News 3/29/23

Top News

HL7 publishes FHIR Release 5.

I will break my journalistic fourth wall in noting once again the industry contributions of “Father of FHIR” Grahame Grieve, who from interviews I’ve done with him always strikes me as an almost painfully humble, accolades-deflecting expert who led the charge that made FHIR a thing and just keeps on quietly doing the work.

Reader Comments

From Peony: “Re: huge health system losses. It’s all about their investments, not necessarily operations.” True in many cases. Health systems made annual fortunes from investing their big profits (which they don’t call that, of course) into investments that ranged from prudent to wildly speculative. Every investor looks smart in a bull market, but health systems are moaning at their investment losses much more loudly they did when bragging about their previous gains. I’m not an accountant, but headlines about shocking losses require further investigation. Did they lose money selling, or are these just paper losses that could be reversed when the market rebounds? How much money did the health system have stashed away that allowed them to play Warren Buffet, and did they buy and sell wisely? If they made money from operations, then should anyone care that their investments generated losses? Sometimes losses are real and critical — such as those in which a health system runs out of cash or sees their bond rating collapse — but I always suspect that it’s like plutocrats who claim crippling losses to the IRS while summering in the Hamptons.  

HIStalk Announcements and Requests

Listening: REM, whose early 1980s concert videos started popping up in my YouTube feed. Lots of people know dramatic singer Michael Stipe and arpeggio guitar master Peter Buck, but the subtle contributions of Bill Berry on the drums and Mike Mills with clean bass lines and high harmonies are underappreciated. The onstage energy and “I can’t believe we get to do this” smiling glances at each other are inspiring. Mills looks like an awkwardly shy teen and Stipe had the charm and appearance of a young Elvis. You can forgive the band for “Shiny Happy People” by watching them work the small crowd from a tiny stage in their dues-paying early days, perhaps with extra points for walking away as friends in 2011 with no plans to milk the reunion tour cash cow.

HIMSS guide reminder for sponsors: I’ve received information from four companies, two of which aren’t HIStalk sponsors, so now’s the time to send your information.  And speaking of conferences, sponsor Consensus Cloud Solutions is at ViVE this week, so I’ve added them to my conference guide.

Were a lot of cattle raised on the open ranges of Tennessee, I pondered upon seeing ViVE attendees posing with cowboy hats like citybilly country music crooners whose need for them is equally questionable, especially indoors and/or at night? I’m pretty sure cowboy hats and boots are, like mouse ears in Orlando, a sure way to self-identify as a tourist.  

ViVE Observations From An Attendee

An HIStalk reader who is attending the ViVE conference sent these notes:

• Announced attendance is 7,500, represented by 650 startups, 425 investors, and 330 hosted buyers. (Mr. H note — I’m surprised that only 330 attendees had their registration comped for agreeing to sit through vendor pitches. That means that a ton of people paid the high registration fee, although I then wonder how many are provider decision-makers).
• The conference had an easy start. You could get into town, take in some scenery, network, and have fun. There was enough going on to feel worthwhile but not jam-packed.
• Sessions were heavy on panels instead of individual speakers. That gives more companies a chance at the front of the room, but in losing the ability for someone creative to kill it with a great presentation instead of answering run-of-the mill moderator questions.
• Content is mediocre rather than thought-provoking or bold. As someone said, “everyone is simply tossing out headlines.” I would like to see a contrarian track where people point out where the shiny objects and overhyped solutions have failed to deliver.
• Live music is everywhere, included a performer in the registration area.
• A brief moment of silence was observed for the Nashville school shooting victims.

Webinars

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

Acquisitions, Funding, Business, and Stock

Value-based care enablement startup Wellvana Health raises $84 million, bringing its total to $140 million.

Sales

• Cone Health (NC) will use Lirio’s Precision Nudging intervention software, initially focusing on patients with hypertension.
• Lee Health (FL) selects B.well’s Connected Health technology to power its forthcoming Lee HealthPass app, which will aggregate patient data into a single interface.
• Catholic Care Center chooses Medsphere’s EHR and PM solutions.
• Netherlands-based Maastricht UMC+ chooses Epic to replace its SAP/Cerner system.

People

Clearsense names Alan Scott (Red Hat) chief enterprise architect.

Scott Cullen, MD (Accenture) joins Avia as EVP of strategic innovation and chief clinical officer.

Louis Raya (Waystar) and Tyler Wells (Waystar) join ADVault as VPs of business development.

Ann Joyal , MS, RD (Wolters Kluwer) joins Symplr as VP of marketing communications.

Announcements and Implementations

Carle Health (IL) implements Scanslated’s AI-powered radiology reporting software, which offers patients easier-to-understand radiology reports accessible through their patient portals.

ConnectiveRx develops a new Enterprise Data Platform that integrates data from every patient and prescriber interaction across its lines of support for enhanced reporting.

Marshfield Clinic Health System implements automated patient registration technology from Notable at its facilities in Wisconsin and Michigan.

UR Medicine (NY) uses DexCare technology to offer on-demand video visits across care settings as part of its Get Care Now program.

Censinet announces GA of Censinet Connect, a service that enables healthcare vendors to digitally share completed security questionnaires and supporting documentation with prospects.

Labette Health (KS) implements chronic care management software and services from ChartSpan.

Philips launches its Virtual Care Management suite of technologies and services for providers, payers, and employers within the US.

Mercy will take over management of county-owned Perry County Memorial Hospital and will invest $6.5 million to transition the facility from Cerner to Epic this fall. Both providers are based in Missouri.

Masimo opens pre-orders for its Freedom smart watch that provides continuous readings of pulse oximetry, ECG, and respiration as well as fall detection. It also features a data privacy switch that can turn off sharing of all data, including location tracking and microphone. A $100 deposit buys a place in line for fall delivery at a $400 discount from a list price that wasn’t mentioned. Masimo, like AliveCor, is fighting Apple over health tracking patents.

Government and Politics

FDA seeks sources for large-scale, de-identified healthcare claims data along with full access to their EHR data for its biologic product surveillance programs. FDA says EHRs provide more granular patient clinical information that is useful for validating claims data, although they won’t serve as the primary data source since they cover smaller populations and aren’t always longitudinal.

Walter Reed National Military Medical Center (MD) goes live on MHS Genesis.

The Health Sector Cybersecurity Coordination Center within HHS publishes a mobile device security checklist.

Carin Alliance publishes a report that describes how patients could provide their identities once to create a credential that could be shared across other systems without using individual portals. It envisions a person-center approach that allows people to interact with various systems in a scalable, low-cost manner.

Other

Humbled and honored to be recognized by Nora, who is immensely pleasured (HE-llo!) to tell me I’ve potentially won a “seal of recognition” from an unnamed organization that will recognize me at its unnamed conference, with no contact information provided except for Nora’s Gmail address. I’ll speculate that graduation from “potential honoree” status involves a transfer of funds. I’ll also speculate that given the conference date, the amply pleasured Nora works for Health 2.0, which has somehow started using a once-respected, HIMSS-owned conference name that it operates from India by way of a Las Vegas mail drop and from the Birmingham Bargains store in an Alabama outlet mall. In case you need an ego-stroking, self-nominated award that requires and offers little, they are “now accepting applications from industry stalwarts!” I assume that the industry stalwarts who have proudly posted a photo of their award failed to realize that this isn’t the actual Health 2.0.

Sponsor Updates

• CarePort will exhibit at AMGA March 29-31 in Chicago.
• CHIME releases a new Leader2Leader Podcast featuring Oracle Health Chairman David Feinberg, MD “The Future of Health Equity with Oracle Health.”
• Clinical Architecture releases the results of its “2023 Healthcare Data Quality Survey.”
• Nordic publishes a new episode of its In Network podcast.
• CloudWave will sponsor the MUSE New England Area Community Peer Group event March 29 in Pittsfield, MA.
• Current Health publishes a new case study, “UMass Memorial Health Builds Leading Hospital at Home Program.”
• Censinet and KLAS Research recognize AGS Health, Clearwater, Divurgent, Ellkay, Fortified Health Security, JTG Consulting Group, Nordic, and Upfront Healthcare for achieving and sustaining their KLAS Cybersecurity Transparent designation.

Blog Posts

• Medication Adherence: A simple workflow for improvement (Arcadia)
• The Burning Platform: Healthcare is in Dire Need of Change (CareMesh)
• How L1 Support and Hosting Services Made Customers Happy and More (CereCore)
• 3 Ways Analytics Can Help Fight Burnout in Healthcare (Dimensional Insight)
• Solve Independent Diagnostic Testing Facility Billing Challenges with Practice Management Software (ChartLogic)
• RapidAWV – Now optimized for any device! (ChartSpan)
• How to Track and Measure Provider Support Activities in Real Time (RCx Rules)
• Improve Operational Efficiency and Reduce Costs and Complexity with 1Clearsense (Clearsense)
• Hybrid Resiliency: Managing Healthcare Cyber Risk with the Best of Reactive and Proactive Security (Clearwater)
• Real-time Messaging Options Blows the Door Off Traditional Channels (ConnectiveRx)
• Healthcare Organizations: Electronic Faxing is Better with eFax and Unite (Consensus Cloud Solutions)
• Training Practices to Help Physicians Succeed at Risk-Based Documentation (and Beyond) (Curation Health)
• 5 Soft Skills to Look for in Prospective Employees (Direct Recruiters)
• Top Priorities for Healthcare CIOs Entering New Organizations (Divurgent)

Contacts

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

Morning Headlines 3/28/23

Wellvana Health announces $84 million capital raise to drive innovation in value-based care enablement

Value-based care enablement startup Wellvana Health raises $84 million, bringing its total raised to $140 million.

CVS Health to Close Acquisition of Signify Health

CVS Health will wrap up its $8 billion acquisition of home healthcare provider Signify Health this week.

Atlantic General Hospital Provides Notice of Data Privacy Event

Atlantic General Hospital (MD) notifies patients of a data breach after discovering hackers had encrypted files on certain computer systems.

HIStalk Interviews Robbie Hughes, CEO, Lumeon

Robbie Hughes, MEng is founder and CEO of Lumeon of Boston, MA.

Tell me about yourself and the company.

I’m an aerospace engineer by background. I got excited about healthcare when I was given a problem coming out college, which looked to me like the normal sort of problem you would see in any industry. Fifteen-plus years later, I’m still doing it, because this is healthcare and things are a bit different.

Our product is the Lumeon Care Orchestration platform. We are a companion app for EHRs that automates clinical and patient workflows. The end result is a massive improvement in care team productivity that transforms the patient experience and improves the wellbeing of the care team more broadly. It’s a tricky thing to do, but we are lucky in that it works extremely well.

You said the last time we spoke that your product helps standardize decision-making rather than standardizing care. Can you give some perspective or examples?

There is a common misconception in the way people think about care processes, that a journey of care starts on the left hand side of a sheet or a screen and ends up on the right. That’s just not the reality we live in. Every patient is different, every disease progression, every care process is different. Things unfortunately don’t happen the way we expect them to.

But if you were to present yourself in front of a physician or a care team member more broadly, they would work you up following a relatively common set of protocols and methods. The output of that workup would essentially be a personalized care plan for you, based on what they see right there in front of them. Standard decisions are being made inherent to how care is delivered, but the way that we implement care from a technical perspective is to assume that care is linear and standardized.

The question becomes, how do you embrace that personal aspect of care that is delivered by care teams, but try to bring the operational efficiency that comes through standardization as you might see in other industries? This personalized yet standardized thing is a bit of a Rubik’s Cube that people struggle to conceptualize and to use in reality. But it actually boils down to one very simple thing, which is that the decisions of around what care should be delivered should always be consistent and should always be repeatable.

For a given presentation, you should always get the same output. That should result in some specific personal action, some specific personal activity for that patient. That inherently means that for every decision, you’re going to get a personalized output, and every patient’s care journey will be the product of a bunch of personalized actions — not standardized actions, but personalized actions based on standardized decisions. The trick to all of this, the trick to delivering great care, is how do you repeatedly and reliably deliver that personalization in a scalable form to create predictable — not standardized, but predictable — processes. Lumeon has worked at how to do that very well, one of the biggest misconceptions that sits at the heart of why scaling healthcare can be difficult. That’s the core of what our business does.

We’ve laid out EHRs so that other clinicians and even the patient themselves have to reverse engineer a bunch of chart elements to try to follow the thought process behind the actions. Are patients themselves usually aware of what their doctor is thinking and could technology help them understand?

That is the $84 billion question, isn’t it? I would reframe that a little bit. Why do we do what we do today? It’s worth saying I’m not a physician, I’m an engineer, so everything looks like a problem to be solved to me [laughs]. The way I think about this particular problem is that if you look at the way a care team practices today, there are these interactions I have with the patient, there are interactions I have with the EHR, and a lot of this stuff is based around this notion that I, as a care team member, don’t, necessarily trust what’s documented in front of me. I’m going to ask the patient or about their history. I’m going to order another MRI. I’m going to do all these things because I as a responsible clinician need to understand that what I’m doing is the right thing for that patient, and that’s a perfectly rational place for them to be. And in a world where people are paid on activity on a fee-for-service basis, that makes economic sense as well.

But in a perfect world, they would be able to look in the EHR and see a complete record with everything there. As a result, they wouldn’t need to reorder things and redo things, because they look at the documentation and say, OK, this is  complete, I trust it, life is good, I will do the right thing by the patient.

So back to your question, the way the patient perceives this is maybe inconsistent delivery, repeating things that they’ve already done, potentially gaps in care where mistakes are made or things aren’t followed up, et cetera. From a care team perspective, what they experience is the repetition of things that should have been done already, but they don’t have necessarily 100% confidence have been done to their satisfaction or done well.

The more we fragment care through increased specialization and more handoffs, the more this problem permeates. In a perfect world, all the documentation would be there. This is actually one reason that what Lumeon does is hard. If you’re trying to introduce automation into clinical care processes, there’s this pyramid of need, and at the bottom of it is complete and accurate data. If the complete and accurate data doesn’t exist in the EHR today, then how on earth can you hope to safely implement automation on top?

You get to the same situation that the care team has, which is that most of it is there, but not enough for them to be able to run it completely, so they ask the patient or they go to secondary sources of data. It’s similar to what we do. We create a composite record, we ask the patient, we ask the EHR, and we ask other secondary data sources and other authoritative records systems that we can speak to. We create this composite synthetic record that says, the EHR says this, the patient says that, the Surescripts or DrFirst or whoever else says these three things, and therefore we believe that the complete picture of the patient is this. And by the way, there’s a conflict between those two things, so we had better give that to someone to reconcile.

If you can create that trust in the data through this super record or composite record, and you can then use that to provide a basic level of cleansing and then ideally automation on top of it because that you’re missing things or things need to be sourced, et cetera, then you are automatically eliminating a huge amount of the stuff that plagues the care team from a busy work point of view. But you’re also joining things up incredibly efficiently for the care for the patient, because what they’re experiencing is direct, precisely choreographed outreach and engagement that is specific and individualized to them.

The psychology is interesting that providers don’t trust each other’s data and instead ask the patient or repeat the test.

It’s very unfortunate, isn’t it? The way that our chief clinical transformation officer would put this is, if we have to go hunting and pecking inside the EHR for something and can’t find it within 10 seconds, we just order another one. Because once you end up in this situation where you have a giant system of record with a huge amount of stuff in it, if it isn’t immediately available and reliable it, you automatically create this need for hunting and pecking.

Once you get into that situation, then immediately you are demotivating the care team. They have better things to do, so it’s easier to place an order, because obviously we have massively optimized for order creation instead of looking through retrospective or historical data to see if something exists. From a Lumeon perspective, or more broadly, from a care orchestration perspective, a lot of the value is bringing that relevant data to bear in the form of specific and automated action so that we can identify even before the encounter is open that we’re missing a couple of things and so we need to do something about it.

In fact, we are missing so many things perhaps that maybe this encounter isn’t worth having face-to-face. Maybe it needs to be diverted to a phone call or something else. That sort of intelligence, I use the word choreography, can be a massive driver of efficiency because it is eliminating that waste work that shouldn’t exist.

How has the business model evolved of an ecosystem between EHR vendors and companies like yours that can add value if given access to EHR data?

It is becoming increasingly clear. From a regulatory perspective, that the roles and responsibility of the EHR are very clear. It is a documentation system, a quality system, and a billing system. There is an entire industry based around the creation, maintenance, and support of that and the regulation around it. That is a treadmill that exists and will continue to exist for a long time. There is a further regulatory point around giving others access to the data that sits within that. Again, that’s only going to get stronger as payment models become more exotic and the need for data and the application of data becomes more acute. Now from an ambition perspective beyond that, it comes down to a cultural question, which is, what is the culture of the company and what are they trying to solve for?

A huge amount of the work that we do as a company is effectively services led. We are sitting with our clients. We are listening to what they do. We are listening to their challenges. We are applying our best practices and our tooling to address their specific challenges, which may be actually unique to them, but against a standard set of models that we have developed over time that we know to be good practices. What that creates is an organization that is obviously strong in product, but also strong in services, change consulting, data and insights, and integration. There’s a bunch of core capabilities that we need to have there and muscles that we are working, which are inherently different to other companies where, for example, maybe they sell something online, it’s very light, you click and you install. The muscles they are working are different.

Just as the comparison between those two companies is different, so the comparison between EHR company and a EHR partner company is going to be. Every company in its DNA has a purpose and has a trajectory that is set based on the things that they do that differentiate them. When a company tries to be everything to everybody, then they will end up losing some of that discipline and some of that excellence. That doesn’t mean that they won’t create a solution that is good enough for some use cases, but it would be exceptional if that company ended up creating the best-of-breed solution in all of those use cases. I don’t believe that you’ll ever see companies that dominate everything everywhere. My belief is that we will find that focus and discipline of execution creates companies that are differentiated through that focus and that discipline. That’s true for the EHR as it is for any other company.

The market has changed due to COVID, hospital financial problems, and hospital consolidation. How do you get a prospect’s attention when they are experienced change management fatigue or have a full plate?

The reason people buy Lumeon is because they have a urgent need to effectively do more with less. They will have strong opinions around how they want to deliver care. They’ll have a strong desire to grow, and they need to work out a way to do that in a way that they haven’t done before, which is to change their care delivery model so that it is supported through technology.

Our experience is that right now we are at a fascinating time in the market, where people are effectively creating rolling budgets. If you can walk in and partner with a health system and say to them, we are going to both improve the quality of care you deliver, drive more revenue, and make your care team happier, and do that on an ROI that pays back on a same quarter or same year basis, everyone is open to that conversation today. That’s a testament to how open people are today to change. They’ve seen what happened in COVID and what was possible. There is an urgency that I’ve never seen in the market to drive that kind of change. It’s incredibly exciting.

What are the company’s goals over the next three or four years?

From a product perspective, we are continuing to develop our knowledge library, our repository of best practice recipes of how to effectively do what I’ve described, do more with less, but in very specific areas. From a personal perspective, that’s the thing that I’m the most excited about. Its truly a knowledge and a knowledge library of how you go into particular use case areas — surgery, inpatient case management, ambulatory care, whatever it might be — what are the specific recipes that work, how do they get done, and what are the outcomes? That is my passion and that’s what we do exceptionally well.

We have started on this journey. We have more to do, but in the space of three years, we will have the most unbelievable content and evidence behind it. That’s the thing that I’m focused on, because it ultimately comes back from, we’ve done this because we’ve delivered these results for our customers.

From ViVE and CHIME with Dr. Jayne 3/27/23

This week I’m in Nashville to experience the combined event that is CHIME and ViVE. I didn’t attend ViVE last year, but I heard stories about it, although Miami might have provided a different vibe than Nashville. 

Speaking of, it’s been some time since I’ve visited. Nashville has undergone some dramatic transformation in the last decade. The downtown Broadway-adjacent areas are chock full of party buses, pedal pubs, and bachelorette parties, at least on a Saturday night. Fortunately, I had a local guide for the evening, and after tapas downtown, we were able to avoid the tourist traps in favor of more interesting neighborhoods with plenty of local color.

It’s amazing to see all the new construction being interspersed with cute bungalows and historic features. It seems to work better in some areas than others, although the real estate prices are pretty high for things that are going to be torn down anyway. Germantown was a neighborhood that caught my eye and we’ll have to plan for extra time there on my next trip. Saturday night was also a quest for the best Old Fashioned cocktail, with the barrel-aged version at the Black Rabbit winning hands down.

Sunday kicked off with registration at the Music City Center. It was a low-key process with no lines. Swag was fairly standard, with a conference bag, water bottle, and mints, with an optional hat. Among the goodies in the bag was a reusable drinking straw from Lirio. I’m a huge fan of reusable straws at home, but I’ve never used them when traveling. If I decide to do so, the little carry bag is a plus.

Then it was back across the street to check in with the CHIME side of the conference, which was even more laid back. I was able to connect with a colleague over breakfast and also make some new friends, so that was a plus. Today was a day for CHIME Foundation members to host focus groups, and there was quite a bit of traffic for the offerings. My first experience with the focus groups was last fall. I found them to be a valuable way to hear about some of the challenges that other organizations are facing and how they’re dealing with addressing them. After hearing some of the stories told in the groups, you feel like you’re not alone.

I attended a couple of focus groups today, and although they were great for networking, the sessions themselves were a bit of a mixed bag as far as content. The attendee evaluation sheets are supposed to include stated goals for the focus groups. One group I attended didn’t seem to have stated goals and the presenter nearly lost control of the group. The discussion veered way off topic, but that conversation still delivered some learning. Namely, that if you get a bunch of CIOs, CTOs, and CMIOs in a room, you never know quite what you’re going to get.

Another group that I attended used an audience polling tool, not only to gather information, but to make sure the participants were engaged. I liked that strategy. Because of the way the polls were constructed, it was clear that they had spent time pre-session to determine what they were trying to achieve with it and how to get the information they wanted. The way the meeting rooms were positioned brought in lot of street noise that was occasionally distracting.

I managed to get out in the afternoon to enjoy the sunshine. I enjoy looking at historic buildings and downtown Nashville doesn’t disappoint. Plenty of buildings have interesting details and there are lots of historic markers around town that I didn’t see when I was out last night.

There are plenty of sassy shoes and boots out on the streets of Nashville, but I wasn’t able to capture pictures without seeming like a creeper. I didn’t have a wing woman with me at the time to act like she was posing for me while I surreptitiously captured a pic of the shoes in question. If you didn’t bring your own boots, there are several boot shops close to the convention center, so there is still time to pick up a souvenir. From there, it was back to the room to do a spot of email, and then on to the CHIME welcome reception.

The reception was hopping, although there was a bit of a check-in process for those of us who didn’t have the right symbol on our badges to indicate that we were CHIME members rather than just ViVE attendees looking to score some appetizers. The crowd was a veritable Who’s Who of healthcare IT, but it was so dark I couldn’t be on the lookout for shoes. The accessory of choice was apparently the light=up cowboy hat that came in black, blue, pink, white, or yellow. One attendee was even spotted wearing one of each color, which seemed excessive, but hey, when in Nashville, you do you.

The lights came on at 7 p.m.and they started moving people out, which coincided with the start of the ViVE opening reception proper. The event was packed. I ended up peeling off for a dinner date, but from the reports I received, I didn’t miss anything earth shaking. If you were there and have something different to report, please let me know.

Because I’m often blogging on the road, I travel with two devices to ensure that there are no questions about inappropriate use of my employer’s resources. My trusty Surface Pro 4 has served me well for more than six years. It has  been nice to carry as my secondary device because it’s not only small, but has great resolution and all the features and functions of a laptop. It also has the Surface Pen, which is great for my drawing-intensive hobby.

Unfortunately, my Surface has started having some battery issues and runs a little hot. I decided to look at options for a replacement. If it gave up the ghost on a trip it wouldn’t be the end of the world since everything I do is backed up to a cloud solution, but when I have free time, I usually don’t think about spending it to shop for hardware. I got a popup on my device today about considering a trade in, and decided to walk through the process just for giggles. My trusty pal has served me well, but apparently it’s worth less than a tank of gas as a trade in. I’ll hang onto it until it fully dies because the value of having a backup device in case of emergency is worth much more than 40 bucks.

If you were replacing an aging Surface Pro, what would you buy? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 3/27/23

How Cigna Saves Millions by Having Its Doctors Reject Claims Without Reading Them

Cigna’s reviewing doctors reportedly use “auto-denial” software that allows them to declare a patient’s test as medically unnecessary in an average of 1.2 seconds, without ever looking at the patient’s medical records.

Successful User’s Guide to High EHR Satisfaction

A new KLAS report finds that EHR personalization is the biggest driver of provider satisfaction, although providers often feel they don’t get much support in that area and resort instead to personal initiative.

US Organ Transplant System, Troubled by Long Wait Times, Faces an Overhaul

The federal government will solicit bids to provide services that have been offered by United Network for Organ Sharing, the top priority of which is to replace the organ-matching computer system in hopes of shortening transplant wait lists and addressing racial inequity.

Monday Morning Update 3/27/23

Top News

ProPublica says that Cigna’s reviewing doctors use “auto-denial” software that allows them to declare a patient’s test as medically unnecessary in an average of 1.2 seconds, without ever looking at the patient’s medical records.

A former Cigna executive says that it’s easier for the company to just deny everything knowing that policyholders will appeal its decision only 5% of the time, not to mention that is saves hundreds of dollars of research time per test by simply rejecting claims using a procedure-to-diagnosis table.

Featured prominently in the article is health IT long-timer Nick van Terheyden, MBBS, who dug into Cigna’s process when they refused to pay for his own test that he knew as a doctor was medically necessary.

Reader Comments

From Ricochet Rabbit: “Re: ambient notes. My doctor asked if I was OK with her using an ambient automated note taker to help her with the progress note. She said it wasn’t as good as Robin, which she has used elsewhere. I can imagine systems identifying key clinical concepts from the discussion and then use ChatGPT to create a progress note.” Accurately summarizing transcribed encounter conversations seems well within even today’s AI capabilities. It would also encourage doctors to communicate their thoughts to the patient, maybe as an intentionally spoken end-of-visit summary. The result could be like a research article’s abstract that tells most readers all they need to know about the article that follows. Robin is a smart assistant for creating clinical documentation for orthopedics, capturing both audio and video from the exam room that are then used by virtual scribes to deliver SOAP notes. The information is collected by a dedicated hardware device and then can be changed or enhanced afterward via the Robin app. I first mentioned Robin when it was released in May 2018.

HIStalk Announcements and Requests

Results from last week’s poll aren’t surprising, neither for the top vote-getters (above) and the bottom-finisher ones (Internet of Things, blockchain, and virtual reality).

New poll to your right or here: From your most recent patient experience with a health system, how would you grade their use of digital tools? I personally don’t mind manual and/or outdated consumer-facing technology as long as the people themselves are empathetic and friendly. My problem is that the people who shove poorly-designed paperwork at you via a clipboard are often arrogantly uninterested in what you think as a customer. Sometimes I wonder if their candidate pool is made up of people whose customer service skills were insufficient to keep their jobs at DMV.

Welcome to new HIStalk Platinum Sponsor JTG Consulting Group. The Miami Shores, FL-based boutique consulting company – which was founded in 2018 by President and CEO Jamel Giuma — specializes in laboratory IT, supporting EHR and laboratory strategies in health systems of all sizes. With  400 years of combined experience, the talented JTG advisory staff has established many longstanding relationships with health systems, providers, and vendors across the industry. It provides vendor-agnostic, patient-centric, and tailored IT services and solutions that help clients maximize interoperability, operational efficiencies, and revenue opportunities. JTG also offers advisory services to help organizations find the optimal path for achieving their strategic vision , helping affect sustainable success through short-term critical turnarounds and instituting long-run foundational changes. The rapidly growing company prides itself on on-time completions, cost effectiveness, and quality of product outcome. It scored 96.1 in an October 2022 report by KLAS Research, with 100% of clients saying they would buy again, and was #7 in Best in KLAS in the HIT Staffing category. Thanks to JTG Consulting Group for supporting HIStalk.

ReMedi Health Solutions will attend ViVE23, so I’ve added them to my sponsor guide for the conference. Ditto Nuance, which should be a fun booth visit given recent DAX and Microsoft ChatGPT-4 announcements.

Speaking of conference guides, sponsors can send me their HIMSS23 participation details for that upcoming guide. It’s easy, it’s free, and you will likely get some booth visitors you would have missed otherwise (especially if your booth features interesting presentations or perhaps site-baked scones).

Webinars

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

People

TriHealth promotes Donna Peters, MBA to SVP/CIO.

Announcements and Implementations

A new KLAS report finds that EHR personalization is the biggest driver of provider satisfaction, although those providers often feel they don’t get much support and that area and resort instead to personal initiative. Nurse aren’t given many options for EHR personalization, so the top success factor for them is being proactive about learning the EHR.

Government and Politics

The federal government will solicit bids to provide services that have been offered by non-profit United Network for Organ Sharing, which has run the country’s transplant program for 40 years. The government’s top priority is replacing the organ-matching computer system in hopes of shortening transplant wait lists and addressing racial inequity.

The National Labor Relations Board clarifies that a February ruling prohibits employers from including non-disparagement or confidentiality clauses in their severance agreement, also noting that the ruling is retroactive and such clauses that are contained in already-signed agreements are nullified by the ruling. The original case involved a Michigan hospital whose severance contracts contained clauses that violated the labor rights of employees.

Sponsor Updates

• Potomac Urology achieves growth with EClinicalWorks EHR and Healow patient engagement solutions.
• Optimum Healthcare IT names Natalie Tollefson HR service delivery director.
• Pivot Point Consulting will sponsor the OCHIN Learning Forum April 2-5 in Las Vegas.
• Volpara Health will exhibit at the National Consortium of Breast Centers conference in Las Vegas through March 27.
• West Monroe Managing Partner Tom Hulsebosch retires to launch the Hulsebosch Hope Foundation, a family foundation that funds public charities that seek to serve the needs of under-resourced communities in Chicago.

Blog Posts

• National Guidelines for Child and Youth Behavioral Health Crisis Care: SAMHSA’s Response (Netsmart)
• Leverage Generative AI to Liberate Information Critical to Patients, Providers (Orbita)
• Medical Answering Services: Urgent Versus Non-Urgent Calls (PerfectServe)
• Accounts Payable Automation in Healthcare: It’s Not Just for Hospitals (Premier)
• How to Track and Measure Provider Support Activities in Real Time (RCxRules)
• Place your bets on data (Redox)
• 3 hospital contact center metrics that indicate the health of your operations (Spok)
• Post-Public Health Emergency Changes to Patient Care (Surescripts)
• Speeding AI implementation in the contact center (Talkdesk)
• Simple Strategies to Boost Online Visibility: A Guide for Rehab Therapists (WebPT)
• From Theory to Reality: Realizing the Elusive Promise of Value-Based Care (Zynx Health)

Contacts

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

Morning Headlines 3/24/23

Vital Secures $24.7 Million in Series B Funding to Advance Its Artificial Intelligence-Driven Software for Patients, Hospitals and Health Systems

ED patient experience software vendor Vital raises $24.7 million in a Series B funding round, bringing its total raised to $46 million since launching in 2019.

House Dems introduce pair of bills to overhaul IT acquisition at Department of Veterans Affairs

Democratic lawmakers propose two pieces of legislation that would overhaul IT procurement within the department, and require the VA to procure an independent audit of its four major IT modernization programs, including the Oracle Cerner project.

State board approves health information exchange rules despite pushback

The Oklahoma Health Care Authority board unanimously votes to implement a statewide HIE despite protests from mental health professionals over patient privacy concerns, and provider pushback on the $5,000 sign-up fee.

News 3/24/23

Top News

ED patient experience software vendor Vital raises $24.7 million in a Series B funding round.

The Atlanta-based company has raised $46 million since its founding in 2019.

Co-founder and CEO Aaron Patzer, MSEE was founder and CEO of money management software vendor Mint, which he sold to Intuit in 2009.

Reader Comments

From Homey D. Clown: “Re: GPT-4. Microsoft’s announcement included a quote from Epic that says the company will be using it.” The Microsoft blog post that announced Azure OpenAI Service quotes Epic SVP of R&D Seth Hain as saying that “we’ll use [GPT-4] to help physicians and nurses spend less time at the keyboard and to help them investigate data in more conversational, easy-to-use ways.” Hain, who joined Epic straight out of college in 2005, has spent the last eight years working on embedding cognitive computing and machine learning into Epic’s software. Health IT software vendors will need to make similar decisions about their financial and technical capabilities to incorporate ChatGPT-like AI into their products as opportunities and user expectations expand.

HIStalk Announcements and Requests

I’ll run my usual online guide of what HIStalk sponsors will be doing at HIMSS23 the week before it kicks off, so send me your details. And since the question comes up every year, we can in fact get a new sponsor onboarded quickly enough to get into the guide, not to mention that they also get 51 more weeks of involvement once we all return home from Chicago. 

I awkwardly put together my first weekly healthcare AI update, not yet confident about content and writing style. Still, I have lined up some good interviews as a result and the more I write, the more I’ll learn.

I have early access to Google’s Bard AI chat tool and found it to be vastly inferior to ChatGPT, even the 3.5 version, as it either gave wildly incorrect responses or declined to answer at all. Its only advantage is that its information is kept current instead of being limited by a training cutoff date, as ChatGPT’s famous knowledge horizon of September 2021. AI will get a lot cooler when it stays current, which may come in the form of merging it with search engines as Microsoft has done with Bing.

Webinars

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

Acquisitions, Funding, Business, and Stock

Primary care operator Oak Street Health, whose $10.6 billion acquisition by CVS is in progress, launches OakWell in joint venture with kidney care management company Interwell Health. OakWell will offer primary care services to patients with end-stage kidney disease directly in the dialysis center, where ESKD patients spend an average of 12 hours per week.

People

Caregility hires Paul Oliver (Cisco) as chief revenue officer.

Announcements and Implementations

Epic integrates Invitae’s genetic testing into its Orders and Results Anywhere network specialty diagnostics suite.

An Intelligent Medical Objects survey of provider leaders finds that 94% plan to implement software to address clinician burnout and a potential recession, while 98% of respondents acknowledge that they need to use data better to confront challenges. Most respondents think that AI is overhyped, yet are adopting it and reporting improvements in clinical quality and administrative functions as a result.

A new KLAS report ranks Epic Community Connect as the top EHR for FQHCs, closely followed by Athenahealth. NextGen Healthcare is the leader in supporting an integrated care model and treating underserved populations. FQHCs express general dissatisfaction with dental management software integration, although NextGen Healthcare customers are content with its Electronic Dental Record integration.

Government and Politics

The Oklahoma Health Care Authority board unanimously votes to implement a statewide HIE and require providers to contribute data to it except for patients who opt out. Mental health providers had marched on the capitol last week over concerns that the personal information of their patients could be compromised, while other providers are unhappy about the $5,000 signup fee.

Other

Former Microsoft HealthVault GM Sean Nolan takes a nostalgic look back at its acquired Azyxxi, which it later renamed to Amalga. He provides some fun backstory – and potentially startup-relevant lessons learned — to the flashy analytics platform that was the hottest thing going for a short time in the early 2000s:

• Azyxxi thought that ETL pre-work is always wrong and not useful for asking new questions, so they loaded data from source systems and relied on heavy SQL processing to transform it as needed.
• The company’s early culture was that users should be able to ask questions themselves instead of dealing with the IT department.
• The product displayed information in an automatically refreshed kiosk-type display in patient care areas. The company’s experts would optimize performance-hogging queries once they saw them being used, which avoided optimizing low-use functions.
• The Amalga team ran into channel conflict at Microsoft, which had salespeople co-selling with third party developers that used Microsoft technologies, meaning that the salespeople “were best buddies with a whole bunch of healthcare data analytics companies that were in direct competition with Amalga.”
• The product was created at Washington Hospital Center by a dedicated team of 40 employees, but prospect hospitals focused on risk avoidance rather than innovation and weren’t motivated to replace an existing, inferior product with one they had to learn.
• Microsoft narrowed its business lines with the hiring of Satya Nadella as CEO in 2014. Amalga was sold to the Caradigm joint venture of GE HealthCare and Microsoft, Microsoft sold its stake, and the company was split into two parts that were sold to Inspirata and Imprivata. He didn’t mention that Microsoft also used the Amalga name on a Thailand-based EHR and RIS/PACS that it acquired from Global Care Solutions (Microsoft later sold that business to Orion Health).

Epic stages a cook-off of its in-house chefs, with Madison magazine offering interesting facts about the company’s massive food service program:

• Epic serves 9,000 made-from-scratch meals per day from three food service buildings and seven culinary venues (soon to be eight).
• The company’s working farm provides some of the produce it uses.
• Several of its recipes are posted online.
• Culinary employees get the same benefits as everyone else, including paid vacations, bonuses, health insurance, sabbaticals, and normal working hours instead of the usual evenings and weekends.
• Epic’s on-campus soda fountain (above) is named after CEO Judy Faulkner’s father Lou, who owned a pharmacy that had a soda fountain.

Sponsor Updates

• CereCore releases a new podcast, “How L1 Support and Hosting Services Made Customers Happy and More.”
• Everbridge CEO David Wagner presides over the opening of the Nasdaq to celebrate the company’s new brand and 20th anniversary.
• The Association of Health Information Outsourcing Services elects HealthMark Group CEO Bart Howe as its new president.
• InterSystems releases a new Health Data Podcast, “Mitigating the Risk of Innovation (ft. Pothik Chatterjee, Lifebridge Health).”
• Meditech releases a new podcast, “Shaping home care and hospice practices at the national level.”

Blog Posts

• CMS Innovation Center: Specialist Incentives for Value-Based Care (Enlace Health)
• 5 Healthcare cybersecurity tips for apps and mobile devices (Fortified Health Security)
• Ensuring Security and Compliance for Life Sciences Data with HITRUST Certification (Healthcare Triangle)
• Medical chart audits: what you need to know (HealthMark Group)
• How EMR Optimization Empowers Your Healthcare Facility’s Top Talent (HealthTech Resources)
• Capitalizing on Tighter EHR-ERP Integration (Impact Advisors)
• The impending crisis in healthcare: Lessons from SVB’s collapse (Nordic)
• What makes clinical terminology so tough to maintain? (Intelligent Medical Objects)
• Communication Breakdown: The Growing Need for Data Integration Services in Community Hospitals (Medhost)
• Preventing Pressure Injuries in Hospitals Takes Best Practices and Technology (Net Health)
• Plans Must Move Upstream to Improve Medicare Advantage Member Outcomes (NeuroFlow)

Contacts

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

EPtalk by Dr. Jayne 3/23/23

People are always asking me how I’m reacting to various things in the news. I was saddened last week to see that Pear Therapeutics is searching for ways to remain viable. They were one of my favorite finds at HIMSS22.

Unfortunately, I don’t think frontline physicians really understand what Prescription Digital Therapeutics (PDT) products are and how they differ from recommending that a patient just download an app. PDTs have to be approved by the US Food and Drug Administration before they can be marketed for patient use. Pear has treatments for substance abuse disorder, opioid use disorder, and insomnia that are clinically proven to provide benefit to patients.

For the technology to make it to patients, however, it has to be prescribed by a licensed clinician, and many clinicians are simply overwhelmed. It’s challenging to get them to learn about new drugs, let alone entirely new paradigms. If someone knows about PDTs, they have to identify appropriate patients, then prescribe the solution. A prescription transmission goes to the PDT company, which then has to fulfill it. In Pear’s case, by providing an access code that allows the patient to download it from Apple or Google Play.

Once the patient begins using the tool, the clinician receives notifications through a prescriber dashboard and can monitor patient progress. It’s not unlike prescribing a medication. The intervention still requires monitoring and follow up by the prescriber, and patient adherence can be an issue. I hope Pear Therapeutics finds what they’re looking for and can continue the good work that they are doing.

I also received some questions about the potential for telehealth use to mitigate the unfolding tragedy in pediatrics, namely, the increase in all-cause mortality for children in the US. A research article published in JAMA last week looked at the increase in child and teen deaths that began pre-pandemic but worsened during last few years. The largest increase in pediatric mortality in 50 years is being led by injuries, which include motor vehicle accidents, overdose, homicide, and suicide. All of them were on the rise prior to 2019, with suicide being on the rise as early as 2007. Even children from ages 1 to 9 had increases in death rates. Infants younger than 12 months were the only ones spared. The article summarizes some of the racial disparities that accompany the rise in mortality, with non-white children being the most impacted.

When talking with people about potential interventions or solutions, everyone says “telehealth” as if it’s a magic bullet. Although telehealth can reduce the burden on families who are trying to get their children help — through easier access, reduced driving, etc., — the reality is that there simply are not enough therapists to go around. Social workers and others who deliver telehealth therapy are leaving the field at an alarming rate. Policy makers need to go deeper and look at the causes of increased mortality. Nearly half of the increase in 2020 was related to firearms deaths, which were the leading cause for children aged 1 to 19 years.

The article points out that nearly all the gains that have been made in pediatric longevity over the past few decades are being erased by “bullets, drugs, and automobiles.” So much for improving outcomes with asthma, vaccine-preventable diseases, premature birth, and the like. I continue to come across parents who bury their heads in the sand about what is going on with their children and who seem shocked when the physicians caring for them suggest that they need to talk to their middle schoolers about sex, drugs, and guns. Frankly, by middle school, it’s a little late for a lot of that, depending on who your kids run with, but as family physicians and pediatricians, we’ll keep trying. We can throw some telehealth at it as well, but it’s a much bigger issue than the majority of people understand.

Several people have also asked for my reaction to “The Match,” which is the National Resident Matching Program. It’s the multi-month mating dance where medical students try to figure out where they will continue their training through internship and/or residency, and where training programs figure out who their workforce will be for the next several years. There were some huge shakeups in Match data this year, with emergency medicine taking a serious hit. It was bad enough that the American College of Emergency Physicians and other organizations issued a joint statement about the specialty’s prospects. It cites “workforce projections, increased clinical demands, emergency department (ED) boarding, economic challenges, the impact of the COVID-19 pandemic, and the corporatization of medicine, among many others” as reasons leading students to choose specialties other than emergency medicine.

I’m not an emergency medicine physician, but I’ve spent the last 17 years of my career practicing alongside EM physicians in the emergency department and high-acuity urgent care settings. The specialty has been absolutely dumped on during the last three years. If you don’t know what ED boarding is, that means that when there aren’t enough beds in the hospital to admit new patients (usually because of nursing or other staffing shortages), those patient stack up in the emergency department. Depending on the facility, often the emergency team has to care for them. Sometimes it’s bad enough that patients are even discharged from the hospital after a multi-day stay without ever going to a regular room.

That’s not what EM physicians signed up for, and it’s not their particular skillset. When primary care practices shut down due to COVID, everyone went to the ED and the urgent cares. Some physicians were seeing 80-100 patients each shift, while other physicians shut down. It was brutal, and the things we saw were horrific. The moral injury from having to ration care still haunts many of us. The sense of powerlessness that most of us felt for weeks grew to months and into years with little relief. Some of us are still coping with the symptoms of post-traumatic stress disorder, and a lot of us have left the profession.

For those frontline healthcare IT folks who have been trying to support the emergency department through all of this, you’ve seen it and understand why students don’t want to choose a career in the emergency medicine trenches. Thank you for your patience and compassion when we were frustrated day after day and the technology seemed like just one more thing causing torment. For those of you who haven’t seen this, or who haven’t been a patient lately, the downstream effects of this Match will ripple through our health systems for years to come. Ultimately patients will continue to bear the brunt of the mess that is the US healthcare system.

Would you encourage your child or loved one to pursue a career in medicine? What about healthcare technology? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 3/23/23

Veterans Affairs shares statement on electronic health records rollout

Mann-Grandstaff VA Medical Center (WA) shares improvements made to the VA’s Oracle Cerner system, and stresses that the VA remains committed to fully implementing the same system as that used by the DoD and Coast Guard.

Mental Health Leader SonderMind to Provide More Personalized Care with Acquisition of Mindstrong Technology

SonderMind, a mental healthcare company that helps match patients with therapists, acquires the technology of virtual mental healthcare provider Mindstrong, which is in the midst of winding down operations.

There in the sky! Not a bird, not a plane, it’s VA’s old VistA system!

The VA will shift its legacy VistA system to the cloud to ensure its functionality and accessibility while the new Oracle Cerner system is optimized and implemented across the department’s remaining facilities.

Healthcare AI News 3/22/23

Reader Note

This is my first weekly healthcare AI news recap, and as such is a work in progress as I learn on the job. I need advice about the topics that interest you, how you would like to see items laid out, and suggestions of individual experts and companies that you follow for healthcare AI news. I’m also interested in interviewing experts. Let me know.

News

Google releases its Bard chatbot to a limited number of users. I got early access and it has a long way to go to catch up even to ChatGPT 3.5, much less GPT-4.

Google is using its Duplex automated calling to contact US healthcare providers to see if their information is correct and to find out if they accept Medicaid, both with the intention of updating Google search results.

Medical device manufacturer Medtronic will incorporate Nvidia’s AI technology into its AI-assisted colonoscopy tool.

Microsoft offers a preview of GPT-4 for customers of its Azure OpenAI Service.

PNC’s treasury management launches PNC Claim Predictor, an AI-powered tool that learns from previously submitted claims to identify future claims that are likely to be rejected. The system integrates with EHRs, including Epic.

The Wall Street Journal looks at startups that are offering AI for healthcare use:

• Abridge AI, which is being implemented at University of Kansas Health System, creates visit summaries from the recorded audio from a visit.
• Syntegra creates validated synthetic patient data that can be used for research when available patient data is limited or when privacy laws limit its use.
• Atropos Health analyzes available anonymized patient records to product observational research.

OpenAI CTO Mira Murati joins the board of Unlearn, which uses AI-generated digital twins of individual patients for work with clinical trials and precision medicine.

Ommyx launches an AI health tracking app and a $15 per month service that integrates data from wearables and sends recommendations about nutrition, activity, and sleep to the user’s calendar.

Pangaea, whose AI technology characterizes patient disease trajectories, predicts the length of stay and morality risk of ICU patients with 85% accuracy. The company says its technology discovers undiagnosed and misdiagnosed patients, reduces treatment costs, and gives drug companies access to provider data in a privacy compliant manner.

France-based startup Nabla announces GPT-3 powered Copilot, a digital assistant that transcribes information from video conversations and generates prescriptions, appointment letters, and visit summary. The tool will initially be provided as a Chrome browser extension and an in-person version will be released soon. The company also sells a tool for patient engagement and secure messaging, video consults, and scheduling, all of which include machine learning.

Research

Researchers find that ChatGPT does a good job explaining myths and misperceptions about cancer, creating summaries that are not noticeably different or less readable than the National Cancer Institute’s answers. The authors conclude that AI chatbots could be useful for people who are seeking cancer information online.

Opinion

Doctors are skeptical that they can trust AI systems that have been trained to think like experts in situations where no single right answer exists, Politico reports. The federal government is pairing AI with expert humans to figure out how they reason on the battlefield or in natural disasters. They are following the model of medical imaging analysis, where AI is defined as successful if its conclusions fall within the boundaries of those offered by radiologists who don’t necessarily agree with each other.

Bill Gates says that AI will be the most important advance in technology since the graphical user interface. He predicts widespread use of Microsoft’s co-pilot technology in Office, controlling computers by writing plain English requests instead of pointing and clicking, and using AI as a personal agent to manage emails and appointments. He foresees AI’s impact on healthcare as helping its workers with repetitive tasks, and in countries with too few doctors, helping patients with basic triage and advice.

An interesting article says that generative AI could fuel a better, more entrepreneurial business model than the Internet’s advertising-obsessed “attention economy” that has killed off newspapers and online content sources.

Resources and Tools

Are you regularly using AI-related tools for work or for personal use? Let me know and I’ll list them here. These aren’t necessarily healthcare related, just interesting uses of AI.

• PromptPal – user-created prompts for ChatGPT and other services.
• Supernormal – records and transcribes Zoom meetings to create notes.
• Engage AI – analyzes the voice characteristics of contact center conversations in real time to give agents suggestions to improve their call quality.
• Futurenda – plans and tracks tasks and time usage.
• Whisper Memos – transcribes recorded phone messages.
• Descript – video editing, podcasting, transcription, and AI voices that can be used for team communication.
• Dall-E 2 – create images from text.
• Branmark – create business logos from text descriptions.
• Synthesia – create videos from text that feature lifelike avatars and 120 language options.
• SlidesAI – create Google Slides from text.
• Yippity – create text or websites into quizzes and flashcards.
• Otter – takes online meeting notes, creates summaries, and auto-join and record meetings from your calendar entry in case you’re late.

Contacts

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

HIStalk Interviews Ed Gaudet, CEO, Censinet

Ed Gaudet is founder and CEO of Censinet of Boston, MA.

Tell me about yourself and the company.

I’m a high-tech entrepreneur. I’ve done 11 startups throughout my career, mostly focused on building products and applying technology and automation to solve customer problems. I’ve done cross industry, everything from finance and energy to healthcare. I entered healthcare in 2010 when I joined Imprivata. I took Imprivata into healthcare, drove marketing and products for them, and then built their cloud platform for communications. We eventually took that company public and then private when Thoma Bravo purchased the company in 2016. 

I  left and attempted retirement, but that didn’t go too well [laughs]. My wife cordially commanded me to go find a job and get off the kitchen table. I started Censinet in September 2017, partnering with investor Keith Figlioli of LRVHealth. We found a syndicate of other investors and launched the company.

Who are your main competitors and what are your differentiators?

I saw while working at Imprivata this requirement to fill out security risk assessments. We used to joke that if you see one assessment, you’ve seen one assessment, because they are all different. They were in different formats, the questions were different, and semantics were different, so it took a lot of time. You could never get really leveraged. When I looked at problems to solve as I was exiting retirement, I kept coming back to this problem. What was interesting to me was looking at all of the alternative solutions that had been out there in the marketplace for probably a decade. Yet the problems — breaches, incidents, and attacks — were getting worse. Whatever we were doing in terms of trying to protect healthcare wasn’t working.

I looked at the problem around risk management in particular. I felt like there was an opportunity to disrupt the market and do something completely different to ultimately move the needle in risk and start to take out risk in healthcare. That was the idea behind it.

Some organizations aren’t what I think of as competition, but they they were providing solutions at the time. They were doing assessments through a combination of technology and services. You had folks like HITRUST with their framework. Then there were a bunch of early-on entrants that were trying to automate the problem through a pipeline approach, a single application, and you couldn’t get leverage.

For example, if Intermountain was using a single application to manage risk, and Cedars-Sinai was using the same application but they weren’t really connected, where’s the leverage? In looking at other markets, technologies, and architectures, I had this epiphany that we should put it on a network. We should think about it as a multi-sided platform. Could we streamline the automation on an exchange, a platform that was connected to the different actors in that process of managing risk information, and ultimately put controls in place to effectively reduce risk over time?

What are healthcare’s risks and how do they compare with those of other industries?

I learned through the Imprivata experience that healthcare is different. It is an ecosystem in and of itself. It’s a large ecosystem. The workflows are different. The requirements are different. The regulations are different. Other competitors or solutions were taking a broad approach to the problem, but I felt like we had to be purpose-built for healthcare. We had to think about the problem through the lens of the CIO and the CISO in healthcare and not worry about other industries, because the problem is so big.

We started with third-party risk. We thought about the vendors and those products and services that they were providing to the health systems. How that could affect risk. At the time, the percentage of third parties that were involved and integrated into the business process of health systems was fairly manageable. But in the past five or 10 years, that percentage has grown exponentially. You’re seeing every business process in a health system directly being run on some type of digital or IT infrastructure or technology.

Cyber risk was mostly in IT problem. Your IT organization would manage the security risk assessments, the process for collecting the data, create the remediations or corrective action plans, and manage that through the business. Cyber risk is now enterprise risk that affects every single department within a healthcare organization. Every business process is affected by cyber risk, because they rely on technology to do their work.

That has made a big impact on our overall strategy and where we’ve taken the product. Where we started with third parties and built the platform, today we have over 34,000 assessed vendors and products in our digital catalog. On the other side of the network, we have over 100 customers across more than 500 facilities. The network is growing, and every new provider we add, every new vendor we add, has a geometric effect. Providers bring new vendors, new vendors bring new vendors and new providers. There’s this flywheel that happens. We get this incredible network effect on our platform, which drives a number of benefits to the participants. 

Part of the vision was that if we’re going to solve this problem around risk and around cybersecurity, we have to take a page out of the bad guys’ playbook. If you think about what they’re doing and why they are so effective, they are organized. They have a cyberattack conveyor belt. They have applied manufacturing principles to cyberattacks. They have this concept of micro services, where each person has a certain role that they manage in the attack. It’s not just one person doing the full stack attack. That organization has made them effective and dangerous, yet from an industry perspective, we haven’t come together. The vision for Censinet was a platform to facilitate that ability to drive that leverage and drive the power of the community to protect itself.

Many recent incidents involved business partners or external technology vendors. What do you look for and what do you provide to the organization that engages with you?

Our history from an organizational perspective is third-party risk. We’ve leveraged that into other areas of risk management. When you think about an initial customer implementation, the customer comes on board and they can easily and quickly start sending out assessments in the platform. They’ll search for a particular vendor or product. They will use the platform to send out an invite that vendor and its products into that process. The analogy is where you want to do an assessment on a vendor and its products and you send out any email with a spreadsheet. We’re automating that workflow and sending out an email with a link to the portal.

The vendor fills out the questionnaire, attaches any supporting evidence or documentation to their claims, and it sends it back to the provider. The provider then has full automation capabilities for things like rating and driving corrective actions or remediations automatically, or they can do it manually in the platform and they can generate all their reporting through the platform as well. That end-to-end process, without us, can up to six weeks the first time time a vendor comes on board. Our SLA guarantee is 10 days or less for that full assessment, which is incredible. The next time that vendor gets asked to do an assessment by somebody else in the platform, it’s a click of a button. The network effect continues to drive that value as more people are added to it. It increases over time and it’s exponential. 

We are doing not just that facilitation. We are also doing those governance functions. We’re driving the curation of the assessment data, the questionnaires based on the regulations that are ever changing, as well as the corrective actions. If a vendor answers in a certain way and risk is generated, then how do we correctively reduce that risk? What do we put in place to move that risk from a certain inherent risk to a residual risk that we can accept as an organization? We do that all on the platform.

Typically without a platform like ours, you do a point in time, set it and forget it. I’m going to purchase this product, I’m going to do risk, and then maybe I’ll be able to do a reassessment at some point, which nobody ever does. With our system, once you do your initial assessment, you’ve got the data in there. You can automatically set up a reassessment for some time, usually a year later. You can tier that vendor into a critical, high, medium, or low tier, which can drive automation on the back end. You have the ability to periodically and continually assess that vendor and their product or products based on maybe a scope change.

For example, if you just set it and forget it, you miss the ability for risk to appear based on some type of scope change. Blackbaud was a donor management that many health systems used a few years ago. On paper. it seemed like it was low risk. No PHI is going to be on this, so we’ll send it through a low risk assessment process. Users changed the scope of usage, and introduced risk, by putting PHI in the application. Because nobody was looking at it, nobody was continually assessing it, they missed it, and it caused a huge breach issue across a number of health systems. 

Having this lifecycle approach is another differentiation that we bring, and an innovation that we bring, to the marketplace. Think about it as a longitudinal record for risk in the same way that the EHR is that longitudinal record of care.

Customers are always faced with the decision of how much they are willing to spend to mitigate whatever risks exist. What framework do they use to evaluate the exposures you call out?

Without a system like this, they are rolling the dice. It’s anyone’s guess. There’s an inability to manage a risk program in a way that can be data driven because the artifacts are scattered. They’re not centrally located, they’re not pulled together, they’re not driven through automation. They might be in emails, spreadsheets, sticky notes, and conversations, so the ability to assess all third parties is difficult without a system like ours.

You have to automate that process. You could have 1,000 vendors with 2,000 products in your environment. You start to apply a solution like ours. Those have to be added to the system. That data has to be captured through maybe a reassessment that can be automatically set, because every day that goes by, someone is buying something new that needs to be assessed.

We often see customers will start with net new vendors and products and quickly realize, wow, we have all these other legacy products that we have three-year contracts with. We need to add them to the system as well. We encourage that, because ultimately you have to understand what that risk is. With a system like Censinet, it doesn’t take a lot of time to do that. There are tools to basically apply tiering to those different vendors and products. Which by the way, people do regardless of whether they have a system or not.

Let’s say they have a handful of products, but they’re doing it manually. What we find is that there’s this tiering that happens a priori before they even do an assessment. They will say, we can’t handle everything, so we’re going to make some judgments. We’re going to stratify artificially these vendors and products into buckets of risk. That’s high, that’s critical, that’s medium, that’s low. But there needs to be a true business impact analysis, where you’re understanding the product and the vendor relationship through the eyes of the business, because ultimately they understand the importance and criticality of that product, not the IT organization. 

There’s this real disconnect with the risk management programs that occurs. Everyone thinks they are doing the right thing by doing these assessments, but there needs to be a broader rubric and a strategic lens to apply across the organization when it comes to risk. Because as you said, you otherwise could be spending a lot of money and getting little benefit. We see that all the time. We see organizations throw point tools at the problem and not think through strategically how to manage risk. Not just today, but in the future.

If you take a tool and you apply it to a terrible process, you’re going to get a terrible result. Vice versa, if you have a great process and you apply a terrible tool, you’re going to get terrible returns. If the tool is good, then the tool should inform the process. The leadership team needs to take that into consideration when they bring these things on board, because they are transforming their organization. They should be open to that. They should be willing to change, because ultimately they’re going to have to change to stay in the game. It’s no longer good enough to throw spreadsheets at this problem. You need a better approach, a more strategic approach, that includes the right resources, the right process, and the right product or technology to move the needle on risk.

What will be important to the company over the next three or four years?

When we first started off with third-party risk, our customers would come to us and say, we love what you’re doing with third parties, but we have another dozen or so risk processes, silos if you will, within the organization. For example, Intermountain said, we have institutional review board processes and we do a number of risk assessments, but we do it in a different product. We are holding this thing together and we have people supporting it. Can you consolidate it on your platform?

We’ve been working with our customers to identify those silos of risk and consolidate them on the platform. We’ve added things like IRB and the ability to do enterprise risk, where the health system can assess its own facility, its own operations, using NIST CSF, using the health industry cybersecurity practices, the HICP framework. Those are being recognized as security practices. In the event of an incident, if you an prove that you’re following the NCSF and applying it, or HICP, and  there’s some type of event or incident, OCR has to take that in consideration as part of some recent regulation. Public law 116-321 provides — I hate to use the word safe harbor, but effectively it’s a safe harbor – if you do the right thing from an enterprise risk perspective. 

We look at M&A transactions, the risk involved with acquiring a new organization, and assessing the risk of that and how you bring that into the platform. If you’re building applications internally or doing integrations, those require assessments as well. You can do that now on the platform. We started off with technical suppliers and technical products, but what about the non-technical suppliers, like a laundry service that may be critical to a health system? The health system is so large that it requires a certain laundry service, and maybe there’s only one that can service them accordingly. What would happen if that laundry service was hit with a cyberattack? That hospital wouldn’t be able to function without laundry. 

Elements of suppliers that are non-technical could have huge impacts to health systems. Maybe the organization is thinking about those, maybe they’re not, maybe they’re in a different system. Medical devices typically are being managed through the biomed team, but there should be some connection with the IT team. Why are they doing it in two separate places? Why are they doing it with two separate processes? We are starting to see the consolidation of all these silos of risk on the Censinet platform, which continues to drive down the unit economics for our customers and deliver interesting, unique value.

Morning Headlines 3/22/23

Nuance and Microsoft Announce the First Fully AI-Automated Clinical Documentation Application for Healthcare

Microsoft-owned Nuance will launch Dragon Ambient EXperience Express, which uses ChatGPT-4 to automatically generate clinical notes, this summer.

Maven Clinic Accelerates Growth in the United Kingdom with Acquisition of Naytal

Maven Clinic, a virtual women’s and family health provider that has raised $300 million, acquires UK competitor Naytal for an undisclosed sum.

Bionic Health raises $3M for its AI health clinic using GPT-4 and other ML models to design better preventative care

North Carolina-based Bionic Health will use $3 million in seed funding to further develop its membership-based “AI health clinic” for preventative care.

Perspectives of Patients About Immediate Access to Test Results Through an Online Patient Portal

A survey involving four academic medical centers finds that nearly all patients appreciate having their test results posted immediately to the patient portal, even if their providers haven’t reviewed them.

News 3/22/23

Top News

Microsoft-owned Nuance will launch Dragon Ambient EXperience Express, which uses ChatGPT-4 to automatically generate clinical notes, this summer.

DAX Express will be included in DAX. It will also be offered as an addition to Dragon Medical One.

DAX Express creates clinical notes using exam room or telehealth conversations with patients.

Nuance will demonstrate the product at HIMSS23.

Reader Comments

From Lloyd Christmas: “Re: DoD’s DEERS personnel system. Hearing that it screws up addresses, pay, and assignments. I imagine it feeds into the Tricare system and probably Cerner.” The Army has also had problems with its IPPS-A human resources system, whose recent problems have resulted in incomplete data that is used for promotions and assignments. Problems in either system are likely to cause problems in Oracle Cerner, although at least the  $600 million IPPS-A system is also from Oracle, based on PeopleSoft.

From Midwest Nice: “Re: Epic. Judy reads HIStalk! Slide shared from March staff meeting.” My goal is that every reader feels as though I’m whispering directly into their ear alone as their guilty pleasure. But I will share one story. Several years ago, some health IT companies were blocking access to HIStalk because they didn’t want their employees to hear the truth (which of course led those employees to simply read after hours from home). I received what I think was my first-ever email from Carl at Epic, which started off with the ominous, “I have a problem with your site.” I nervously continued: “Some of our employees are telling me that they aren’t able to access HIStalk from work. We can’t determine if the problem is on our end or yours. Can you help me out so they can keep reading?”

HIStalk Announcements and Requests

Welcome to new HIStalk Platinum Sponsor Marble. Marble provides a holistic API platform representing the simplest way to get patient authorization and access to a vast data network from 120 million patients and 65,000 healthcare organizations. On the front end, Marble captures and verifies patient identity, obtaining explicit patient consent to access and share patient data and storing that data with FHIR-compliant companies using the Marble API. Developers gain network searchability and data retrieval at their fingertips while meeting HIPAA compliance and other privacy mandates. Thanks to Marble for supporting HIStalk.

Attention ViVE 2023 attendees: check out what HIStalk’s sponsors say they will be doing there next week.

I’m not often a fan of suddenly trendy words and phrases, but this one’s efficiency gets my green light: 3Xing (it works with any number). You 3Xed your revenue, which is the same as tripling it (which is the same as increasing it by 200%, which confounds a lot of people).

Webinars

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

Sales

• UR Medicine Highland Hospital (NY) will use software from Medaptus to manage inpatient physician assignments.
• Mental health system Brook Lane (MD) selects Commure’s Strongline staff safety alert system.
• Northwell Health will implement Epic, with the first go-lives scheduled for 2025.
• Vitas Healthcare will implement WellSky’s hospital and palliative care solution in its 50 hospices.

People

Julia Strandberg, MBA (Pear Therapeutics) joins Philips as chief business leader of its connected care businesses, including enterprise informatics.

KLAS Research promotes Steve Low, MS to president.

Caregility hires Kedar Ganta, MBA (Cisco) as chief product and engineering officer.

Health Data Movers promotes Karla Christopher and Brandon Camp, MBA to VPs of delivery.

Announcements and Implementations

Delaware-based ChristianaCare’s Center for Virtual Health launches a subscription-based, direct-to-consumer virtual primary care service in six states.

Children’s Hospital of Philadelphia develops a remote patient monitoring program for babies discharged from the NICU and an RPM program focused on malnutrition.

Maternity telehealth provider Ouma Health will partner with MedArrive’s field provider network to offer in-home services to pregnant women and newborns, especially high-risk Medicaid beneficiaries. The companies note that Medicaid mothers are often erroneously labeled as non-compliant when they miss appointments because of problems with transportation or taking time off from work.

Gozio Health enhances its mobile platform to support customized experiences by user type.

KLAS interviews a small number of Oracle Health customers about their perception of the company:

• The percentage of clients that see Oracle Health as a long-term partner has dropped significantly, particularly in large health systems.
• Customers say they are losing patience waiting for the company’s RevElate RCM solution, for which communication has been infrequent.
• They also question whether Oracle Health has enough staff left to implement RevElate after several rounds of layoffs.
• While customers think that Oracle Health will execute better than Cerner, they are uneasy about the lack of detail in the company’s plans.

Government and Politics

Politico reports that the FTC decided not to sue to block Amazon’s $4 billion acquisition of One Medical due to the case being considered too hard to win. Questionable negotiations with Lyft just before Amazon Care was shuttered and the One Medical deal announced had raised federal red flags, but the online retailer’s far-reaching tentacles have left lawmakers unable to effectively pinpoint exactly which markets may have been monopolized.

The VA will launch a pilot of its internally-developed Internal Scheduling System this summer, enabling medical support assistants to see available appointment slots for particular providers without navigating five or more windows. The VA is also looking for commercial software “like ZocDoc or Kyruus” to help its providers manage community referrals.

The FTC offers a deep dive into the enforcement actions it took against GoodRx and BetterHelp after they allegedly used pixel-tracking technology to share user health data with third parties for advertising.

Privacy and Security

UC San Diego Health notifies patients that vendor Solv Health used analytics tools that distributed information to third-parties without authorization on the scheduling websites of the health system’s Express Care and Urgent Care clinics.

Other

A survey involving four academic medical centers finds that nearly all patients appreciate having their test results posted immediately to the patient portal, even if their providers haven’t reviewed them. Some of those whose results were abnormal reported being worried and trying to understand what the results meant to their health, but 95% of them wanted immediate access to continue anyway. The authors suggest conducting further studies of pre-counseling — which was not associated with lower levels of worry in the study — and allowing portal users to designate their notification preferences for abnormal results or to hold results until after working hours, perhaps even on a per-test basis based on the patient’s level of concern.

Sponsor Updates

• Lakes Region Mental Health Center (NH) expands its use of Netsmart technology to include the CareFabric platform.
• Meditech, Algonquin College, and Queensway Carleton Hospital in Canada, partner to teach EHR configuration, workflows, collaboration, and security in lab sessions this semester.
• Artera will exhibit at The Beryl Institute’s Elevate PX event March 27-29 in Dallas.
• Azara Healthcare congratulates FQHC customers Community Health Center of Southeast Kansas and Valley Professionals Community Health Center (IN) on being recognized by HHS as 2022 Million Hearts Champions.
• Baker Tilly releases a new Healthy Outcomes Podcast, “Direct-care workers in the post-acute care sector – challenges and opportunities.”
• CereCore publishes a new case study, “An Epic Implementation Story: Fast Tracking Epic Integration for a New Pediatric Facility.”
• Nordic releases a new episode of In Network’s Designing for Health podcast.
• ChartSpan becomes the exclusive chronic care management partner of Arkansas Hospital Association Services.
• Dimensional Insight will exhibit at AMGA 2023 March 28-31 in Chicago.
• CompTIA honors Divurgent SVP of Delivery Rebecca Woods with its 2023 North American Spotlight Award for advancing women in technology leadership.
• CereCore expands its specialized IT staffing services in the Dallas-Fort Worth area to better serve the area’s healthcare and life sciences industries.
• The latest Philips Capsule patient deterioration Surveillance solution receives market clearance from the FDA.

Blog Posts

• The AI Advantage: Complete, Accurate, and Compliant Medical Coding (AGS Health)
• What conditions are causing hospital readmissions? (Arcadia)
• How Virtual Monitoring Technology Improves Patient Safety (AvaSure)
• How encryption can take your data security to the next level (Philips Capsule)
• Managing Post-Acute Care to Improve Quality and Reduce Costs (CarePort)
• Bottom Line: Cost Savings is Why Meditech EHR and AP Automation Make Sense (CereCore)
• A time of growth at Oracle Health (Oracle Cerner)
• Digital Health Companies: Get Ahead of the Cybersecurity Implications of the SVB Collapse (Clearwater)
• How EMR Optimization Empowers Your Healthcare Facility’s Top Talent (HealthTech Resources)
• Improving Health Equity by Understanding the Social Drivers of Health (CTG)
• Top Questions About Hospital-at-Home (Current Health)

Contacts

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

Morning Headlines 3/21/23

Washington prepares for war with Amazon

Politico reports that the FTC decided not to sue to block Amazon’s $4 billion acquisition of One Medical due to the case being considered too hard to win.

RookMotion Raises $1.7M in Pre-Seed Funding to Empower Companies With More Actionable Health Data, Rebrands to Rook

Texas-based wearables data integration and analytics startup Rook raises $1.7 million.

Infinity Announces New Name, Now SimiTree Behavioral Health

Behavioral health IT vendor Infinity rebrands to SimiTree Behavioral Health after being acquired by the RCM, outsourcing, and professional services company SimiTree last year.

HIStalk’s Guide to ViVE 2023

AGS Health

Booth 1619

Contact: Christina Cussimanio, SVP of marketing

christina.cussimanio@agshealth.com

802.777.4084

AGS Health is more than a revenue cycle management company – we’re a strategic partner for growth. With expert services complemented by AI-enabled technologies and high-touch support, AGS Health is the premier revenue cycle partner for leading health systems, physician groups, and academic medical centers in the US. AGS Health employs more than 11,000 team members globally and partners with more than 100 clients across a variety of care settings, specialties, and billing systems. Anyone who is seeking an end-to-end revenue cycle management partner should seek out AGS. We will be hosting a charity event for the Kids In Need Foundation where participants can stuff a pencil case for a child in need.

AvaSure

Booth 911

Contact: Laura Melendez, event manager

laura.melendez@avasure.com

If you are interested in setting up a meeting or talking with AvaSure experts like our Chief Product Officer, Jacob Hansen, you can request a time.

AvaSure provides the leading hospital virtual care platform to systems with nursing and staffing shortages that are challenged to significantly reduce labor costs without sacrificing patient health outcomes. Recently recognized by KLAS Research as the leader in reducing the cost of patient care, AvaSure is the pioneer in providing best-in-class, video-based AvaSure TeleSitter and TeleNurse solutions. As a trusted partner of more than 1,000 hospitals, AvaSure combines remote patient monitors, virtual nurses, and other providers on a single platform to enhance clinical care without placing any additional burdens on existing staff.

Baker Tilly

Booth 2407

Contact: Charlie Cook (charlie.cook@bakertilly.com), Ed Ricks (ed.ricks@bakertilly.com, 843.521.7191)

Baker Tilly is a top eight CPA Advisory firm worldwide. We’d love to have you chat with Ed Ricks, former health system CIO and COO, about how we are helping health systems solve the nursing shortage with an AI platform in conjunction with our change management and analytics services. Helping remove barriers to care delivery, improve patient and clinician satisfaction, and improve the bottom line. Go there. Start here.

Care.ai

Booth 1512

Contact: hello@care.ai

Visit booth #1512 to learn how leading health systems use care.ai’s Smart Care Facility Platform to optimize their processes. Discover how our platform empowers care teams to deliver personalized, quality care leading to better patient outcomes.

CereCore

Booth 2704

Contact: Jillian Whitefield, business development manager

jillian.whitefield@CereCore.net

248.891.5557

CereCore provides IT services that make it easier for hospitals and healthcare systems to focus on supporting hospital operations and transforming healthcare through technology. We partner with clients to extend their team through comprehensive IT staffing and application support; technical, professional, and managed services; IT advisory services; and EHR consulting because we know firsthand the power that integrated technology has on patient care and communities.

Clearwater

Kiosk 1 in the Cybersecurity Pavilion

Contact: John Howlett, SVP and chief marketing officer

john.howlett@clearwatercompliance.com

773.636.6449

Clearwater helps organizations across the healthcare ecosystem move to a more secure, compliant, and resilient state so they can successfully accomplish their missions. We do this by providing a deep pool of experts across a broad range of cybersecurity, privacy, and compliance domains; purpose-built software that enables efficient identification and management of cybersecurity and compliance risks; and a tech-enabled, 24x7x365 Security Operations Center with managed threat detection and response capabilities.

Join us on Tuesday, March 28, at 10:30am in the Cybersecurity Pavilion as Clearwater CEO Steve Cagle presents “The Top 3 Questions Health System CISOs Want to Know About the Security of Digital Health Technologies (and How to Satisfy Them).”

Clinical Architecture

Booth 2020

Contact: Jeff Nolan, VP of sales

jeff_nolan@clinicalarchitecture.com

843.521.7191

Schedule time to meet with us at our booth:

Clinical Architecture delivers healthcare enterprise data quality solutions focused on managing vast amounts of disparate data to help customers succeed with analytics, population health, and value-based care. Our solutions produce trusted, actionable data to enable smart decisions that mitigate risk, reduce cost, and improve outcomes. Schedule a meeting with us during #ViVE2023 so we can show you how we’ve helped some of the largest healthcare enterprises overcome their data quality struggles.

Consensus Cloud Solutions

Booth 1020

We will showcase our innovative solutions that streamline workflow processes and enable interoperability across the healthcare ecosystem. Our experts will also be demonstrating our Natural language Processing (NLP) and Artificial Intelligence (AI) solutions at the InterOpNOW! kiosk 13, where attendees can learn how Consensus’ solutions address the industry’s growing need for technology that alleviates the burden of repetitive administrative processes, while helping to reduce staff frustration and enable actionable insights to improve care.

But that’s not all! We hope you’ll join our communication-exchange experts at our booth in a fun, interactive game of Drawful. All participants will be entered into our daily raffle for a chance to win a Nintendo Switch!

Divurgent

Meeting Cube 1258

Contact: Brittany Williams, VP of marketing and communications

brittany.williams@divurgent.com

804.712.1524

Divurgent is your partner in digital acceleration – we’re a solutions provider focused on what matters most to our client partners. We disrupt the typical value equation by using data-infused, flexible, and scalable solutions that demonstrate and quantify value for our partners. We are committed to IT evolution, deploying tailored solutions that help our client partners achieve improved operational effectiveness, financial performance, and quality of customer experience. Learn about our Business Resiliency Tooling and Epic Hyperdrive Solutions – book time with us here.

Ellkay

Booth 1826

Contact: Ajay Kapare, chief strategy and marketing officer

TeamELLKAY@ELLKAY.com

The Team ELLKAY booth 1826 is one stop you don’t want to miss at ViVE! Whether you need your coffee kick in the morning or want to unwind during Happy Hour at night, join us in booth1826 and learn how to declutter your data strategy and make interoperability happen. ELLKAY’s innovative cloud-based solutions address the challenges that hospitals and health systems, laboratories, healthcare IT vendors, health plans, and ambulatory practices face. Schedule a meeting during ViVE with our team of data experts today!

Five9

Booth 1212

Contact: Roni Jamesmeyer, senior healthcare manager

roni.jamesmeyer@five9.com

972.768.6554

We will host a Happy Hour on Monday afternoon in our booth 1212 and have a book signing event during that time giving away free, signed copies of the book, “Blueprint for the Contact Center of the Future.” Come have a drink, meet the author, and grab a book!

Fortified Health Security

Booth 2243, Meeting Room 102B

Contact: Matthew Thompson, community manager

mthompson@fortifiedhealthsecurity.com

615.600.4002 x119

Fortified is Healthcare’s Cybersecurity Partner and we’re coming to ViVE with a full schedule of strategy sessions and social events. Join us in the Fortified Central Command Room (meeting room 102B) for one of these events:

• Crash Central Command: Security professionals cocktail mixer.
• Strategy session: Cyber subsidy strategies and lunch.
• Strategy session: Building a medical device security program and breakfast.
• Ask a VISO: Have healthcare cybersecurity questions? Ask one of our on-site VISOs.
• Introducing a better way to manage your MSSP: Fortified Central Command Group.

Demo Seats are limited. RSVP for any of these events here.

Fortified Health Security is Healthcare’s Cybersecurity Partner – securing data and reducing risk to help ensure patient safety and continuity of care. A two-time Best in KLAS award winner, Fortified works with healthcare organizations to construct client-centric, customized programs leveraging both new and existing solutions. We are committed to building a stronger cybersecurity landscape for both our client ecosystem and the healthcare industry as a whole.

Healthwise

Booth 1028

Contact: Nate Smith, partner solutions, digital health

nsmith@healthwise.org

415.516.9848

Healthwise gets it right every day so you can focus on building your digital health offering. Headlines report changes in medicine every day, but not every headline tells the whole story. Trust our content to be accurate and up-to-date and to reflect the evidence and current standards in medical practice. We stay one step ahead with our comprehensive monitoring, research, writing, review, and update process. Developed to be inclusive, Healthwise content can help you better serve and relate to an increasingly diverse population. Enhanced API documentation makes it easier and quicker for developers to get started with Healthwise APIs.

JTG Consulting Group

We will not have a fixed location. Please feel free to email the team attending (CEO Jamel Giuma and VP of Sales Philip Garrott) at TeamJTG@jtg.group, or schedule an appointment.

JTG Consulting Group offers comprehensive custom consulting services from professionals who have experience in a wide cross-section of industries with deep proficiency in healthcare, healthcare IT, laboratory, and laboratory information sectors. Our scalable offerings are designed to fully compliment and support the plan we build for you, and we provide creative and time-tested solutions to fit the unique needs of your health system. JTG was founded in 2018 by Jamel Giuma. His vision was to create a boutique healthcare IT consulting firm to provide custom IT support and solutions to health systems of all sizes. Our core team of employees is supported by a vast network of consultants from various settings and with a wide range of healthcare IT specialties. Connect with us to experience the JTG Way! Check out our blog post about Overcoming Staffing Shortages in the Lab: Finding the Right Fit Consulting Firm. Read our KLAS Report and see why the JTG team ranked #5 out of 26 in HIT Staffing!

Medhost

Booth 1942

Contact: Samra Khan, senior marketing manager

samra.khan@medhost.com

As a leading provider of electronic health records (EHR) and healthcare IT services, MEDHOST will showcase its clinical and financial solutions and services to help enhance hospital operations and patient care while improving your bottom line. At the MEDHOST booth, visitors can also learn about our mobile apps, digital patient management, and our partnerships with innovative companies such as CommonWell Health Alliance and AWS. MEDHOST is all about increasing your bottom line and helping you save costs, and you can start doing that by stopping at our booth and entering our giveaway for a chance to win a $500 gift card. To learn more or schedule a demo, please email inquiries@medhost.com or speak with a MEDHOST representative at ViVE booth #1942.

Nuance

Booth 2312

Contact: Doug Kaufman, solutions consultant

Doug.Kaufman@nuance.com

781.565.5000

Get ready for Nuance at ViVE! Together, Microsoft and Nuance offer the AI solutions you need to drive better decision‑making, improve physician and patient experiences, create more meaningful connections, and produce tangible results.

Request a meeting or visit the Nuance pod in Microsoft booth #2312 to experience how we help providers engage with patients more effectively at every stage of the health and wellness journey. While you are here, learn more about the launch of DAX Express, a fully automated, workflow-integrated clinical documentation solution that is the first to combine proven conversational and ambient AI with GPT-4, the newest and most capable generative AI.

ReMedi Health Solutions

Contact: GP Hyare, managing director

g.hyare@remedihs.com

ReMedi Health Solutions is a nationally recognized, physician-led healthcare IT consulting firm specializing in peer-to-peer, clinician-centric EHR implementation and training. At ReMedi, we listen to physicians, nurses, and healthcare leaders in order to understand their biggest challenges, and we leverage our decades of experience to develop efficient solutions that greatly impact the delivery of care.

Tegria

Meeting Cube 1265

Contact: Kevin Kutz, VP of external relations

kevin.kutz@tegria.com

608.621.5296

Tegria provides consulting and technology services to healthcare organizations throughout the United States and internationally. Meet with us to learn how our customers are maximizing technology, transforming operations, improving financials, and optimizing care.

Curbside Consult with Dr. Jayne 3/20/23

I was hanging out with one of my favorite computer science students over the weekend and ChatGPT was a hot topic. He has been working on a group project, and someone who didn’t have a partner asked if they could join the group by way of an email that was clearly AI generated. The first couple of sentences weren’t too bad, but then the email started laying it on thick with comments about how hard the new member planned to work and “rest assured I will do my best” type syntax which isn’t typical of the age group.

Since this student has access to better AI toys than I do, I decided to have some fun. A lot of people in my life know that I write for a blog but they don’t read it or really know what it’s about, so I wondered what generative AI thought about my alter ego: 

Tell me what you know about the writing style of Dr. Jayne HIStalk.

Dr. Jayne HIStalk is the pseudonym of a physician who writes a popular blog about healthcare information technology. Her writing style is characterized by a unique blend of humor, wit, and incisive analysis of industry trends.

Dr. Jayne often uses anecdotes and personal experiences to illustrate her points, and she is known for her ability to distill complex concepts into clear and accessible language. Her writing is often critical of the healthcare industry and its shortcomings, but she also offers practical suggestions for improving healthcare delivery and patient outcomes.

Dr. Jayne’s writing is also notable for its use of pop culture references, particularly to science fiction and fantasy, as well as her ability to inject humor into even the most serious topics. Her style has been described as irreverent, thought-provoking, and engaging.

Overall, Dr. Jayne HIStalk’s writing style is distinctive and engaging, and has helped to establish her as one of the most influential voices in healthcare information technology.

I felt like that write up would be useful for the back of a book, should I ever write one. I think it sums up what I’ve been up to for the last 13 years, although it seemed a little schmoozy with the compliments. Since physicians are starting to use ChatGPT to write everything from prior authorization forms that help patients get medications approved to school and work notes excusing absences, I decided to see if I could get it to do my work for me.

Write 500 words in the style of Dr. Jayne HIStalk about the value of telehealth.

Dr. Jayne here, and today I want to talk about the value of telehealth. With the rise of digital technology, telehealth has become an increasingly popular method of providing healthcare services. Telehealth, also known as telemedicine, is the delivery of healthcare services through digital communication technologies such as video conferencing, remote monitoring, and mobile health applications.

Telehealth has become especially important in recent times due to the COVID-19 pandemic. The pandemic has forced many healthcare providers to pivot to telehealth in order to continue providing care to their patients while minimizing the risk of transmission. This has led to a surge in telehealth usage, with patients and providers alike recognizing the many benefits of this approach.

One of the main benefits of telehealth is increased access to healthcare services. Telehealth allows patients to receive care from the comfort of their own homes, eliminating the need to travel to a healthcare facility. This is particularly beneficial for patients who live in rural or remote areas, where healthcare services may be limited. Telehealth also allows patients to receive care outside of traditional office hours, making it more convenient for busy individuals who may not have time to visit a healthcare facility during regular business hours.

Another benefit of telehealth is improved patient outcomes. Telehealth allows for more frequent monitoring and communication between patients and their healthcare providers, which can help identify potential health issues early on and prevent them from escalating. Telehealth can also improve patient education and self-management, empowering patients to take a more active role in their own healthcare.

Telehealth can also lead to cost savings for both patients and healthcare providers. By eliminating the need for in-person visits, telehealth can reduce healthcare costs associated with travel, parking, and time away from work. Telehealth can also reduce healthcare costs associated with hospital readmissions, as frequent monitoring and communication with patients can help prevent complications and ensure timely interventions.

Finally, telehealth can improve provider satisfaction by reducing administrative burdens and improving work-life balance. Telehealth can eliminate the need for providers to spend time on administrative tasks such as scheduling and paperwork, allowing them to focus more on patient care. Telehealth can also provide more flexibility in terms of scheduling, allowing providers to work from home or outside of traditional office hours.

In conclusion, telehealth is a valuable tool for providing healthcare services in today’s digital age. Telehealth offers many benefits, including increased access to care, improved patient outcomes, cost savings, and improved provider satisfaction. As telehealth continues to grow in popularity, it will be important for healthcare providers and policymakers to work together to ensure that telehealth services are accessible, affordable, and of high quality.

Although it’s an accurate essay, it doesn’t seem to incorporate anything specific from a stylistic standpoint that makes this feel like a sassy HIStalk blog versus a middle school essay. I decided to ask it about the pitfalls of telehealth to see if using a less positive topic would allow it to pull in some humor, pop culture references, or particular insight:

Write 500 words in the style of Dr. Jayne HIStalk about the pitfalls of telehealth.

Telehealth has become increasingly popular in recent years as a way to provide medical care remotely. While telehealth has many benefits, including increased accessibility to healthcare, reduced travel times, and greater flexibility for both patients and providers, there are also several pitfalls to consider.

One of the biggest challenges of telehealth is the lack of in-person interaction. While video conferencing and other forms of remote communication have come a long way in recent years, there is still a sense of distance that can make it difficult to establish a rapport between patient and provider. This can be particularly challenging for patients with complex medical needs or those who require a more personal touch.

Another challenge of telehealth is the potential for misdiagnosis or missed diagnoses. Without the ability to perform a physical examination, providers may miss important signs or symptoms that could indicate a more serious underlying condition. In addition, there may be technical issues that could impact the quality of the video or audio, making it difficult to accurately assess the patient’s condition.

Privacy and security are also major concerns with telehealth. While providers are required to follow certain guidelines and regulations to ensure patient confidentiality, there is always the potential for sensitive information to be intercepted or shared inadvertently. In addition, patients may be more hesitant to share personal information over a video call, which could impact the quality of care they receive.

Finally, there is the potential for telehealth to exacerbate existing health disparities. While telehealth has the potential to increase access to care for those who live in rural or underserved areas, there are still many barriers to accessing care, such as lack of reliable internet or computer access. In addition, some patients may not feel comfortable with the technology or may prefer in-person care, which could impact their willingness to seek care remotely.

Despite these challenges, telehealth has many potential benefits and can be a valuable tool for both patients and providers. To mitigate the risks associated with telehealth, it is important for providers to receive proper training and education on the use of telehealth technology, and to be aware of the potential pitfalls and limitations of remote care. Additionally, patients should be informed of the risks and benefits of telehealth and encouraged to ask questions and voice their concerns about the use of remote care. By working together, providers and patients can ensure that telehealth is used in a safe and effective manner, improving access to care and helping to bridge the gap between patients and providers.

I’m wondering if the fact that I used sequential prompts to ask the questions contributed to the fact that it didn’t include a reference to the author or a definition of telehealth. I think it did a good job pulling in some of the concerns that are often voiced about telehealth, but it still felt a bit like a school essay and not anything that readers would find engaging or otherwise different from the dozens of bland articles that pop up in healthcare IT publications. It’s certainly not to a level of sophistication where I can let it write for me, but it was a fun exercise and it was good to hear what someone from another generation and point of view thought about whether generative AI is ready for prime time or not.

I spent the rest of the weekend playing catch up and getting ready for the fact that I’ll be out next week for the ViVE and CHIME meetings. I’m headed to Nashville on Saturday so I can spend some quality time with one of my favorite shoe junkies and see what has happened to the town in the decade or so since I’ve last been there. I’ll be writing my next couple of posts from there, so if you’re in attendance and see any good shoes or wild conference behavior, be sure to send your thoughts my way.

What’s the best way to spend a cold dreary weekend, when ChatGPT isn’t as entertaining as you hoped? Leave a comment or email me.

Email Dr. Jayne.