News 10/18/23

Top News

Waystar announces that it filed IPO documents in August that reportedly value the company at up to $8 billion.

Waystar says it booked $196 million in sales for the quarter ending June 30 versus $173 million for the same quarter last year.

The revenue cycle management company was formed in 2017 with the merger of Navicure and ZirMed. Waystar has since acquired Connance, HealthPay24, Patientco, PARO, Digitize,AI, and ESolutions. 

Webinars

October 25 (Wednesday) 2 ET. “Q&A: What’s new with the NSA? A No Surprises Act update.” Sponsor: Waystar. Presenters: Joseph Mercer, JD, managing director, Marwood Group; Heather Kawamoto, VP of product strategy, Waystar. The No Surprises Act created a lot of change,  and those changes are still coming. A panel of revenue cycle experts answer frequently asked questions and offer a concise update on the NSA, including legislative developments, FAQs, and tips for navigating changes.

October 25 (Wednesday) 2 ET. “AMA: The Power of Data Completeness.” Sponsor: Particle Health. Presenters: Jason Prestinario, MSME, CEO, Particle Health; Carolyn Ward, MD, director of clinical strategy, Particle Health. Is your healthcare organization looking to drive profitability and scale quickly? Our experts will explore how comprehensive clinical data can revolutionize the health tech landscape. This engaging discussion will cover trending topics such as leveraging AI and data innovation to enhance patient care and outcomes, real-world examples of organizations leading the charge in data-driven healthcare, overcoming challenges in data completeness and interoperability, and visionary perspectives on the future of care delivery.

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

Acquisitions, Funding, Business, and Stock

The loss of a legacy customer and associated $4.5 million in annual revenue prompts RCM vendor Streamline Health Solutions to move forward with a corporate restructuring plan that includes a 24% reduction in its workforce and the promotion of Benjamin Stilwill to CEO. Former CEO Wyche “Tee” Green will transition to executive chairman. STRM shares have lost 40% of their value in the past 12 months versus the Nasdaq’s 31% gain, closing Tuesday at $0.30 and valuing the company at $18 million.

Aspirus Health will acquire St. Luke’s in signing a definitive agreement that has been unanimously approved by the boards of both health systems. The agreement calls for Aspirus to implement Epic and its other standard systems at St. Luke’s within 24 months of closing, which is expected in the spring of 2024. St. Luke’s went live on Meditech Expanse in mid-2019. The combined organization will operate 19 hospitals and 130 outpatient locations with 14,000 employees.

Drug chain Rite Aid files for Chapter 11 bankruptcy and hires a new CEO as it struggles with slowing sales, debt, and a Department of Justice opioid lawsuit.

Sales

• AdventHealth will use tech-enabled clinical support from Wellvana to improve access and outcomes within its network of primary care clinics in Florida.

People

Samir Shah, MD (Envision Healthcare) joins Qure.ai as chief medical officer.

Cordea Consulting names Travis Earlywine (Lowes) regional VP of sales.

Announcements and Implementations

Highmark Health (PA) will implement Google’s new Vertex AI Search technology across its enterprise. It is initially using the generative AI tool as a part of an automated, post-visit medical documentation workflow pilot project.

King’s Daughters Medical Center (MS) implements BridgeHead Software’s HealthStore clinical data repository as a part of decommissioning its legacy Meditech Magic EHR. KDMC went live on Meditech Expanse last December.

Guelph General Hospital in Ontario goes live with Sectra’s cloud-based enterprise imaging technology.

Government and Politics

The VA will establish four AI centers to test and apply new AI solutions at partner VA medical centers. The centers support the VA’s recently announced AI strategy, which includes using AI to improve care outcomes and experiences for veterans.

Privacy and Security

Mt. Graham Regional Medical Center (AZ) works to restore computer systems after a September 27 ransomware attack.

University of Vermont Medical Center President and COO Stephen Leffler, MD tells lawmakers at a joint subcommittee hearing in Washington, DC that more federal grants should be made available to help health systems purchase stronger cybersecurity software. Leffler also shared the details of the hospital’s recovery from a 2020 ransomware attack, which led to 28 days of downtime and $65 million in costs.

Other

Epic employees complain on Reddit that the company has announced that it will no longer allow them to work from home during heavy snow days. Some of them note that Epic’s new hires often have never driven in snow and therefore are prone to creating automotive mayhem.

Sponsor Updates

• Healthwise posts a case study of how Duke Health used its health education to increase the success rate of its smoking cessation program.
• Availity offers RevSpring’s staff-assisted payment and merchant services as part of its Availity Essentials multi-payer platform.
• AvaSure will host its 2023 Symposium October 25-26 in Grand Rapids, MI.
• Inovalon’s Claims Management Pro solution is offered on the PointClickCare Marketplace.
• Baker Tilly publishes a new case study, “Handled with care: UT Health San Antonio’s Oracle HCM journey towards one cloud.”
• Nordic publishes another episode of its In Network podcast, “Designing for Health: Bre Loughlin.”
• Bamboo Health publishes a new case study, “Revolutionizing Nevada’s Behavioral Health Referrals: A Leap Forward for 988 Suicide Prevention and Crisis Lifeline Services.”
• Censinet releases a new Risk Never Sleeps Podcast featuring cybersecurity expert Frank Riccardi.

Blog Posts

• Navigating the Challenges of Transcription: Finding a Solution that is Accurate, Timely & Secure (AdvancedMD)
• From Pain to Progress: Streamlining LIS Upgrades with JTG Consulting Group (JTG Consulting Group)
• Coding and Documentation Synergies: The Power of CAC and CDI Integration (AGS Health)
• How to create a trusted and consistent data foundation for healthcare (Arcadia)
• Building a Pan-European Paediatric Data Collaboration Network (Aridhia)
• Leveraging High-Quality Clinical Data to Safeguard HEDIS Quality Bonus (Availity)
• Why Injury Prevention Technology Used by Athletes is so Effective in the Workplace (Bardavon)
• Copay Adjustment Programs: What Brand and Hub Teams Need to Know (ConnectiveRx)

Contacts

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

Morning Headlines 10/17/23

Streamline Health Executes Strategic Restructuring, Provides Corporate Update

RCM vendor Streamline Health Solutions announces layoffs, the loss of a legacy customer, and management changes including a new CEO.

Rite Aid Takes Steps to Accelerate Transformation and Position Company for Long-Term Success

Rite Aid files for Chapter 11 bankruptcy protection and names a new CEO as part of its corporate restructuring strategy.

Healthcare payments startup Waystar makes IPO filing public

Waystar goes public with its IPO filing, announcing plans to list its shares on the Nasdaq alongside a bump in quarterly sales.

Curbside Consult with Dr. Jayne 10/16/23

Generative AI continues to be a hot topic around the virtual physician water cooler. My colleagues have come to expect me to have my finger on the pulse of innovation, even though interacting with these solutions is a small part of my current work in clinical informatics.

OpenAI recently announced that “ChatGPT can now see, hear, and speak,” heralding an opportunity for a “more intuitive type of interface” that allows the user “to have a voice conversation or show ChatGPT what you’re talking about.” The blog details the potential of the technology to impact daily life.

As an aspiring amateur chef, I’m intrigued about the potential to “snap pictures of your fridge and pantry to figure out what’s for dinner (and ask follow up questions for a step by step recipe).” At any given time, my kitchen has a stack of recipes that I find intriguing. It would be great if artificial intelligence could parse them and determine which ones I might be more likely to make, and what ingredients I need to make their creation a reality.

Plus and Enterprise users get first crack at the new features, with voice coming on mobile platforms and images being available on all platforms. As for voice, the goal is for users to be able to have a conversation with the virtual assistant after choosing one of five voice options.

As an early adopter of the Garmin Nuvi back in the dark ages before Google Maps, I miss my former trusty companion “Ken the Aussie” and was hoping that there would be a similarly engaging option available with the new solution, especially since the company states they worked with professional voice actors to create the options. Alas, I didn’t find an internationally-accented voice – the options are named Juniper, Sky, Cove, Ember, and Breeze.

I can’t wait to explore the image options. One of the use cases that OpenAI lists includes “analyze a complex graph for work-related data.” I have some absolutely crazy pictures of whiteboard drawings that I’ve collected over the years and can’t wait to unleash AI technology on those and see what sense it can make of them, if any. New York Times reporter Kevin Roose got a sneak peek at a beta version of the technology recently and shared his results. He noted some issues:

• Taking a picture of the front page of the newspaper, he asked ChatGPT to summarize it. The AI hallucinated, “inventing a statistic about fentanyl-related deaths that wasn’t in the original article.”
• The technology “flopped” when asked to assist with a crossword puzzle.
• It referred to a stuffed dinosaur as a whale.

It was also unable to assist with deciphering a diagram for assembling a piece of IKEA-esque furniture, although I’m less surprised by that than the other issues mentioned. He also noted limitations in how the technology processes images of human faces, although he mentions this is functioning as designed. Developers wanted to avoid it being used for facial recognition or critiquing people’s appearance. As someone who has cared for teens who have been cyberbullied, I’m grateful for the latter.

The New York Times reporter found the voice capabilities to be particularly powerful, referring to it as “Siri on steroids” with a “fluid and natural” voice that has “slight variations in tone and cadence that make it feel less robotic.” He notes that his request to hear the story of the Three Little Pigs “in the character of a total frat bro” was “a sleeper hit.” (The example is available in the article, if you’d like to give it a listen – I agree it was pretty funny.)

Honestly, I can’t wait to ask it to tell me a story about healthcare IT from the perspectives of some of the archetypal personas we see in the industry: the exuberant CEO, the frustrated project manager, the surly end user, and the burned-out clinician. It would probably be more entertaining than some of the talks we saw at conferences like HLTH, hands down.

Earlier in the month, OpenAI had also announced that its Dall-E image generator was being incorporated into ChatGPT. When AI-generated images first came on the scene, there were a lot of concerns about copyright issues, competition with human artists, and the role of AI in the creative process. Now that the technology is becoming more accessible, some of my physician colleagues have also been concerned about the potential for using generative AI to create images that can be passed off as medical records in order to manipulate a physician into providing treatments or medications for which a patient might otherwise be inappropriate.

There was a big discussion among our group about the potential for diversion of controlled substances if patients presented with AI-generated x-rays, CTs scans, or MRIs. I’m seeing an increasing number of physicians paying attention to political happenings, so of course there was concern with the potential to use AI to manipulate upcoming elections. Of course, there are plenty of bad human actors that already have the technology to do those sorts of things, but somehow things just seem scarier to some when automation is involved.

OpenAI isn’t the only company that’s doubling down on chatbot investments. Google recently released improvements that allow Bard to access information from Gmail, Google Docs, and Google Drive accounts through a feature called Bard Extensions. It can also draw from YouTube and Google maps for information. Although those enhancements potentially represent a substantial increase in generative power for sophisticated applications, I’m more interested in straightforward but potentially complex tasks, like helping me parse through the hundreds of emails I receive each day across both my personal and HIStalk accounts and helping me identify which ones might be most intriguing.

Given my consulting work helping organizations streamline their meeting calendars, I’d also love to unleash a chatbot to parse calendar data to help me figure out which meetings should be moved to maximize attendance, which should be kept where they are, and which might be able to be eliminated. Of course, most of the organizations I work with are still devotees of Office 365, so Bard isn’t going to be much help there.

What do you see as the areas with the greatest potential for generative AI, and what do you see as the biggest potential pitfalls? Leave a comment or email me.

Email Dr. Jayne.

Readers Write: Easing HCC Coding Adoption by Using Insights and Assessment for More Accurate Data

Easing HCC Coding Adoption by Using Insights and Assessment for More Accurate Data
By Shahyan Currimbhoy

Shahyan Currimbhoy, MS is vice president of product of Edifecs of Bellevue, WA.

Healthcare provider organizations that are participating in Medicare Advantage plans are acutely focused on the adoption and execution of Hierarchical Condition Category (HCC) coding. HCC is a healthcare risk adjustment model that is used to predict the healthcare costs of individuals or populations based on medical conditions. Adoption requires disciplined and accurate documentation and coding of all relevant medical conditions to properly reflect the health status of patients. Accuracy is critical. Even the slightest inconsistency or error can impact risk scores and subsequent reimbursements to providers.

HCC coding is an important model for healthcare reimbursement risk adjustment because it offers the benefit of accurately predicting healthcare costs. Unfortunately, as it has been put into practice, it has elevated some operational challenges. It’s no secret that coding has long-been an administrative burden on the healthcare system. Over time, we’ve learned that automated, integrated, and system-wide technology can help reduce these burdens. In the present evolution of our healthcare system, we also know the viability of value-based care (VBC) desperately depends on alignment between documentation, provider engagement, and claims coding.

The implementation of HCC coding requires a thoughtful approach. If done right, organizations could quickly see opportunities to refine and improve the encounter documentation process and care delivery.

Your HCC Coding Approach: Collaborate with Clinicians

As care teams recognize HHC coding as a critical component of an organization’s business model, identifying the right deployment approach is an important early step. Each health system will take a different approach, but change must be met with ease and collaboration. Organizations that attempt to move into alternative payment models (APM) by flipping the switch overnight on new processes or technologies will encounter pushback from care teams and coding staff. Value-based payment participants will have a better outcome if they ease into the transition, including starting with tools that are made for VBC, and weaving them into the existing team structure and processes.

Care teams and coding staff will have questions. Will HCC coding be addressed before, during, or after the visit? Will coders and clinicians collaborate in person or electronically? Consult your clinicians before determining the best approach. Excluding them will undoubtedly result in a missed opportunity to best understand how strategy could impact their day-to-day workflows, which can lead to a more challenging implementation process.

A collaborative approach will result in more accurate coding in the long run, playing a huge role in reducing the time providers are spending confirming or rejecting a suspected condition.

Coding Insights and Provider Education Support Entering High-Risk Sharing Arrangements with Confidence

Even with automation and collaboration tools, care teams that have incorporated HCC can still find themselves coding inconsistently. For leadership to understand where education and resources are needed, there needs to be provider-level visibility of coding efficacy. Without data-driven insights into provider quality risk operations, this can prove challenging.

With the proper sources, providers can build patient registries, identify where the patients are, and build standard care pathways to ensure that patients are getting proper care. Leadership can gather the clinicians to share knowledge and identify variations in care. Treating HCC coding as a discipline, rather than as an administrative or financial function, helps ensure alignment between providers and the coding team, which drives improved patient outcomes.

Organizations with confidence to move into high-risk sharing arrangements can use automation and natural language processing (NLP) to drive scalability, collaborative tools that allow care teams to work in unison, and performance analytics to help the whole care team continue to improve.

Using “MEAT” to Fully Assess New Conditions Against Patient History

VBC payment models often require a comprehensive understanding of a patient’s medical history, always culled from various sources and locations. Consolidating diagnostic codes linked to HCCs becomes difficult when a patient is treated at multiple departments within a clinically integrated network (CIN) with separate EMRs. In today’s state of financial resources, the right integrations and automation tools are key.

Organizations are empowering clinical review specialists by giving them a comprehensive view of each patient’s medical history, as well as the tools needed to help identify the gaps in care. If medical history is reviewed prior to an encounter, it can reduce some of the burden on clinicians during the patient visit. With the comprehensive view and additional time, providers can better assess new potential conditions using the acronym “MEAT” as suggested by the AAPC (monitoring, evaluating, assessing/addressing, and treating).

MEAT serves as the connective tissue between documentation, provider intervention, and claims coding, and is essential for any reliable risk adjustment program. VBC relies on this alignment, confirming that money is flowing to organizations that are most at risk, and ensuring that patients with chronic conditions are served efficiently. Combined with tools that simplify HCC recapture, such as artificial intelligence and machine learning, these approaches can save time across the care team and ensure care continuity and revenue capture for chronic disease management.

Stop Using Old Solutions for New Practices

Automation tools and assessments like MEAT help care teams, providers, and coders ensure that HCC coding accurately reflects the true burden of patient populations. Without the necessary systems and technology infrastructure in place, following the guidelines in practice can be challenging. Health systems that are incorporating VBC arrangements often expect to solve new problems with old solutions, and that is just simply not realistic. Organizational efficiencies leading to increased clinician satisfaction, improved financial performance, and better clinical outcomes can be realized with the right operational components to support automation, visibility, and collaboration for both provider organizations and health plans.

Morning Headlines 10/16/23

Sphere Announces Agreement to Divest Commercial Division

Sphere will sell its Commercial Division to commerce enablement company NMI, allowing it to sharpen its focus on core business such as its TrustCommerce healthcare gateway, Health IPass patient engagement solutions. and Qgiv digital fundraising platform for non-profits.

VA’s new artificial intelligence centers will focus on iteration in AI testing process, agency official says

The VA will establish four new AI centers to test and apply new AI solutions at partner VA medical centers.

Walgreens plans to close some 60 VillageMd clinics

Walgreens will close 60 of its drugstore-attached VillageMD clinics as it pursues $1 billion in cost reductions following a Q4 loss that is the first in its 122-year history.

Monday Morning Update 10/16/23

Top News

Walgreens will close 60 of its drugstore-attached VillageMD clinics as it pursues $1 billion in cost reductions following a Q4 loss that is the first in its 122-year history.

Walgreens paid $5.2 billion in late 2021 to increase its stake in VillageMD. The Walgreens interim CFO insisted in Thursday’s earnings call that the company will “unlock the embedded profits at Village” by cutting costs, improving execution, and “right-sizing the footprint” in focusing on the highest-opportunity markets and expanding integration of the company’s digital assets.

Walgreens also says it will reduce retail inventory and optimize product mix, which might make one wonder why the highly-compensated executives waited for a crappy quarterly earnings report to do so. Actually, maybe the company agrees since they have already canned the CEO, CFO, and CIO.

Worth a read is the analysis by AI company founder Sergei Polevikov, who says half of the company’s 2023 loss of $3 billion is due to money-losing VillageMD while the remainder is because of “kitchen sinking,” where all of the company’s problems are blamed on previous management in an opportunity to clean up the ugly books. He previously wrote a brilliant piece titled “Why did I say No to 100 SPAC offers? Because SPACs are Ponzi schemes” in which SPAC salespeople pushed him to take his AI company public, but didn’t bother to ask questions about profits or ROI since their interest was pumping and dumping, fueled by insiders hyping the company to unload shares to retail investors who shortly after took it in the shorts.

Reader Comments

From Boyd Blender: “Re: PE firm acquiring a health system. That would be an unwelcome intrusion.” The intrusion has already occurred, as private equity firms already own health systems, physician practices, clinics, ambulance services, hospices, insurers, drug companies, ED staffing firms, health IT software vendors, pharmacy chains, dental and vision offices, and funeral homes. Meanwhile, ever-larger health systems are exhibiting PE-like behavior in closing less-profitable sites, running investment firms, and strong-arming patients to pay balances due while generously enriching their executives. Patient expectations of empathy, customer focus, and an emphasis of quality over revenue – even when the patient is an executive of the same health system — usually lead to disillusionment.

HIStalk Announcements and Requests

Many poll attendees wouldn’t attend any conferences if they had to pay their own way, but some say they would self-fund trips to a vendor’s user group meeting, HIMSS, or ViVE. I’ve long held that at least on the provider side, conferences are bestowed as paid vacations for executives with little expectation of ROI. I say that from experience, having enjoyed the budget and paid time off to traipse off to conferences about which my health system employer asked little and for which I held minimal expectation of benefit to my employer.

New poll to your right or here: Which of the following non-job issues were the main reason you left an employer? Everybody understands quitting over better opportunities, boss conflicts, or lack of challenge or inspiration, so I’m looking for broader, company-wide issues.

I’m never going to trust Google to lead AI innovation until it improves Gmail. I use it in the most basic ways possible, but still marvel that (a) selecting all items in Promotions and then clicking Delete All runs what looks like a primitive macro that leaves many emails undeleted; and (b) deleting emails on mobile brings up a pointless and unmovable “Conversation moved to trash” message that hides the next email. Only a UI-indifferent engineer could find Gmail easy to love. I’ve used it since mid-2005 and its appearance and sometimes frustrating behavior hasn’t changed much, like Google is reluctant to mess with it.

Sign up as a new HIStalk sponsor and Lorre will give you the rest of this year for free, a deal that rewards action rather than indecision.

Webinars

October 25 (Wednesday) 2 ET. “Q&A: What’s new with the NSA? A No Surprises Act update.” Sponsor: Waystar. Presenters: Joseph Mercer, JD, managing director, Marwood Group; Heather Kawamoto, VP of product strategy, Waystar. The No Surprises Act created a lot of change,  and those changes are still coming. A panel of revenue cycle experts answer frequently asked questions and offer a concise update on the NSA, including legislative developments, FAQs, and tips for navigating changes.

October 25 (Wednesday) 2 ET. “AMA: The Power of Data Completeness.” Sponsor: Particle Health. Presenters: Jason Prestinario, MSME, CEO, Particle Health; Carolyn Ward, MD, director of clinical strategy, Particle Health. Is your healthcare organization looking to drive profitability and scale quickly? Our experts will explore how comprehensive clinical data can revolutionize the health tech landscape. This engaging discussion will cover trending topics such as leveraging AI and data innovation to enhance patient care and outcomes, real-world examples of organizations leading the charge in data-driven healthcare, overcoming challenges in data completeness and interoperability, and visionary perspectives on the future of care delivery.

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

Acquisitions, Funding, Business, and Stock

Sphere will sell its Commercial Division to commercial enablement company NMI as a non-core business. UPDATE and correcting an earlier version of this item: the company is retaining the healthcare offerings as part of its specialized integrated verticals, selling only the Commercial Division that serves non-integrated SMB retail customers. Sphere says the sale will allow it to focus on fully integrated payment and software experiences, which in healthcare includes its TrustCommerce healthcare gateway and Health IPass patient engagement solutions.

UnityPoint Health and Presbyterian Healthcare Services end their plans to merge.

Venture capital firm Andreessen Horowitz provides vendor advice from health system digital health leaders on selling AI products:

• Frame the problem instead of assuming that buyers seek AI for AI’s sake.
• Identify the person who is charged with fixing the problem, not the one who is most excited about AI.
• Understand the buyer’s roadmap to solving problems, their buy versus build framework, and their value proposition for choosing a startup versus an incumbent vendor.
• Define the ROI case and KPIs to avoid “death by pilot.”
• Focus on user workflow since organizations aren’t interested in standalone solutions and those that add steps the clinician’s work.
• Be transparent about why you need data and how it will be managed.
• Pricing methods include mirroring the cost of an existing solution that will be replaced, API-based pricing that allow customers to build their own applications, a straight SaaS subscription, and charging based on what employees would be paid to achieve similar results.
• Raise investor funds based on the high cost of compute resources that are needed to develop products. Those funds are one form of product moat, along with hiring skilled AI people, gaining access to proprietary data, and achieving market lock-in where health system customers are reluctant to replace incumbent vendors.

Announcements and Implementations

A Kerala, India-based startup creates user-friendly scheduling software that updates the assigned appointment time with a prediction of when the visit will actually begin based on the doctor’s real-time schedule. The system also allows doctors to transfer their appointments.

Financial Times-backed European startup publication Sifted asks investors which digital health companies they like, although the investors don’t indicate any financial interest in the companies they name:

• Abtrace (UK) – preventive care monitoring.
• Floy (Germany) – radiology image analysis.
• Lighthearted.AI (UK) – wearables for heart condition detection.
• Lindus Health (UK) – clinical trial platform.
• Nabla (France) – ambient documentation.
• Nebu-Flow (UK) – smart nebulizers.
• Nelly Solutions (Germany)  – digital signatures and credit.
• Nyra Health (Austria) – digital stroke rehabilitation.
• Phare Health (UK) – medical coding.
• Sohar Health (UK) – insurance eligibility.
• Tortus.ai (UK) – EHR task automation for physicians.
• Upheal (Czech Republic) – note-taking for mental health professionals.
• Verisian (UK) – clinical data analysis.

Atrium Health surveys primary care users of Nuance’s DAX Copilot. Almost all report ease of use and an improved documentation experience, while two-thirds think it has improved their care delivery experience.

A LinkedIn post describes Northwestern Medicine’s pilot project for IT Locker, in which employees who forget their laptops at home can submit a quick form to receive a PIN that allows them to withdraw a loader.

Other

Doctors, nurse practitioners, and physician assistants at Allina Health System’s clinics vote to unionize and will be represented by Service Employees International Union. Physicians who were involved in the organizing campaign complained that understaffing at the clinics is swamping them with managing refill requests, patient messages, and lab results.

The parents of 28-year-old Ohio hospital ED nurse Tristin Kate Smith, who died by suicide in August, discover and publish “A Letter to My Abuser,” which they found on her laptop. The abuser she references is profit-driven health systems, which she said compromise patient care by laying off staff, ignoring nurse input, and failing to supply security to protect workers, all while providing gratuitous pizza parties and “healthcare heroes” pens. She blames health systems for exploiting nurses who are constantly being asked to do more with less while lining their pockets delivering overpriced healthcare. She concludes, “If I stay, I will lose my sanity – and possibly my life – forever.”

Sponsor Updates

• NTT Data sponsors the US Marshals Golf Classic, supporting the families of fallen officers.
• The 2023 Surescripts White Coat Award recognizes 11 healthcare industry leaders in performance, innovation, and accuracy.
• Aga Khan University Hospital in Nairobi, Kenya implements Meditech Expanse.
• Spok releases the 2023 State of Healthcare Communications Report.
• The Dermatology Specialists realizes a 50% reduction in claim submission lab and a 33% reduction in payer rejections after implement RCM optimization services from EClinicalWorks.
• Atrium Health reports that Nuance’s DAX Copilot solution has improved the documentation experience for almost 85% of physicians.
• Netsmart will exhibit at the National Association for Home Care and Hospice Conference and Expo October 15-17 in Washington, DC.
• PerfectServe will exhibit at the American Association of Physician Leadership Fall Institute October 26-29 in Scottsdale, AZ.
• Sectra releases a new podcast, “The power of remote reading – why radiologists should never settle for less.”
• Symplr partners with the Daisy Foundation to celebrate nursing excellence with the Moments that Matter video series.
• Artera, Availity, Consensus Cloud Solutions, Dimensional Insight, EClinicalWorks, HealthMark Group, Linus Health, Meditech, MRO, and Nuance will exhibit at MGMA’s Leaders Conference October 22-25 in Nashville.

Blog Posts

• What Meditech’s top podcasts reveal about healthcare drivers (Meditech)
• The 5 Biggest Takeaways from ‘Bridging the Gap,’ Our First Ever user Summit (NeuroFlow)
• Burnout’s triple threat: Compromising care, clinicians, and cash flow (Nordic)
• Top 3 Considerations for an EHR Upgrade (Optimum Healthcare IT)
• Highly Trained, Under-Utilized: Advocating for a Shift in Pharmacy Care (OmniSys)
• The healthcare executive’s guide to AI (Redox)
• NASP Recap: How Tech is Closing Info Gaps in Specialty Medication Fulfillment (Surescripts)
• For Epic Implementations the Right Project Manager is Crucial (CereCore)
• Revenue cycle 101: Referral status, authorizations vs. referrals + more (Waystar)
• The $150K Email (VisiQuate)

Contacts

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

Morning Headlines 10/13/23

Access Healthcare Acquires Envera Health

RCM vendor Access Healthcare acquires Envera Health, which offers patient engagement solutions.

Twenty-Three Hospitals in North Dakota Form New Network to Strengthen Rural Healthcare

Nearly two dozen independent hospitals in North Dakota form the Rough Rider High-Value Network to achieve economies of scale; better coordinate care; and improve efficiencies through collaborative IT, health information exchange, and telemedicine.

WellSky Acquires Corridor, Expands Commitment to Offering Best-in-Class Coding, Revenue Cycle Management Services for Post-Acute Industry

WellSky acquires Corridor, which offers coding and RCM services to post-acute care organizations.

Prevounce Health Extends Series A to $7M to Grow Remote Care Management Solutions

Remote patient monitoring and chronic care management company Prevounce Health announces $7 million in Series A funding.

OptimizeRx Announces Agreement to Acquire Medicx Health for $95 million to Expand its Omnichannel Reach to Consumers

OptimizeRx acquires healthcare consumer-focused marketing and analytics software vendor Medicx Health for $95 million.

News 10/13/23

Top News

FDA creates a nine-member Digital Health Advisory Committee that will advise it on topics such as AI, augmented and virtual reality, digital therapeutics, wearables, and remote patient monitoring technology.

Nominations will be accepted through December 11 online.

HIStalk Announcements and Requests

I have never listened to an industry podcast and don’t expect to, but chatty health IT celebrity-seekers are sure cranking out a ton of them. I don’t see how the pool of skilled hosts and expert guests is sufficient to fuel all of the amateur broadcasting that fills my X and LinkedIn feeds, but surely they wouldn’t bother if no one was listening. I can’t see spending 30 minutes listening to a conversation that could be distilled into a couple of sentences, especially if there’s a lot of self-promotion or vendor-paid endorsing going on.

Listening: Eloy, which turned up on a YouTube channel that covers rare progressive rock albums. That led me to happily discover that the band’s catalog is on Spotify. It’s fascinating to listen to music of the wildly creative and diverse 1970s, when bands focused on music rather than choreography, computer trickery, and marketing. The musical groups usually faded quickly into obscurity and unrelated day jobs, with their deepest and most creative thoughts from their teens and early 20s preserved on seldom-heard and rare LPs like insects in amber. The music can be wistfully naive and sometimes primitively executed, but it’s moving to hear knowing that their youthful creators have either died or are into their 70s and 80s.

Just about every social media post I’ve seen about HLTH involves parties, group hugs, and selfies. I’m wondering if anyone found solid business value from attending in lieu of doing actual employer work? It sits well down the list of “conferences I would pay out of my own pocket to attend” in my active poll. Conference attendees apparently set the ROI bar a lot lower than they would for a software purchase, requiring little beyond a target-rich networking environment.

Webinars

October 25 (Wednesday) 2 ET. “AMA: The Power of Data Completeness.” Sponsor: Particle Health. Presenters: Jason Prestinario, MSME, CEO, Particle Health; Carolyn Ward, MD, director of clinical strategy, Particle Health. Is your healthcare organization looking to drive profitability and scale quickly? Our experts will explore how comprehensive clinical data can revolutionize the health tech landscape. This engaging discussion will cover trending topics such as leveraging AI and data innovation to enhance patient care and outcomes, real-world examples of organizations leading the charge in data-driven healthcare, overcoming challenges in data completeness and interoperability, and visionary perspectives on the future of care delivery.

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

Acquisitions, Funding, Business, and Stock

Cigna’s Evernorth Health Services acquires the asynchronous virtual care assets of Bright.md, which it will incorporate into its MDLive virtual care service that it acquired in April 2021 for a reported $1 billion.

RCM vendor Access Healthcare acquires Envera Health, which offers patient engagement solutions.

Yale New Haven Health asks the state of Connecticut to provide financing for its acquisition of three hospitals that are owned by cyberattack victim Prospect Medical Holdings. YNHH also wants Prospect to lower the $435 million acquisition price of the hospitals, whose financial condition is dire to the point of not being able to buy supplies and pay physicians.

Epic offers SmartUser, the renamed Power User program whose website allows any provider to register for 17 free virtual efficiency classes that offer 1 CME credit. Epic says that attendees report that each course attended saves them one hour per week.

WellSky acquires Corridor, which offers coding and RCM services to post-acute care organizations.

People

Rick LeMay, MS (Clearwater) joins First Health Advisory as EVP of enterprise security and technology.

Announcements and Implementations

Lumeon announces Conductor for clinical workflow automation, which includes command center orchestration, digital rounding, and a campaign builder.

Wolters Kluwer Health announces Health Language Platform, a FHIR terminology server that works with Microsoft Azure’s FHIR service.

Sutter Health will create an innovation center by early 2024, for which it is seeking a San Francisco location.

Philips announces interoperability between its Capsule Medical Device Information Platform and its Patient Information Center IX.

Israel’s Soroka Medical Center is using facial recognition to match trauma victims that it is treating to photos that have been sent to a hospital-created email address by concerned family members. Tele Aviv-based Corsight AI provided the technology at no charge.

Microsoft introduces new healthcare-related tools to its Fabric analytics platform that can assemble and standardize data from multiple sources – such as EHRs, imaging systems, lab systems, medical devices, and claims data – and present it in a single view. The company also announced Azure AI Health Bot, which can answer staff questions about treatments and protocols and patient portal queries about symptoms and medical terms. Microsoft also announced a text analytics solution, along with generative AI models that create a patient history, simply medical reports into patient-friendly language, and help radiologists identify possible radiology report errors.

Government and Politics

California’s Delete Act is signed into law, requiring data brokers to delete all information they have on file pertaining to the person who makes the request. The state is required to create a single webpage that routes the individual’s request to all data brokers. It also requires companies to delete all information on file, not just the data they collected about the requester themselves.

Other

A Nature comment article says that use of AI in clinical practice may be limited because developers focus on population-level predictive accuracy while failing to take individual patient differences into account, causing the tools to sometimes offer unreliable advice in failing to answer the “are you sure” question. That leaves clinicians to assess factors that may be misleading the technology.

Sponsor Updates

• Valley ENT reaches 10,000 patients with its first Text2Pay campaign using Healow Payment Services from EClinicalWorks.
• InterSystems welcomes eight new companies to its Startup Program, bringing the total number of participants to 35.
• MRO announces that it has been recognized as the top-performing company for release-of-information digital technology and vendor efficiency in the latest KLAS Release of Information Performance Report.

Blog Posts

• Burnout’s triple threat: Compromising care, clinicians, and cash flow (Nordic)
• Funding Social Care: Streamline Payments to Community-Based Organizations (Findhelp)
• Customer Experience in the New Health Economy (Five9)
• Creating Effective Health Education Content at Scale (Healthwise)
• A No-Fail Guide to Minimizing No-Shows (Medhost)

Contacts

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

EPtalk by Dr. Jayne 10/12/23

The theme of this week’s edition of “Where in the world is Dr. Jayne” seems to involve cities that have either “falls” or “rapids” in the name. We just left the fifth iteration, and I have to say each one has been inspirational in its own way. 

This particular example was flanked by a historic site commemorating a failed business venture that attempted to harness the power of the falls. The owners would control the volume of the pool upstream and unleash it when there were wealthy investors visiting, making the falls seem as if they could generate more power than was realistic.

Reading that plaque instantly reminded me of some of the things I see day in and day out in healthcare IT. Sometimes it’s hard to figure out what’s real code and what’s vaporware because the demos are extremely slick. Of course, those of us who have been in the trenches for a while know that everything is always cooler before you actually buy it, but it was interesting to be reminded that companies have been overstating their potential as long as there have been commercial endeavors.

HIMSS registration is open. This year, I’m branching out to a different hotel. It’s right next door to the place I usually stay, so I won’t be hiking longer to the convention center, but I’m hopeful that it will be better maintained than my old standby was the last time I stayed there.

I was hoping that the new management would innovate on conference pricing, but they’ve kept the tiered pricing structure that makes me feel like I’m being nickel and dimed. A Basic Conference Pass is $945 and includes the opening reception, exhibit hall, education sessions, and “select networking events.” You have to spend an additional $300 to get the Conference Plus Pass, which includes the mentioned items plus the post-conference recordings.

I always appreciated those when they used to be part of the base package since it’s impossible to cover the entire exhibit hall for HIStalk and make it to a decent number of sessions. Not to mention that it always seems like there are two sessions I want to attend at the same time, so that was nice. The pricier pass also includes a pre-conference forum and the Thursday night special event. For an additional $90, you can get the Provider Executive Pass, which includes access to the CXO Experience and an Executive Summit. It looks like the session recordings can be added on for the bargain price of $199. The Thursday night event is available a la carte for $85, but no details about the event are available yet.

I went through the process and noticed some subtle changes to the registration process. Depending on what I listed as my “Worksite,” I saw different options for the passes that were available to me, including a disclaimer on the Provider Executive Pass that said it was “subject to HIMSS approval.” I was also asked if I’d like to participate in the new Hosted Buyer program, which provides two nights of hotel accommodation and travel expense reimbursement in exchange for two hours of time meeting with qualified exhibitors. I was asked to “provide up to 2 goals/objective you have for HIMSS24” and of course the first things that came to mind after “avoid the Florida humidity” were snarky, including “find a coffee line that’s less than 30 minutes long” and “exhibit hall booth crawl with Matthew Holt.” The latter has a greater chance of happening than the former, but we’ll have to see what wishes the HIMSS conference fairies grant me in 2024.

During some downtime during my travels, I went hiking with an old friend who also does information technology work. Her organization is open to the public several days per week and sits in the social services realm, so employees tend to be more office based, although they allowed some employees to work remotely at least part time during the pandemic, particularly on the days when the office wasn’t open to the community. In an effort to double down on culture building, they decided to use one of those non-client-facing days to conduct an all day team-building event.

I have to say, her recounting of the day puts some of the “forced fun” events I’ve heard of into perspective. First, management advertised a “secret breakfast location,” where they would ask people to leave their cars for the day. My friend drives a classic convertible that is in the process of restoration and probably shouldn’t sit out uncovered all day, so she asked if she could have the address in advance to drive by and make sure it would be OK, and was told no. Of course, nothing says respect like not trusting an employee to keep a location confidential while making sure their needs are met.

After breakfast, a bus was to pick the group up and take them to their next location. The “limo bus” that arrived was complete with LED lighting and a bejeweled pole dancing apparatus, which left many of the mostly conservative employees dumbfounded. Employees were driven on that ultimate party bus to the local Walmart, where they were given $20 and 20 minutes to scour the store with a buddy and buy something with the caveat that it “can’t be anything you really need” and that they would have to show it to everyone later and explain why they bought it.

My friend thought that was an odd task as there were several things she would have preferred to spend the unexpected money on but didn’t want to have to explain her purchases to the group. At first, I wasn’t totally understanding the assignment as I thought it was to spend money for something for a donation item to a good cause or something similar, but as she clarified the process it seemed even weirder. Ultimately she ended up with a denim jacket since that would fit the assignment, but she admitted to me that she’d likely take it back and spend the money on what she needed in the first place.

From there it was back on the party bus, with other activities that she felt weren’t that productive as far as bringing the team together or helping them get to know one another. She described the pace as frantic and rushed and said they didn’t feel they had enough time to complete what they were being asked to do, and it was just stressing people out. Towards the end of the day, management asked the team to complete survey cards, collecting them in a hat. They then asked participants to draw a random card out of the hat and read it to the group, and I bet they were surprised when comments such as “exhausting” or “total waste of time” or “we have a pole, where’s the dancer” were read aloud.

My friend is betting they might have a different strategy as they plan for next year’s team-building event, but personally I can’t wait to hear what they come up with. Team-building is a tricky business. Done well, it can create new relationships and strengthen existing ones. Done badly, it can highlight how disconnected leadership is from the team.

Speaking of disconnects, one of the side topics around the virtual water cooler this week was the idea of hospitals and health systems purchasing naming rights for stadiums and other public venues. Although the physicians in the discussion see the value of naming as a marketing tool, they questioned how organizations can spend millions of dollars on those opportunities when they can’t find money to retain nursing staff, recruit scarce subspecialty clinicians, or manage medical debt and collections policies in a patient-centric manner.

I wondered how pervasive this issue is and did a quick tour through a Wikipedia listing of sponsored sports venues in the US. I found 23 instances of the word “health” appearing in those names, including AdventHealth, Atrium Health, Dignity Health, Mayo Clinic Health System, Mercy Health, Sutter Health, and UC Health. Comparing the US to other primarily English-speaking developed nations , there were no examples of the word “health” or “hospital” in the listings from Australia, Canada, New Zealand, or the United Kingdom.

Does your health system employer have naming rights or sponsorships in the community? Does it contribute to better patient care or is it a distraction? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 10/12/23

Evernorth Acquires Bright.md Technology Platform, Enhances MDLIVE’s Virtual Care Experience for Patients and Clinicians

Cigna’s Evernorth Health Services subsidiary acquires and will incorporate Bright.md’s asynchronous virtual care technology and clinical assets into its MDLive telehealth service.

FDA Establishes New Advisory Committee on Digital Health Technologies

The FDA will create a Digital Health Advisory Committee to help the agency better understand the benefits, risks, and clinical outcomes associated with digital health technologies.

Health tech company in bankruptcy cuts 20 jobs, names new CEO

UpHealth Holdings, which filed for Chapter 11 bankruptcy protection several weeks ago, lays off 20 employees and names a new CEO as part of its cost-reduction efforts.

Healthcare AI News 10/11/23

News

Microsoft introduces new healthcare-related tools to its Fabric analytics platform that can assemble and standardize data from multiple sources – such as EHRs, imaging systems, lab systems, medical devices, and claims data – and present it in a single view. The company also announced Azure AI Health Bot, which can answer staff questions about treatments and protocols and patient portal queries about symptoms and medical terms. Microsoft also announced a text analytics solution, along with generative AI models that create a patient history, simply medical reports into patient-friendly language, and help radiologists identify possible radiology report errors.

Google Cloud rolls out AI-powered clinician search for its Vertex AI Search platform. The company says it will speed up clinician EHR searches and to perform more complex operations such as suggesting billing codes or determining if patients meet enrollment criteria for clinical trials. It can also cite and link the source of the information that it finds to ease concerns about hallucination.

University of California health systems and other groups launch VALID AI, which will review uses, pitfalls, and best practices for using generative AI in healthcare and research. The invitation-only group’s name comes from Vision, Alignment, Learning, Implementation, and Dissemination.

Business

Permanente Medical Group will expand its pilot project with France-based autonomous scribe vendor Nabla to 10,000 physicians. The browser-based Nabla Copilot generates clinical notes from conversations between providers and patients and offers white-label API integration with EHRs.

FluidAI Medical raises $15 million in a Series A funding round. The company offers an postoperative patient monitoring tool, powered by sensors and AI, that warns surgeons of anastomotic leaks in the GI tract that has an 8% surgical incidence with 12% mortality. The company is based in Canada and its product has not been cleared for sale in the US, although it lists Cleveland Clinic and Texas Medical Center as partners.

Research

Researchers say that clinical use of AI-powered predictive models feeds data back into the EHR on which model updates are trained, which will then reduce their accuracy when their training is updated. The authors observe that retraining can actually degrade model performance, as updated EHR information disrupts the connection between presentation and outcome. They recommend that health systems document the machine learning predictions that are used on a given patient and warn that a “model-eat-model world” can render an individual model and future models worthless.

Other

Biomedical researchers tell Stat that nobody knows if a given healthcare algorithm is useful because the companies that develop them don’t share data with researchers or anyone else. The authors propose that a federal agency test algorithms against a standard test set and publish their accuracy results, including a breakout by demographic groups, that FDA would use in reviewing a product for approval. They note as a precedent NIST, which evaluates facial recognition software in publicly available reports.

Contacts

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

Morning Headlines 10/11/23

Commons Clinic Announces $19.5M Series A Financing to Unseat Specialty Care Incumbents With its New Model for Spinal Care, Orthopedics, and Pain Management

Los Angeles-based Commons Clinic, which offers value-based specialty care for orthopedics, raises $19.5 million in a Series A round.

Leading Remote Health Care Company Optimize Health Completes $18 Million Series B Financing

Remote patient monitoring and chronic care management vendor Optimize Health raises $18 million in a Series B funding round.

Sutter Health Announces Cutting-Edge Innovation Center to Revolutionize Patient Care & Elevate the Healthcare Experience

Sutter Health (CA) will open an innovation center by the end of 2024 that will offer collaborative space for technology partners to incubate new products and services.

News 10/11/23

Top News

Private equity firm General Catalyst launches Health Assurance Transformation Corp., which will work with the firm’s 20-plus health system partners to test new care delivery and workflow optimization technologies developed by companies within its portfolio.

HATco will also eventually seek to purchase a health system through which it can pilot additional concepts.

General Catalyst’s portfolio includes Athelas, which recently acquired Commure; Aidoc; Imprivata; and Transcarent.

Former Intermountain Health CEO Marc Harrison, MD, MMM will serve as CEO of HATco.

Webinars

October 25 (Wednesday) 2 ET. “AMA: The Power of Data Completeness.” Sponsor: Particle Health. Presenters: Jason Prestinario, MSME, CEO, Particle Health; Carolyn Ward, MD, director of clinical strategy, Particle Health. Is your healthcare organization looking to drive profitability and scale quickly? Our experts will explore how comprehensive clinical data can revolutionize the health tech landscape. This engaging discussion will cover trending topics such as leveraging AI and data innovation to enhance patient care and outcomes, real-world examples of organizations leading the charge in data-driven healthcare, overcoming challenges in data completeness and interoperability, and visionary perspectives on the future of care delivery.

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

Acquisitions, Funding, Business, and Stock

The cycle of de-listing warnings, extensions, and appeals for failing to file financial reports continues for Veradigm, for which Nasdaq has granted a temporary de-listing stay pending a November 16 hearing.

Walmart will offer no-charge virtual primary care from Included Health to 1 million people who are covered by its employee health insurance plan. Walmart’s pilot project with the company saw an 11% reduction in total cost with only 10% of those treated moving to an in-person care setting. One-third of the visits related to chronic or preventative care.

Commons Clinic, which offers value-based specialty care for orthopedics from two Los Angeles area clinics, raises $19.5 million in a Series A round. The company vows to disrupt the “stagnant hospital-centric model” in favor of conservative treatment, digital-first services, and use of surgery centers for procedures.

Sales

• Citizens Medical Center (TX) will implement Meditech Expanse.
• Clemson Rural Health (SC) selects health information exchange and storage capabilities from Sync.MD.
• Intermountain Health will use Clearsense’s 1Clearsense data archival service to consolidate data from its legacy systems.

People

Ashlee DesJardins (StayWell) joins Cordea Consulting as regional VP of sales.

University of Cincinnati College of Medicine names biomedical informatics professor Rodrigo Deliberato, MD, PhD chief research information officer.

Munson Healthcare (MI) names Michael Saad, MBA (University of Tennessee Medical Center) CIO.

Mike Heckman, MBA (Rockcreek Way) joins Beterra Health as president.

Announcements and Implementations

Healthwise announces GA of Health Compass, a service that delivers educational healthcare content in any format to any digital channel.

In England, King’s College Hospital and Guy’s and St Thomas’ NHS Foundation Trusts go live on Epic, which Epic says is the largest single go-live in the world with 51,000 users involved.

Cedars-Sinai launches a virtual healthcare app for patients in California using technology from K Health.

Care.ai equips its Smart Care Facility Platform with Google Cloud’s generative AI and data analytics.

Northern California HIE SacValley MedShare works with Konza National Network to develop behavioral health analytics dashboards.

Orlando Health rolls out AndorHealth’s ThinkAndor Virtual Hospital technology.

Verato will incorporate Clear’s consumer-facing identity verification technology into its healthcare master data management solution.

Main Street Health, which provides an in-house care coordination navigator in each of its 900 mostly small and rural practices in 18 states to support value-based care, raises $315 million in new capital. Investors in the round include the five largest Medicare Advantage plans in the US. One of the company’s investors and builders is Russell Street Ventures, which also backs CareBridge, a provider of remote care to Medicaid patients who prefer at-home care to nursing home admission. That company is named as the fastest-growing in the US by Inc. 5000, with a 157,000% revenue increase last year to $873 million.

Government and Politics

The DEA extends a COVID-initiated rule allowing providers to prescribe select controlled substances via telemedicine through the end of 2024.

The Oklahoma Fraternal Order of Police sues Oklahoma Health Care Authority, claiming that its HIE is unconstitutional because it requires providers who treat Medicaid patients to submit details about the encounter. The plaintiff’s lawyer says the HIE is “the most dangerous attack on Oklahomans’ privacy in the history of the state” and questions its authority to mandate participation or to impose fees that should instead be appropriated by the legislature.

Privacy and Security

The state insurer of the Philippines, which has warned its 36 million members that a ransomware attacked has exposed their information, admits that it didn’t renew its antivirus software agreement in May before the incident because of new government procurement rules. PhilHealth has since asked the antivirus vendor for a 30-day trial of new software.

Other

Advocate Health will send 100 of its Epic experts to England, where they will help seven London hospitals transition to Epic.

Best Buy will partner with virtual care provider Wheel and pharmacy technology vendor HealthDyne to sell prescription continuous glucose monitors from its website. The retailer plans to allow customers to upload CGM prescriptions from their own physicians to their Best Buy health profile.

Sponsor Updates

• Ascom staffers raise $5,000 by riding 10,000 miles in the Great Cycle Challenge to help fight pediatric cancer.
• Nym expands its suite of outpatient solutions for RCM automation to include outpatient surgery and visits.
• Veradigm becomes the first major EHR to join FDB’s Vela e-prescribing network.
• Nuance ranks as the leading vendor for mid-RCM healthcare providers, according to a recent Black Book Research survey.
• Baker Tilly publishes its “Healthcare M&A Update: H1 2023.”
• Censinet releases a new Risk Never Sleep Podcast featuring Skip Sorrels.
• CloudWave wins the Managed Security Solution of the Year Award in the 2023 Cybersecurity Breakthrough Awards program.
• CereCore releases a new podcast, “Vision and Value-Driven EHR Optimization: A Leadership Interview.”
• Current Health publishes a new case study, “The Geek Squad Effect.”
• Surrey and Sussex Healthcare NHS Trust in England roll out Sectra’s enterprise imaging technology to a sixth trust.

Blog Posts

• Implementing a Revenue Cycle Maturity Framework: Best Practices (AGS Health)
• Data on FHIR: Interoperability standards for whole-person care (Arcadia)
• Are You Struggling with Interoperability Challenges? You’re Not Alone (AdvancedMD)
• Screen, stream, support: The tech-driven future of mental health (Nordic)
• Best Practices for Centralized Virtual Sitting (AvaSure)
• Building New Data Connections Helps Brands Lower Adherence Barriers (ConnectiveRx)

Contacts

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

Morning Headlines 10/10/23

Main Street Health Announces $315M Financing Round to Expand Into 26 States

Main Street Health, a practice management company focused on helping rural primary care providers transition to value-based care, announces $315 million in funding and expansion into eight additional states.

Venture capital firm General Catalyst wants to buy a health system

General Catalyst launches Health Assurance Transformation Corp. to acquire health systems that will serve as testing grounds for new care delivery and workflow optimization technologies.

UC Davis Health, NODE.health, and Leading Health Systems launch VALID AI

University of California health systems and partners including hospitals, payers, nonprofits, and vendors launch the VALID AI collaborative to promote best practices for generative AI in healthcare.

Curbside Consult with Dr. Jayne 10/9/23

Hitting the road over the last couple of weeks, I had to really strip down the essentials of what I needed to get my work done. It’s definitely a shocker to go from having either multiple monitors or one ridiculously large monitor to a single laptop screen. I know there are portable second monitor setups out there, but I wanted to see if I could manage the laptop life for more than the week that I usually travel at a time.

My travel companion is in the process of relocating, so I was a bit limited on the overall space in the car due to the household goods crammed into every square inch. I’m the kind of person who has lived in a tent for the better part of a month, so I figured I could find a way to make it work.

It got me thinking about the things I use every day in my home office and how that setup compares to when I used to work in a corporate office and when I go on site for consulting engagements. The home office is always my first choice because it has exactly what I need and I can leave out the things I use often and store the things that are more occasional-use items. The corporate office was similar, although I didn’t have anything on my desk that I’d be sad about in the event it disappeared. We had a standard set of corporate-issued supplies, like a stapler, three-hole punch, and tape dispenser that I don’t really remember using since the whole point of our project was to be paperless. I had an inordinate number of push pins, though, since our cube walls were secretly fabric-covered bulletin boards and I certainly took advantage of that as a way to hang pictures, flyers, and other bits of decoration.

When I travel for consulting engagements, I’ve been fortunate that most of my clients provide nice “hotel” space that includes a multiple monitor setup with docking station and ethernet cable. I had one client whose idea of a productive workspace was an L-shaped bank of bar-height countertops that faced a wall on one side and a set of floor-to-ceiling glass windows on the other. We had to vacate our station at the end of every day, so I ended up carting everything around all the time. If you came in later than others, you were stuck in front of the windows with their never-ending glare.

The stools that they had at these “desks” weren’t exactly the right height, either, and their lack of a footrest meant that your feet ended up dangling. The other option was a cushy armchair with a folding desk on one of the arms that was barely big enough to hold your laptop and definitely wasn’t large enough to accommodate a mouse. In either setup, the idea of a second monitor was a figment of my imagination. I can’t say that I was sad when the engagement ended.

As employers demand that people return to the office, it’s going to be important to create the kind of spaces that make people actually want to come to the office. Will they have a designated space that they will share with one or two other people, or will it be a free-for-all every day to see who works where? Will they have the amenities needed to be productive, such as dual monitors? Will there be company-provided snacks or drinks beyond the stereotypical burned coffee? Many of us have become content in our home office hideaways, and it’s going to take time to reorient us to office rules, such as making sure to take our containers out of the refrigerator before clean-out day and to avoid bringing allergens to the office that might negatively impact our colleagues.

As people go back and forth in a hybrid situation, it will be more important than ever to make sure accounts sync seamlessly between the corporate office and the home office. People also need to figure out what the must-haves are for each office environment and whether they will need to bring things from place to place to feel they have what they need.

I ran across an article recently that talked about dealing with digital clutter, which might be a contributing factor for anxiety and frustration. The author specifically calls out things like photos, old presentations, expense receipts, and other digital artifacts that might be rarely seen but are always present. Then there are the physical objects, including charging cables, old phones, the keyboard that your company shipped to you that you don’t like but will need to possibly return some day, and more.

The author offers some strategies for decluttering. On the topic of power cables, the recommendation is to toss anything that doesn’t have an identified device that it goes with. If there are extra cables, one shouldn’t keep more than two of each version. Further recommendations include discarding anything that hasn’t been used in six months, although we’re reminded to be sure to discard it responsibly. I’m lucky that my city does an electronic recycling event every other month, but not every community is that fortunate.

For cables that are used regularly, the article recommends organizing them as much as possible, including attaching them to desk legs or bundling them for neatness. I’ll admit, I have a pile of twist ties on my desk. I’m always meaning to do some cable management, but I never get around to it. I wonder what that subconsciously indicates about me.

The author goes on to talk about “digital hoarding” and managing obsolete data. They recommend getting rid of files that haven’t been opened in years, purging smartphone apps that aren’t used, and cleaning up photo libraries. Quick decluttering can involve removing duplicates or photos where our technique was less than ideal, or just organizing images into folders. More extensive decluttering involves curation where we determine if particular photos are something we want to see again in the future.

Honestly, if I tried to get into that, I know I’d have an acute case of analysis paralysis, so I’m going to take a pass on that suggestion. It’s definitely easier to clean up data, at least for me. Deciding to purge client files after a certain number of years or months seems cleaner than trying to make a value judgment about whether I think I will want to look at it in the future.

At least for the foreseeable future, I’ve stripped my needs down to what can fit in a business-style backpack and a 40-liter duffel. My traveling companion doesn’t care if I’m wearing the same two pair of Columbia pants all the time, and we are intentionally not going anywhere that requires a fancier level of dress. I’ve got my laptop and a small travel mouse, although I do wish I had brought my full-size one, but I’m sure I’ll eventually get used to the tiny one. I’ve adapted from my ever-present stack of sticky notes and my trusty whiteboard to their digital counterparts, and it was fun to remember that’s how I used to do it back in the day when I traveled every other week, since I had forgotten. Of course, I’ll probably feel different about this when I get back to my bank of monitors, but at least for now it’s fun to rough it a little bit.

What are the office essentials that you absolutely must have, whether at home or in a company facility? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 10/9/23

VA to share health info with private-sector medical systems

The VA and 13 health systems pledge to share data to improve veteran healthcare.

LGI Healthcare Solutions Acquires Boston Software Systems.

Canada-based health IT company LGI Healthcare Solutions acquires healthcare automation vendor Boston Software Systems.

DEA extends pandemic telehealth rules for prescribing controlled substances

The DEA will continue to allow providers to prescribe select controlled substances via telemedicine through the end of next year.

New Generative AI-Native Health Company RhythmX AI Announces Precision Care Platform for Doctors to Deliver Hyper-Personalized Care to the Right Patient at the Right Time

Investment firm SAIGroup funds and launches RhythmX AI, which analyzes longitudinal data to make recommendations to doctors.

Monday Morning Update 10/9/23

Top News

The VA and 13 health systems pledge to share data to improve veteran healthcare via three objectives:

• Accurately identify veterans when they seek care from community providers.
• Connect veterans with resources that promote health and healthcare, especially with those VA services that lower their out-of-pocket expenses.
• Coordinate care and exchange information about care requested and provided, regardless whether they are enrolled in VA health benefits.

Reader Comments

From Supplicant: “Re: health system announcement forthcoming. Don’t run this until you hear it from another source because it might out me.” Sorry to be vague in avoiding exposing the reader’s identity. If you’re privy to details of an upcoming health system’s product switch that I haven’t mentioned, which includes some interesting hosting choices, email me. I’ll keep everyone anonymous while making sure it’s not just easily identified insiders who know.

HIStalk Announcements and Requests

Poll respondents attribute different factors to the success of Epic. Some offered other choices:

• A demonstrated, take-charge implementation process.
• Software architecture that allows Epic to enhance and develop faster.
• Trying to do the right thing, even in the absence of financial reward.
• Connectivity among Epic sites.
• Being led by a founder instead of flipping owners or going public.
• Hiring smart people and motivating them to work hard for customers.
• Being the safe choice for health system C-level executives.
• Marketing in the “invite your friends” sort of way, like an exclusive club where clients want to connect to each other.

New poll to your right or here, featuring a question I ask every few years: Which annual conference would you attend if limited to one and paying your own way?

Topping my current list of annoying business terms: “unlock,” when vendors offer to sell the “key” to snatching some elusive business benefit if you just sign on the line which is dotted. Honorable mention goes to replacing the single-syllable and perfectly descriptive “use” with the bloviatory “utilize” or “leverage.” I’ll also nominate “currently” for superfluity – “I am currently working” adds nothing except three syllables to “I am working,” although maybe it’s an improvement over “at this point in time.”

Webinars

October 25 (Wednesday) 2 ET. “AMA: The Power of Data Completeness.” Sponsor: Particle Health. Presenters: Jason Prestinario, MSME, CEO, Particle Health; Carolyn Ward, MD, director of clinical strategy, Particle Health. Is your healthcare organization looking to drive profitability and scale quickly? Our experts will explore how comprehensive clinical data can revolutionize the health tech landscape. This engaging discussion will cover trending topics such as leveraging AI and data innovation to enhance patient care and outcomes, real-world examples of organizations leading the charge in data-driven healthcare, overcoming challenges in data completeness and interoperability, and visionary perspectives on the future of care delivery.

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

Acquisitions, Funding, Business, and Stock

Canada-based health IT solutions provider LGI Healthcare Solutions acquires healthcare automation solutions vendor Boston Software Systems. 

Virtual rheumatology provider Remission Medical will offer services through KeyCare and coordinating patient care with Epic-using health systems.

Investment firm SAIGroup funds and launches RhythmX AI, which analyzes longitudinal data to make recommendations to doctors.

Announcements and Implementations

Black Book announces the top-performing vendors among HIM users surveyed in the areas of computer-assisted coding, clinical documentation improvement, speech recognition, transcription, and outsourced coding services.

Government and Politics

Cigna will pay $172 million to settle False Claims Act charges that it assigned diagnosis coders review patient medical records to find additional billable codes after its Medicare Advantage plan had already been paid. The Department of Justice says Cigna hired third-party vendors to send nurse practitioners into member homes to find additional billing opportunities, but did not allow them to perform diagnostic tests to support their conclusions or to treat the conditions they supposedly found. DoJ says Cigna inappropriately assigned diagnosis codes for morbid obesity, congestive heart failure, chronic kidney disease, and other chronic conditions without supporting documentation and failed to refund taxpayer money when it was caught.

Doctors push back on CMS’s Merit-Based Incentive Payment System (MIPS) as quality standards toughen as was originally designed, pushing more doctors into penalties rather than rewards.

Privacy and Security

Hackers claim to have acquired user data from the 23andMe genetic service and are selling it online. This data was accessed through the website’s feature that allows users to share information with potential DNA-matched relatives. The hacker alleges that CEO Anne Wojcicki was aware of the breach two months prior and chose not to disclose it, claiming that her family members were shorting company shares in anticipation of a stock price slide.

Other

KFF Health News looks at Dollar General’s test of offering mobile healthcare services from the parking lots of its small-town stores. The company is partnering with New York-based DocGo, which is is being investigated by the New York attorney general after complaints about its treatment of asylum-seekers under a $432 million no-bid contract under which it providers housing and busing. DocGo CEO Anthony Capone resigned last month after a New York newspaper found that he lied about earning a graduate a degree in computational learning theory in pursuing a multi-billion dollar contract with US Customers and Border Protection. Publicly traded DocGo’s market cap is $623 million after shares dropped 44% in the past 12 months. I’m wondering if the van has a restroom for the nurse (and potentially patients) and how safe it is for a nurse to be sitting in the parking lot of stores whose headlines often involve OSHA fines and customer violence. I would not be comfortable welcoming some parking lot rando into the van for an exam.

Central Maine Medical Center settles a malpractice lawsuit that was brought by a patient who claimed that doctors ignored his elevated PSA results, allowing his prostate cancer to spread untreated. The lawsuit says that a computer system upgrade failed to import some lab results into the dashboard of the new system.

Stanford’s medical school dean says that AI will be medicine’s most important development since antibiotics, predicting that it will break down access barriers, improve quality and consistency, increase the efficiency and speed of clinical trials, and reduce rote memorization in medical education. He predicts that responsible AI deployment will create societal benefits and earn patient acceptance in 10 years.

California regulators find that Adventist Health Simi Valley’s administration of two doses of the blood thinner Lovenox within two hours probably caused the brain bleed death of an 81-year-old patient 18 hours later. The original Lovenox order was discontinued after one dose, causing it to disappear from the active profile and to be missed by a second doctor who ordered another dose. The orders were approved by separate pharmacies that didn’t communicate with each other, an Adventist corporate pharmacy and another that is local to the hospital.

The VA finds that a four-hour VistA downtime at the Kansas City VA was caused by a network technician’s keyboard-surfing cat, whose keystrokes deleted a server cluster configuration.

Sponsor Updates

• Black Book’s survey of VC and tech investors reveals the top 50 rising stars in healthcare IT’s ecosystem of startups.
• MRO will present and exhibit at AHIMA 2023 October 8-10 in Nashville.
• Nordic releases a new Designing for Health Podcast, “Interview with Evan Heigert.”
• Wolters Kluwer will add generative AI capabilities to UpToDate.

Blog Posts

• Introducing two new Conversation AI Services (Nuance)
• 6 Communication Channels for EHR Implementations (Optimum Healthcare IT)
• Pharmacists, You Are Appreciated. (OmniSys)
• Nurses of Note 2023: The Regional Practice Administrator Celebrates 30 Years in the Field (PerfectServe)
• The State of Play: What Prescribing Trends Say About the Future of Primary Care (Surescripts)
• Do Family Caregiving Benefits Exist for Employees? (Trualta)
• Revenue cycle 101: prior authorization + referrals (Waystar)
• October 2023 Interoperability Monthly Update: TEFCA, QHINs, ONC’s Latest News (Zen Healthcare IT)

Contacts

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