility, and skincare. The Royal Australian College of General Practitioners has raised concerns that Eucalyptus may be illegally advertising drugs directly to consumers and allowing its doctors issue prescriptions from questionnaires rather than real-time consultations as the law requires.

Mayo Clinic will use Google’s low-code Enterprise Search in Generative AI App Builder to combine Google search with generative AI to provide information to clinicians and employees.

Government and Politics

The VA’s Northwest regional director says that Mann-Grandstaff VA Medical Center won’t be required to reduce staffing or services to address its expected $35 million budget shortfall that was mostly caused by its problematic implementation of Oracle Cerner.

Sponsor Updates

• Lumeon publishes an infographic titled “Healthcare Is in Crisis: Is It About to Get Much Worse?”
• HFMA awards Premier’s Pinc AI InflowHealth solution its Peer Reviewed by HFMA designation.
• Care.ai’s Smart Care Facility platform integrates with Samsung’s healthcare-grade display.
• Divurgent releases a new episode of The Vurge Podcast, “Using Data in HIT.”
• Nordic publishes a new episode of DocTalk titled “An asset-based approach to health IT.”

Blog Posts

• Five Effective Urgent Care Marketing Strategies (Experity)
• Healthcare Cloud Migration Benefits and Lessons Learned (Healthcare IT Leaders)
• Navigating the data maze: The significance of value sets in healthcare (Intelligent Medical Objects)
• Vital Signs: The Rise of Automated Healthcare Software Testing (Keysight)
• Meet Anamika Patel, Optimum CareerPath Graduate and Ambulatory Analyst (Optimum Healthcare IT)
• Consensus Conductor Can Do… What? Yep, Integrate All Your Communication Workflows in One Place (Consensus Cloud Solutions)
• Preventive Healthcare with AI: A Smarter Approach to Disease Prevention (Lucem Health)
• Addressing Cybersecurity in Rural Healthcare (Medhost)

The following HIStalk Sponsors achieve top user ratings in Black Book’s analysis of financial and RCM solutions:

• Optum – chargemaster and price transparency solutions.
• AdvancedMD – end-to-end RCM outsourcing, small physician practices.
• AGS Health – end-to-end RCM outsourcing, hospitals under 100 beds.
• Rhapsody – enterprise master patient identifier solution.
• Meditech – patient accounting, community hospital.
• Upfront Healthcare – patient communications and financial RCM satisfaction solutions.
• VisiQuate – revenue analytics solutions.
• Waystar – inpatient claims management systems; end-to-end RCM software and technology, large hospitals and medical centers 250+ beds; end-to-end RCM software, large hospital chains, systems, corporations, IDNs; end-to-end RCM software, small to mid-size hospital chains, systems, corporations, IDNs; patient payment technology.

Contacts

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

EPtalk by Dr. Jayne 6/8/23

When I certified, one of the major components of the clinical informatics board exam curriculum was public health informatics. As a family physician, I understand the value of public health, and especially after the pandemic, most of us understand how underfunded it is in the US.

Various studies show that a dollar spent on public health has the power to reduce future healthcare spending by anywhere from $11 to $80 depending on the nature of the intervention, yet it’s still not where we prioritize our spending. The reality is that prevention isn’t sexy and doesn’t make money for the people who pay for lobbying, but a girl can hope that eventually policies will shift in a way that makes better funding a reality. A recent article in the American Journal of Public Health looked at the US life expectancy compared to that of other nations over the better part of the last century.

The author found that the US life expectancy began falling in the 1950s and continued to worsen over the last four decades. He also noted regional variation across different parts of the US, finding that the Midwest and south-central states fared worse than other regions. Almost a third of the US states have 60% or fewer of their children vaccinated, and that’s a basic public health intervention that is proven to save lives and reduce days missed at work and school. When people don’t see the value in that, it’s hard to get them on board with funding more “exotic” interventions like community gardens, food pantries, nutrition and cooking classes, and healthy environments for exercise and community activities.

As a clinician, it’s difficult to watch the decisions that health systems continue to make as they prioritize high-earning surgical subspecialties and cutting-edge interventions while they refuse to fund staff expansions in primary care. I’d love to see more research looking at the long-term cost savings and quality of life improvements when preventive care is prioritized.

I had that on my mind when I came across an article about how Regenstrief Institute is working with the National Association for Chronic Disease Directors on a project that will use EHR data to estimate chronic disease burdens at the national and local levels. I wasn’t aware that there was a project in the works for a Multi-State EHR-Based Network for Disease Surveillance (MENDS) or that local public health organizations will be able to tap into it.

The goal is for the EHR-derived data to replace more manual efforts, such as health department workers having to canvas at the community level. There are barriers to the data sharing, however, including the lack of a mandate for hospitals and provider organizations to share their data with public health agencies. Other potential issues include lack of accuracy in diagnosis coding and lack of staffing at public health agencies.

The Office of the National Coordinator for Health IT is looking for feedback on expanding the US Core Data for Interoperability classes and elements. The list of data elements was expanded to better reflect the clinical quality measures that are in use with Centers for Medicare & Medicaid Services quality reporting programs and also to incorporate greater use of FHIR-based reporting. The draft list of data elements for USCDI Version 4 will be open for public comment until June 30.

I had the chance to help a colleague out today when they were working on a specific formatting issue for a scholarly work. It’s been a long time since I’ve published anything, and as I was digging into the details, I was impressed by the number of resources available on the internet. Back in the day when I was a regular on the presentation circuit, you had to have a stack of reference manuals to make sure you got everything right before submitting your paper, which had to be sent in a box since it was typed, double spaced, and printed with multiple copies. As we think about standards in healthcare and standards in the digital universe, it’s intriguing to remember that some of the first usability standards were set for written scholarly works. When papers were all written with the same stylistic features, it made it easier to understand the content and less likely for the reader to have to wade through a confusing format. Usability principles have evolved over time, but still adhere to a common core of thinking, and it was nice to be pulled in as an “expert” on the topic.

I’ve been back on the road recently and summer travel is in full swing. Unfortunately, I started today’s leg of the trip at an airport that decided it would be good to shut down 50% of the women’s restrooms for maintenance at a time when they had 20 arrivals and departures in the hour surrounding my flight. Needless to say, it created some bottlenecks.

I always wonder if people exhibit the behaviors that I see in the airport during their “regular” lives. At least where I live, I never see people ordering hard liquor with their breakfast, but you see it a lot at the airport. In the boarding line today, I had two guys behind me chugging beers after they had been told they couldn’t take them down the jetway. There was also a group of high schoolers, the majority of whom had full-size bed blankets for their trip and were juggling all their gear while trying to figure out how to repack to try to get it all on board. I felt bad for their chaperone, who had largely lost control of the group. I’ve chaperoned groups of teens before and we always had strict rules about what they could bring or not bring so that we could avoid issues at the gate like I saw today.

On the plane, one of the students in front of me spent the majority of the flight kneeling backwards in her seat, talking to the person in the row next to me. Their chaperone, who was in the same row, just ignored it. Although it was annoying, I remember what it was like to be a teenager, so I decided to just tune it out. There have been so many changes to the typical US teen experience during the last couple of years that this might the only trip these kids have taken (or might ever take), and it’s good to see schools who are encouraging their students to see the world. I also learned today that you can’t take a bowling ball through the TSA checkpoint at this particular airport even though the TSA app says it’s permitted.

What’s the most interesting thing you’ve seen during travel this year? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 6/8/23

Wolters Kluwer acquires U.S. AI-enabled drug diversion detection software

Wolters Kluwer Health acquires Invistics Corporation, which offers AI-enabled software for drug diversion detection.

Karoo Health seeds $3M for value-based heart care

Tech-enabled, value-based cardiac care startup Karoo Health raises $3 million in seed funding.

Healthcare Triangle Receives Nasdaq Delisting Notice; Appeals Determination

Healthcare Triangle appeals Nasdaq’s decision to de-list the company after its failure to comply with listing requirements by the May 30 deadline.

Yuvo Health Raises $20.2 Million Series A Financing To Advance Innovation in Value-Based Care for Federally Qualified Health Centers

Yuvo Health, which offers FQHCs technology-based operational and administrative expertise for value-based care, raises $20 million in a Series A round of financing.

Significo Secures 12 Million USD Series A Funding to Revolutionize Personalized Health Recommendations and Strengthens Leadership Team

Significo will use $12 million in new funding to further scale its personalized health recommendation API for employee wellbeing companies.

Healthcare AI News 6/7/23

News

Mayo Clinic will use Google’s low-code Enterprise Search in Generative AI App Builder to combine Google search with generative AI to provide information to clinicians and employees.

Boston Children’s Hospital, which drew recent attention for posting a job for a ChatGPT prompt engineer, tells Mashable how it may use the technology to solve real-world problems such as helping patients navigate its buildings or to create patient-specific discharge and rehabilitation instructions using their EHR data.

Wolters Kluwer Health acquires Invistics Corporation, which offers AI-enabled software for drug diversion detection.

Primary and urgent care chain Carbon Health launches hands-free AI charting across all of its clinics and providers. Appointment audio is analyzed with AWS Medical Transcribe, then processed with GPT-4 to generate an EHR-ready notes document. Early studies show that unedited accuracy is 88%, charts are 2.5 times more detailed than with manual entry, and chart completion time was reduced from 16 minutes to four. The company says it may sell the software to other provider groups.

AvaSure adds AI-powered enhancements to its TeleSitter virtual care platform in which the virtual safety attendants will be alerted when a patient who is at risk for a fall or elopement tries to sit up or leave the room. The company is partnering with Kinometrix, which applies AI predictive analytics to EHR data to identify patients with fall risk.

FDA issues 510(k) clearance for Ezra’s AI-enhanced MR images for early cancer detection, which the company says would reduce full-body MRI screening cost by 30%. The company says it hopes to offer a 15-minute, $500 full body scan versus today’s one-hour scan that costs $1,950.

Business

LeanTaas announces a generative AI solution that gives leaders insights about patient flow, scheduling, block management, and other capacity management measures.

Clarify Health is beta testing a generative AI solution called Clara, which analyzes claims data to recommend care opportunities.

ObjectiveHealth launches an AI-powered clinical trials feasibility and recruitment platform that identifies the most qualified study candidates using risk factors and biomarkers from their EHR data, then keeps participants engaged by streamlining appointments and communications.

SafelyYou, which offers AI video and remote monitoring support for dementia care in senior living communities, including fall detection, raises $30 million in funding.

Research

University of Colorado medical school researchers are studying patient experiences with AI that simulates conversation, raising questions about potential bias created by the appearance of the chatbot’s avatar and the ethics of nudging people into healthcare behaviors without restricting their choices.

Researchers find that ChatGPT provides evidence-based answers to public health questions with 91% recognition versus a cumulative 5% recognition among Alexa, Siri, Google Assistant, Cortana, and Bixby. However, ChatGPT, along with the other tools, rarely offers referrals and instead gives advice. The authors conclude that public health agencies should publish a database of recommended resources that AI could use in fine-tuning its responses to refer people to vetted resources.

NYU medical school researchers describe NYUTron, a large language model they trained to on EHR notes to forecast clinical and operational event in real time with better accuracy compared to traditional methods. They tested the system at NYU Langone Health System on five predictive tasks: 30-day readmission, in-hospital mortality, co-morbidity index, length of stay, and insurance denial. The authors say that models trained on highly tailored data are more useful than using larger, less-specific datasets, but they still require a lot of computational horsepower.

Other

Kenya-based “contract cheaters” who ghost write essays and complete assignments for students in wealthy countries worry that ChatGPT could replace them. One of them says that most of his customers are studying nursing and healthcare. A January study found that 89% of the surveyed students are using ChatGPT to help them with homework and 53% used it to write an entire essay.

South Korea is using AI-powered image analysis to assess the health of North Korea’s leaders, determining that Kim Jong Un weighs over 300 pounds, has dark circles under his eyes, and may suffer from a sleep disorder.

Contacts

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

Morning Headlines 6/7/23

RxLightning Closes $17.5M Series A to Accelerate Growth and Remove Barriers to Essential Specialty Medications

RxLightning, which specializes in digital specialty medication enrollment solutions, raises $17.5 million in a Series A funding round.

Digital Technologies in Cardiac Rehabilitation: A Science Advisory From the American Heart Association

An American Heart Association science advisory group says that digital technology can address many of the challenges faced by center-based cardiac rehabilitation and care programs.

Codex IT Acquires Professional Services Company

Eye care-focused health IT firm Codex IT acquires EyeDeal Consulting, marking its third acquisition of 2023.

Cardinal Health announces the merger of its Outcomes business into Transaction Data Systems and related partnership

Cardinal Health sells its Outcomes business to pharmacy software vendor Transaction Data Systems.