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HIStalk Interviews Jonathan Rosenberg, CTO, Five9

February 6, 2024 Interviews No Comments

Jonathan Rosenberg, PhD is chief technology officer and head of AI at Five9 of San Ramon, CA.

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Tell me about yourself and the company.

My job is to direct our overall technology strategy, run our AI engineering teams, and figure out how to apply AI technologies to the evolution of contact center technology, which is a super interesting and exciting space. I’ve been in the IP communications industry for approaching 30 years. I was previously the chief technology officer for Webex and for Skype before that.

How has technology changed the way that inbound telephone calls are managed?

It’s having a huge impact, and that impact is going to get even bigger over time. Probably the biggest thing is that we have been able to dramatically improve self-service, not having to wait on hold to speak to a live agent for tasks that users would prefer to self-service anyway. 

There’s tons of examples in the healthcare space, things like appointment scheduling and rescheduling, looking up and getting information on prior authorizations, answering questions about hospital visits, benefits coordination, cost estimates, and insurance verification checks. The list goes on and on. All of these things are relatively easy to support with self service. We can get the call to the right person and understand what the caller wants, collect information, and direct them to the right place. We’ve all experienced way too much transferring. You get to the wrong person, then you transfer somewhere else and you have to repeat everything all over again.

But it isn’t just inbound, there’s outbound as well, communication from healthcare providers and payers to their patients and customers.

Are technologists surprised that many people still prefer making a phone call?

The death of voice in the contact center, which has been predicted for 20 years, is absolutely, positively false. We are seeing an increased amount of usage of communication of the technology. It’s not that people aren’t doing other things. They are, but it’s the total amount of interaction that’s happening between customers and the brands and companies they work with. That has increased as these additional tools, like chat, SMS, and website have gone up.

But at the end of the day, there’s a lot of stuff where people still want to call and talk. It’s faster. It’s interactive. You feel greater levels of trust, especially when you talk to a live person. And in many cases, you want to speak to a real person. We don’t think that everything will go to self-service. That is best done with voice, especially in high-emotion, high-stress situations like we see in healthcare. A voice of empathy — nothing beats that.

What is the role of AI-powered virtual agents?

It has two sides. People understand less about what we call agent assist. In agent assist, AI is involved, but it isn’t replacing the human agent, it is augmenting them. It provides lots of benefits to the agent that help them do a better job and provide a greater experience for the customer. That includes things like coaching the agent to make sure that they perform their checklist of required tasks to the patient or to the customer. Helping provide information at the agent’s fingertips so they don’t have to put the customer on hold and go look something up — the information can just be put right in front of them.

Another really good thing that we have seen is that our agent assist application provides a live, real-time transcript to the agent. If they didn’t quite hear what someone said, they can just glance back at the live transcript.

That is one half of agent assist. The other half is self-service use cases, where a customer or patient calls in and they are talking or chatting with a bot to provide these self-service kinds of use cases that I’ve described. Both of these are powerful in the contact center.

Are health systems assembling all of their interactions with patients – mailings, outbound calls, fundraising, billing – so that anyone who interacts with them has the full story?

One of the hardest problems to solve in the industry is breaking down these silos. It is becoming more important than ever for companies that are providing customer service to do that. 

One of the interesting drivers that will accelerate the collection of all this information together is this emergence of generative AI and large language models. These things are incredibly powerful and highly beneficial to a lot of the use cases that we are talking about. They need contextual data to work. They need to know about the caller and the customer to provide the experience they want.

The more of this information that you can collect and feed to that generative AI model, the better job it can do to provide superhuman experiences, something that you couldn’t even hope to get from a human alone. We are excited about that, and we think it will drive a lot of the collection of all this data together.

Healthcare is powered by fax machines, photocopies, and clipboard forms, yet consumers interact everywhere else with chatbots, smart search, and voice processing. Will healthcare embrace these technologies?

I hope so. Customers in general are seeing advances in technology and how they receive service in other industries, and that sets levels of expectation.

For the benefit of healthcare, a lot of the rest of the world is becoming more sensitized to the type of issues that have traditionally prevented or made it difficult for healthcare to do this, related to sensitivity of data and the protection of personal information. With all of this, especially with this genre of AI technology, those questions are top of mind now for buyers of these products and services. They were top of mind for healthcare before, and now they are top of mind for everybody else. That will drive increased attention to solving those problems so that we can deliver solutions that are broadly adaptable in the healthcare industry. That’s the optimist in me that thinks this way and hopes to see this technology penetrate quickly across healthcare.

Health systems have grown by acquisition into regional or even national organizations that have a large scale and an increased technology capability, but that may create more bureaucracy. How will this affect their use of technology?

In some sense, centralization helps a lot of these things. It consolidates the buying power and the deployment of these technologies. You can deliver it out to your regional hospitals and practices so that everyone gets it quickly. Instead of every single doctor’s office or hospital having to do this on their own, you get to do it just once. That could be helpful in accelerating adoption of this technology.

How does a software company incorporate AI into their product when it changes every day?

At Five9, we have adopted a strategy that we call engine-agnostic. That means that we have built our software platform so that we can consume third-party AI engines, as we call them. These engines are the raw ingredient that do the processing.

For example, the thing that takes an audio file and spits out a transcript. Or the thing that takes a sentence of text and delivers the intent. What was the thing that the customer said? Or you send it a paragraph and it produces the medication name, the doctor name, and the dosage off the information paragraph.

These are like raw engines. We have designed our system to allow those to be pluggable, so that we can adapt and evolve as these technologies improve. They are improving at a lightning, breathtaking pace, and that has definitely made it challenging. In fact, we have already switched our underlying LLM engines a few times for different use cases. We have only been able to do that because of this engine-agnostic strategy.

How will the market respond to companies that add the simplest AI wrapper to their product with few actual benefits, just to be able to use the marketing buzzword?

Especially in the contact center, tons of little startups said, “We can finally build the chatbot that the world has wanted.” Then they throw a UI wrapper in front of ChatGPT and call it a day. 

That’s not what the market wants. The market, especially in the contact center space, wants a platform that spans all of the interaction modes – voice, chat, email, SMS, and social channels. They want powerful reporting and analytics. They also want to make sure that humans and AI are integrated together so that calls and chats can bounce between them, and all of that just works. 

That’s hard. You realize that the value proposition is delivering all of that, and then plugging in the AI to make it better. The platform plays are the likely winners in the in the contact center technology space, and we are one of them.

AI allows companies to create closed models of their internal documentation and processes to help a frontline person who is in the middle of a call or chat session. Is that creating new possibilities?

This is another thing that has taken a generational leap forward. Prior to large language models and generative AI, we would have to train a custom model on the different intents, as we call it, different use cases and things that would be discussed in the conversation that need to be detected that would then trigger information to be shown to the agent. That all had to be done looking at their existing conversations to go collect all that data to train and fine tune the model. 

Generative AI has changed dramatically the way that we can think about that. We used to need to enumerate every single use case, what might be said and asked, and then handcraft the model to detect it and handcraft the response that should be shown to the agent. Now with gen AI, we can just ingest all of this knowledge, processes, and documentation the same way a human agent would go read those materials. Then we can give written direction to the agent assist functionality on what we want to do. It can start to provide this knowledge and guidance.

We are seeing great initial results with this, and this is what we are building towards. It will be transformational in this space in the coming years. It is incredibly powerful and amazing technology.

What does the company’s strategy look like over the next three or four years?

With generative AI, three to four years is like really far away [laughs]. But it’s that thing, generative AI. It’s going to be incredibly amazing in delivering superhuman experiences to customers and delivering the kind of customer experience that the contact center market has always dreamed of delivering to customers, but that in many cases, fell short of expectations. Now we have the tool to deliver the kind of experiences that we have really wanted to.

I talk about the end of call hold. I can’t wait for the day when you can call the contact center, you want to speak to someone live, and they never need to put you on hold ever again. Because anything that they need, anything that they have to say, anything that they need to do, is instantly at their fingertips. That will be a great day, and we are working towards that day in the next two to four years.

Morning Headlines 2/6/24

February 5, 2024 Headlines No Comments

Inovalon Acquires VigiLanz; a Leading Clinical Surveillance and Patient Safety SaaS and Data Company

Health data and analytics company Inovalon acquires clinical surveillance and patient safety software and data vendor VigiLanz.

SAMHSA and ONC Launch the Behavioral Health Information Technology Initiative

SAMHSA and ONC launch the Behavioral Health Information Technology Initiative, which will invest $20 million over the next three years to promote the use of health IT within behavioral healthcare and practice settings.

Bonfire Analytics Raises Oversubscribed $2M Venture Round to Accelerate Digital Health, Medical Device, & Biotech Adoption Across Healthcare Providers

Bonfire Analytics, which offers health tech sales software and analytics, raises $2 million.

Curbside Consult with Dr. Jayne 2/5/24

February 5, 2024 Dr. Jayne 9 Comments

I was invited last week to an onsite meeting at the local office of a national company, where a “return to work” policy had recently been enacted. Employees are expected to be in the office at least three days per week if they live within a certain radius of an office, regardless of whether their teams are located in that office or not.

One of the attendees was grumbling about the fact that he is the only member of his team that works in this market, so he essentially drives to the office and sits in a cube, where he attends video conferences most of the day. He mentioned that despite the policy, he’s often the only person in his part of the office, which doesn’t do a lot for building employee morale or enabling the growth of the company’s culture.

I was interested to see all the amenities in the building, which included a nice-looking cafeteria and an area that could be configured with courts for indoor sports and lawn-style games. I suspect that they pre-date the era of remote work, when everyone was in the office and people weren’t coming back in a fragmented way.

Given the fact that for this company, proximity to an office determines the need to return to in-person work instead of being part of a specific team or holding a specific job role, it’s no wonder that people are not thrilled about the return to work policy. It will be interesting to follow up in a few months to see whether more people are embracing in-office culture or whether it’s just causing more bitterness. Expecting people to collaborate in an office where there aren’t any team members simply makes no sense.

Having worked in environments that are in-person, completely remote, and various combinations in between, I’ve seen how company culture is governed more by people’s behaviors than by whether they’re interacting in person or online. For example, in remote environments, particularly when people are working in multiple time zones, it can be easy to overlook people’s posted work hours and schedule meetings that are too early or too late for them. I’ve had to do that on occasion, but try to only do it when there’s an external constraint, like physician attendees who work from one of the coasts and need to accommodate clinic hours, or something like that. I always reach out to the impacted people rather than just sending the appointment, so that people know it’s coming and can let me know if they can attend the meeting or whether we need to make other arrangements. Using that approach, most people are willing to adjust their schedules to accommodate an early or late meeting, but it’s the fact that you discuss it that helps build rapport, teamwork, and by extension, company culture.

Whether in-person or remote, it’s also important to have a culture where people can put focus time or work blocks on their schedules and have those times be respected. Those blocks need to be created in a way that respects existing standing meetings or important team meetings, but no one should ever be made to feel bad that they want time during their scheduled workday during to actually do their work. Remote employees often struggle with failing to achieve work-life balance because they are always at their workplace, and creating an expectation for them to spend time after-work hours playing catch-up due to overly full schedules isn’t a culture builder.

It was interesting timing to have this meeting since several articles about the topic were published this week. Gizmodo had a headline offering “There’s More Proof That Return to Office is Pointless,” highlighting a study from the University of Pittsburgh that demonstrated that return to office policies don’t positively affect productivity. Researchers looked at a sample of S&P 500 companies and concluded that such policies were more about corporate control than stock performance. They found negative correlations between returning to the office and key indicators such as employee satisfaction, ratings of work-life balance, and opinions of senior management.

Companies allege that returning to the office builds trust, but I have found that trust is best built, regardless of work location, by doing things such as giving employees the resources they need, ensuring that employees have adequate time away from work (such as uninterrupted lunch breaks), not requiring employees to have their cameras on 100% of the time, and assuming positive intent when employees seem to be asking a lot of questions.

Another colleague I talked to is convinced that her company’s return to office policy is a play to make good on bad real estate decisions that were made when people failed to realize the impact of remote work during 2020, 2021, and 2022, when others modified their leases due to the impact of the COVID pandemic. One of the companies I worked with in 2020 saw the proverbial handwriting on the wall and made the decision to unload countless square feet of real estate. They made it clear that they wouldn’t be going back to in-person work, and unsurprisingly, employee satisfaction continues to be high and turnover numbers are smaller than they have ever been.

Fast Company also had an article on the topic that highlighted results from a recent survey that indicated that half of potential employees wouldn’t even apply to a job if it was entirely in-person. Flexible work can be a tremendous asset for neurodivergent employees or those with disabilities, chronic medical conditions, or high commuting costs. There’s also the issue of environmentalism and the potential to reduce carbon emissions when fewer people are driving to a physical office.

I’m not saying that allowing employees to work remotely is all sunshine and lollipops. I’m wondering if some of the movement towards return to office policies has to do with declining professionalism. I’m sure many of us working remotely have done the “business on the top, pajamas on the bottom” wardrobe look and that’s OK. The people I work with regularly either have tidy home offices or use electronic backgrounds, although I do get distracted by those that have animations such as rain or snow on the windows.

However, in attending meetings for professional organizations and committees, I see a lot of people whose home lives have become part of their work lives, including interruptions from children and pets. Life happens, but when your kids are wandering in and out of your call, there’s always the option to turn off your camera, make an apology for the disruption, or even step away.

There’s also evidence that virtual meetings aren’t being done optimally, causing employees to become fatigued and inattentive on calls. Researchers looked at employee engagement during calls, along with physiological measurements, over two working days, encompassing nearly 400 meetings. They cross-referenced their data with questionnaires about work attitude and engagement, finding that fatigue during calls is due to mental underload and boredom in the workplace. They found that disengaged employees have a harder time maintaining focus in meetings where cameras are off, leading to multitasking behaviors and further distraction. They mentioned that highly automated and non-cognitive tasks such as walking can be carried out during meetings, and I suspect that extends to the knitting and crochet that I see some of my physician co-workers doing during committee meetings.

I know of a number of hospitals and health systems that allow technology workers to live anywhere in the US, even though their patient care sites aren’t nationwide. It would be interesting to specifically compare their outcomes to those that require workers to do the same jobs in person that others do remotely. Only time will tell whether organizations will back off on their return to office mandates.

Have you recently been subject to a return to office policy? If so, how is it going? Leave a comment or email me.

Email Dr. Jayne.

Readers Write: Would We Do It All Again? Insights from a Designated QHIN Regarding the Application Process

February 5, 2024 Readers Write No Comments

Would We Do It All Again? Insights from a Designated QHIN Regarding the Application Process
By Jay Nakashima

Jay Nakashima, MBA is executive director of EHealth Exchange of Vienna, VA.

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I was asked recently, “Would we do it all again?” Knowing what we know now, would we still have been among the first organizations to apply to become a Qualified Health Information Network (QHIN) under the Office of the National Coordinator for Health IT’s (ONC) Trusted Exchange Framework and Common Agreement (TEFCA)?

Honestly, the answer is yes. But I’m glad it’s behind us.

There’s no doubt the QHIN process was a necessary step toward achieving nationwide healthcare interoperability. As the nation’s first federally endorsed health information exchange that already exchanges 21 billion transactions annually and in all 50 states, there was never a question whether EHealth Exchange would participate in the process.

But it was not always an easy and straightforward process to becoming one of the first Designated QHINs. As anyone who has developed a new system or process knows, what makes perfect sense in planning doesn’t always work out as intended. Unforeseen challenges pop up, and things need to be tweaked and adapted. We expected that.

Now that we’ve had a chance to take a breath and regroup after achieving QHIN designation, it seemed like a good time to share some thoughts and perspective to help others going through the application process.

The healthcare industry is slow to adopt new technology. After all, we’ve been talking about nationwide interoperability for more than 15 years, and while we have made great strides, it is not ubiquitous. The QHIN application process, by comparison, is incredibly fast. The timeline to accomplish various tasks can be remarkably short, sometimes only a few days or weeks in between deadlines. To keep up, an applicant must be prepared to move quickly because once an application has been accepted for testing, Candidate QHINs have 12 months to achieve designation status.

One thing that helped EHealth Exchange was that our team got started well before we entered the official application process. We looked at the proposed language in the QHIN Technical Framework (QTF), which was published in 2022, and spent more than six months ensuring that we closed any gaps between EHealth Exchange’s technology platform and our policies to ensure compliance with TEFCA requirements, standard operating procedures, and protocols. By the time the application was released, we were ready.

This process — and more importantly, the responsibility of becoming a QHIN — is not for the faint of heart. It was a two-year process for EHealth Exchange, and the work doesn’t stop after designation. For those entering the application process now, it’s worthwhile to review the requirements and begin tackling initial tasks before the clock starts.

Although the applicant QHINs were market competitors, we also were all working to achieve the same thing, which gave us a compelling reason to collaborate. Many applicants turned to each other for assistance, and we even began early testing together, unprompted by the government. Candidly, I thought that competition might hinder our abilities to work effectively together, and I am happy to say that that never surfaced. We were all a team working together toward a collective goal.  As others go through the QHIN application process, we would encourage a similar level of appropriate and compliant cooperation with your fellow applicants and Designated QHINs. After all, we all win with national interoperability. 

It’s always easier to drive on a freshly paved road, and I like to think that, along with our future QHIN exchange partners, EHealth Exchange helped pave the way for the next applicants.  As I said before, any new process – particularly one with the level of technical complexity that health data exchange demands – is going to run into unforeseen problems. And boy, did we encounter a lot of them. Steps have been refined. Some requirements have been clarified or adjusted, and new ones have been added. 

For example, each Candidate QHIN had to create its own terms and conditions. In Common Agreement Version 2.0, the Recognized Coordinating Entity (RCE) is proposing a standard set of terms and conditions that each QHIN, and its participants and sub-participants, must adopt to participate in TEFCA, which is a simpler and more consistent approach. The process is now better documented and defined, and I am optimistic that those changes will make it easier for other applicants. 

While I wouldn’t volunteer to repeat the journey we took, for new applicants, you should have no qualms undertaking the application process. Not only because it has been tried and refined, but also because I believe deeply in its value. I’m excited to see TEFCA come to life and to bring our experience to bear in support of our future QHIN exchange partners, the RCE, and most importantly, the American health system and the patients whose care depends on nationwide exchange.

Readers Write: More Technology is Not Always Better in Specialty Medication Workflows

February 5, 2024 Readers Write No Comments

More Technology is Not Always Better in Specialty Medication Workflows
By Julia Regan

Julia Regan, MBA is founder and CEO of RxLightning of New Albany, IN.

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Over the past decade, there has been a consistent promise made that technology would make provider and care team lives easier. However, the proliferation of EHRs, point solutions, manufacturer and vendor portals, and digital devices have made various processes not only more cumbersome, but more confusing and frustrating.

In specialty medication onboarding specifically, an HCP may need to visit upwards of 40 portals or websites throughout their day to check patient benefits, submit prior authorization, find and complete enrollment forms from various manufacturers, collect patient consent, and track enrollment statuses. It’s no wonder that healthcare is facing a burnout crisis.

As technology has become ubiquitous, it has created an additional challenge for biologic coordinators and medication access teams, especially those that work to support patients with complex treatment plans or work across therapeutic specialties. This, in turn, increases cognitive load, screen time, and clicks, slowing the completion of the necessary steps in a patient’s care journey and decreasing overall speed-to-therapy.

As an example of portal fatigue, a medication access team member at a large health system may need to support an oncology patient who is prescribed multiple brand name specialty medications, each of which requires portal access to obtain assistance. One of the drugs may have a manufacturer-sponsored co-pay assistance program, another may be eligible for foundation assistance, while another may need additional approvals via prior authorization. In order to effectively support this patient through their medication access journey, multiple portals and logins are required.

Instead of the common perspective that “more technology = better,” we must shift to a new perspective that says that “unified, purpose-built – even less – technology = better.” Instead of forcing teams to scour the web for up-to-date manufacturer forms, why not house all forms, and enable submission and delivery of those forms, in one solution? Instead of routing a form for patient and provider signatures via a distinct process, why not enable seamless signature collection at the point of care? Instead of manually researching affordability options — foundations, PAP, co-pay, etc. — on a variety of sites, why not integrate those options into the same portal where the forms and signatures live? Creating a uniform, digital entry point that leverages a repeatable process for any drug, any manufacturer, and any patient can significantly reduce cognitive load and burnout.

As I’ve had conversations with providers, care teams, and medication access specialists over the past few years, the more I’ve realized that “more technology ≠ better.” As patients enter and exit their offices, they wish for integrated, intuitive, secure technologies that minimize work and accelerate the speed at which they can deliver quality care. While the specialty medication onboarding process includes a variety of steps to help support patient access  — benefit verification, PA, consent, financial assistance, and fulfillment — there is no reason that these steps cannot be automated, integrated, and fast. An HCP should not have to worry about which manufacturers may or may not have sponsored a program, or if the technology will work for a specific patient. To reduce burnout and create consistency, technology should work the same way every time.

It is up to clinical leads, IT teams, and other leaders to sound the alarm and support the launch of solutions that reduce burden and burnout for their teams, instead of those that create more work. A single digital entry point for any patient and any medication is a reality that is within reach. We just need to drive provider adoption of these tools. The only way we can ensure better, faster, more affordable care for patients is to help providers with the work they do every day.

HIStalk Interviews Jonathan Davis, CEO, Trualta

February 5, 2024 Interviews No Comments

Jonathan Davis is founder and CEO of Trualta of Ottawa, ON.

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Tell me about yourself and the company.

I started Trualta about six years ago. I was investing in healthcare education companies that provided training, continuing education, and certification for healthcare professionals. It dawned on me that there were so many great best practices for caring for loved ones, especially aging loved ones, that families didn’t have access to. For example, why did an aide in a nursing home know how to manage a particular symptom of cognitive decline, but a family member didn’t?

That inspired me to think about how we could adapt professional-level training to the families who need it most. That was the start of Trualta. We built a caregiver education platform with articles, videos, and modules to help families build skills and establish confidence to provide care at home.

Right away, we started working to demonstrate that trained, confident family members can provide better care at home. By proving those outcomes, we could partner with governments, payers, and providers to offer Trualta for free to caregivers. We always believed that the caregiver shouldn’t pay for support. We know caregivers are often already facing unexpected costs.

Since then, the business has grown to offer not just caregiver training and support, but also community and coaching.

People don’t always know in advance that the caregiver role is about to be placed on them. What is the most common training and support they need?

That’s very true. Many caregivers don’t even self-identify as caregivers. The training and support that is most effective is a mix of topics related to the caregiver’s own wellness and how to manage this often unexpected, challenging care situation. We personalize our content to the caregiver’s unique care situation and the conditions they manage at home for their loved one. At the end of the day, all caregiving journeys are different. We anchor on the training outcome. We want our caregivers to feel more confident and less alone, which we know leads to better care for the patient, the loved one they are caring for.

What is the blend of people, technology, and support that makes it possible to successfully send patients home for care?

On the technology side, we’re all about finding the right support for the right caregiver at the right time. Maybe it is post-surgery. Let’s say Mom or Dad got a hip replacement. We know that individual care situation and can target the caregiver with specific content. For example, a common reason for readmission might be a UTI or a bed sore.

Where the technology and the tech-enabled community and coaching come in is that we start to understand how the caregiver is feeling. They’re a bit lonely and isolated, providing care 24/7 for their partner who is recovering at home. We know that they would benefit from a support group, so we direct them to one. It is a virtual, tech-enabled support group, but it is facilitated. To us, that’s a healthy mix of technology and people. If the care situation escalates and we see a high risk of caregiver burnout, we can route that person to a one-on-one coach.

A national challenge is the large number of baby boomers who will eventually need care, but with fewer people to care for them. How will that play out?

This is such a tough problem on both the demand and supply sides. On the demand side, we have this aging population. Folks are also living longer, with a higher likelihood of certain chronic conditions or cognitive decline. We know that older adults prefer to age in place. Then we have government policy promoting home and community-based settings instead of the institutional setting.

Demand is way up, but there’s an acute workforce shortage, so supply is also down. That market dynamic is putting so much on the family members. It’s more important than ever that our healthcare stakeholders support families and people who care for loved ones at home with skills, community, support services, and coaching.

How do you work with partner organizations?

We are thought partners with the organizations we work with. Most of the payers and providers that approach us know that they could be doing more for caregivers, and intuitively understand it will lead to better outcomes for members and caregivers. But they don’t really know where to start. They don’t have a caregiver strategy. Often, they don’t really know who the caregiver is or have contact information for them.

We build that strategy with them. We provide the learning and support platform, and then make sure it’s integrated into the workflow and existing systems.

Do you roll it out broadly, or is it case by case?

Generally, our partners have specific populations in mind where we focus, but access to the program is usually available across the organization, because supporting caregivers is becoming an enterprise-wide priority.

We’ve always focused on high-need populations. We’ve helped a lot of folks in really challenging care situations, like parents of kids with intellectual and developmental disabilities, or caregivers for individuals with dementia, cognitive decline, or a recent stroke. These are areas of focus where a social worker, nurse, or discharge team might be more deeply ingrained with Trualta than in other service lines.

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

Our vision for Trualta is that caregiver support is as ubiquitous as patient education. At every point of care, any discharge, especially with our aging population and shift to value-based care, it is so important that families are supported.

Our vision is, let’s take caregiver support from being a “nice to have”, where a few teams are doing it with some populations, and make it a critical part of every point-of-care experience. If a caregiver is present, we need to identify them, engage them, and support them to ultimately improve outcomes for their loved ones. We need to make sure that they are not overwhelmed and burning out.

Morning Headlines 2/5/24

February 4, 2024 Headlines No Comments

NIH looks for new EHR to replace its 20-year old legacy system

The National Institutes of Health seeks $200 million in funding to replace its Altera Digital Health Sunrise system that it calls CRIS.

VMG Health Acquires Compliance Risk Analyzer from DoctorsManagement

Consulting firm VMG Health acquires Compliance Risk Analyzer, auditing and predictive analytics software developed by DoctorsManagement.

Allina Health deal shifting 2,000 workers to Optum

Allina Health will outsource IT and revenue cycle management services to Optum, which will rebadge 2,000 health system employees effective May 5.

Rivia Health Raises $3.25 Million in Series Seed Funding with PHX Ventures

RCM vendor Rivia Health raises $3.25 million in seed funding.

Monday Morning Update 2/5/24

February 4, 2024 News 2 Comments

Top News

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The National Institutes of Health seeks $200 million in funding to replace its Altera Digital Health Sunrise system that it calls CRIS.

NIH Clinical Center CIO Jon McKeeby says that 40 of his 120 IT employees are at retirement age, raising concerns about support for the complex, best-of-breed system that the hospital installed in 2004 when it was known as Eclipsys Sunrise Clinical Manager. 


Reader Comments

From Snowbound: “Re: Oracle Health. Laid off 124 Cerner employees in Springfield, MO after CoxHealth announced that it is moving to Epic.” Oracle filed a WARN act notice with the state on February 1, adding that the health system has already made offers of employment to all of the employees who were affected.

From Twin Cities Healthcare Watcher: “Re: Allina outsourcing RCM to Optum. This will be interesting considering the MN AG’s focus on Allina’s billing practices and the history of regulatory intervention in MN with outsourced billing services such as at Fairview in 2012-2013.” Fairview’s former RCM vendor Accretive Health, renamed in 2017 to R1 RCM, paid a fine and agreed to stop doing business in Minnesota in 2012 after being charged with lax security practices and sending high-pressure employees into the hospital ED to demand payment in advance from patients who were suffering from strokes and heart attacks. Accretive referred to the practice as “Accretive Secret Sauce” that it internally proclaimed “check out our ASS.” Accretive’s big customer Ascension partnered with a private equity firm to buy a 40% stake in the company for $200 million in late 2015, since increased to a 54% share.

From LinkedIn Park: “Re: interview. It seems like everyone in the industry I know reached out to me the day my interview with you ran, and I have quantified the HIStalk effect by observing that my LinkedIn profile views are up over 300%.” Thanks for letting me know. 


HIStalk Announcements and Requests

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A majority of poll respondents say they have experienced discrimination that hurt their careers, most commonly related to age and sex.

New poll to your right or here: How has the market competitiveness of the former Cerner changed since Oracle acquired it in June 2022?

Thanks to these companies that recently supported HIStalk. Click a logo for more information. Also, extra thanks to long-time HIStalk Founding Sponsors Healthwise and Medicomp Systems

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Webinars

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


Acquisitions, Funding, Business, and Stock

Allina Health will outsource IT and revenue cycle management services to Optum, which will rebadge 2,000 health system employees effective May 5.

HCA Healthcare says in its earnings call that a key area of investment will be advancing the company’s digital capabilities to “unlock the embedded value we see in our operations.”

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A Boston Globe reporter tracks down the 190-foot, $40 million, Galapagos-docked yacht that is owned by Ralph de la Torre, MD, MS, the former heart surgeon who partnered with a private equity firm to create Steward Health Care Systems as CEO. The reporter notes that Steward, which is teetering on insolvency that may force a taxpayer bailout, quadrupled the private equity firm’s investment by selling the land under its hospitals, allowing the company to walk away with $800 million and de la Torre to award himself a $100 million bonus, after which he yachted up.


Announcements and Implementations

In Canada, a university IT professor says that the health system has squandered billions of dollars on proprietary software development that led to all 10 provinces having their own expensive IT systems that don’t work together. He advocates developing open source software for billing, labs, and diagnostic imaging instead using HermesAPI, which would mean “sending less money to prop up American software companies.”

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Visage Imaging launches Visage Ease VP for Apple Vision Pro. It includes a cinematic rendering engine, 4K resolution on virtual screens, independence from room lighting, and natural input using hands, eyes, and voice.

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Cedars-Sinai develops Xaia, a mental health support app for the Apple Vision Pro. It offers immersive therapy sessions that are led by a digital avatar that simulates a human therapist. The hospital has licensed the system to VRx Health for commercialization.

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The Permanente Medical Group publishes its initial experience with Nabla’s smartphone-based ambient scribing system, which it says has been used by 3,400 of the 10,000 invited physicians, of which around 1,000 have used it for more than 100 encounters. Physicians report that it is saving them time, even though they are required to approve the AI’s draft version, and patient feedback has been positive. The most common reasons for not using the tool include the required activation steps, lack of familiarity, and lack of integration with other workflow solutions.


Government and Politics

Two Texas doctors are indicted in federal court for submitting phony medical bills to the insurers of student athletes that they had not treated. The doctors, who owned sports medicine practice management system vendor Vivature, used the patient information that had been entered by athletic trainers to submit fraudulent bills for other services. The indictment lists three universities, including Auburn University, that shared the payment that Vivature received. The defendants are also charged with fraudulently billing for COVID-19 testing in partnership with international resorts who tested Americans who were traveling aboard. The DoJ says the defendants obtained $70 million between the schemes.


Privacy and Security

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Computer, phone, and email systems remain down at Lurie Children’s Hospital (IL) following a February 1 cyberattack.

The CEO of one of the five hospitals whose shared services organization was taken offline by cyberattack in October 23 says that some major systems remain down and he expects that it will take most of 2024 for the hospital to fully recover from the attack.


Other

Not (yet) healthcare related. A finance employee of a huge Hong Kong company makes a $26 million money transfer for a confidential corporate transaction, as instructed in a video call with the CFO and other executives. He learned afterward that the video call attendees were AI-generated deepfakes and the money recipients were scammers.


Sponsor Updates

  • Waystar joins Meditech’s Alliance program
  • EClinicalWorks announces that its Sunoh.ai AI-powered ambient listening technology now integrates with EClinicalMobile and EClinicalTouch apps on iOS and Android smartphones, iPads, and Microsoft Windows and macOS devices.
  • NeuroFlow will exhibit at the AMSUS 2024 Annual Meeting February 12-15 in National Harbor, MD.
  • RxLightning (Claritas Rx) names John Paulson senior director of business development.
  • SnapCare will exhibit at the ACNL Conference February 4-7 in Monterey, CA.
  • Symplr achieves milestone recognitions in 2023, garnering industry and employee acclaim as a leader in healthcare operations.
  • Wolters Kluwer Health makes the NEJM AI journal available on its Ovid medical research platform.

Blog Posts


Contacts

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

Morning Headlines 2/2/24

February 1, 2024 Headlines No Comments

Where do we go from here on digital therapeutics?

The digital therapeutics market is stagnating in the US, as evidenced by vendor bankruptcies and lack of Medicare coverage for the sector’s products.

Cohere Health Raises $50 Million in Equity to Meet Increased Demand for AI-Driven Transformation of Prior Authorization Process

Prior authorization technology vendor Cohere Health raises $50 million in equity funding, increasing its total to $106 million.

Carpl guides healthcare providers through the growing market of radiology AI apps

Carpl, a San Francisco-based startup that has developed a marketplace of vetted radiology AI apps, raises $6 million.

SAMHSA releases final rule on opioid use disorder treatment

The Substance Abuse and Mental Health Services Administration makes some COVID-19 flexibilities permanent, including the ability for Opioid Treatment Programs to prescribe opioid use disorder medications via telehealth without an initial in-person evaluation.

Network outage affects phone, internet service at Chicago’s Lurie Children’s Hospital

Lurie Children’s Hospital in Chicago works to recover from a Wednesday network outage that has impacted its internet, email, phone lines, and MyChart access.

News 2/2/24

February 1, 2024 News 2 Comments

Top News

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A Stat review says that digital therapeutics is stagnating in the US, as evidenced by vendor bankruptcies and lack of Medicare coverage for their products.

The authors note that Pear Therapeutics shut down less than a year after CMS denied the company’s request to consider its substance abuse order product (pictured above) as a billable medical device.

Few commercial payers cover digital therapeutics because of concerns about efficacy, which poorly designed vendor studies have failed to prove.

The article says that vendors who want their products covered like traditional drugs will need to perform similar studies that meet a comparable standard of evidence, which is risky because of high cost and the possibility that their products aren’t effective. They could also sell their products to providers who might be reimbursed by payers for achieving specific results.


HIStalk Announcements and Requests

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Thanks to the folks at DrFirst, which booked the Top Spot banner (at the upper right of the HIStalk page) for the long term, initially to showcase their participation in the ViVE conference. I appreciate the support.

Repetitive, I know, but winding down – sponsors that are participating in ViVE and/or HIMSS should complete the respective forms so I can list you in my guides pro bono (does that word make you think of U2 or Cher?)


Webinars

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


Acquisitions, Funding, Business, and Stock

Cardinal Health acquires group purchasing company Specialty Networks for $1.2 billion in cash, calling out the strategic value of its AI-driven PPS Analytics product that analyzes data from EHR/PM, imaging, and dispensing systems for clinical decision-making and for purchase by drug companies.

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Medical practice patient communication technology vendor Vital Interaction raises $15 million in Series A funding.

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Fabric, a healthcare enablement startup that was formerly known as Florence, acquires Gyant, which offers health systems an AI-powered virtual assistant.

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Prior authorization technology vendor Cohere Health raises $50 million in equity funding, increasing its total to $106 million. It has five health plan customers.

Hindenberg Research predicts a “breakdown” for private equity-backed mental health rollup LifeStance, which has 6,400 clinicians, 600 centers in 33 states, a market cap of $2 billion, and a mountain of debt. It says the company is running out of cash, employs mostly therapists who bill at low rates compared to psychiatrists, provides stock grants to its highest-performing prescribers of drugs that have a high abuse potential, and pushes clinicians to see up to 30 patients per day. Former employees say that the industry has such low barriers to entry that LifeStance provides no value or even negative value because “all you need to do to open up your own private practice is post a thing on Facebook and start seeing private, cash-only patients.”


Sales

  • Smile Train will provide its partners and affiliates access to select medical journals via Wolters Kluwer Health.
  • VNAcare expands its relationship with Netsmart to implement its MyUnity EHR.
  • ACO Vytalize Health will use WellSky Next-Generation Provider Solution for care coordination between acute and post-acute providers.

People

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Oracle expands the role of former CMS Administrator Seema Verma, MPH to EVP/GM of Oracle Health, the former Cerner business.

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Workforce management solutions vendor Hallmark Health Care Solutions names industry long-timer Bruce Cerullo, MS as CEO. He replaces co-founder Isaac Ullatil, MBA, who will transition to strategic advisor.

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JTG Consulting Group hires Jaimie Augustine (Copan Diagnostics) as chief growth officer. She replaces Lisa Potter, who was promoted to COO.


Announcements and Implementations

Atlantic Health will acquire Saint Peter’s Healthcare (NJ) and move it to Epic.

ECRI lists its top health tech hazards for 2024:

  1. Usability of medical devices intended for in-home use.
  2. Insufficient cleaning instructions for medical devices.
  3. Drug compounding without technology safeguards.
  4. Environmental harm from patient care.
  5. Lack of AI governance in medical technologies.
  6. Ransomware.
  7. Burns from single-foil electrosurgical electrodes.
  8. Medication errors caused by damaged infusion pumps.
  9. Defects in orthopedic implantables.
  10. Web analytics software and the misuse of patient data.

Publicly traded hospital operator Community Health Systems migrates to a FHIR-based clinical data platform on Google Cloud and is implementing the company’s AI technologies.


Government and Politics

A law firm says that an Epic case that was heard by the Supreme Court raises the legal issue of proving that employees actually signed arbitration agreements that include employment class action waivers. It notes that employees are arguing that they don’t remember signing the agreement, which places the burden on the employer to prove that their electronic signature wasn’t provided by someone else.

The Substance Abuse and Mental Health Services Administration makes some COVID-19 flexibilities permanent, including the ability for Opioid Treatment Programs to prescribe opioid use disorder medications via telehealth without an initial in-person evaluation.

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England’s health regulator finds that IT systems at Newcastle upon Tyne Hospitals – a Global Digital Exemplar and HIMSS EMRAM Stage 6 designee – are not always integrated and don’t always promptly provide staff with information they need. Inspectors noted that OR information is documented on paper and then entered into electronic systems afterward because of slow systems, which was measured at 45 minutes from log-in to retrieval of a single patient’s vital signs and fluid balance. The inspectors also observed that maternity staff are required to document the same information in two systems due to lack of integration.

Regional West Medical Center settles its contract dispute with Oracle for $6 million versus the $15 million that the company wanted, freeing it to convert to Epic. The hospital blamed financial losses and the lowering of its bond ratings on the revenue cycle disruption that was caused by its 2018 implementation of Cerner Millennium.


Other

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A data manipulation expert uses AI to determine that a Harvard Medical School neuroscientist included plagiarized images in 21 journal articles, including images that came from other papers and from vendor websites.


Sponsor Updates

  • CereCore publishes a new case study, “Liverpool Women’s NHS Foundation Trust: Successful EPR Transition Journey.”
  • Hyndman Area Health Center expands its use of EClinicalWorks technology with the addition of AI solutions including the Sunoh.ai virtual scribe.
  • WellSky will use cloud, analytics, and AI technologies from Google Cloud.
  • Impact Advisors joins Epic’s new Rev Cycle Partners program.
  • Findhelp names Dallas Mudd (United Way of Northwest Arkansas) senior director of partnerships.
  • Health Data Movers welcomes Eric Williams (Kaiser Permanente) to its board.
  • Inovalon names Katie Smith (Inari Medical) senior manager of clinical analytics.
  • The Lean HealthTech Podcast features KeyCare CEO Lyle Berkowitz, MD “Virtual Visionaries: KeyCare’s Revolutionary Approach to Telehealth.”
  • Konza National Network appoints Jonathan Smith, MPH (Lawrence-Douglas County Public Health) to its Board of Directors.
  • Broadlawns Medical Center (IA) maximizes efficiency with Meditech’s labor and delivery solution.

Blog Posts


Contacts

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

EPtalk by Dr. Jayne 2/1/24

February 1, 2024 Dr. Jayne 1 Comment

Physicians who care for children — including pediatricians, family medicine physicians, and psychiatrists — have been sounding the alarm for years with regard to the negative impacts of social media on the health of the world’s youth. I’ve been following the recent hearings in the US Senate Judiciary Committee this week on the topic of child sexual abuse. Executives from TikTok, X, Snap, Discord, and Meta were grilled by senators about the platforms’ role in child exploitation.

For those of you who might not be following the issue closely, abuse and exploitation of kids via social media platforms is more than cyberbullying and child pornography. The list of problems continues to expand, and includes not only the sharing of images and videos, but also predators grooming children for abuse and potential trafficking.

Drug use is also a serious concern. I’m sure a lot of parents don’t know that you can use Snapchat to buy fentanyl. As an urgent care physician, I’ve seen the faces of parents who can’t believe that the pricey TikTok-promoted cosmetic products they gave their pre-teen daughters for Christmas have caused the horrible rashes that resulted in a $100 co-pay and prescription medications.

I continue to encounter parents who are willing to help their children lie to gain access to social media even though they’re not old enough to meet the age restrictions, because they are terrified that their children will be ostracized if they’re not keeping up with their peers. I also see children who have zero parental limits on social media use, which can manifest with sleep disturbances, poor academic performance, and serious behavioral health issues.

One hot topic during the hearing was the Kids Online Safety Act, which only two of the five platform leaders were willing to support. Others claimed that the Act contains provisions which are too broad and may clash with free speech issues. The act includes language not only addressing abuse but also predatory marketing and would potentially reduce the power of notifications and auto-played videos that trigger users’ dopamine pathways and contribute to compulsive and addictive behaviors.

YouTube was notably absent from the hearing, despite the platform’s popularity among teen media consumers. Unfortunately, the hearing ended without consensus or clear solutions and those of us who have seen countless children harmed will have to continue to wait for yet another bill on Capitol Hill to finally get passed.

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I received a message from the CDC’s V-safe program this week, inviting me to participate in health check-ins for the updated COVID vaccine. Unfortunately, one has to register within six weeks of receiving the vaccine. For those of us who are frontline physicians of a certain age who received the updated vaccine shortly after it became available, I guess we’re out of luck as far as participating in vaccine surveillance. Seems like that should have been something they coded and released to time appropriately with the vaccine’s arrival in retail locations.

Unfortunately, this is just the kind of food for thought that conspiracy theorists latch onto, since it can be used to try to support the assertion that that “government really doesn’t want us to know about how many people are harmed by these vaccines.” I serve on the health advisory board for our local school district, and most of us are still seeing COVID-deniers in practice. Many don’t want to seek medical care because they’re afraid they’ll be tested for COVID. Maybe someday health literacy in our country will improve to a place where clinicians can spend more time rendering care and less time refuting medical misinformation.

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As a telemedicine physician, I’m concerned about the conflicting priorities that our industry faces, including balancing patient satisfaction and perceived convenience with elements such as clinical quality and antibiotic stewardship. One of the challenges is the lack of telemedicine-specific metrics, which leads organizations to try to mold in-person clinical quality measures to virtual care. The Agency for Healthcare Research and Quality has created the AHRQ Safety Program for Telemedicine, which will help prescribers look at antibiotic usage over an 18-month period starting in June 2024. The program will provide educational sessions to providers, including scripts for navigating patient concerns about not having their wishes met when they request “a Z-Pack to nip things in the bud since we’re going into a weekend,” which universally makes physicians cringe. Providers are expected to perform better on antibiotic-related quality measures after participating in the program, and continuing education credits are available. There is no charge to providers to be part of the program, which is a welcome element for those of us already spending too much to maintain board certification and other recognitions.

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Mr. H recently mentioned concerns by developers such as Microsoft and Google with regard to the cost of the computing power needed for AI projects. I’m a bona fide space nerd, having once wanted to be the first physician living permanently in space. Instead, I’m content to watch from the sidelines as scientists execute cool projects that I could only dream of. I’ve followed NASA’s Ingenuity helicopter, which nearly every journalist describes as “plucky,” especially since it was planned for less than a half dozen missions and eventually flew 72. Ingenuity weighs less than 4 pounds, but provided an amazing amount of data about the ability to achieve powered autonomous flight on another planet.

A headline about the craft caught my eye this week, noting that the craft “packed more computing power than all other NASA deep space missions combined.” This was a challenge given its small size, with engineers having to forego heavy components whose design would mitigate radiation damage and the extreme temperatures on Mars. Instead, designers specified off-the-shelf components, including the brain of the helicopter: the Qualcomm Snapdragon 801 processor, which was used in smartphones nearly a decade ago. Here’s to those IPhone 6, Blackberry Passport, and Google Nexus 6 users whose daily calls shared NASA-worth technology and they didn’t even know it. Photo credit: NASA/JPL.

What was your childhood dream? Are you working in a related field or would you give up your meeting-filled days for a ride into outer space? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 2/1/24

January 31, 2024 Headlines No Comments

Cardinal Health to acquire Specialty Networks and its PPS Analytics platform, a technology enabled multi-specialty group purchasing and practice enhancement organization in urology, rheumatology and gastroenterology

Cardinal Health will acquire Specialty Networks and its PPS Analytics software for $1.2 billion.

Oracle Taps Former Trump Official Seema Verma to Lead Cerner Business

Confirming HIStalk reader rumors, Oracle taps former CMS Administrator and current Oracle Life Sciences lead Seema Verma to head up Oracle Health.

Austin-Based Vital Interaction Closes $15M Series A Funding Round to Revamp Patient Communication with Hyper-Personalization

Austin-based patient engagement and retention technology startup Vital Interaction raises $15 million in a Series A funding round.

Health care operations enabler Fabric pays cash for AI helper Gyant

Fabric, a healthcare enablement startup formerly known as Florence, acquires Gyant, which offers health systems an AI-powered virtual assistant.

Healthcare AI News 1/31/24

January 31, 2024 Healthcare AI News No Comments

News

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Oracle announces a generative AI service that supports text generation, text summarization, and LLM-contextualized search results. The company says it will release search, aggregation tools, and prebuilt agent actions across its SaaS applications, including those of Oracle Health.

Apple will reportedly release AI features with IOS 18 in June, reportedly including enhancing Messages to answer questions and auto-complete sentences.

The State of Illinois launches a Google AI-powered portal for families to access behavioral and mental health resources.

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In UAE, Emirates Health Services launches an AI-powered virtual nurse that answers patient questions, provides medical advice, and helps with assessment and triage. EHS will also assess patient-reported symptoms to schedule appointments with the correct specialty. EHS is running a long list of AI projects, including those related to diagnosis, treatment, disease prediction, patient monitoring, and speech-powered clinical documentation.

Microsoft and Google warn investors that the arms race to develop AI products will be expensive due to the computing power it requires.


Business

The Justice Department is reportedly issuing subpoenas to drug companies and EHR vendors to determine if AI is being used to influence prescribing in ways that breach anti-kickback and false claims violations

Microsoft and OpenAI are reportedly in talks to invest up to $500 million in AI-powered robot developer Figure AI, which could value the 2022 startup at $2 billion. The latest autonomous model is 5’6” tall, can carry 44 pounds, walks at 1.2 meters per second, and operates for five hours when charged.


Research

Researchers apply AI and sophisticated analytics methods to test the detection of Medicare fraud, noting that traditional auditors only have enough time to look for specific suspicious patterns.


Other

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Cleveland Clinic says in its annual meeting that it is piloting AI for answering the questions of patients with chronic disease, creating ambient clinical documentation, predicting patient volume, and creating draft responses to questions that are submitted via Epic’s MyChart.

The hottest job in corporate America is the executive in charge of AI, according to the New York Times. It notes that Mayo Clinic in Arizona has hired its first chief artificial intelligence officer. 

An AAMC story describes the experience of physicians who are using AI to create documentation from recordings of their patient encounters. Eric Poon, MD, MPH (Duke Primary Care) says he is finishing his clinical schedule on time for the first time in his life, also noting that he didn’t realize how his EHR typing was slowing down the visit. Matthew Anderson, MD (Atrium Health) says he has a summarydraft in his hand 15 seconds after the visit ends. However, users say that ambient listening tools aren’t perfect in deciding what parts of the conversation to include or exclude, and some of them report that they spend quite a bit of time editing out extraneous information. They also say that it works well for quick visits, but less so when visits involve multiple medical issues.


Contacts

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

An HIT Moment With … Steve Shihadeh

January 31, 2024 Interviews 1 Comment

An HIT Moment With … is a quick interview with someone we find interesting. Steve Shihadeh is founder of Get-to-Market Health of Malvern, PA.

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Startups have been forced to adjust their strategies, execution, or expectations as investment activity dropped substantially. How will that change the industry over the next few years and how should companies prepare for a turnaround?

At the end of 2022, and throughout 2023, startups and most mid-sized companies shifted their #1 priority to conserving cash. Forecasts of possible recession and rising interest rates put a damper on spending of all types, and especially the more expensive industry events. Companies lowered expectations, cut staff, and tried to do more with less, or at least hold their own. In my opinion, industry momentum, risk taking, and progress on using tech to improve healthcare were all off course for the last 18 months.

2024 has a much different feel already, with several significant funding announcements and a renewed focus on growth. Digital health investors who showed lots of patience over the last year and a half are pushing for the returns they were promised when their funds launched. As a result, I expect attendance, new product announcements, and customer interest at the big national shows to be on the upswing.

The HIMSS conference has a new owner and competition from ViVE and HLTH, with an emphasis on hosted buyer programs by all three. How would you advise companies to plan their participation in these conferences for maximum return on investment?

HIMSS23 in some ways seemed a little dated. It was big as ever, but when compared to the feel of ViVE and HLTH, it needed a reboot. I guess HIMSS understood that, and I am really curious how the show will change this year under new leadership.

To get maximum returns on your tradeshow investment, I think my assessment last year mostly holds true. The top three of the top 10:

  1. Pick the most important show for any booth investments.
  2. Have a presence, even if just one key person, at as many shows that you can.
  3. Send only your best, most committed people.

What has changed in health tech marketing since the pandemic eased?

The pandemic pushed people to hone great digital marketing skills and tools. That is table stakes today, and now we have the full return to strategic in-person events like trade shows and targeted regional and bespoke events. 

The vast improvements in marketing in our space continues to impress me. When I first started Get-to-Market Health in 2017, we presented to a CEO about how we would recommend he revamp marketing. He said something to the effect of, “I am going to just hire a grad assistant type instead.”

That was then. Now, to keep pace, most digital health companies have a strong marketing VP who is directly aligned with the sales VP. Awareness, public relations, lead generation, lead conversion, pipeline development, and deal closure are very much a team effort. Digital tools, social marketing, and micro-targeted outreach are mandatory today, and it is great to see companies taking full advantage of new ways to educate customers.

How will the increased healthcare involvement of big tech firms such as Microsoft, Oracle, and Google affect the ways that healthcare-only vendors run their business? 

I was able to see firsthand the impact of a big tech firm committing to healthcare when I was with Microsoft about a decade ago. The company made large-scale market development investments, engaged in key policy discussions that smaller companies just can’t do, and along with Amazon, laid the foundation for the cloud business in healthcare as we know it today.

I am bullish that the big tech firms that stay committed to the space — “stay committed” being the key point — can really drive change and make a difference. I would advise our clients and friends in the space to carefully evaluate who has the staying power before they go all in with one of the bigger players.

What is your advice for health tech startups given the business and industry conditions that you expect over the next two years?

Assuming the general economy stays strong, I see a great run for the companies in our space who have most of these attributes:

  • Differentiated products or services.
  • Demonstrable ROI that holds up to CFO scrutiny.
  • Company culture that your employees enjoy and your clients can feel.
  • Sales and marketing teams that work together.
  • A thoughtful plan of how to work with or around the big vendors.

Healthcare delivery in the US is complicated. but when it works, is the envy of the world. Technology improvements need to be made in all facets to drive down costs — the US is not the envy of the world on this point — and continually improve care. Every hospital in our country can benefit from all that tech has to offer, which is why I remain so positive on the runway in front of health tech companies.

Morning Headlines 1/31/24

January 30, 2024 Headlines No Comments

DOJ’s Healthcare Probes of AI Tools Rooted in Purdue Pharma Case

The Justice Department is reportedly issuing subpoenas to drug companies and EHR vendors to determine if AI is being used to influence prescribing in ways that breach anti-kickback and false claims violations

Regional West leader outlines changes, hears feedback during forum

Regional West Medical Center (NE) will pay Oracle $6 million to settle a contractual lawsuit, after which it will move forward with implementing Epic.

Valendo Health wants to bring value to diabetes care

Valendo Health, a remote diabetes patient monitoring and value-based care startup that works directly with endocrinology practices, raises $4 million in seed funding.

Peloton Equity Leads Growth Investment in OnPoint Healthcare Partners

Health IT and services company OnPoint Healthcare Partners secures an undisclosed amount of funding from Peloton Equity and Fort Maitland Capital.

News 1/31/24

January 30, 2024 News 3 Comments

Top News

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A district attorney in New York charges a 21 year-old Florida man with stealing the prescribing credentials of hundreds of doctors, which he used to fill and sell tens of thousands of prescriptions for narcotics across pharmacies in multiple states. He faces 19 charges, including illegally selling controlled substances and diverting prescription medications.

Devin Magarian sold prescriptions that customers picked up themselves or would provide the actual drugs that his team of runners obtained from the pharmacies. He charged premium prices to customers, who he recruited via a Telegram advertisement board, because the drugs came directly from pharmacies with no chance of adulteration.

He was arrested while visiting New York to collect $14,000 from a customer who had bought 630 Oxycodone pills using one of the fake prescriptions.

The Nassau County, NY district attorney warns that drug dealers have turned into cybercriminals who know how to exploit e-prescribing systems, noting that the defendant issued 18,500 phony prescriptions to pharmacies in 18 states in a single five-hour period. Authorities have not provided details on which system he compromised or how he did it.


Reader Comments

From Force of Nature: “Re: Summa Health. I heard the podcast stumble that you mentioned about their cost of implementing Epic. Summa has corrected the transcript to $85 million.” Thanks.


HIStalk Announcements and Requests

Sponsors: you still have time to complete my information form for ViVE and/or HIMSS if you are participating.


Webinars

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


Sales

  • HHS’s Advanced Research Projects Agency for Health selects IT support, design, development, and implementation services from Leidos.
  • Torbay and South Devon NHS Foundation Trust in England will replace 25 systems with Epic.
  • Vytalize Health will use WellSky’s Next Generation Provider technology to enable bi-directional communication and care coordination between Vytalize’s ACO members and acute and post-acute care providers.

People

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Unlock Health names Kevin Thilborger, MHA (Huron) chief managed care officer and chief revenue strategy officer.

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Kerry Armstrong (Care.ai) joins LookDeep Health as VP of sales.

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Glytec names Patrick Cua (HealthStar Growth Partners) CEO; Erik Eaker, MHA (LetsGetChecked) COO; and Ashley Reynolds, PhD, RN, MSN (Vault Coaching and Consulting) chief product and experience officer.

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Keith Eggert, MHA (University of Miami Health System) joins Abax Health as chief strategy officer.

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Aaron Rucker, MBA (University Clinical Health) joins Murray-Calloway County Hospital as CIO.

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Manhattan Surgical Hospital (KS) hires Joe DeSimone (Umbrella Managed Systems) as CIO.

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Katie Peppler (Tegria) joins B.well Connected Health as VP of strategic accounts.

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Retired industry long-timer Matt Atwood, MBA, MSHI, who was most recently global implementation leader of Philips Connected Care Informatics, died of colon cancer last week. He was 55.


Announcements and Implementations

Israel’s Health Ministry confirms that at least 20 hospitals have been affected by a software glitch within Elad Health’s Chameleon EHR that has led to dozens of patients being given incorrect medications. Ministry officials were first alerted to the problem 10 days ago, when hospitals began reporting that patient discharge letters contained the wrong prescriptions. Elad Health says the malfunction has been fixed. The EHR is used by 75% of Israel’s hospitals.

Atropos Health collaborates with Google Cloud to connect its de-identified patient database to Google Cloud’s tools.

Philips will stop selling its Respironics sleep apnea machines in the US to settle federal charges that the devices contained noise-reducing foam that the company knew could disintegrate and cause cancer in users. The company recalled the machines in mid-2021, several years after it was made aware of the problem. Users were advised to stop using the machine during the recall period that lasted more than a year. Philips, whose CPAP machines held a 37% market share in the US, could also face criminal charges.


Government and Politics

The Justice Department is reportedly issuing subpoenas to drug companies and EHR vendors to determine if AI is being used to influence prescribing in ways that breach anti-kickback and false claims violations. EHR vendor Practice Fusion, now owned by Veradigm, paid $145 million in 2020 for using EHR alerts to push the prescribing of opioids in a contract with drug maker Purdue Pharma. The lead investigator who pursued Practice Fusion and four other EHR vendors says that Practice Fusion made some attempt at compliance, AI-driven recommendations could be harder to track and could make more persuasive recommendations using personalization.

Texas Attorney General Ken Paxton requests medical records from a second out-of-state provider, seeking information from a Georgia telehealth clinic to verify that it does not offer gender-affirming care to Texas minors. The state requested extensive records from Seattle Children’s Hospital in November, and the Georgia clinic owner says she has seen similar letters that were sent to other organizations. The requests raise questions about the Texas AG’s authority over other states and HIPAA’s requirement to provide patient records only in response to a court order or subpoena after notifying the patient.


Other

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Meritus Health (MD) credits its Epic system for helping it reduce opioid prescriptions by 55% over the last five years. The switch to Epic in 2018 allowed doctors to see facility-wide prescriptions in real time and yielded data that was used to create the policies of its new Pain Management and Opioid Stewardship Committee.


Sponsor Updates

  • CereCore publishes a new e-book, “The Buyer’s Guide to IT Managed Services: Elevating Healthcare Excellence.”
  • Agfa HealthCare celebrates a 20-year image management partnership with Amiri Hospital in Kuwait.
  • Cardamom Health names Jennifer Riffle (Nordic) a senior consultant.
  • Censinet will support healthcare organizations interested in assessing, managing, and improving coverage of and compliance with the Healthcare and Public Health Sector Cybersecurity Performance Goals recently released by HHS.

Blog Posts

Black Book’s list of top, physician-rated ambulatory EHR vendors include the following HIStalk sponsors:

  • Netsmart – behavioral and mental health / geriatrics / physical therapy and rehab / psychiatry
  • Medhost – emergency medicine
  • Experity – urgent care and occupational medicine

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Morning Headlines 1/30/24

January 29, 2024 Headlines No Comments

FL Man Who Allegedly Commandeered E-Prescribing Privileges of Doctors Charged with Criminal Sale

A district attorney in New York charges a Florida man with stealing the e-prescribing credentials of multiple doctors, which he then used to illegally issue and sell tens of thousands of prescriptions for narcotics across multiple states.

Russian National Sentenced for Involvement in Development and Deployment of Trickbot Malware

Vladimir Dunaev is sentenced to five years in prison for his role in a wave of Trickbot ransomware attacks that extorted millions of dollars from hospitals, schools, and businesses between 2016 and 2022.

ApolloMed and Bass Medical Group to Forge a Value-Based Healthcare Partnership

Bass Medical Group will use a $20 million investment from ApolloMed, as well as the physician network optimization company’s value-based care and operational technology and services, to expand its value-based care arrangements in California.

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RECENT COMMENTS

  1. I think Disingenuous is confused (or simply not aware of how it has been architected). How control of Epic is…

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  4. RE Judy Faulkner's foundation wishes: Different area, but read up on the Barnes Foundation to see how things work out…

  5. Meditech certainly benefited from Cerner and Allscripts stumbles and before that the failures of ECW and Athena’s inpatient expansions. I…

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