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Monday Morning Update 4/5/21

April 4, 2021 News 1 Comment

Top News

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Bank of America acquires patient payments technology vendor AxiaMed for undisclosed terms.

AxiaMed’s Payment Fusion offers software vendors the ability to integrate the company’s patient payment solutions with their applications.

Bank of America is developing proprietary merchant services for its clients after dissolving its decades-old joint venture with First Data last year following that company’s $22 billion acquisition by financial services technology vendor Fiserv.


HIStalk Announcements and Requests

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Here’s your top five finishers for US capital of healthcare technology, which I intentionally left undefined.

New poll to your right or here: What is your COVID-19 vaccination status? I ask specifically about timing since HIMSS21 is in August, so that’s the next in-person event data for many of us. I’m double Pfizered, so I’m good to go.

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

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Webinars

April 21 (Wednesday) 1 ET. “Is Gig Work For You?” Sponsor: HIStalk. Presenter: Frank L. Poggio, retired health IT executive and active job search workshop presenter.  This workshop will cover both the advantages and disadvantages of being a gig worker. Attendees will learn how to how to decide if gig work is a good personal fit, find the right company, and protect themselves from unethical ones.

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


Acquisitions, Funding, Business, and Stock

SOC Telemed announces Q4 results: revenue down 13%, adjusted earnings –$3.9 million versus $0.2 million (the company did not release per-share earnings). The company went public in a SPAC merger on November 2, 2020, with share price dropping 32% since then versus the Nasdaq’s 21% gain, valuing the company at $469 million.

The Global X Telemedicine & Digital Health exchange-traded fund was down 3.4% in the past month versus the Nasdaq’s 1% drop. The fund is up 26% since its July 30, 2020 inception versus the Nasdaq’s 23% rise. Its top holdings are Guardant Health, Nuance, Omnicell, Agilent Technologies, Illumina, and Labcorp.


Sales

  • Plexus Research joins the TriNetX global health research network.

COVID-19

Daily US vaccinations exceeded 4 million for the first time Friday, pushing the total of Americans vaccinated to over 100 million. CDC says that 23% of adults and 55% of senior citizens have been fully vaccinated, while 40% of adults have received at least one shot.

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I noticed this cool patch on the arm of a female airman whose Air Force unit was participating in FEMA-operated mass vaccination clinic and asked if I could take a photo. She was deployed from the 335th Air Expeditionary Group, Medical Operations Squadron, which has also provided COVID-19 support to hospitals.

Brazil digs up old graves to make room for the soaring number of bodies from new COVID-19 deaths, 67,000 in March 2021, as the country has vaccinated just 2% of its population and its hospitals are running out of oxygen and ICU beds. President Jair Bolsonaro replaced one-third of his cabinet and all of the country’s military commanders last week, raising concerns that he is preparing for a military coup to remain in office as opponents urge impeaching him for mismanaging the pandemic.

Florida Governor Ron DeSantis issues an executive order that bans the use of COVID-19 vaccination passports in the state, blocking government offices from issuing them and businesses from requiring them. He cites freedom and privacy concerns, saying that “individual COVID-19 vaccination records are private health information and should not be shared by a mandate.” He also notes that some citizens may have infection-acquired immunity and that some may decline to be vaccinated for health or religious reasons.

Google creates a memorable public service announcement that urges people to get vaccinated against COVID-19.


Other

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Aspirus joins other health systems in notifying patients that its vendor MedData exposed their protected health information on a public-facing website. The revenue cycle services vendor was notified by DataBreaches.net in early December that claims data had been found in an open source data repository, although the company did not remove the files immediately and patient letters weren’t sent until last Wednesday. MedData says that a former employee, a developer, saved files to their personal folders on the website. The other health systems involved so far include Memorial Hermann, OSF Healthcare, SCL Health, and University of Chicago.


Sponsor Updates

  • Black Book Market Research names Spok a top-performing behavioral health and mental healthcare industry vendor in the secure provider communications platform category.
  • Kyruus completes its acquisition of HealthSparq, paving the way for seamless, cross-channel care navigation.
  • Netsmart shifts one of its divisions to permanently working from home while it transitions the rest of its 2,400-member workforce back to the office.
  • Pivot Point Consulting celebrates its 10th anniversary.
  • Health Data Movers appoints Monica Gupta and Alyssa Rapp to its board.
  • PMD releases a new video, “Meet our CEO – Philippe d’Offay.”
  • CRN gives Pure Storage a five-star rating in its “2021 Partner Program Guide.”
  • Relatient publishes a new e-book, “The Expert Guide to Patient Engagement Software.”
  • Vocera receives FIPS 140-2 certification for its Smartbadge, required to support secure wireless communication in VA and DoD healthcare facilities.

Blog Posts


Contacts

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

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Katie the Intern 4/2/21

Hi, HIStalk! Long time, no write. Things have been really busy, but I am still making time to write some columns here and there. 

This week’s column focuses on B.well Connected Health, a healthcare technology company that provides a platform for healthcare consumers to stay connected to their providers and their data in a digital, personalized health experience. I spoke with CEO Kristen Valdes, who founded B.well in 2016 as “a way to transform the way consumers interact with the healthcare delivery system by giving them access to all of their health data in one place.”

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Valdes has been an executive in the healthcare field for over 20 years, working in digital health and helping to start one of the first private Medicare Advantage plans in the country. When her daughter began facing an undiagnosed medical issue, she began to see holes in the healthcare information delivery system and felt that she could create a business to fill those needs. 

“When my own child was born with a very significant autoimmune condition, here I was, this healthcare industry expert, and I could not navigate the system on behalf of my daughter,” she said. “She had a near-fatal incident because two EMRs couldn’t communicate with one another.”

It took seven years to get her daughter properly diagnosed, and seeing the failures in the communication of healthcare systems drove Valdes to create a technology company that could mend the breaks. B.well was founded as a system to allow users to have access to their in-person, digital, and virtual care at all times and to share that information with whomever they want. 

“We are a B2B business. We sell into health systems, insurance companies, and pharmacies as a way to aid them in their digital transformation towards the consumerization of health,” Valdes said. “B.well finds a way to connect services that businesses offer into consumer lives, even though 99% of the time, they are outside of the doctor’s office.”

Consumers need to navigate their medical needs and B.well wanted to make it easy for users to have access to all their data, records, appointments, recommendations, and more, all in one place, Valdes said. Though it is not an EHR, B.well is bi-directionally integrated with EHRs.

The process of creating a delivery system started with many questions, including how such a system could get access to healthcare data and give it back to users. “You cannot engage someone in a personalized way if you don’t know anything about them,”  Valdes said. “Data is critical to the consumer.”

Valdes had to make sure that the technology would not impact an EHR’s flow. The integration of B.well is there to connect consumers to their records and information. Regulations were put into place with technology standards that allowed open API interfaces, an important piece to the puzzle. Open API interfaces unlock the ability to push and pull information seamlessly between systems, Valdes said. 

The B.well team did surveys and analyses to see where the user pain points in healthcare data are, creating a basic features list based on the results. Users wanted a simple, affordable system that allows quick and easy access to providers and simple directions for when they need to do something. 

“We started with consumers first and architected what they would want to see out of the healthcare system. Then we reverse engineered that into the data holders and stakeholders of healthcare where all the information as mapped that would be needed to pull together,” Valdes said. “That’s where we determined that a net-neutral platform for consumers was possible.”

B.well also helps providers move their focus into population health as they adjust from fee-for-service models to value-based care. When physicians can see data in real time and track which patients are going to appointments and filling medication accurately, they are able to see their results and adjust care based on outcomes. 

“Because we connect consumers to their data with their consent, we also empower them to share that data back to their provider if they choose,” Valdes said. “Healthcare providers have not historically had the visibility to that information, nor have they had the ability to see the interactions with the healthcare system that happens outside of their own offices. As we shift to value-based care is, it’s much easier to help a provider take risk, meaning that they are going to be responsible for someone’s health outcome.” 

Outcomes are important in value-based care, and to get real results, engagement is necessary. B.well sports a 64% engagement rate versus the industry average 17%, meaning that users both engage and take action towards their health by using the B.well technology system. B.well knows that consumers do not want to log in to a health application once a day, but they will respond when messages are relevant. 

“The way that we define engagement is that consumers not only log in to the application, but they actually take an action towards bettering their health,” Valdes said. “Because we have access to a consumer’s data, we only target them with information and nudges at the point of time that it’s appropriate in their care.” 

B.well also recently partnered with Mastercard as a way to enhance the safety of ID verification for B.well’s services. To verify identity and increase the safety of data and information sharing and matching, B.well will use Mastercard’s biometric tech to validate the identity of users. This has already been implemented in B.well’s use of Mastercard through ThedaCare’s Ripple health management tool.

“In-person encounters are not always the first encounter we have in healthcare,” Valdes said. “We partnered with Mastercard to improve digital identity beyond what healthcare offers today.” 

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That’s it for today! I enjoyed learning about a healthcare delivery system that interacts with EMRs and EHRs to better connect users to their healthcare data and information. Thanks for reading! 

Katie The Intern

Katie

Email me or connect with me on Twitter.

Weekender 4/2/21

April 2, 2021 Weekender 1 Comment

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Weekly News Recap

  • HIMSS acquires healthcare supply chain-focused SCAN Health.
  • Cerner finalizes its $375 million acquisition of Kantar Health.
  • VA Secretary Denis McDonough expresses concern about productivity at its first live Cerner site and the possibility that the project’s cost could exceed its $16 billion budget.
  • Net Health acquires Casamba.
  • MTBC rebrands to CareCloud, taking the name of a previous acquisition.
  • The Department of Justice asks for more information about Optum’s proposed $13 billion acquisition of Change Healthcare.

Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. M in Illinois, who asked for Mini Magic Boards for online sessions of elementary school class. She reports, “This fun and engaging writing tool has been used during our remote learning lessons and during our preschoolers’ asynchronous time as well. They really love to use it, as it gives them an opportunity to practice their writing skills beyond a pencil and paper. We’ve used it to practice writing numbers, letters, their name, drawing shapes, and more. It has made a big difference during our lessons and students have shared photos of how they’ve been using it at home as well. Thank you again for helping us get this writing tool in our preschoolers’ hands and get them excited about learning remotely.“

The one consistent aspect of the US healthcare non-system is maximizing profit. A nine-state group of anesthesiologists sues UnitedHealthcare, claiming that the giant insurer used its clout to steer surgeons away from using the group’s services. United responded by saying that the private equity-owned US Anesthesia Partners, which is not in United’s network, was demanding to be paid double or triple the median rate. The practice countered by claiming that the insurer’s parent company UnitedHealth Group offers its own medical services,  has 50,000 physicians on staff, and holds partial ownership of Sound Physicians, an expanding business that offers emergency and anesthesiology services.

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Adam Litwin, MD,  who served prison time 20 years ago for impersonating a surgical resident for several months at UCLA Hospital – he forged prescriptions, although he didn’t participate in surgeries – fails to match for medical residency for the second time following his 2018 graduation from a for-profit medical school in the Caribbean. One factor in his getting caught at UCLA was that he wore a white jacket adorned with a silk-screened image of his own face, which he claims other doctors envied. Googling “Saint James School of Medicine” turns up fascinating stories from former students and a published US residency match of 6% to 20% over several years.

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A former Atrium Health paramedic who is awaiting trial for fatally poisoning his wife with eye drops he had added to her glass of water is arrested for intentionally setting fire to an in-flight medical helicopter, which was forced to make an emergency landing. Josh Hunsucker refused to give permission for his wife’s body to be autopsied and quickly cashed out her life insurance, but a blood sample that was taken for her organ donation was found to have high levels of tetrahydrozoline, the decongestant in Visine that apparently triggered his wife’s heart attack due to her previous heart problems. Authorities think he was copying a murder in which a former VA nurse killed her husband with Visine two years after he recovered from an injury sustained when she used a crossbow to shoot an arrow into his head.

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Jacksonville, FL police arrest a man who was injecting people with Chinese-labeled Botox while drinking malt liquor and champagne, posing as an oral surgeon at an advertised a “Botox and Bubbles” event at an aesthetic spa. At least his price was right – he charged $350 versus the typical $1,200 cost. Googling “Botox & bubbles” turns up thousands of similar events at aesthetic practices, although they are focused on marketing the service rather than delivering it on the spot.


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Morning Headlines 4/2/21

April 1, 2021 Headlines No Comments

SCAN Health Transitions to HIMSS

HIMSS acquires SCAN Health, which offers healthcare supply chain traceability events, a supply chain maturity scale, business case competitions, and design competitions.

Revelstoke’s Carrus Acquires Archetype Innovations

Healthcare training software vendor Carrus acquires EHR training program company Archetype Innovations.

Cerner Finalizes Acquisition of Kantar Health

Cerner wraps up its $375 million acquisition of Kantar Health, a data, analytics, and real-world evidence and research consulting subsidiary of New York-based Kantar Group.

News 4/2/21

April 1, 2021 News 6 Comments

Top News

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HIMSS acquires SCAN Health, which offers healthcare supply chain traceability events, a supply chain maturity scale, business case competitions, and design competitions.

The company, which is funded by the Canadian government, is hosted by the University of Windsor’s business school.

SCAN Health was launched in 2017 with a four-year, $1.6 million government grant that ended this year.

HIMSS Analytics was one of SCAN Health’s partners and financial supporters.


HIStalk Announcements and Requests

Today’s best Internet meme — April 1 is the only day on which Americans will question whether something they read on the Internet might be untrue.

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I took advantage of some special Donors Choose matching funds and those of my Anonymous Vendor Executive to fully fund these teacher requests:

  • A financial literacy kit for Ms. P’s fifth grade class in Fayetteville, NC.
  • Mice and headphones for Ms. G’s elementary school class in Sharon, WI.
  • Science and math materials for Ms. H’s elementary school class in Houston, TX.
  • Hands-on math tools for Ms. M’s elementary school class in Houston, TX.

I took a short, solo, family-related trip this week, the first time I’ve been on an airplane in quite a while. Every person I saw was appropriately masked, all flights were full (one was even oversold with a $900 offer to take a flight three hours later), and the airports were jammed with restaurant lines that looked 100 people long. It was like before COVID, which actually felt pretty good. People-watching yielded two instances where teen passengers showed up in pajamas, which reminded me of that years-ago fad where college students would head out to restaurants at 2:00 on a weekend afternoon in their PJs for breakfast. I have a feeling that the pent-up demand for travel, restaurants, and entertainment and sports events is about to explode as more people get vaccinated. Here’s a tip for Southwest passengers with Group C boarding who are doomed to a middle seat – take the seat between two folks who are conversing, or where one of them is a child. It’s almost always two family members, one of whom will move to the middle so they can sit together and leave you with the aisle.


Webinars

April 21 (Wednesday) 1 ET. “Is Gig Work For You?” Sponsor: HIStalk. Presenter: Frank L. Poggio, retired health IT executive and active job search workshop presenter.  This workshop will cover both the advantages and disadvantages of being a gig worker. Attendees will learn how to how to decide if gig work is a good personal fit, find the right company, and protect themselves from unethical ones.

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


Acquisitions, Funding, Business, and Stock

The Center for Health Affairs sells its CHAMPS Oncology business, which helps providers with cancer registry participation, to clinical data solutions vendor Q-Centrix.

Acute telemedicine technology and solutions vendor SOC Telemed completes its $194 million acquisition of competitor Access Physicians. 


Sales

  • University Hospitals of Cleveland will implement Epic, according to a reader-forwarded internal email. It will replace Allscripts Sunrise.
  • Southwest Medical Center (KS) chooses Healthcare Triangle for cloud disaster recovery services.

People

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Matthew Smith (Ensocare) joins Kno2 as VP of sales and strategic partner alignment.

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Sharecare hires David Guthrie (PatientPoint) as CIO/CISO.

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Walmart Chief Medical Officer Tom Van Gilder, MD, JD, MPH will leave the company next month.


Announcements and Implementations

Samsung integrates GetWellNetwork’s solution with its healthcare-grade smart HTVs, eliminating the need for external hardware.

Netsmart is named the highest-satisfaction behavioral health ambulatory EHR vendor by Black Book Research, which also found that only 18% of respondents feel they are technically ready to engage electronically for care coordination, patient record exchange, and population health. 

Beth Israel Deaconess Medical Center will use Google’s Care Studio EHR search tool, expanding a pilot project that started at Ascension.

Audacious Inquiry publishes a guide to the new CMS Conditions of Participation requirement for hospitals to send ADT notifications to the community providers of those patients.


COVID-19

Results from the ongoing Phase 3 clinical trial of Pfizer’s COVID-19 vaccine indicate that protection lasts for at least six months and it works against the South African variant. It was also found to be 100% effective in the small number of trial participants that were 12 to 15 years years old. The study has raised no safety concerns, clearing the way for eventual full FDA approval beyond the vaccine’s Emergency Use Authorization.

CDC reports that 21% of US adults have been fully vaccinated, as have 51% of those 65 and over, as 100 million people have received at least one dose.

Nursing homes report that COVID-19 cases are down 98% and deaths down 95% from their peak on December 20. The CMS data does not break out totals by vaccination status.

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FDA issues Emergency Use Authorization two at-home, antigen-based COVID-19 rapid tests that don’t require a prescription, Quidel’s QuickVue At-Home and Abbot BinaxNOW. The tests are intended for serial screening, where an individual who does not have COVID-19 symptoms needs to be tested several times. FDA’s decision took nearly a year, keeping the tests from being sold when they could have had a major impact. Availability and price have not been announced and it’s not clear how self-test results can be used to prove COVID-19 status.

The Washington Post reports that despite dire predictions, some of the country’s richest health systems boosted their incomes in 2020, reporting big surpluses that were increased even more by federal COVID-19 bailouts. Baylor Scott & White Health reported its biggest-ever operating margin as it booked $815 million in profit for 2020, aided by $454 million in taxpayer-funded relief. UPMC tripled its 2019 margin with an $836 million profit that includes $460 million in bailout funds, while Mayo Clinic’s predicted $3 billion revenue loss ended up being increased revenue and a $728 million profit, including $338 million in bailout funds. Big health systems are either lousy at forecasting or good at manipulating politicians.

People who have had COVID-19 need just a single dose of the Pfizer vaccine to reach maximum immunity, researchers find.

A Baltimore company that manufactures both J&J and AstraZeneca vaccines as a subcontractor ruins 15 million doses of the one-shot J&J product when its workers confuse the two products and mix them together. The company, Emergent BioSolutions, was called out last year for selling the federal government $626 million worth of COVID-unrelated national stockpile items, such as anthrax vaccine, that consumed more than half of the stockpile’s budget during high demand for PPE. The most recent US anthrax attack was 20 years ago, when five people died, and the stockpile contains enough doses for 10 million people. The company bought the vaccine patent from the State of Michigan, then raised prices to the federal government six-fold, as that product plus smallpox vaccine increased its revenue to $1.5 billion as it used its clout to halt the development of better and cheaper vaccines by competitors. President Trump had appointed one of the company’s former consultants to run the office that oversees the stockpile. The company’s market value is over $4 billion. 

In England, a study of discharged COVID-19 patients finds that they were admitted four times as often and died eight times more frequently compared to the control group. The rates of respiratory disease, diabetes, and cardiovascular disease were higher and not limited to elderly patients. Nearly 30% of the discharged patients were readmitted and 12% of them died.

Houston Methodist will give its 26,000 employees until mid-April to either get at least one dose of a COVID-19 vaccine have their religious or medical exemption approved. The health system says 83% of employees have been vaccinated and it is mandatory for new employees. The American Hospital Association says it expects most hospitals to hold off from making vaccination mandatory until FDA gives them its full approval instead of Emergency Use Authorization.


Sponsor Updates

  • Vyne Medical launches a podcast series, with the first episode covering “The Future of Healthcare IT in a Post-COVID Era.”
  • Utah Business names Health Catalyst CEO Dan Burton “CEO of the Year 2021.”
  • Wolters Kluwer Health is named publisher of the American College of Medical Quality’s “American Journal of Medical Quality.”
  • InterSystems joins the Vulcan FHIR Accelerator Program to expand interoperability in life sciences.
  • Black Book Research
  • PerfectServe’s Optimized Provider Scheduling powered by Lightning Bolt achieves top customer satisfaction rankings in the latest Enterprise Physician Scheduling report from KLAS.
  • President Bill Clinton will keynote the Everbridge COVID-19: Road to Recovery Executive Summit May 26-27.
  • Azalea Health Innovations integrates its AzaleaONE EHR with PatientPing for event notification.
  • G2 names Halo Health a leader in its “Clinical Communication and Collaboration Grid Report for Spring 2021.”
  • The HCI Group releases a new “DGTL Voices with Ed Marx” podcast, “How IT Saves Lives.”
  • Imprivata and Emerging Global Technologies partner to bring innovative digital identity technology to healthcare providers in the Middle East.
  • Kyruus publishes a new case study, “How Baystate Health Increased Online Accuracy and Access with a Comprehensive Provider Data Foundation.”
  • LexisNexis publishes a new white paper, “Knowledge-Based Authentication Simplifies MyChart Patient Portal Enrollment.”
  • Meditech publishes a new case study, “Princeton Community Hospital improves response time and physician efficiency with Meditech Expanse and Teknicor.”
  • Medicomp Systems releases the first episode of its “Tell Me Where It Hurts” podcast with Jay Anders, MD.

Blog Posts


Contacts

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

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EPtalk by Dr. Jayne 4/1/21

April 1, 2021 Dr. Jayne No Comments

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March 30 marked Doctors’ Day in the US. The date was selected in honor of the anniversary of the first use of general anesthesia in the US, when Dr. Crawford Long used ether prior to a tumor surgery. The US formalized the date in 1990, when President Bush signed a joint resolution created by the 101st US Congress. My practice did nothing to celebrate, so I marked it on my own by scrolling through some photos of my physician exploits. By far one of my most challenging (and rewarding) experiences as a physician was staffing the 24th World Scout Jamboree in 2019. I never thought I would be practicing in a tent, but it was an experience I’ll never forget.

This week also included the ONC 2021 Annual Meeting. I initially had high hopes of making a number of the sessions, but was quickly sidelined as I had to put out some fires with my clients. I was able to catch bits and pieces of some of the presentations but will have to use the on-demand recordings to see the rest of the ones that were on my must-see list. From the sessions I made it to, predictable themes included the use of health IT in the COVID-19 response and interoperability. Major pushes for the former include a basic FHIR approach for vaccine scheduling that could make it easier for patients to find vaccine compared to the “Hunger Games” approach that many patients are experiencing as they compete for scarce spots.

National Coordinator Micky Tripathi credited the health IT industry with making progress on interoperability. He also noted that ONC is helping the White House with plans for vaccine passports. There was also discussion of how health information exchanges fit within the context of nationwide health networks such as the CommonWell Health Alliance. The meeting had over 2,000 attendees in an all-virtual environment and I heard mention of several post-meeting happy hours and get-togethers, also virtual.

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I did a little bit of traveling last week. Even though it was a mid-week trip, my overall impression was one of very few business travelers and mostly leisure travelers, despite the CDC’s recommendation against leisure travel. Fewer seasoned business travelers makes for a messier boarding and deplaning experience, for sure. Most passengers were well behaved and kept their masks on and I didn’t see any flight attendants having to give people extra warnings. My work took me to New Orleans, where I spotted this great mini-pharmacy kiosk. Since many of the patients I see in urgent care haven’t tried any home remedies before coming in, maybe we need strategies like this to encourage people to try a Tylenol or a Claritin before running to the doctor.

One of my best friends is a surgeon. We have been having ongoing conversations about the role of telehealth in his practice versus mine. A recent JAMA Surgery article reported on a study that showed a rise in new patient visits being conducted via telehealth in surgical subspecialties, at least during the first wave of the COVID-19 pandemic in April 2020. The study was conducted in Michigan and found that almost 40% of new patient visits were telehealth-based (compared to 1% pre-pandemic) and decreased as the first peak of the pandemic began to subside.

My last visit to a surgeon could definitely have occurred via telehealth since the physical examination performed was cursory at best and added nothing to the case, other than forcing me to sit for 20 minutes waiting in an awful pink gown that was four sizes too big. As a patient just seeking a second opinion about my MRI and ultrasound results, I could have avoided the hour-long round-trip commute, dealing with the parking garage, and taking more time off work than I wanted to.

Speaking of that visit, it also included some genetic testing, and I was a bit surprised at how the process went compared to previous testing I had done in 2017. The practice didn’t give me any kind of anticipatory guidance on what to expect other than to tell me that results would be back in two weeks (which actually took three). A few days after I had my blood drawn, I received a text from the lab vendor offering me a preliminary cost estimate for my labs, which the surgeon had told me verbally would be fully covered by my insurance. When I followed the link, I had to verify some basic demographic information, then was taken to a page that told me it actually couldn’t give me the estimate due to insurance issues.

When the results were available, I received a MyChart message rather than a phone call from the physician, who claimed that they had a wrong number in the chart and therefore couldn’t reach me. After confirming that every single phone field in Epic has my cell number, I wondered if she even tried to redial after reaching someone else. The message let me know my results were “fine” except for a mutation I already knew I had, and she told me to make sure I’m getting colonoscopies, which I already do, and which she should know since we discussed both the mutation and my recent scope at the visit.

All of that data should be in the EHR from previous visits, so I was left with the impression that she wasn’t fully contemplating my case when she sent the results. Since the outside labs can’t be displayed in MyChart, I’m still waiting for a paper copy of them to be sent to my home. After a previous medical misadventure when the ordering provider missed an abnormal result and told me results were “fine,” I’m not closing the book on this one until I have the paper copy in hand. Just when I think healthcare can’t get any more disorganized or that I can’t have yet one more less-than-optimal patient experience, I continue to be surprised.

Also in the journals this week was a paper on “Factors associated with opting out of automated text and telephone messages among adult members of an integrated health care system.” The authors looked specifically at the volume of messages as a predictor of opting out. They found that patients who received 10 or more text messages or two or more interactive voice response messages were more likely to opt out of receiving future messages. As anyone who has ever opted out of a consumer loyalty program knows, text fatigue is real. Healthcare providers should consider message volumes carefully and make sure they’re balancing what they send with the desired outcomes.

Back to telehealth, a recent piece discussed the realities of telehealth contacts and the things physicians observe in that context. Physicians are able to observe clues from the home environment or interact with families in ways they haven’t been able to previously, sometimes leading to more effective care. I’ve certainly seen some eye-opening situations during telehealth interactions, but as part of a nationwide telehealth-only organization, have even less ability to intervene than I might if I was a traditional primary care physician performing telehealth visits with my own patients. My organization doesn’t have the ability to connect patients with social services or home health referrals, so usually we end up referring patients to brick-and-mortar providers in a process that can take months if the patient doesn’t already have a PCP. We’ll see if payers continue to cover telehealth services as the pandemic dynamics change. Everyone is concerned about the potential for fraud, so we’ll just have to see how things go.

What’s your prediction for the ongoing availability of telehealth services? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 4/1/21

March 31, 2021 Headlines No Comments

CirrusMD Announces $20 Million in Series C Funding

Text-based telemedicine company CirrusMD raises $20 million in a Series C funding round led by Blue Venture Fund.

Q-Centrix Introduces the First Enterprise Clinical Data Management Platform

Clinical data management company Q-Centrix acquires Champs Oncology, a Cleveland-based software and services vendor focused on cancer registry programs.

Governor Lamont Announces Funding To Integrate Remaining Electronic Health Records With Prescription Drug Monitoring Program

Connecticut Governor Ned Lamont allocates $1.3 million in CMS funding to help providers connect their EHRs to the state PDMP via Appriss Health’s PMP Gateway interface.

HIStalk Interviews Josh Schoeller, CEO, LexisNexis Healthcare

March 31, 2021 Interviews No Comments

Josh Schoeller is CEO of LexisNexis Healthcare.

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Tell me about yourself and the company.

I’ve been in the data and analytics space for over 25 years, the last 15 in healthcare. At LexisNexis Healthcare, we use data and analytics to help healthcare operate better and to create healthier communities. That’s front and center right now, given that we spend 18% of our GDP — over $11,000 on every man, woman, and child — for healthcare, yet we don’t even rank in the top 10. We have a lot of work to do, and our data and analytics can help us get better.

How are providers using third-party socioeconomic data of patients, either for care improvement or for their own business outcomes?

They are starting to use it more. I would say that we were pioneers in the SDOH space when we launched our product a little over three years ago, so we have spent a lot of time educating the market. We did some work last year with industry leaders across payer, provider, and health tech on defining the ethical uses of social determinants of health. There was a lot of consternation around how this data should be used.

At the end of the day, it is proven that health outcomes are driven just as much by your social factors as they are by any clinical conditions. It’s critical, if we are going to move to a value-based care system, that we treat people holistically. Their health, not just their clinical conditions. That’s what SDOH is for.

On the provider side, they are using it more from an HRA, health risk assessments, perspective. When you are signing in for your appointment, they’re utilizing information that they give you. They’re not using third parties as much. Some of the cutting edge systems are. We are seeing the third-party use more on the health insurance or the payer side, probably because of the scale. They are not as connected to their members, so they use that third party to get broader insights around population health for larger populations.

To what extent are health systems using outside data?

More and more. That is one of the great areas that we impact today. There isn’t a shortage of data, there’s a shortage of usable data. It is disconnected, siloed, and not standardized. That’s a big piece of what our business does, to help do that data standardization, data transformation, and the linking of that data to incremental data assets to help make better decisions in healthcare.

What are the challenges and imperatives around provider data management?

I was one of the founding members of Enclarity, a company that LexisNexis bought in 2013. We started in 2006 to try to solve provider data quality issues for the industry. Everybody is trying to keep that data up to date, and if every organization is trying to do the same thing, it’s terribly operationally inefficient. If we could do it in one place and leverage that across the industry, then we could do it better, faster, and cheaper for the industry.

We have been successful in being able to roll that out. We have large provider data management businesses across healthcare in health systems, hospitals, health insurance companies, life science institutions, and retail pharmacy.

The challenge is that providers move around a lot. US consumers move on average once every seven years, but the rate of provider change that we see in our MD and DO database is more like 24% per year. To keep up with that, you need to have systems that allow you to monitor, because providers are busy and they are not going to self-report in any meaningful way. We need to be able to monitor and use analytics to track and keep key demographics and key credentials up to date, which then allows us to process claims and have accurate directories for people to find their providers.

Provider data management and the resulting directories have turned into a consumer-facing tool that delivers competitive advantage.

Absolutely. You saw a couple of years ago that a lot of the attorney generals started making regulations around the accuracy rates of provider directories. They were saying that almost one out of every two providers listed weren’t accepting new patients, were no longer at that location, were no longer in network, or had a phone number listed that was no longer correct.

People were going on the exchanges to purchase their insurance, and the #1 driver of choosing an insurance plan outside of price is, do I get to stay with my provider? Almost 50% of the time, they were going to see their provider and finding out that they couldn’t. Then they had to choose between paying out-of-network rates or being disrupted by having to choose a new provider. In California, the AG likened it to a cereal company that lists false ingredients on the box. They put these regulations in place for consumers, not only for their access to care, but also for general continuity.

How are health systems using your systems and data in new ways, especially around the pandemic?

All of our solutions revolve around our three core data assets. They are differentiated proprietary data assets.

First is our provider data, which is the most correct current and comprehensive provider profiles in the US.

The second is the largest de-identified medical claims repository, about 2.2 billion medical claims. You can imagine not only being able to understand where a provider is and what their profile looks like, but now understanding what procedures and what diagnoses they’re doing at what location and who they are referring to, with all that transactional detail being linked. 

The third is more on the consumer side. LexisNexis is one of the largest aggregators of public and private data sources. We utilize that to create a large consumer data asset. That’s a highly regulated data set, but we can utilize it for patient safety. Linking data together from different data sites, making sure that we have high precision, and linking consumer health information together. 

We utilize it for protecting access to data. We do consumer authentication. Health data is yours. As a consumer, you own it. The hospital system doesn’t and the health payers don’t. But for you to get access to it, the covered entities need to make sure you are who you say you are. We have a sophisticated technology to be able to do that identity authentication.

Third is the profile enhancement, like you mentioned before, which is social determinants of health. I’ll give you one use case. During the pandemic, everybody needed to get tested, and now everybody is getting vaccines. We are at the front lines of that, doing the identity authentication. When you log in to check your test results, we’re authenticating that you are who you say you are. When you log in to make an appointment to get your vaccine, we’re doing instant identification of you to make sure that you are a real person so you can then log in to make that appointment.

You mentioned de-identified claims data. The trend is toward drug companies using real-world evidence and performing virtual clinical studies using provider EHR data sold them by third parties, which brings up challenges of data quality and ownership. What challenges do you see in the sudden rush to create a business of selling research data to drug companies?

You nailed the two challenges with it. They call it tokenization of the data. The de-identification of the data needs to meet statistical standards so that it cannot be re-identified. Certainly the SMART on FHIR HL7 standards will help create a better standardization of that data to make it more usable, but we are on the cusp of getting into that with the interoperability rulings coming into play.

Once it is de-identified, you don’t have the consent issue because it is no longer identifiable. But if the entity that is utilizing the data has identified information and they’re trying to link it to it, that can create some concerns as well.

From a hospital system perspective, there’s the new revenue stream of creating real-world evidence, real-world data assets, and leveraging them for life science companies. But I think that the next evolution is even greater, which is not de-identifying it, but  instead the hospital system, as a covered entity, is using it for real-time clinical decision support and clinical health pathways. We need a broader learning and research capability around how we are treating our patients. De-identification allows us to use data for clinical trials, but it’s even more valuable to be able to use it in interacting with our patients on the hospital and health system side.

Are providers using the “patients like this one” model to tap into broad evidence similarly how Amazon recommends an additional item because other customers like you bought it?

Absolutely. The cohort management of the like, I guess I’ll call it, is not only important for providers, but you are starting to see consumers want to be a part of that community and to understand that data.

I run the LexisNexis Healthcare business. Our sister company is Elsevier Health, one of the largest health content companies in the world. We have been doing a lot of work with them to  look within hospitals and health systems to see how they are using content related to those clinical pathways that you described for treatment, as well as for patient engagement. Upon discharge, how are we enabling those patients to understand more about their current health condition, how they should be treating it, and motivating and engaging them to be more in tune with their own health?

How widely are health systems using multi-factor authentication for security and applying technology to positively identify patients?

It’s going to be more and more of a concern. As interoperability enables the rate of health data exchange to go up, up, up, we are going to see the need for tighter data security and identity authentication go up, up, up as well. Some of the regulations have the NIST IAL criteria for authentication. Some of that requires biometrics, which we call TrueID on our side. It uses a driver’s license or a passport photo to verify.

There’s always a fine balance between compliance and enablement of the consumer. You don’t want to put them through such a security gauntlet where 50% of them give up and don’t end up logging in and getting access to the health information that they access. It’s that fine line. As a technology company, we want to enable it to be less abrasive to the consumer, but at the same time, enhancing the overall risk detection on the identity side.

You have seen that we’ve acquired several companies over the last few years, ThreatMetrix being the largest. ThreatMetrix is the largest digital identity network contributory database in the world that understands the IP address of your laptop and your phone. As you are logging in, we can say, “that phone belongs to Josh Schoeller” versus seeing that it’s routing through Eastern Europe. Doing bot detection, checking that the keystrokes are at the speed of someone typing instead of the same individual doing 136,000 transmissions in the last 30 minutes trying different access codes. All those things need to happen behind the scenes and in real time to help with security and to enable consumer access to their health.

How will vaccination passports work?

Every state has their vaccine registries. We work with several partners that interact with them and help them in various ways. All vaccine locations are required to submit to the federal registry.

The question is, will that become a consumer asset? We are seeing apps and companies pop up, saying that you can have your vaccines documented on your phone and pull it up when you want to go to a concert, get on an airplane, or send your kids back to school. There is definitely value in that utility, but the question is, what’s the commercial model? Will people actually pay for that access? If not, what’s the commercial viability of that space? Certainly this pandemic gave us all new kind of understanding. It changed the game as far as the importance of vaccinations and people’s access to them.

How has the pandemic changed the company’s business?

When the pandemic hit, we got together to say, what are the risks and what are the opportunities? We are a health business, and this is a health pandemic, so it’s going to be more impactful to us than other industries or other areas of the broader business.

We were able to look at how we could pivot into the needs that the pandemic created. Within three weeks of the offices shutting down last, almost a year ago this week, we created the LexisNexis COVID data resource. We put that out on the internet for free. That tracked every day all of the people who got COVID, using the Johns Hopkins data. We overlaid that with our claims data to understand hotbeds of comorbidities. We then overlaid that with our social determinants of health to understand other impacts to those communities. Finally, we overlaid it with our provider information. Where are the pharmacies, where are the hospitals that need to treat all these people? You could start to see hotspots of where we needed more resources. That was put out there to help the research community. Out of that, we interacted a lot with our customers around how they could utilize their data during COVID.

On the broader industry side, we were already moving rapidly towards digital healthcare, the digitalization and consumer-driven healthcare. COVID probably moved us five years ahead in that area. We saw a 400% increase in the use of telemedicine. That’s not going to go away. Consumers, because of all the news and all the information that was out there, generally got more engaged, and they did that in a digital way. That’s not going to change.

Our business needed to pivot to help both the consumer-patient-member as well as our customers, who are payers, pharmacies, and hospital systems. How we can help that digital experience — from a data security, compliance, and operational efficiencies perspective — improve health and healthcare delivery in the United States?

Do you have any final thoughts?

We are on the cusp, and we are seeing it every day, of healthcare transforming. It is consumer driven and digitally driven, but at its roots, it will be driven by the use of data and analytics to help drive better health care outcomes.

LexisNexis and other companies are in a unique position to help both public and private sector healthcare improve healthcare outcomes. That’s our mission and goal over the next several years. I’m bullish on us being able to improve healthcare delivery, as well as health outcomes, to create healthier communities across the US and being able to have the data and metrics to track that from an ROI perspective for our customers.

Morning Headlines 3/31/21

March 30, 2021 Headlines No Comments

SteadyMD Raises $25 Million to Power Telehealth Infrastructure for Digital Health Companies and Employers in All 50 States

Telehealth provider SteadyMD raises $25 million in a Series B funding round, increasing its total to $35 million.

Optimum Healthcare IT Acquires TrustPoint Solutions

Optimum Healthcare IT acquires TrustPoint Solutions, which offers technology planning and implementation solutions.

VA secretary worried by productivity issues, rising costs of $16 billion EHR rollout

VA Secretary Denis McDonough is concerned about user productivity at its first live Cerner site, raising the issue that the project’s cost could exceed its $16 billion budget.

SOC Telemed Completes Acquisition of Access Physicians To Form Largest Acute Care Telemedicine Company in the US

Acute care telemedicine company SOC Telemed acquires competitor Access Physicians for $194 million.

News 3/31/21

March 30, 2021 News 1 Comment

Top News

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Specialty-focused software and analytics vendor Net Health acquires Casamba, an EHR developer that focuses on home health, hospice, and outpatient therapy providers.


HIStalk Announcements and Requests

Listening, and continuing my 1960s psychedelia fascination: Vanilla Fudge, in a bizarre, grainy TV appearance that captures the era perfectly. The tuxedo-wearing, white-bread TV host gamely turns it over to the annoyingly trippy and somewhat pretentious Fudge, who having enrobed themselves in trendy Nehru jackets, dashikis, and scarves, employ the wildest flourishes imaginable while go-go dancers in tunics and knee-high white boots gyrate freeform to the band’s cover of “You Keep Me Hanging On.” The Fudge could have lip-synced like most bands did in these crappy TV variety shows that catered to senior citizen viewers downing shots of Geritol, but they instead laid down a museum piece of their divisive talent in which every member achieved maximal punchability but sounded great doing it. The over-the-top yet consummately skilled bass player is Tim Bogert, who died in January at 76. The go-go dancers are now great-grandmas with wild memories.


Webinars

April 21 (Wednesday) 1 ET. “Is Gig Work For You?” Sponsor: HIStalk. Presenter: Frank L. Poggio, retired health IT executive and active job search workshop presenter.  This workshop will cover both the advantages and disadvantages of being a gig worker. Attendees will learn how to how to decide if gig work is a good personal fit, find the right company, and protect themselves from unethical ones.

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


Acquisitions, Funding, Business, and Stock

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Crossover Health, an online and in-person primary care company that serves payers and employers, raises $162 million in a Series D funding round, bringing its total raised to $282 million. Earlier this month, the company expanded its territory for Amazon employees from its pilot site of Dallas to four more states. The founder and CEO is Scott Shreeve, MD, who founded Medsphere with his brother Steve in 2002.

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Cardiac remote patient monitoring and data management company PaceMate raises $8 million.

Telehealth provider SteadyMD raises $25 million in a Series B funding round, increasing its total to $35 million.

Optimum Healthcare IT acquires TrustPoint Solutions, which offers technology planning and implementation solutions. 


Sales

  • Carilion Clinic (VA) will work with MetiStream to develop AI-enabled Surgical Clinical Review software to improve case reviews and decision-making.
  • Tampa General Hospital (FL) will add TytoCare’s home medical exam kit to its virtual TGH Urgent Care services.
  • Millennium Physicians (TX) goes live with RCxRules to automate charge review and charge correction, integrated with their NextGen PM/EHR.

People

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Kristen Hagerman, MS, RN-BC (Connected Care Consulting) joins Kaleida Health (NY) as CNIO and VP of clinical informatics.

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Censinet hires Cormac Miller (Optum) as president and chief commercial officer.

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Divurgent names Stephanie Evans (Accenture) security and privacy principal.

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Flatiron Health promotes Carolyn Starrett to CEO. She succeeds Nat Turner, who will remain chairman of the board.


Announcements and Implementations

In West Virginia, Cabell-Huntington Health Department will implement Epic through a partnership with Mountain Health Network.

Sharp HealthCare (CA) implements patient review and feedback capabilities from Podium.

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Healthcare Triangle develops Readabl.ai, automated document capture, processing, and data-routing software.

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A Brigham and Women’s study finds that Epic-using medication prescribers would receive 94% fewer alerts by using Seegnal, a commercial clinical decision support product that was developed by Israel-based Seegnal EHealth. Seegnal’s platform uses patient EHR data, algorithms, drug interaction references, and pharmacokinetic and pharmacogenetic databases to present only relevant alerts and then suggest alternatives. The company says its system offers 98% accuracy versus the 6% provided by commercial EHRs, then allows clinicians to detect, prioritize, and resolve problems in 5-10 seconds.

Health plan support company NeuGen implements real-time care alerts from PatientPing.

Pivot Point Consulting expands its virtual care services practice to include telehealth selection and implementation, integration, revenue cycle, patient experience, and app development.

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A new KLAS report looks at social determinants of health referral networks, with Aunt Bertha leading the small pack. Unite Us – which just announced a funding round that values the company at nearly $2 billion — scored well, though with fewer healthcare customers.


Government and Politics

VA Secretary Denis McDonough says in a House hearing that he is concerned about user productivity at its first live Cerner site, Mann-Grandstaff Medical Center (WA), raising the issue that the project’s cost could run over its $16 billion budget.

Tulsa-based MyHealth Access Network withdraws its protest of the state’s selection of Orion Health to provide a statewide HIE platform for $49.8 million, which is nearly $30 million more than its own bid. MyHealth founder and CEO David Kendrick, MD says it’s time now to focus on partnering with the new HIE to improve care for patients across the state.


COVID-19

Federal health researchers report that the Moderna and Pfizer COVID-19 vaccines prevent 80% of infections two weeks after the first injection, then 90% two weeks after the second shot. The CDC study also found that the vaccines seem to offer protection against coronavirus variants. It also noted that while more than 50% of people weren’t having symptoms when they were diagnosed, 90% eventually developed them.

CDC reports that 50% of all US seniors have been fully vaccinated.

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The White House assigns HHS to standardize the development and management of vaccine passports to support business reopening and travel, encouraging solutions that are free, open source, secure, and able to create both electronic and paper documentation similar to an airline boarding pass. The government has identified at least 17 initiatives that are underway. An unnamed official says such credentialing will take time because “this has a high likelihood of either being built wrong, used wrong, or a bureaucratic mess” since developers need to consider how to address variants, track booster shots, and account for yet-unknown immunity duration.

Meanwhile, the Wall Street Journal suggests that people keep their vaccine card because it is often their only record of being vaccinated, although the card design is not consistent and would not be hard to fake.

HHS will investigate a three-location, surgeon-owned California outpatient clinic that has been paid $146 million from the federal government’s COVID-19 patient assistance program. The practices are owned by Anthony Dinh, DO, an ENT and plastic surgeon.

The New York Times examines COVID-19 testing bills from Lenox Hill Hospital (NY), which advertises its testing services on a banner outside its ED but doesn’t mention that the hospital charges $3,000 per test, multiples of the typical cost. One family needed 12 tests last year to return to work and school and was billed $39,000. The paper also found that owner Northwell Health has charged similarly high prices for drive-through tests by tacking on ED fees. Federal law requires insurers to fully pay for COVID-19 testing with no cost to patients, so patients don’t actually have to pay, but as a medical billing expert told the paper, “This is such a gold mine for hospitals because now they can charge emergency fees for completely healthy people that just want to be tested. This is what you’d expect from a market-oriented approach to health care. It’s the behavior our laws have incentivized.” Northwell says patients who present a doctor’s order are sent to a service center that does not charge ED fees, but those who just show up – many from seeing the banner urging them to do so — are evaluated in the ED with the facility fee added on. Lenox Hill has also been criticized for opening a freestanding ED and charging patients, who sometimes confuse it with an urgent care center, many multiples of the usual cost, such as $3,000 to treat a sprained ankle. Northwell’s closest urgent care center down the street performs the same COVID-19 test with a doctor visit for just $350, so choosing the wrong of two doors will cost an extra 700%.

Pfizer will begin US studies in April of a version of its COVID-19 vaccine that can be stored under normal refrigeration.


Other

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Wisconsin’s UW Health OB-GYN department requires patients to sign surgical consent forms the day of surgery instead the day before, as noted in a newly issued medical board order against Jay Lick, DO. A patient told Lick in an office visit that she did not want her ovaries removed as part of a hysterectomy, then called his office back later to say that she had changed her mind. The nurse added an EHR note that Lick didn’t see, so the ovaries weren’t removed and she had to undergo a second surgery later the same day. The state’s review noted that the clinic’s EHR does not share information with the hospital’s EHR, so the information that the surgery team reviewed during surgery timeouts did not indicate ovary removal. The board also found that the OR team used medical procedure terminology that the patient would not have understood, so she didn’t catch their mistake. The clinic’s consent forms wasn’t scanned into the hospital EHR until after the patient had been discharged.


Sponsor Updates

  • King Abdulla Medical City in Saudi Arabia goes live on Agfa HealthCare’s enterprise imaging.
  • The Chartis Group names Mike Brown (MD Anderson) director.
  • HST Pathways will incorporate RCM software from Waystar with its software for outpatient surgical centers.
  • Frost & Sullivan recognizes Wolters Kluwer Health with a 2021 New Product Innovation Award for its suite of clinical surveillance solutions.
  • Glytec releases the newest version of its EGlycemic Management System, including enhancements and new integrations to improve workflow and patient safety.
  • Hills Health Solutions incorporates GetWellNetwork’s patient engagement solutions with its technologies already in use in hospitals Australia and New Zealand.

Blog Posts


Contacts

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

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Morning Headlines 3/30/21

March 29, 2021 Headlines No Comments

Crossover Health Secures $168 Million in Series D Financing to Fuel Expansion of National Primary Health Service

Crossover Health, a primary care company serving payers and employers like Amazon, raises $162 million in a Series D funding round, bringing its total raised to $281.5 million.

MTBC is Now CareCloud

Ambulatory health IT company MTBC rebrands to CareCloud, which it acquired in early 2020.

Net Health Acquires Casamba

Specialty-focused software and analytics vendor Net Health acquires Casamba, which has developed EHR software for therapy providers, and home health and hospice organizations.

PaceMate Closes Series A Financing to Accelerate Growth

Cardiac remote patient monitoring and data management company PaceMate secures $8 million in Series A financing from Ballast Point Ventures.

Curbside Consult with Dr. Jayne 3/29/21

March 29, 2021 Dr. Jayne No Comments

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I recently received an email from Doximity, which is kind of like a physician-specific LinkedIn that also offers some services such as being able to call patients using your cell phone but have your office number display in the caller ID. The email invited me to review a personalized report on diagnostic behavior among US clinicians, comparing me to other family physicians using data provided by CMS. It sounded interesting, so of course I clicked the button. It goes without saying that when CMS data is your kind of clickbait, you must be a clinical informaticist.

The actual report was less exciting than the teaser – it only showed five diagnoses for a total of seven claims. Sinusitis was the leader, with pinkeye, wrist sprain, allergic rhinitis, and right lower quadrant pain following. That’s a typical day in urgent care, but I was surprised to see such a small number of claims. Digging deeper into the information that came with the report, the data was drawn from CMS claims files available at Data.CMS.gov. It also reflected the 2019 calendar year. I’m pretty sure I saw more than seven Medicare beneficiaries in 2019, but who knows how the data was parsed.

There was also a set of comparison data, looking at how I fared versus other physicians in my specialty in the same state. I apparently see significantly fewer cases of hip pain, cellulitis, and bronchitis than my peers. I found that funny since I’m an urgent care physician and those kinds of acute conditions make up the bulk of my practice. I’m sure they were pulling the data using the CMS specialty taxonomy codes alone and not stratifying by place of service. I wonder how I would stack up against other urgent care docs in my area. The top diagnoses in my state were not surprising – hypertension, hyperlipidemia, and type 2 diabetes. These were similar to national diagnosis rates.

The one thing I did find surprising was the number of encounters that they said family physicians were billing for “Encounter for screening mammogram for malignant neoplasm of breast.” I don’t know a single family physician who performs or interprets mammograms, so I was surprised that the data said that more than 71,000 of my peers have been documenting it on claims. Based on the coding education I’ve received, it should only be coded by the person reading the mammogram, but maybe something has changed and I missed it because I’ve been deep in the COVID-19 trenches.

I visited the CMS data site and try to find the raw data to see if I could come up with other conclusions, but was never able to find the correct file for 2019. Probably it was there but named something that didn’t click in my brain as being a claims data file, even though I tried various filters and searches including just trying to restrict to outpatient data. I would be curious to see how the diagnosis patterns shifted over the years and whether the usual problems are still the usual problems. I know there have been some shifts in conditions like sinusitis due to the pandemic, since more people are wearing masks.

I’m not sure how useful the data would be if I had it since it’s just Medicare data, and Medicare beneficiaries represent a small percentage of my practice. It would be much more useful as a provider to be able to see a big, aggregated data set that looked at multiple years, irrespective of where I’ve practiced. Sure, you could get your diagnosis mix out of your EHR, but for people like me who have worked in a variety of settings and places, that’s easier said than done.

Data is interesting stuff, but it’s only as powerful as the people who have access to it and the tools they have to manipulate it. If we really want to use it to make change, we need to be able to further stratify it. For example, what does my data look like when compared against other in-person urgent care settings? How does an independently-owned urgent care’s treatment habits compare against one that is owned by a hospital system? Does it make a difference whether physicians are full-time or part-time, or how long it has been since they finished their medical training? It would be fun to have that kind of data at your fingertips, at least if you’re someone who’s into that sort of thing.

Although I’m pretty good at manipulating data, I miss having easy access to dedicated data analysts on a daily basis. As a CMIO, I loved having a team where I could explain a business problem and trust that they knew not only how to find the data in the applications (or who would know, if they didn’t) but also the best ways to render it depending on the intended audience. Working with my health system clients, I tend to be at the mercy of their IT teams and sometimes it can take weeks for a request ticket to make it through the support queues before I hear from someone who will attempt to track down the information I’m looking for. Sometimes it even takes so long that by the time we have an answer to the question, the team has moved forward with a decision without the benefit of data. That can be maddening, but it’s common when there is a mismatch of supply and demand.

I think the more useful type of report looks at not only what you diagnosed, but how you treated it, as well as whether the condition was well controlled if it’s a chronic one. Physicians seem to see some of those reports more often in the post-Meaningful Use era than they used to previously, but I know that some organizations only present their clinicians with data a couple of times a year where others may have monthly or real-time access. If there are any physicians out there who received a similar report from Doximity, I’m curious what you thought of your data and whether it was useful in any way.

What kind of reports would help your clinicians deliver the best care and best outcomes? How often should they be reviewed? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 3/29/21

March 28, 2021 Headlines No Comments

DOJ Extends Review of UnitedHealth, Change Healthcare Deal

The Department of Justice requests additional information from Change Healthcare about its proposed $13 billion acquisition by UnitedHealth Group’s Optum.

Preveta Raises $2M To Coordinate Care For Early Disease Detection

Los Angeles-based Preveta, which has developed care coordination software for cancer patients, raises $2 million.

ESO Receives Strategic Investment from Vista Equity Partners to Accelerate Delivery on Mission to Improve Community Health and Safety Through Data

Vista Equity Partners invests in ESO, which helps EMS agencies, fire departments, and hospitals share health data more effectively.

Monday Morning Update 3/29/21

March 28, 2021 News 7 Comments

Top News

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A Change Healthcare SEC filing indicates that the company has received a Department of Justice request for additional information about its proposed $13 billion acquisition by UnitedHealth Group’s Optum.

The American Hospital Association asked DoJ for an antitrust review on March 17, expressing concerns about reduced health IT market competition and moving control of healthcare data from the independent Change Health to the insurer-owned Optum.


HIStalk Announcements and Requests

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The most popular poll respondent options for improving the privacy of patient data involve restricting the sale or sharing of identifiable data without the patient’s permission.

New poll to your right or here: Which city or region has the strongest claim to call itself the US capital of healthcare technology? I’m sure I didn’t think of every contender, so add a comment after voting if I missed an important one. I’ll compare these results to those of a similar poll I ran many years ago.


Webinars

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


Sales

  • Summit Healthcare announces several sales of its Provider Alert ADT notification and care coordination solution, including Lincoln Surgical Hospital, Bartlett Regional Hospital, and Madera Community Hospital.

People

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Jillian Wood, MBA joins Pivot Point Consulting as VP of marketing and operations.

Sphere promotes Ryne Natzke, MBA to SVP of growth and strategy.


COVID-19

The remarkable pace of COVID-19 vaccination in the US continues with daily doses exceeding 3 million, as CDC reports that nearly 20% of adults are fully vaccinated and 72% of those 65 and over have had at least one shot.

Case counts are surging again in Michigan, Massachusetts, and the New York tri-state area , with much of the increase in the 10-19 age group. Overall US case counts are also rising again, with increases in 34 states, and hospitalization numbers are up in 20 states. Former FDA Commissioner Scott Gottlieb, MD urges surging vaccine supplies to the hardest-hit areas.

In Canada, a physician and past president of the Ontario Medical Association says that COVID-19 has exposed the weaknesses of non-integrated EHRs. He says it’s getting better, but in the mean time, “There’s no way of tracking who’s ill and no way of sharing information electronically from say Collingwood hospital to Toronto General and there’s no way of sharing information from the hospital to public health if someone’s really sick with COVID so they can start the contact tracing process. It’s all done by paper and fax and that sort of thing.”


Other

The updated HIMSS21 schedule shows that some of the keynote speakers that were scheduled for HIMSS20 will be back —Alex Rodriguez, former governors Terry McAuliffe and Chris Christie, and Arianna Huffington. I assume that former President Trump won’t be kicking things off this time around. I made my keynoter suggestions last November.

KHN describes a patient whose $30 yearly arthritis injection was suddenly billed at $1,400, of which she owed $355. The hospital-employed doctor had been moved up one floor in the same building to be classified as a “hospital setting” that supports a $1,260 “operating room services” fee even though the woman didn’t have a procedure or infusion. The hospital threatened to take her to collections, so her family chipped in to cover the cost. As someone pointed out on Twitter, it would be like a Starbuck’s $2 coffee that costs $20 if you buy it from a stand inside a grocery store.


Sponsor Updates

  • Nuance announces that independent ambulatory clinics are accelerating the adoption of its Dragon Ambient Experience (DAX) ambient clinical intelligent solution and reporting significant gains in satisfaction.
  • Pure Storage’s FlashBlade nears $1 billion in sales and is used by more than 25% pf the Fortune 100.
  • GHU Paris selects Sectra’s digital pathology solution.
  • Vocera is partnering with Status Solutions to enhance and expand alert management solutions in long-term care facilities.
  • The Modern CTO podcast features Waystar CTO Chris Schremser.

Blog Posts


Contacts

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

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Weekender 3/26/21

March 26, 2021 Weekender 1 Comment

weekender


Weekly News Recap

  • Amwell’s Q4 and fiscal year numbers, along with anemic projections for 2021, send shares down.
  • Bankrupt Astria Health again blames Cerner for its financial problems in bankruptcy court, saying the company overstated the integration between Millennium and its revenue cycle offerings that caused collections to plummet.
  • Providence spinout DexCare raises $20 million.
  • Data and analytics vendor Komodo Health raises a $220 million Series E funding round.
  • Appriss acquires PatientPing for a reported $500 million.
  • Aggregation and analytics vendor Evidation Health raises $153 million.
  • VA Secretary Denis McDonough orders a 12-week strategic review of its Cerner implementation following reports of problems at its first live site, Mann-Grandstaff VA Medical Center.
  • AHA asks the Department of Justice to review Change Healthcare’s $13 billion acquisition by Optum.

Best Reader Comments

[Re: Amazon’s virtual health business] Local primary care physicians / groups may be able to use this as a platform to deliver virtual health services (Amazon seller services model). If the movement towards loosening state-based licensing requirements continues to gain steam and results in long-term policy changes (Amazon might put some lobbying dollars behind it), this particular play can have a real impact in addressing clinical resource shortages, especially in rural and underserved areas. (Vikas Chowdhry)

[On Ro] They say, ‘Oh, healthcare is a $4 trillion market – it’s so massive.’ But that’s the worst thing in the entire world; it’s awful how large it is. And I think what we have the opportunity to cut it in half with technology.” So, watch out world! Ro is out to cut healthcare by $2 trillion. He further claims that: “While Ro doesn’t work with insurance currently, Reitano points out that he’s not against the concept entirely” (thank for letting us exist, exhaled UnitedHealthCare, Anthem, Aetna, Cigna and Humana) …  I wish I had the [misplaced] confidence of a well-connected, well-funded white male. (Ghost of Andromeda)

We obsess a little too much over legislating privacy around PHI versus privacy in general. (James E. Thompson, MD)


Watercooler Talk Tidbits

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Readers funded the teacher grant request of Ms. L in California, who asked for a library of 22 books for her class of 3-6 year olds with Autism Spectrum Disorder. She reports, “These books will be used for virtual story times and small group lessons via zoom. Additionally, they will possibly sent home for parents to read to their children. Eventually when school reopens in a face-to-face manner, we will finally be able to read our stories as an entire class. We thank you for your donations and passion for helping students learn to love literacy.”

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Industry long-timer John Hummel died on March 20 at 67. He had served as SVP/CIO of Sutter Health, CIO of California Prison Healthcare Receivership, CTO of Dell Perot Systems, and CISO of Tahoe Forest Hospital District and Taos Health System.

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Bobby Brown, MD, a four-time World Series winner with the New York Yankees who left the game at 29 to pursue a career in cardiology and then returned as American League president for 10 years, died this week at 96. He also served in the Navy in World War II while completing his pre-med work, then was recalled for the Korean War, where he served as battalion surgeon. He was the last surviving Yankee of the 1940s. He told his future wife how to introduce him to her parents: “Tell your mother that I’m in medical school, studying to be a cardiologist. Tell your dad that I play third base for the Yankees.”

The Defense Health Agency updates its RFI for a cloud-based veterinary EHR that will replace its custom-built system that manages medical records, scheduling, billing, and inventory for 140 DoD facilities. The new system must interoperate with its Cerner EHR for humans, the Air Force’s Working Dog Management System, and the military’s animal disease surveillance and laboratory systems.

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A man who lived for 35 years since the age of 15 thinking he would die any time of a brain cancer that is usually quickly fatal discovers from old medical records that he was diagnosed incorrectly. Jeff Henigson was contacted last year by a neuropathologist who saw his story on BBC News and told him that he had seen just three cases of anaplastic astrocytomas where the patient beat the expected bleak life expectancy of 2-3 years, and two of those cases involved an incorrect diagnosis by a pathologist. Henigson dug through his old paper medical records that his mother had kept, in which two pathologists from local hospitals declared his tumor benign, but a second opinion in 1986 from an unnamed prominent institution concluded that he had a different kind of tumor that was aggressive and likely to be fatal. Based on that faulty diagnosis, he endured surgery and months of brain radiation and chemotherapy that left him with permanent hearing loss, vision problems, epilepsy, and lung problems.

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A painting by reclusive street artist Banksy that honors NHS frontline COVID-19 workers sells for $23 million, with the proceeds going to Southampton Hospitals Charity. The price, at 10 times the pre-auction estimate, is the most ever paid for a Banksy work.


In Case You Missed It


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Morning Headlines 3/26/21

March 25, 2021 Headlines No Comments

Amwell Announces Results for Fourth Quarter and Full Year 2020

Telehealth vendor Amwell reports Q4 results: revenue up 34% with a net loss of $50.6 million versus $22.7 million.

Everlywell Acquires PWNHealth and Home Access Health Corporation, Forming Everly Health

At-home lab test vendor Everlywell acquires testing company PWNHealth and self-collected lab test processor Home Access Health Corporation, valuing the company at a reported $3 billion.

Astria Health files complaint against former billing collection vendor

Astria Health (WA) blames Cerner for its bankruptcy and the closure of Astria Regional Medical center in bankruptcy court, contending that Cerner fraudulently misrepresented that Millennium would integrate seamlessly with its revenue cycle offerings.

News 3/26/21

March 25, 2021 News 1 Comment

Top News

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Telehealth vendor Amwell reports Q4 results: revenue up 34% with a net loss of $50.6 million versus $22.7 million. The company did not provide per-share numbers.

Amwell saw increases of several hundred percent in providers and visits for the year, but revenue increased only 65%.

AMWL shares, which closed on their first day of trading in September 2020 at $23.07, are at $17, valuing the company at $4 billion.

Amwell expects $265 million in revenue for 2021, nearly flat over 2020, and a loss in the $150 million range.


HIStalk Announcements and Requests

Reminder: several folks have said they no longer get my email updates. There’s a cure: sign up again. Hyperactive spam filters have driven email deliverability way down, especially for those that are sent to a group, so it can’t hurt to re-enter your email address (you won’t get duplicate email).

Jenn came up with a “Beat the Heat” HIStalk sponsorship idea for companies that won’t be exhibiting at HIMSS21. Sign up as a new Platinum sponsor and Jenn will include a promoted webinar and an email announcement just because she’s nice. For the cost of a HIMSS21 exhibit hall power strip, (OK, I’m exaggerating slightly), you’ll get exposure that lasts a year rather than three frantic days, and you’ll be running long before the conference starts. The crazy market valuations of health technology companies these days suggest that it’s a good time to get your company name out there among actual decision-makers, especially with all these SPACs desperately looking for dance partners to acquire. Tell Lorre that Jenn sent you.

Listening: After All, an obscure 1960s Tallahassee, FL band of Florida State graduates whose “heavy on the Hammond” British-sounding psychedelic prog sound at times resembled their contemporaries ELP, the Doors, or even Blood, Sweat & Tears. Their experimental album tracks were all over the place and the singer was trying to figure out whether to croon or growl, but they gave it their best shot for the band’s only album and its weeks-long existence– they hired a local 19-year-old Tallahassee poet (who later co-wrote “Tennessee Whiskey”) to write lyrics for songs in several popular styles, recorded the album with stunning production quality in two days as a producer friend’s freebie, then immediately went back to their day jobs having taken and missed their one shot. The band’s singer-songwriter, Mark Ellerbee — an FSU music grad who had served in Vietnam as an Army medic — enjoyed several years of minor fame as the drummer of the Oak Ridge Boys and worked for the state until he died in 2013 at 71, with his obituary video including the back jacket of the After All album. I hope Mark Ellerbee’s grandson knows how much his grandpa and his buds rocked it back in 1969 even though the world paid no attention. I think a movie is in order, complete with a psychedelic soundtrack. Rock in peace, Mark.


Webinars

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


Acquisitions, Funding, Business, and Stock

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At-home lab test vendor Everlywell acquires testing company PWNHealth and self-collected lab test processor Home Access Health Corporation, valuing the company at a reported $3 billion. Founder and CEO Julia Cheek, MBA is an investor and previously worked as an executive of money transfer company MoneyGram.

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Ginger, which offers mental health and coaching services via text chat and video, raises $100 million in a Series E funding round.


Sales

  • MiraVista Behavioral Health Center (MA) will implement Medsphere’s EHR and revenue cycle platform.
  • Government IT provider FEI Systems will add NextGate’s EMPI to its data warehouse platform for patient matching and identification.

People

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Methodist Le Bonheur Healthcare hires Ron Fuschillo, MBA (Renown Health) as SVP/CIO.

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MTBC – which will soon be renamed to CareCloud after acquiring that EHR vendor in January 2020 – promotes A. Hadi Chaudhry to CEO. He replaces Stephen Snyder, JD, who will move to chief strategy officer and continue as a director.

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C. Pat Heyman joins Health Systems Informatics as VP of sales.


Announcements and Implementations

Wolters Kluwer, Health announces Chart Review Accelerator, part of its Health Language platform, which helps clinicians by scanning medical records using clinical natural language processing for medical necessity reviews, HEDIS quality reporting, and risk adjustment.

Humana and Epic will add support for electronic prior authorizations and member insights, expanding their original project that developed Humana’s Real-Time Benefits Check tool. They will also add decision support for specialist referrals.

Cerner will enable EHR data retrieval to New York Life to reduce life insurance application processing time.

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A new KLAS report looks at the patient engagement ecosystem, which it defines well in the above graphic. Vendors that are increasing their capabilities the most, often through acquisitions, are GetWellNetwork, Vocera, Salesforce, and CipherHealth. The broadest capability hospital-centric vendors are Epic, Allscripts, and R1, while on the ambulatory side, it’s Athenahealth, NextGen Healthcare, Luma Health, and Mend. The most commonly offered capabilities are pre- and post-visit communication and education. Providers are increasingly interested in white-labeled products that allow them to create their own branded digital front door.


Government and Politics

HHS OCR announces its 17th HIPAA RIght of Access settlement, as Arbour Hospital agrees to pay $65,000 for failing to provide a patient with medical records copies within 30 days despite a previous OCR warning involving the same patient.


COVID-19

CDC reports that 130 million COVID-19 vaccine doses have been administered, with 18% of US adults being fully vaccinated as well as 44% of those 65 and over. The White House doubled its vaccination goal Thursday in aiming for 200 million vaccine shots in President Biden’s first 100 days.

US deaths are at 541,000.

Michigan’s COVID-19 case rate has jumped to the country’s second-highest, with big increases in younger populations who aren’t eligible for vaccination yet, and hospitals are again filling with COVID-19 patients. Health officials think the increase is due to more infectious strains and spread via youth sports among parents of school-aged children. The state’s vaccination program started slowly, but rollout is accelerating and experts say it’s a race against the variants, which may be a challenge that other states experience.

AstraZeneca insists in an update that despite the concerns of US government scientists, its COVID-19 vaccine is 76% effective at reducing symptomatic infection and 100% effective against severe cases.

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The COO of Chicago’s 122-bed Loretto Hospital resigns following reports that he used COVID-19 vaccine that was intended for low-income West Side residents and used it to vaccinate employees of his luxury wristwatch dealer, his favorite steakhouse, and Trump Tower, where he owns a $3 million condo. Anosh Ahmed, MD also posted a photo of himself posing with Eric Trump with a claim that he vaccinated him as well, but later said he was joking. The hospital admits that 200 people at the CEO’s church were also given hospital vaccine early and it reportedly also offered shots to county judges. The hospital has been cut off from further vaccine shipments.

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The LA Times estimates that venture-backed startup Curative, led by a 25-year-old founder, has earned at least $1 billion in revenue from sales of largely unproven self-administered mouth swab tests for COVID-19. The city of Los Angeles paid the company at least $82 million to run mass testing sites, for which the city is seeking federal reimbursement, and the company is billing health insurers — who are forced by law to pay for the tests — $325 each versus an actual cost of a few dollars. A Colorado health system retested some of the company’s results and found them to be wrong, while FDA says its self-testing is not reliable.  


Other

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Astria Health (WA) blames Cerner for its bankruptcy and the closure of Astria Regional Medical center in bankruptcy court, contending that Cerner fraudulently misrepresented that Millennium would integrate seamlessly with its revenue cycle offerings. Astria Health says its collections went from 97% of net revenue to 54% after Cerner’s billing system went live and the Medicare and Medicaid claims of its clinics were frequently rejected. Cerner denies the allegations. Cerner previously objected to the health system’s planned bankruptcy because Astria Health had $10.7 million in unpaid bills that it did not plan to pay because it said Cerner problems had cost it $150 million, but the parties resolved that issue in December 2020 and the bankruptcy proceeded. 


Sponsor Updates

  • Medicomp Systems launches a new healthcare podcast spotlighting ways to improve health IT.
  • Black Book Research names Netsmart as having the highest customer satisfaction among post-acute ambulatory health technology platforms.
  • IT Central Station ranks Everbridge the top IT alerting solution for 2020 based on peer product reviews.
  • Long-term care alert management system vendor Status Solutions and Vocera will integrate their offerings to route notifications via the Vocera Badge, smartphone app, or workstation.
  • Clinical Architecture releases a new podcast, “Reimagining Public Health Surveillance and Reporting with Dr. Donald Rucker.”
  • The Chartis Group has been honored by Forbes as one of America’s Best Management Consulting Firms for the third consecutive year.
  • Ingenious Med publishes a new white paper, “How to Minimize Physician Burnout and Optimize Revenues: Lessons learned from the pandemic.”
  • Lyniate publishes a new white paper, “Integration Strategies for Healthcare IT Vendors.”
  • Medhost offers its customers role-based Medhost Learning Essentials from Medhost University.

Blog Posts


Contacts

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

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Reader Comments

  • Vikas Chowdhry: Will AI (I prefer the term Machine Learning - ML) magically fix all the incentives that have been created in the US heal...
  • Brian Too: I dunno. Seeking an answer in AI for America's healthcare woes seems a little desperate. LIke, adding one magic new in...
  • meltoots: You forgot that politics will have to be programmed in your AI. On both sides of the aisle, misinformation, doing things...
  • IANAL: So what should Cerner do though? They have some market issues because the largest potential or current customers have at...
  • Ghost of Andromeda: That's exactly the opportunity here! Cerner is struggling and could really use someone who knows how to execute with dis...

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