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EPtalk by Dr. Jayne 6/17/21

June 17, 2021 Dr. Jayne No Comments

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Today’s big news is the Supreme Court’s dismissal of a major challenge to the Affordable Care Act. This is the third time that the healthcare law has been upheld. This challenge was based on the concept that since the individual penalty portion was eliminated in 2017, the entire law should be struck down. The court voted 7-2 to block the suit, stating that the plaintiffs did not have appropriate standing to bring the case. I don’t think that we’re done with challenges to the Affordable Care Act, but I know that patients who count on its provisions are breathing a sigh of relief.

I ran across a great op-ed piece recently that focuses on how “humans are getting in the way of digital health.” It cites the piecemeal application of technologies as a major barrier to transformation as compared to other industries like banking or logistics, where everyone involved jumped on the bandwagon. Other challenges include a lack of technology education and training for the people who need to use digital health along with teaching stakeholders to assess the value of new technologies so that they can add the right systems at the right time. The author calls for meaningful provider education through structured training, including peer-to-peer training, formal education, and inclusion of evidence-based guidelines. These seem like they would be basic tenets for successful clinical / digital transformation, but there are a lot of organizations missing the boat.

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I went to visit a new PCP this week. We used to work together and he knows my informatics background, so he was happy to give me a tour of my Epic chart after I asked if he could see the results of my recent genetic testing. It turns out they are buried as scanned documents. He noted that the governance and quality control on the scanning can be a bit lacking at times. Having done numerous quality improvement projects and revisions to organizations’ document management systems, I know what a pain it can be when documents are filed or tagged in the wrong place. Hopefully, the majority of their results are coming in electronically at this point, but I’m sure there’s plenty of scanning going on with referral letters, consultation letters, hospital discharges, and more.

He happily reviewed the blood pressures I had logged in the Withings Health Mate app on my phone. We both agreed with liked the display because it shows averages in numerical form that can be filtered by month as well as a graphically-based view that gives a red / yellow / green view of the ranges for a patient’s values. That’s the kind of data we need to be incorporating for remote patient monitoring rather than burdening physicians with thousands of data points that need to be sifted through. He agreed with me that my crazily high blood pressure a couple of months ago was likely due to a combination of work stress and too much ibuprofen. I enjoyed watching my lab results arrive throughout the afternoon and all was well, so I’m good for another year.

Business Insider reports that Google is shrinking its health team, reassigning 130 workers from its health division into other areas of the company such as Search and Fitbit. The company restated its commitment that Google Health “will continue to build products for clinicians, conduct research to improve care and make people healthier, and to help ensure all health-related projects at Google meet the highest standards.” The count of those employees has now dropped to 570 from a March headcount of 700.

The publication also reports that Walmart Health has filed documents to expand its virtual care solution to 16 additional states, doubling its count. I don’t know anyone who has used the company’s telehealth offering, but would be interested to share (anonymously, of course) any reader experiences. The company’s brick-and-mortar offices are limited to a handful of states, so we’ll have to see how long it takes them to cover the entire US for telehealth.

Meanwhile, CNBC reports that Amazon Care has signed multiple corporate clients who plan to make use of its telehealth services. They’re holding announcement of those names until later in the summer, but I’m extremely curious – if anyone has rumors they would like to report anonymously, we would be happy to entertain them. The program was launched in 2019 as an internal employee benefit and includes virtual urgent care visits, free telehealth consults, and fee-based in-home visits for testing and vaccinations.

Having been part of the healthcare IT industry for a while now, I’ve been exposed to various company cultures. Some have included some hard-partying aspects and a fair amount of alcohol consumption. One vendor I worked with had an open beer tap in the office on Fridays, while another frequently referred to its staff as “a drinking company with a software problem.” That seems to have become a bit more tame in recent years, but I came across an article mentioning concerns that increased alcohol use could be a secondary consequence of the pandemic. Especially with work from home, juggling household responsibilities, economic worries, and the stress of the pandemic itself, alcohol use is on the rise. Given pandemic precautions, it will be interesting to see what the level of alcohol consumption looks like at HIMSS. Hopefully as things return to normal, consumption will stabilize. Still, let’s look out for each other, and if you see one of your colleagues struggling, offer your support.

Fast Company skewered Epic recently over the rollout of the Deterioration Index clinical prediction tool, which is designed to help physicians determine when patients can be moved into or out of higher levels of care. The authors note that the Index was deployed without independent validation or peer review and that physicians cannot see how the raw data is used to calculate the score. There are concerns about the potential for bias in the model based on the underlying data sets upon which it was created. Other worries involve the risks of medical trainees relying too heavily on the index rather than developing their own clinical intuition. The authors call on Epic to release the underlying logic for peer review along with the anonymized data sets used during the internal validation process.

I’d be interested to hear from clinical informaticists whose institutions use the tool. How do you think it’s working, and have you identified any issues? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 6/17/21

June 16, 2021 Headlines No Comments

Walmart Provides Digital COVID-19 Vaccine Record

Walmart offers pharmacy customers who receive the COVID-19 vaccine the ability to digitally store their vaccine records via their Walmart.com accounts using technology based on the Vaccination Credential Initiative’s Smart Health Cards standard.

HHS Releases Project US@ Draft Technical Specification Version 1.0 for Comment

ONC releases the Project US@ Draft Technical Specification Version 1.0 for public comment as part of its work to develop a healthcare standard for representing patient addresses.

Ksana Health Secures $2M Seed Round to Launch Advanced Mental Health Monitoring Platform

Behavioral health app startup Ksana Health raises $2 million in seed funding and joins Anthem’s digital incubator.

Stillwater Medical Center Reports Major Computer Outage, Officials Confirm

Stillwater Medical Center (OK) recovers from a computer outage that forced it to cancel appointments and briefly shut down its emergency room.

Morning Headlines 6/16/21

June 15, 2021 Headlines No Comments

HST Pathways Announces Merger with Clariti Health for Enhanced Patient Price Transparency Resources as Part of its End-to-End Premium Technology Solution

Ambulatory surgery center software vendor HST Pathways acquires patient price transparency vendor Clariti Health.

Tiger Global-backed Bright Health aims for over $14 bln valuation in U.S. IPO

Bright Health, which sells Medicare Advantage insurance in 13 states with claims of technical capabilities, targets its IPO at a $14 billion valuation.

Protenus Raises Series D After Doubling Revenue While Reducing Risk for Health Systems

Healthcare compliance analytics company Protenus raises $21 million in a Series D funding round, bringing its total raised to $57 million.

News 6/16/21

June 15, 2021 News 2 Comments

Top News

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Ambulatory surgery center software vendor HST Pathways acquires patient price transparency vendor Clariti Health.


Reader Comments

From Forensic Bean Enumerator: “Re: the just-announced $200 million accelerated share repurchase of Allscripts. Remind me again what their PPP loan was and how many employees have been let go of late?” I’m too old school to be an investor today — where stock price is like a baseball card’s “value” in reflecting investor supply and demand rather than company profit, competitive position, and future prospects – but I’ll note that MDRX shares that were at $6 a year ago are now at $18, although longer-term holders haven’t fared nearly as well. I’m also not contemporary enough in my investment knowledge to see share buybacks as having anything to do with the company’s actual business or to link customer happiness with that of stock traders. That’s why Paul Black holds shares worth $30 million and I hold zero shares worth $0, raising the “if you’re so smart, why aren’t you rich” argument.

From End Gamer: “Re: Cerner. The most recent layoffs feel more final than earlier rounds, as long-time leaders in sales and IP have left. The company needed to make some changes post-Neal Patterson, but not this kind. Perhaps you could get some anonymous views from former Cerner leaders about what they see as the company’s best steps and outcomes.” I’m certainly willing to receive anonymous submissions, but I don’t know how much useful insight a former executive would have. Cerner certainly lost its Neal swagger and competitive fire under company man Brent, whose droning “new operating model” mantra resulted in CERN shares rising just 8% from the day he started until the day he announced he was leaving, eating the dust of the boring old Nasdaq index that jumped 92% in the same period. Let’s also not forget that the Cerner board chose Brent, who had never run a publicly traded company, and approved everything he did, showing little backbone in capitulating to an activist investor whose minor share ownership would have generated an appropriately colorful response from Neal. Former executives might have interesting ideas about what Cerner should do strategically, but really the company’s most important decision is choosing its third-ever CEO. As a large, publicly traded company, I would guess they will hire a boring corporate leader, maybe a retread from a different industry who knows how to make the numbers look good. Brent will become Cerner’s John Sculley, the forgotten guy who got Steve Jobs fired and then nearly ran the company into the ground as his dismal CEO replacement before he himself got the axe, although Brent’s problem was doing too little instead of doing actual harm and Neal Patterson won’t be returning to save the day like Steve did. The board made a big mistake in not promoting President Zane Burke to CEO, which seemed obvious even at the time. But to be fair, we cheap-seaters with 20-20 hindsight don’t know what Brent has been dealing with or whether anyone else would have done any better.


HIStalk Announcements and Requests

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I’m not a big user of my old Google Assistant and Echo Dot smart speakers, but I wanted to play Spotify playlists at low volume in a couple of rooms where my Sonos speakers aren’t needed. My search was timely since Amazon just opened a sale on the Echo Dot at $50 for two units. The sound and capabilities are decent for a $25 device, although now I have to figure out what else it can do.


Webinars

June 24 (Thursday) 2 ET: “Peer-to-Peer Panel: Creating a Better Healthcare Experience in the Post-Pandemic Era.” Sponsor: Avtex. Presenters: Mike Pietig, VP of healthcare, Avtex; Matt Durski, director of healthcare patient and member experience, Avtex; Patrick Tuttle, COO, Delta Dental of Kansas; Chad Thorpe, care ambassador, DispatchHealth. The live panel will review the findings of a May 2021 survey about which factors are most important to patients and members who are interacting with healthcare organizations. The panel will provide actionable strategies to improve patient and member engagement and retention, recover revenue, and implement solutions that reduce friction across multiple channels to prioritize care and outreach.

June 30 (Wednesday) 1 ET. “From quantity to quality: The new frontier for clinical data.” Sponsor: Intelligent Medical Objects. Presenters: Dale Sanders, chief strategy officer, IMO; John Lee, MD, CMIO, Allegheny Health Network. EHRs generate more healthcare data than ever, but that data is of low quality for secondary uses such as population health, precision medicine, and pandemic management, and its collection burdens clinicians as data entry clerks. The presenters will review ways to reduce clinician EHR burden; describe the importance of standardized, harmonious data; suggest why quality measures strategy needs to be changed; and make the case that clinical data collection as a whole should be re-evaluated.

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


Acquisitions, Funding, Business, and Stock

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Private equity firm Berenson Capital acquires Interactive Digital Solutions, a video collaboration and telehealth software vendor known for its MedSitter patient-monitoring technology.

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Release-of-information and clinical data interoperability vendor MRO acquires Figmd, a health data aggregation, analytics, and registry company based in Illinois. MRO acquired Cobius Healthcare Solutions, a reimbursement and compliance risk management technology company, earlier this year.

Bright Health, which sells Medicare Advantage insurance in 13 states with claims of technical capabilities, targets its IPO at a $14 billion valuation.


Sales

  • Hartford HealthCare (CT) selects Upfront Healthcare’s Care Traffic Control patient engagement and communication software.
  • Ozarks Healthcare (MO) will deploy patient e-signature technology from Access.
  • Orthopedic Care Physician Network implements Emerge’s ChartScout and uses its EHR data conversion tools as it migrates to Athenahealth.

People

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Tim Quigley (Baptist Health Care) joins CloudWave as chief client officer.

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Former consultant David Sand, MD joins ZeOmega as chief medical officer.

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Nordic names Paul Slaughter (Leidos) EVP of enterprise support services and promotes Ian Mamminga to EVP of managed services.

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Behavioral health EHR vendor Kipu names Paul Joiner (Availity) CEO and Rick Pharr (WebPT) COO.


Announcements and Implementations

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Healthcare Triangle announces GA of its new CloudEz software-as-a-service, giving organizations the ability to set up their own cloud work environments.

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Medcare Hospitals & Medical Centres in the United Arab Emirates has implemented Capsule’s Medical Device Information Platform to connect its medical device ecosystem to its clinical information systems.

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Talkdesk announces the launch of Healthcare Experience Cloud for Providers, contact center technology for the enterprise that coordinates and personalizes patient communications.

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Beacon Health System (IN) adopts ProviderMatch software from Kyruus to better enable patients to find providers and schedule appointments.


Sponsor Updates

  • Agfa HealthCare will present during the virtual UK Imaging & Oncology Congress Online through June 25.
  • CarePort will exhibit at ACMA 2021 June 22-25 in Orlando.
  • CareSignal shares the assessment of a post-operative opioid stewardship program using its electronic-based automated text and phone messaging platform in which over 80% of patients engaged with more than half of all messages.
  • Experian Health VP Karly Rowe will present on SDOH at Reuters Digital Health 2021 June 16.
  • The local news covers International Medical Center’s implementation of the InterSystems TrakCare EHR.
  • Women’s Health Connecticut connects to the Connecticut Medical Society’s CTHealthLink, part of the Konza Health Network.
  • Sectra expands its AI marketplace to include digital pathology apps.
  • EClinicalWorks releases a new podcast, “Making the Most of EClinicalWorks Billing and RCM.”

Blog Posts


Contacts

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

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Morning Headlines 6/15/21

June 14, 2021 Headlines No Comments

Berenson Capital Acquires Interactive Digital Solutions

Private equity firm Berenson Capital acquires Interactive Digital Solutions, a video collaboration and telehealth software vendor known for its MedSitter patient-monitoring technology.

MRO Announces Acquisition of Clinical Data Interoperability Company FIGmd

Release-of-information vendor MRO acquires Figmd, a health data aggregation, analytics, and registry company based in Illinois.

Kipu Announces Strategic Investment from TCV – Appoints Paul Joiner as CEO and Rick Pharr as COO

Behavioral health EHR vendor Kipu names Paul Joiner (Availity) CEO and Rick Pharr (WebPT) COO alongside an unspecified investment from TCV.

Curbside Consult with Dr. Jayne 6/14/21

June 14, 2021 Dr. Jayne No Comments

Today’s post is an interview with Laura Miller, founder and CEO of TempDev of Miami, FL.

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Tell me about yourself and the company.

I started TempDev back in 2000. We are primarily a NextGen Healthcare consulting firm, working in practice management and EHR. We tend to be technology driven. I have my degree in computer engineering, we have quite a few engineers on staff, and we have quite a few female engineers. We have development solutions and we also focus on implementation and training as well as project management.

You started as a NextGen application specialist at a physician organization. What gave you the confidence to go out on your own?

I had a good mentor, and a lot of women have that story. I had somebody who encouraged me to do this and also helped me establish myself and my career, who taught me a little bit about consulting. It was a time where I don’t think there were that many people with engineering backgrounds doing development for NextGen clients, and so I think the market was primed for it. As I started exploring, I realized that there was a lot of business opportunity.

I was lucky that on a personal level, I didn’t have a ton of financial obligations. My husband works at Microsoft and we had full benefits. It wasn’t the riskiest of moves, but when I try to tell people that, everyone says, “It still was.” I ended up leaving my full-time job and starting TempDev, and here we are 14 years later.

As an entrepreneur responsible for the livelihoods of others, what kind of thoughts were running through your head as the world began to shut down due to COVID-19?

That was the scariest time I’ve ever had in my career. We have always grown as a company. We had never had to have those difficult thoughts and conversations. We have been incredibly fortunate in our trajectory to never had that enter the picture for us at that level.

As COVID started to happen, at first it was a slam of work. Everybody was implementing telehealth and they didn’t know how to see patients or how to bill it. All these organizations we were working with didn’t even know how they were going to keep their lights on, much less that they were going to spend their money on consultants to try to deliver telehealth, and then let us go.

We were fortunate that there were a couple of companies that kept a lot of our consultants working. It was the first time we had ever had a bench in our entire 14 years. We took the time to say, let’s invest in us. It was the first time we had taken a step back and said, let’s build some things for TempDev. We have some people who aren’t busy. Let’s build some products so that when things come back, and they will come back, we will be ready for them. 

We did. We invested heavily in a couple of products. We invested in COVID testing templates, COVID vaccine templates, and credit balance tools. As things started to come back, it took off and we are busier than ever now.

For the COVID-19 vaccine templates, have you seen a lot of ambulatory practices that have had access to the vaccine or being able to distribute it to their patients?

I’ve actually been pleasantly surprised at who I’ve seen get access to vaccines. It has not been my private practices, the big groups that typically are engaged with consultants. It has been our smaller community health groups and tribal groups. It has been the groups that, as you talk equitable vaccines and you have those conversations, it’s who you want to have these vaccines. It’s who you want to be out there giving them to the community. That was who had the vaccine and who we were talking to in December about vaccinations. A lot of our private clinics didn’t get them until more recently.

Are ambulatory medical practices  starting to rebound?

Most of our clients have rebounded. The investment in FQHC, we’ve definitely been seeing a pickup in that market. They are starting to feel some of the investment that came earlier this year in them and are starting to be able to make improvements they have been wanting to make for a long time. I would say that for most of our groups, their volume is back.

As they are getting back up to speed, what kind of trends are you seeing as they reprioritize their technology goals?

Telehealth is here to stay. Everybody is asking, in what capacity? How are we going to get reimbursed? What does that look like in the future?

As both a patient and a consultant, I love telehealth. I think it’s so wonderful, especially since many of us waste so much time getting to a doctor and sitting in waiting rooms for a five-minute appointment, a checkup, or a talk about a result. It’s so great to be able to have a quick conversation. That needed to happen and a physician can get reimbursed for it, so I think telehealth is here to stay.

TempDev has always been a remote company, so as the pandemic started to unfold, we were well positioned because everybody already worked from home. But for most of our clients, a lot of people aren’t going back to work. Some of the smaller groups tend to be where we see the IT people going back. But a lot of the groups we work with, they’re scaling down on their real estate. If they are talking about maybe getting people back, it is certainly in a much more limited capacity, because I think people got accustomed to working from home and they think it works for a lot of people.

Patients having direct access to their visit notes is a hot topic. Have you seen an increase in requests for help meeting those requirements?

People are still confused by information blocking, especially with the fact that that rule happened during the pandemic. It caught a lot of people off guard. I don’t think they entirely know what it means. I know there were countless webinars. I know people were telling them about it. But I don’t think everybody has grasped what is going to happen there because we don’t get a ton of questions about it other than “Hey, how do I meet this requirement?” which we will walk through with them. We don’t get a lot of questions around, what’s the downstream impact, what if my patient reads this, and should I put this in a note? These are things that you have to think about now that you’ve opened the gate to all of that information. I don’t think people have gotten there yet.

As the only woman in your computer engineering degree classes, what advice do you have for women who are pursuing the STEM fields?

Stay in it.So often we get intimidated, or we often feel like it’s not our place and we don’t belong. I personally never felt like I fit into that culture. It’s not who I am. I love technology, but I do not like a geek culture. I don’t have anything against it. That doesn’t mean that I wasn’t good at math and science or that I couldn’t code, but I didn’t always fit in, and that was OK. I think I brought diversity to something that maybe wasn’t diverse.

Also, a lot of us women just are not showboats. It’s not who we are naturally. That doesn’t mean that we don’t know the information. You also don’t have to have a 4.0 GPA to do well in businesses and to do well in engineering. You can get a B in a class or you can struggle through some engineering classes and that doesn’t mean you’re not cut out for it, it just means that sometimes you might have to work a little harder.

So many cultural things are set up to make us believe that it’s not a place where we belong. I so often just want to tell girls, hey, you belong here. That’s one of the reasons we tend to have a lot of women here, especially for being a tech company. People ask, how did you get all these female engineers and how is your tech team led by all women? It’s because it’s a place where women want to be, because culturally, we fit in here. We didn’t define the culture that a lot of other tech companies have out there. That made something special and something different where people wanted to be and where people wanted to stay, because it is tough.

It’s not the easiest field to be in. In college, they used to tell us things like, you’re going to be up until 3 a.m. in a lab before you’re going to launch a product, and that’s the way life is. I thought, I want a family. I don’t want to be in a lab at 3 a.m. before a product launch, I want to be home in my bed sleeping, and I want to have a life, and I want to have balance. I’m here to tell you that it’s totally fine, and you can have that. It’s not how life has to be. That isn’t necessarily what is presented to you early on in college and in your early career.

You have your children on your team. What advice do you have for young entrepreneurs who are building a company to make sure they have time for family?

You have a limited time with your children because they go off to college. You get 18 years with them, hopefully. Or they’re at home and you don’t want to waste it. I have made it a rule to pretty much to stop work from 5:00 to 8:00 each evening. I have my phone on me, so if something blows up, I will get on it, but things can wait. You can’t work your entire life. Your children are good at making you understand what your priorities are and keeping them in check. From 5:00 to 8:00 every day is my kids’ time. Then I put them to bed and I will probably go back on my email and I will probably finish up my workday. But I make sure I always have time for them. I make sure they know that they are number one and everything else is number two.

That doesn’t mean I won’t go out of town or that I don’t sometimes treat work with a high priority that needs to be, but it can never be above my kids. That’s who I am and that drives me. I’ve never run into a problem with it. So many times we as women are set up to believe that there’s something wrong with that and there isn’t. Going back to work from home culture, I can run out and get my kid who is sick from school and bring them home. They can lay in their bed and be sick from school and nobody at work is judging me. They don’t even know I’m gone, and they don’t even know my kid’s home sick. That’s something so nice about being able to be a mom and being able to balance your work.

Do you have any final thoughts?

If you’re not working in a place that makes you happy, build a place that makes you happy. Try to do the right thing at that place and make whatever decisions are needed to build a place where people want to be, where women or employees feel valued and feel like they can put their families first, feel like they can take care of clients and still have time, and still have work-life balance. Build that as a company because you can’t run down your employees. Your employees are your number one asset. If you ever ask me the hardest part of my job, it’s recruiting and finding employees to fill the positions we have. Losing an employee is even harder for us. Make sure to respect that and build a place where employees want to be, and always have that as your guiding light.Make sure it’s a place where all employees want to be and not just a certain subset.

Morning Headlines 6/14/21

June 13, 2021 Headlines No Comments

Chief Operating Officer of Network Security Company Charged with Cyberattack on Medical Center

A federal court indicts the COO of Atlanta-area Internet of Things security vendor Securolytics, claiming that he launched a 2018 cyberattack against Gwinnett Medical Center (now Northside Hospital Gwinnett) for personal financial gain.

Joint DOD-VA Medical Center Will Be Major Test for Electronic Health Record Interoperability

Captain James A. Lovell Federal Health Care Center (IL), a joint facility used by both the VA and DoD, will be the first test of interoperability between their respective Cerner implementations.

Mount Sinai Health System Launches Elementa Labs, A Virtual Incubator Program

Mount Sinai Innovation Partners has launched a virtual incubator program to help health IT and biotechnology startups develop their products leveraging Mount Sinai Health System’s resources and expertise.

Monday Morning Update 6/14/21

June 13, 2021 News 3 Comments

Top News

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A federal court indicts the COO of Atlanta-area Internet of Things security vendor Securolytics, claiming that he launched a 2018 cyberattack against Gwinnett Medical Center (now Northside Hospital Gwinnett) for personal financial gain.

Vikas Singla allegedly disrupted the hospital’s phone service, obtained information from a digitizing device, and disrupted network printing for unspecified purposes.

Singla pleaded not guilty to 18 charges, was released on $20,000 bond, and will return to court June 23.


HIStalk Announcements and Requests

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Poll respondents are nearly universally in favor of implementing a national patient identifier, with the majority of those believing that its use should be mandatory.

New poll to your right or here, as suggested by a reader: Looking back five years, which aspects of healthcare have been significantly improved by technology?

Reminder: I’ll include HIStalk sponsors who are exhibiting at and/or attending HIMSS21 in my HIMSS guide if you submit your details. Meanwhile, It’s not even summer yet and Las Vegas will have daily highs in the 117-degree range for most of this week, to the point that motivational speakers could convene one of their BS firewalking rituals by just having participants take their shoes off and walk 20 feet on a Strip sidewalk.

It feels as though the industry is taking an actual summer break, as opposed to the never-ending virtual connections of 2020, given the absence of significant news over the weekend. Shockingly, I saw no new announcements of money-losing companies that I’ve never heard of being valued at billions of dollars, no eye-rollingly fawning articles describing how AI will disrupt healthcare, or non-experts seeking attention by claiming that Cerner or Meditech or some other company might be acquired by someone someday. It may be that everybody is saving their energy for HIMSS21, but I suspect that isn’t the case and instead we’re just enjoying a return to pre-pandemic summer life. At any rate, enjoy today’s minimal reading time since I have no incentive to dishonestly pad things out just to hold your attention.


Webinars

June 24 (Thursday) 2 ET: “Peer-to-Peer Panel: Creating a Better Healthcare Experience in the Post-Pandemic Era.” Sponsor: Avtex. Presenters: Mike Pietig, VP of healthcare, Avtex; Matt Durski, director of healthcare patient and member experience, Avtex; Patrick Tuttle, COO, Delta Dental of Kansas; Chad Thorpe, care ambassador, DispatchHealth. The live panel will review the findings of a May 2021 survey about which factors are most important to patients and members who are interacting with healthcare organizations. The panel will provide actionable strategies to improve patient and member engagement and retention, recover revenue, and implement solutions that reduce friction across multiple channels to prioritize care and outreach.

June 30 (Wednesday) 1 ET. “From quantity to quality: The new frontier for clinical data.” Sponsor: Intelligent Medical Objects. Presenters: Dale Sanders, chief strategy officer, IMO; John Lee, MD, CMIO, Allegheny Health Network. EHRs generate more healthcare data than ever, but that data is of low quality for secondary uses such as population health, precision medicine, and pandemic management, and its collection burdens clinicians as data entry clerks. The presenters will review ways to reduce clinician EHR burden; describe the importance of standardized, harmonious data; suggest why quality measures strategy needs to be changed; and make the case that clinical data collection as a whole should be re-evaluated.

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


Sales

  • SouthEast Alaska Regional Health Consortium goes live on Nuance Dragon Ambient Experience.

Announcements and Implementations

California will implement an electronic vaccination verification system “very shortly.” The state emphasizes that the unspecified system is not a vaccine passport because it will be offered only to private businesses who can decide for themselves how to use it, if at all.


Government and Politics

Captain James A. Lovell Federal Health Care Center (IL), a joint facility used by both the VA and DoD, will be the first test of interoperability between their respective Cerner implementations.


Sponsor Updates

  • Waystar partners with career development nonprofit Inroads to launch a health IT internship program for local students.
  • Healthwise has received seven Digital Health Awards for its patient education videos and content in the Health Information Resource Center’s 2021 spring competition.
  • Netsmart VP & GM of CareGuidance AJ Peterson is included in the Kansas City Business Journal’s list of 2021 NextGen Leaders.
  • Protenus publishes a new report, “2021 Diversion Digest: COVID-19 Conceals True Scope of Clinical Drug Diversion in 2020 as Incidents Left Undiscovered.”
  • Talkdesk names Laura Butler (Workfront) chief human resources officer.
  • Tegria publishes a new white paper, “Cloud-Based Managed Services Allow Healthcare Organizations to Do What They Do Best: Focus on Patient Care.”

Blog Posts


Contacts

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

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Weekender 6/11/21

June 11, 2021 Weekender No Comments

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Weekly News Recap

  • Iodine Software acquires ChartWise Medical Systems.
  • Cerner eliminates 500 positions.
  • Amazon announces significant growth and external customer interest in its Amazon Care telehealth service.
  • Ciox Health announces its intent to merge with Datavant in a deal valued at $7 billion.
  • Definitive Healthcare, which acquired HIMSS Analytics in 2019, prepares to go public.
  • RCM vendor Craneware enters an agreement to acquire pharmacy software vendor Sentry Data Systems.
  • SAIC announces plans to acquire government health IT contractor Halfaker and Associates.
  • UF Health Central Florida’s two hospitals go back to paper following a May 31 ransomware attack.

Best Reader Comments

With all of this money being poured into startups by VCs and PE and everyone promising a better widget to do X, how would patients (or consumers of health care) respond if they were to be asked this (Reagan) question – “Are you better off today than you were four years ago?” Is care more accessible? Valuable? Equitable? Cheaper? Safer? (Ghost of Andromeda)

I do worry about the monetization of the healthcare and the drive for young practitioners to get the best specialty. Some, I am sure are just drawn to that specialty, others are drawn to the compensation. The monetization goes up and down the stack, from VCs purchasing rural hospitals so they can overcharge for labs, to purchasers of EHRs so they can overcharge the clinics, to hospital administrators who have forgotten that a hospital is for patient care, not for generating an insurance bill or funding a collections company. (J Brody Brodock)

From a medical output standpoint, the most productive primary care practices probably have less than five providers. Technology provides little to no benefit. Practices get larger so that they can negotiate with insurance. The dynamics are different for single and multi speciality and hospital owned of course. We shouldn’t raise the compensation for primary care. We shouldn’t raise the compensation for anyone in medicine. We should lower barriers so that there is more competition. (IANAL)

One of the truisms I was told a long time ago by family medicine founding fathers is that primary care has always failed to compete adequately in the American way of doing things. Our commitment to patient care — our mensch-like attitudes to do good on local scales one case at a time, coupled with our lower incomes has kept primary care physicians from putting the same amount of money and time resources into changing the system as our specialist colleagues. That has only been exacerbated by the lobbying dollars of the pharmaceutical and insurance firms along with the large organized health care industry in general to take advantage of primary care physicians as malleable, low-cost solutions. Bluntly put, while we are doing our quarterly CME questions for our 2.5 points, thereby allowing our leaders to justify their latest layer of obfuscation without real change, we could have been communicating and networking with others. (Kevin Hepler)

If we are being completely honest, it’s about, how do we make the field of medicine more attractive to clinicians? And all of that adds up to going back in time. Society has already chosen, and mostly, society doesn’t care. (Brian Too)

Bold of Ascension to so immediately follow Baylor Scott & White, without even waiting to pick up some lessons learned. The latter has, at the most generous, an extremely bumpy year ahead as it tries to recover from its continuing hemorrhage of experienced Epic employees (retained and outsourced alike) and astonishing lack of due diligence (as admitted by its leadership). I suppose if more organizations outsource, analysts will be more persuadable that this is the way of the future instead of temporary insanity and attempt to stick it out. Can’t we just have nice things? (formerly BSW)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. M in Kentucky, who asked for an inspiration board for her kindergarten class. She reports, “Thank you for your generous donation to this project. Our Royal Imagination Station is so helpful for easy access and viewing from anywhere in our classroom. It is so handy to move the board throughout our classroom, so that every learner can easily see the display. My learners use it daily for creating anchor charts, practicing letter writing, phonemic awareness for letters and sounds, and reviewing previous learning materials (as a reference tool). We will enjoy this useful tool for many years to come.“

Dartmouth’s medical school apologizes and drops its threats of expulsion against 17 students who it had claimed cheated on an online exam by looking up answers. The university secretly monitored the use of its learning management system by test-takers by reviewing its activity log after the fact, but the Canvas tool was not designed for that purpose and a New York Times review found that the software’s automated background activity can mimic user interaction.

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In the UK, a liver surgeon who was suspended in 2017 for using a surgical laser to burn his autograph into patient organs is allowed to practice again.

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MIT Technology Review takes a look at the vaccine waitlist site Dr. B, which collected 2.5 million signups from people who hoped to be matched to leftover vaccine doses. The site, which was founded by Zocdoc founder and former CEO Cyrus Massoumi, refuses to say whether anyone actually found vaccine after signing up and how their data will be used or sold (the site is not a covered entity, so users enjoy no HIPAA protections). The site had agreements with just two vaccination sites in the entire US when it went on a PR blitz in March, but accepted signups nationally. Meanwhile, Dr. B has at least 56 employees, many of which have a background in politics, and it has acquired similar services. Massoumi unsuccessfully sued Zocdoc last year claiming that he was ousted by his conspiring co-founders in 2015. UPDATE: the company provided this response:

Dr. B was launched at the height of the COVID crisis to get vaccines into as many arms as possible and we have saved lives through this effort. While we have already sent more than 1.1 million notifications to users about available vaccines, we don’t track when shots have been received. User privacy is our top priority and Dr. B never rents or sells user data. At any time, users can also ask to stop receiving notifications and also completely purge their data from Dr. B.

The New York Post says that insurer Clover Health has become a “meme stock” whose share price swings wildly based on the whims of Reddit “WallStreetBets” traders, also noting that the company’s two co-founders – who became billionaires when Clover Health went public via a SPAC — bought three non-profit New Jersey hospitals and converted them to for-profit CarePoint, with one of them earning the distinction as the most expensive hospital in America. The hospitals, which dropped insurance contracts so they could bill ED visits at out-of-network rates, charged one teacher $9,000 to apply a bandage to her cut that required no stitches. Day-trading Redditers got interested in Clover Health shares when a short-selling analyst claimed that the company is inflating sales.

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An anti-vaccine doctor and nurse who were brought to an Ohio health committee meeting as expert witnesses who oppose business or the government requiring COVID-19 vaccination argue that not only have COVID-19 shots killed 5,000 people, they also magnetize recipients. The nurse dramatically proclaimed to state legislators, “Explain to me why the key sticks to me,” sticking with her script even as the key failed repeatedly to stick to her neck. Both healthcare professionals cited as their information source “pictures all over the Internet.”

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Sentara Albemarle Medical Center (NC) celebrates its longest-tenured employee, 82-year-old Willie Mae Overton, who started working at the hospital in 1961.

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A military publication profiles 30-year-old Nevada Air Guard 1st Lt. Caleena Longworth, MD, whose youthful appearance and spring graduation from medical school earned her the nickname “Baby Doc.” She completed medical school in working around her COVID-19 deployment, where she was involved with testing and vaccination. 


In Case You Missed It


Get Involved


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Morning Headlines 6/11/21

June 10, 2021 Headlines No Comments

Iodine Software Acquires ChartWise Medical Systems

Healthcare AI vendor Iodine Software acquires clinical data improvement software and services company ChartWise Medical Systems.

Cerner to Eliminate Abut 500 Jobs From Its Global Workforce

Cerner will eliminate 500 positions, though it still plans to hire 2,600 people by the end of the year.

TCS Healthcare Announces Acquisition of DataSmart Solutions

Population health management software vendor TCS Healthcare Technologies acquires DataSmart Solutions, which sells predictive risk analytics software.

Transcarent Raises $58 Million in Series B Funding to Accelerate Consumer-Directed Health and Care Experience for Self-Insured Employers

Transcarent raises $58 million in a Series B funding round, increasing its total to $98 million.

News 6/11/21

June 10, 2021 News 6 Comments

Top News

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Healthcare AI vendor Iodine Software acquires clinical data improvement software and services company ChartWise Medical Systems, which is the #1 ranked CDI vendor in “Best in KLAS.”

Iodine acquired physician query platform vendor Artifact Health on May 25


HIStalk Announcements and Requests

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Welcome to new HIStalk Platinum Sponsor Tegria. Tegria helps healthcare organizations of all sizes accelerate technological, clinical, and operational advances that enable people to live their healthiest lives. Based in Seattle with teams throughout the United States and internationally, Tegria is comprised of more than 3,000 strategists, technologists, service providers, and scientists dedicated to delivering value for customers. Founded by Providence, Tegria is committed to creating health for a better world. Thanks to Tegria for supporting HIStalk.

Here’s a Tegria intro video I found on YouTube.


HIStalk sponsors: it’s time to collect information for my HIMSS21 guide, which is a viewable / downloadable summary of sponsor booth location, conference activities, and contact information  (example here). I will also list your company even if you aren’t exhibiting but will have someone available for onsite meetings. Submit your information to be included. Non-sponsors still have time to participate by signing up in the next few weeks.


Webinars

June 24 (Thursday) 2 ET: “Peer-to-Peer Panel: Creating a Better Healthcare Experience in the Post-Pandemic Era.” Sponsor: Avtex. Presenters: Mike Pietig, VP of healthcare, Avtex; Matt Durski, director of healthcare patient and member experience, Avtex; Patrick Tuttle, COO, Delta Dental of Kansas; Chad Thorpe, care ambassador, DispatchHealth. The live panel will review the findings of a May 2021 survey about which factors are most important to patients and members who are interacting with healthcare organizations. The panel will provide actionable strategies to improve patient and member engagement and retention, recover revenue, and implement solutions that reduce friction across multiple channels to prioritize care and outreach.

June 30 (Wednesday) 1 ET. “From quantity to quality: The new frontier for clinical data.” Sponsor: Intelligent Medical Objects. Presenters: Dale Sanders, chief strategy officer, IMO; John Lee, MD, CMIO, Allegheny Health Network. EHRs generate more healthcare data than ever, but that data is of low quality for secondary uses such as population health, precision medicine, and pandemic management, and its collection burdens clinicians as data entry clerks. The presenters will review ways to reduce clinician EHR burden; describe the importance of standardized, harmonious data; suggest why quality measures strategy needs to be changed; and make the case that clinical data collection as a whole should be re-evaluated.

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


Acquisitions, Funding, Business, and Stock

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Cerner lays off what it says is “hundreds” of employees. Unverified workers posted on Reddit:

  • Speculation of the total number let go ranges from 1,000 to 4,000. UPDATE: A Cerner spokesperson says the actual number is 500 employees of its 26,000.
  • Some of those involved say they worked on the company’s DoD and VA projects, and at least one employee who claims to have been affected says their developer jobs are being sent offshore.
  • One says that shared services engineering had a 22% workforce reduction, while another said that 15% of Healthe are gone.
  • Others said that several VPs were let go.
  • Several say that Cerner fired new hires in its development and technical academies.
  • Some speculate that the layoffs are intended to boost profit to make a rumored acquisition of the company more attractive.

Population health management software vendor TCS Healthcare Technologies acquires DataSmart Solutions, which sells predictive risk analytics software.

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Transcarent raises $58 million in a Series B funding round, increasing its total to $98 million. Its CEO is former Livongo founder, chairman, and CEO Glen Tullman.

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Patient privacy technology vendor Datavant will merge with Ciox Health, creating a patient data exchange business operating under the Datavant name that the companies say will generate $700 million in revenue and a valuation of $7 billion. Ciox CEO Pete McCabe will lead the business as CEO.

Healthcare business intelligence vendor Definitive Healthcare files IPO documents with the SEC.

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Amazon has signed up several companies as customers of its Amazon Care telehealth service. The company is expanding the virtual portion of the service to all 50 states this summer, eventually followed by national availability of its mobile medic visits and two-hour prescription delivery.

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Several insurers, Cleveland Clinic, IBM, and Sentara Healthcare invest in newly launched Avaneer Health, with JPMorgan health executive Stuart Hanson, MBA joining as CEO. The announcement describes the company with little detail:

Driven by its vision for a more productive and people-centered industry, Avaneer Health is building an inclusive network, breakthrough infrastructure and solutions to unlock healthcare’s potential. The groundbreaking company enters the market with an expert team of change agents; investment from top industry players; and a technology backbone designed to support a vast array of platforms for greater applicability and use in reducing administrative costs, accelerating care and improving the experience for people and their families.


Sales

  • The United Kingdom Ministry of Defense will use InterSystems HealthShare to normalize, aggregate, and de-duplicate data into a longitudinal unified care record for the Defense Medical Services.

People

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Rodrigo Martinez, MD (ENT and Sleep Specialists) joins PerfectServe in the newly created position of chief medical officer.

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FOLX Health hires Dana Clayton (Optum) as VP of operations.


Announcements and Implementations

Healthcare consumer insight vendor Carrot Health will incorporate social determinants of health data from LexisNexis Risk Solutions into its predictive models.

UK-based Nuffield Health uses Lumeon’s Care Journey Orchestration Platform to scale its COVID-19 rehabilitation program across 40 regional centers.

Meditech announces its upcoming integration with IOS 15’s enhancements to Apple Health, in which providers can launch a web-based dashboard within Expanse to view the information that a patient has shared with them.


Other

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This is a savagely witty comparison of the real law (HIPAA) versus the imaginary one (HIPPA) that clueless folks use as justification for not doing something. The graphic is making its way around the Internet, although I don’t know the original source.


Sponsor Updates

  • First Databank joins the National Council for Prescription Drug Programs Elite Partner Program.
  • CTHealthLink, part of the Konza National Network, will explore opportunities to incorporate technologies developed by the UConn School of Nursing’s Analytics and Information Management Solutions.

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 6/10/21

June 10, 2021 Dr. Jayne No Comments

I recently completed a short-term consulting engagement where I was asked to evaluate a health system’s physician training strategy and to make recommendations to make it more effective. Like many organizations, they’re struggling with physician burnout and many fingers are being pointed at the EHR. The IT department is convinced that the technology can’t possibly be at fault, so it must be how the physicians are using it, and therefore the training team’s fault. Since the IT team has a stronger political voice in the organization, training went under the microscope and a friendly CMIO was dispatched to the scene (virtually, of course).

I’m no stranger to these scenarios and was happy to take the engagement. I’ve seen enough failed EHR implementations to know that the success and happiness of physicians is directly proportional to not only the level of configuration of the EHR to meet local needs, but also to the amount of training required by the organization. For a complex system that will be ever-present within patient care, expecting physicians to know how to use it well after a couple of hours is not realistic. There’s often a belief that physicians won’t tolerate a greater amount of training, but I’ve found that they will be glad to attend if the training is high value and helps them use the EHR effectively. What they won’t tolerate is poorly delivered training with inappropriate clinical scenarios and lack of recognition of how they do their work.

Often training teams lack sufficient budget to be able to deliver the type of training needed, so I always arrive armed with journal articles and case studies. One of my favorites is from Applied Clinical Informatics. The title says it all: “Local Investment in Training Drives Electronic Health Record User Satisfaction.” It’s from the pre-pandemic era, published late in 2019, and I suspect that it might not have been widely read because by the time it was getting into circulation, most of us were laser-focused on COVID-19. The authors surveyed over 72,000 clinicians across more than 150 organizations to identify opportunities to have better return on EHR investments. One overarching theme is that there are “critical gaps in users’ understanding of how to optimize their EHR” and a proposed solution is to invest “in EHR learning and personalization support for caregivers.” I can’t tell you how many practices I’ve visited where the physicians don’t have any medication favorites built, don’t have defaults set properly, and have their drug/drug and drug/allergy checking settings at annoyingly high levels. Just fixing those few things typically reduces provider frustration immensely.

In evaluating my client, it turns out that the training team, IT, and operations all share the fault around poor usability and poor adoption. The users haven’t been able to take advantage of individual configuration and personalization settings because IT told operations it would make the system difficult to support. Training can’t deliver content around what’s not available, and unless physicians had used the same EHR in another venue, they wouldn’t be aware of what they were missing.

For the training content that the organization was attempting to deliver, they were lacking in resources, not only in headcount to deliver the training, but in having someone with expertise in adult learning who could design appropriate resources. They had decided that all training would be classroom style and group oriented, often with mixed subspecialties which added to attendee confusion as people asked questions that were not relevant to other attendees.

When the pandemic hit, they just migrated everything to Zoom and hoped for the best. Indeed, what wasn’t working before still wasn’t working, and for those not accustomed to online meetings, the training strategy truly failed to deliver. I had to do some significant education around learning styles, the risks of multitasking, and the need to assess mastery rather than simply presenting content. Fortunately, my client was receptive to the suggestions and is hoping to use some adult learning experts from an affiliated university to help fill the gaps. They’re also going to send members of the core application team back to training so they can fully understand the EHR’s personalization and customization features, since the people who made the decisions not to use them are long gone.

They’re also surveying the physician user base to find out how they want to learn and what works best for their needs. Some are going to still want/need classroom training, but in the post-pandemic era, they might value the convenience of a remote approach. I’ll check back with them once they have their survey results and the application team finishes training, and hope to be able to help them finalize a plan for rolling out additional personalization features to their user base. I see some additional satisfied users in their future.

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I had some things to celebrate this week, and after reading a recent article about the Promoting Interoperability program, I decided that not having to worry about whether I was going to attest or take a penalty should be added to the list. A recent study showed I’m not alone at saying no. The study looked at Florida Medicare providers who participated in the Meaningful Use (and successor) programs between 2011 and 2018. Only 43% of those receiving a first-year incentive payment went on to achieve payments in subsequent years. This translates to a cessation in funding that was intended to help support EHR adoption and practice transformation. I certainly don’t fault physicians for failing to continue participation – the reporting requirements were painful and for smaller practices the additional work was daunting.

However, since Medicaid providers tend to serve the state’s most vulnerable patients, it may mean that those practices that didn’t continue participating haven’t fully embraced the tools in their EHRs that could help them close care gaps for those populations. On the other hand, it could just mean that they were sick of the reporting requirements and decided to use their scarce resources to work on initiatives that provided direct patient benefits. I’m interested in hearing from practices that stopped participating, and whether they were able to continue to advance EHR adoption and use of additional technologies such as patient portals and outreach tools without receiving additional funding.

Are you part of the Meaningful User Drop Out club? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 6/10/21

June 9, 2021 Headlines 1 Comment

Datavant and Ciox Health Announce Merger, Creating the Largest Neutral and Secure Health Data Ecosystem

Ciox Health announces its intent to merge with Datavant in a deal valued at $7 billion.

Monogram Health Closes $160M Series B Funding to Fuel Acceleration of Next Generation Kidney Care Model

Kidney care company Monogram Health raises $160 million in a Series B funding round led by TPG Capital.

Nuvolo Secures Additional Funding for Series C From Mayo Clinic

Workplace management software vendor Nuvolo wraps up a $32 million Series C funding round with an additional investment from Mayo Clinic.

Morning Headlines 6/9/21

June 8, 2021 Headlines No Comments

LetsGetChecked Announces $150 Million Series D Fundraise to Grow Comprehensive Virtual Care Capabilities

At-home testing company LetsGetChecked raises $150 million in a Series D funding round, increasing its total to $260 million.

VA to Wrap Health Records Review ‘In a Few Weeks,’ Secretary Says

VA Secretary Denis McDonough says governance, transparency, and management issues will be top priorities for the department as the review of its Cerner roll out concludes.

New Mountain’s Ciox Nears Merger With Datavant

Bloomberg reports that health information management vendor Ciox is preparing to merge with Datavant, which uses AI to help its healthcare customers secure, match, and share health data.

Definitive Healthcare Announces Confidential Submission of Draft Registration Statement for Proposed Initial Public Offering

Healthcare market intelligence vendor Definitive Healthcare, which acquired HIMSS Analytics in 2019, prepares to go public.

HHS to issue timeline for health care data sharing guidance in coming months

HHS will soon share the timeline for the release of the Trusted Exchange Framework and Common Agreement (TEFCA).

News 6/9/21

June 8, 2021 News 6 Comments

Top News

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Scotland-based RCM vendor Craneware will acquire Sentry Data Systems, a Florida-based hospital pharmacy procurement, revenue cycle, and compliance solutions business, for $400 million.

Sentry offers software and services that support health system 340B drug purchasing programs.


Reader Comments

From Little Wing: “Re: software. I’m looking for a company that develops AI-based applications that a local government could use to track and report on the treatment and care for abused children in the social services program.” Readers, suggest a company from your experience and I’ll forward the information.


HIStalk Announcements and Requests

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Welcome to new HIStalk Platinum Sponsor Azara Healthcare. The Burlington, MA-based company is the leading provider of data-driven analytics, quality measurement, and reporting for the Community Health and physician practice market. Azara solutions empower more than 1,000 Community Health Centers, physician practices, Primary Care Associations, Health Center Controlled Networks, and clinically integrated networks in 36 states to improve the quality and efficiency of care for more than 25 million Americans through actionable data. Specific products include data reporting and analytics; care management; patient outreach; MIPS and APMs management and reporting; patient registry and population health; and the FHIRstation interoperability platform. Recent company news includes its merger with the population health division of SPH Analytics and its #1 Black Book ranking in end-to-end population health vendors, best-of-breed provider technology. Thanks to Azara Healthcare for supporting HIStalk. 


I’m required to occasionally purge inactive email subscribers from the HIStalk Updates list. You might want to enter your email address again just to make sure you didn’t fall off the list inappropriately (you won’t get duplicate emails regardless). Signing up for no-spam email updates is the secret weapon of more than a few industry leaders who are driven to be the first to know.


Webinars

June 24 (Thursday) 2 ET: “Peer-to-Peer Panel: Creating a Better Healthcare Experience in the Post-Pandemic Era.” Sponsor: Avtex. Presenters: Mike Pietig, VP of healthcare, Avtex; Matt Durski, director of healthcare patient and member experience, Avtex; Patrick Tuttle, COO, Delta Dental of Kansas; Chad Thorpe, care ambassador, DispatchHealth. The live panel will review the findings of a May 2021 survey about which factors are most important to patients and members who are interacting with healthcare organizations. The panel will provide actionable strategies to improve patient and member engagement and retention, recover revenue, and implement solutions that reduce friction across multiple channels to prioritize care and outreach.

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


Acquisitions, Funding, Business, and Stock

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At-home testing company LetsGetChecked raises $150 million in a Series D funding round, increasing its total to $260 million.

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San Francisco-based primary and urgent care company Carbon Health marks its first foray into chronic condition management with the acquisition of digital diabetes clinic Steady Health. Carbon Health hopes to have 1,500 clinics across the country within the next four years. It operates 70 clinics in 13 states and offers virtual care in select locations.

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Membership-based primary care company One Medical will acquire Iora Health, which offers similar services for seniors, for $2.1 billion. Iora Health co-founder and CEO Rushika Fernandopulle, MD will become One Medical’s chief innovation officer.

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Mendel will use an $18 million Series A funding round to further scale technology that uses AI to make sense of unstructured health data from health records and medical literature. The startup markets its services to healthcare organizations that are looking for analytics-ready data.


Sales

  • Gillette Children’s Specialty Healthcare (MN) will implement Infor’s CloudSuite Healthcare software with assistance from Bails & Associates.
  • Twin County Regional Healthcare (VA) will offer telecardiology services from Access Physicians, a division of SOC Telemed.
  • Together Women’s Health (MI) selects Emerge’s ChartGenie, ChartScout, and ChartPop data conversion and integration tools to help two of its member practices transition to Athenahealth.
  • UMass Memorial Health will power its new Hospital at Home program with Current Health’s remote care management technology.
  • South Texas Physician Alliance selects LeadingReach for referral management and care coordination.

People

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Erich Huang MD, PhD (Duke Health) joins Onduo as chief scientific and innovation officer.

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HealthTrust promotes Michael Seestedt to CIO.

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CitiusTech names Bhaskar Sambasivan (Eversana) president.

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Hospital supply chain, analytics, and interoperability solutions vendor SCWorx promotes Tim Hannibal to CEO.

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Conversational AI vendor Orbita hires Patty Riskind, MBA (Qualtrics) as CEO.


Announcements and Implementations

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Apple adds new health-related functionality to IOS 15, including the ability to share health and wellness data from its Health app, new trending tools for health measures and goals, a Walking Steadiness measure, improved lab results display, and the option to store immunization and test results directly in the Health app. Apple Watch adds a measure of respiratory rate during sleep and a new Mindfulness app. Cerner announced that it will support the enhancements in the fall.

Wolters Kluwer Health releases telehealth-specific Health Language value sets for use in claims processing, care coordination, and benefits systems.

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Jvion develops a Behavioral Health Vulnerability Map to help providers better address conditions that contribute to mental illness.

Augusta Health works with care and social services coordination software vendor Unite Us to develop Unite Virginia, a tech-enabled care coordination network for healthcare and social services providers.

Seven hospitals in Ontario will go live on a shared Epic system in December.

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MUSC Health (SC) implements Etiometry’s clinical decision support software in its cardiovascular ICU, with an eye to also installing it in the OR.

KLAS distills its information on each of the four major health system EHR vendors into individual “Complete Look” reports, which conclude:

  • Allscripts — C- in product, C- in loyalty, 18% of customers report deep interoperability as adoption of DbMotion wanes. Sunrise has 4% of US hospital beds. Sunrise is an integrated, highly customizable platform, but Sunrise Ambulatory Care and Sunrise Financial Manager are not widely used. For transformational technology, significant interface maintenance is required since each system has its own database.
  • Cerner — C in product, C+ in loyalty, 28% of customers report deep interoperability as customers benefit from its CommonWell connection. Millennium has 25% of US hospital beds. Cerner offers a broad Millennium suite that reduces third-party integration and is proven in both large and small organizations, but patient accounting is a weakness and the company’s less-prescriptive implementations lead to variability in customer success.
  • Epic — B+ in product, A in loyalty, 63% of customers report deep interoperability with Care Everywhere and its connection to Carequality. Epic has 42% of US hospital beds. The company’s fully integrated suite has topped all software suites for 11 years running, is proven in big health systems, and offers a widely used patient portal and population health management solution, although it has a high upfront cost and some modules require in-house expertise to build.
  • Meditech — B+ in product, A- in loyalty, 10% of customers report deep interoperability as most customers use point-to-point interfaces or HIEs, although its CommonWell connection is used by some early adopters. Expanse has 4% of US hospital beds. Meditech offers consistent development on Expanse, integrated offerings, and affordability that has made it the leading product for community hospitals, but Expanse costs more than the company’s legacy solutions and larger health systems have been historically hesitant to choose it.

Other

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Teladoc sues Avail – which offers an audio-visual platform that supports surgery collaboration, consultation, and education – for infringing on three of its patents.

Amazon offers Prime customers a six-month supply of some common prescription medications for $6 with free two-day delivery.

Two universities – one a non-profit, the other a for-profit – are vying to give Montana its first medical school. Colorado-based Rocky Vista University College of Osteopathic Medicine wants to open a satellite college in Billings, while Benefis Health System (MT) CMIO Paul Dolan, MD, MMM is leading an effort to bring a non-profit medical school operated by Touro College and University to Great Falls. The US has eight for-profit medical schools opened or announced, all of which are in the West and all but one of which offer osteopathic rather than allopathic training.


Sponsor Updates

  • CHIME releases a new episode of its Leader to Leader podcast featuring Dr. First President Cameron Deemer.
  • CarePort develops Quality Score, a scoring system that summarizes the quality of care delivered by skilled nursing facilities for short-stay patients.

Blog Posts


Contacts

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

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Morning Headlines 6/8/21

June 7, 2021 Headlines No Comments

One Medical Announces Agreement to Acquire Iora Health

Membership-based primary care company One Medical will acquire Iora Health, which offers similar services for seniors, for $2.1 billion.

Clinical AI Technology Leader Mendel Raises $18M in New Capital

Mendel will use an $18 million Series A funding round to further scale technology that uses AI to make sense of unstructured health data from health records and medical literature.

Craneware to Raise GBP140 Mln to Help Fund Sentry Acquisition

RCM vendor Craneware will acquire Sentry Data Systems, a hospital pharmacy procurement, revenue cycle, and compliance solutions business, for $400 million.

Curbside Consult with Dr. Jayne 6/7/21

June 7, 2021 Dr. Jayne 6 Comments

Last month, the National Academies of Sciences, Engineering, and Medicine released their report on high-quality primary care for US residents. The National Academies are private, non-profit organizations formed with the goals of informing US public policy and providing independent analysis and advice. After spending a couple of decades in academic medical centers and integrated healthcare delivery networks, I have a greater degree of trust for independent analysis compared to some of the output I’ve seen from “not-for-profit” organizations that have billions of dollars in the bank.

The report is titled “Implementing High-Quality Primary Care: Rebuilding the Foundation of Health Care.” The Academies’ press release is quick to note that “no federal agency currently has oversight of primary care, and no dedicated research funding is available. The report recommends the US Department of Health and Human Services (HHS) establish a Secretary’s Council on Primary Care and make it the accountable entity for primary care, as well as an Office of Primary Care Research at the National Institutions of Health (NIH).”

The report outlines a plan where patients should be able to have consistent primary care and that they should declare their primary care provider annually so that payers can ensure accountability and quality measures. This sounds similar to what I experienced on a rotation in the United Kingdom many years ago, where patients were expected to “register” with their general practitioner so that they would have a source of care if they needed it. This is very different than some of the consumer-oriented models of care that are booming in the US, where healthcare has become purely transactional, and many patients value convenience above all else. The decline in primary care availability over the last several decades has fueled growth in urgent care and retail clinics, and patients no longer see continuity or having a relationship with a primary care provider as something important.

In my experience, that erosion of respect and responsibility has contributed to a decrease in the number of students who want to go into primary care fields. Compensation is another big factor, and the report recognizes that as well, calling on more equitable compensation for primary physicians as compared to subspecialty care. There’s still a perception in the US that the best and brightest medical students go to the high-dollar subspecialties. As I sat doing my quarterly board certification questions tonight (which were quite difficult), it made me reflect on how much better it would be if the best and brightest were drawn to primary care, where they could solve diagnostic dilemmas firsthand rather than having to refer those cases out or potentially order tens of thousands of dollars in diagnostic testing.

The report notes that primary care practices were initially left out of COVID-19 relief packages and that they have not been fully utilized in support of testing, contact tracing, and vaccination efforts. It suggests that pandemic-related changes should become permanent, including coverage for telehealth services and reductions in documentation requirements.

I was intrigued by some of the suggestions made by the committee. One was that CMS should increase physician payments for primary care services by 50%. For practices struggling with a razor-thin margin, that would be a good start. Even better would be if non-CMS payers followed suit or increased their rates even higher than 50%. Another recommendation would be that CMS identify overpriced healthcare services and reduce the rates on those services to make them less attractive. I’m sure professional groups and vendors will oppose that, though, depending on whose cash cow might be in line for the sacrifice.

One of the major things that goes unsaid in the report is the massive culture change needed in US healthcare. We need to shift from a culture that venerates technology for the sake of technology to one that venerates knowledge and wisdom, with the appropriate and judicious use of technology as appropriate. Patients have grown to equate high-tech care with high-quality care, even when studies show that the technology is not helpful. I’ve seen dozens of patients come to urgent care hoping we will order advanced imaging studies, such as MRI scans, where they’re clearly not indicated, because patients feel like having an MRI will give them an easy answer. Why do four to six weeks of physical therapy and conservative management to see if your problem gets better when you can just have an MRI?

The needed culture change also applies to pharmaceuticals. We have to make some of the best initial treatments, like diet and exercise, more attractive than just popping a probably-expensive pill. This is a place where technology might really give us a boost, if we can use gamification and people’s inherent competitive natures to spur them to action. Technology can help give positive reinforcement and provide interventions and coaching that patients may not have had access to without it. Attitudes towards non-pharmaceutical interventions aren’t going to change overnight, though.

The committee also calls on leadership to use digital technology to make primary care more efficient, higher quality, and more convenient. It calls on the Office of the National Coordinator for Health Information Technology to address clinician user experience part of the next set of certification requirements.

A big piece of efficient data management though isn’t going to be the user interface of individual systems – it’s going to be addressing once and for all the absurd level of information blocking that goes on between health systems in the same city. As an independent urgent care physician, I could not get a single one of the four health systems in town to grant me access to their systems for “refer and follow” data access, regardless of how many patients I sent them or how many of their patients I cared for when their own physicians were unable to see them. I wish I had a fraction of the dollars I wasted ordering duplicate tests because I didn’t have full access to my patients’ health records.

I don’t think that anyone disputes the idea that a strong primary care infrastructure would not only improve people’s health and save lives, but would save our country a tremendous amount of money. Other nations (whether wealthy industrialized ones or middle-tier countries) have seen this value and have constructed their healthcare systems accordingly, while we have constructed ours around special interests, shareholders, and profit. According to the Organization for Economic Cooperation and Development, 5% of US health spending goes to primary care compared to 14% in other wealthy nations.

Although I started my career in the primary care trenches, I struggle to encourage medical students to follow that path unless they have a full understanding of the current state of things. I enjoy focusing my informatics work on trying to strengthen technologies that support primary care, but it’s going to take a lot more than bells and whistles to truly make it an attractive career again. As the pandemic eases, we’ll have to see what governmental entities have to say about the recommendations in the report, and how many decades it might take to make them a reality.

What do you think about the need to rejuvenate primary care? Will culture continue to dominate regardless of how much technology we try to throw at it? Or will we just watch history repeat itself? Leave a comment or email me.

Email Dr. Jayne.

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