Readers Write: It’s Time for EHRs to Alleviate, Not Exacerbate, Clinician Burnout

It’s Time for EHRs to Alleviate, Not Exacerbate, Clinician Burnout
By Nancy Pratt, RN

Nancy Pratt, RN, MSN is senior vice president of clinical product development of CliniComp of San Diego, CA.

We all see the headlines – clinician burnout is taking an enormous toll. It is estimated that 47% of US healthcare workers may leave the profession by 2025. One of the most-cited sources contributing to burnout is electronic health records (EHRs), with nearly 60% of physicians in one poll suggesting that EHRs need a complete overhaul.

In my work with clinicians, their biggest frustration with EHRs is time. So much of their time is spent doing manual, EHR-related tasks, causing them to spend nearly twice as much time in the EHR as they do with patients. A poll by Stanford Medicine found that hospital-based physicians spent 25 of the 37 minutes on behalf of each patient in the EHR.

It doesn’t need to be this way. By collaborating with physicians, nurses, pharmacists, and other clinicians, EHRs can become a trusted part of care delivery processes, freeing clinicians to focus on their patients and recapture the most satisfying qualities of their professions. With a focus on human-centered design, EHRs can help reduce clinician burnout in three ways:

Capture documentation naturally as part of the workflow

Given the frustration with documentation, EHRs need to move beyond focusing on transactions to creating efficient, supportive workflows for all clinicians. One process that is often frustrating and burdensome is medication reconciliation. A well-designed EHR workflow can present this critical step at a natural point in the care process. By presenting a side-by-side comparison of what’s current and what’s needed for the patient, the process becomes a fast and accurate way for physicians to manage medications.

Bring device data into the workflow automatically

Using standard integration protocols, such as APIs, EHRs can automatically integrate data from bedside monitoring and other devices into user-focused workflows. Instead of requiring nurses to enter data manually, the EHR should be fully integrated, perform calculations automatically, and present in a user-friendly way. In addition to reducing errors and manual tasks, nurses working with monitored patients report saving as much as 15 to 20 minutes per patient per shift with this level of integration.

Remove downtime as a barrier

It’s surprising that system maintenance and upgrades still require planned downtime for many EHRs, slowing down care delivery with manual, paper-based workarounds. Unplanned downtime, experienced by 96% of organizations according to one study, can be even more onerous. EHRs should be built upon modern foundational architectures that don’t require scheduled downtime and have built-in redundancy to prevent unplanned downtime. Preventing downtime alleviates a common source of stress for clinicians when care delivery is hampered by lack of access to patient information.

It’s time for the industry to listen when so many clinicians say EHRs need to be revamped. Using flexible, well architected technologies and collaborating with clinicians, EHRs can enhance rather than hinder care delivery. At last, EHRs can support clinician wellness by enabling them to provide the highest quality patient care, bringing the joy of helping patients back into their day-to-day work.

Readers Write: Ineffective TCM Programs are Keeping Patients in the Hospital

Ineffective TCM Programs are Keeping Patients in the Hospital
By Briana Rodriguez, RN

Briana Rodriguez, RN is director of clinical services of LIghtbeam Health Solutions of Irving, TX.

The healthcare industry is facing an uphill battle, as staffing shortages persist while the demand for clinical professionals continues to increase. With fewer skilled workers to perform necessary care delivery tasks, healthcare organizations must be thoughtful with their clinical resources. One area that is causing clinical and financial strain on organizations due to limited resources is transitional care management (TCM) programs.

According to the Centers for Medicare and Medicaid Services (CMS), nearly 20% of all Medicare patients discharged from a hospital will be readmitted within 30 days, driving over $26 billion in additional costs each year. There are a multitude of reasons, both preventable and unpreventable, that a patient may be readmitted to the hospital. Chief among them is being enrolled into an inefficient, uncoordinated transitional care management program that fails to maintain engagement and make timely contact.

Understanding how and why your organization’s TCM program is insufficient is the first step to make meaningful process changes that demonstrate success in reducing readmission rates, lowering healthcare costs, and improving patient outcomes.

The goal of any TCM program is to perform timely and thorough patient follow-ups within crucial post-discharge windows to ensure quality of care and reduce patient complications. A standard transitional care management program comprises three main elements:

• Interactive contact. Initial patient outreach is performed within 48 hours post-discharge by a supervised staff member with the skills to address the patient’s status.
• Coordinating care behind the scenes. Care teams provide non-face-to-face services, such as clinical education, addressing follow-up needs, provider communication, referrals, and scheduling assistance.
• Follow-up visit. A face-to-face visit is scheduled with a provider within 7-14 days post-discharge, depending on medical severity

However, staffing shortages and insufficient resources can make even the three basic components of a TCM program difficult to accomplish. What sets a successful, effective TCM program apart is the ability to provide regular outreach, keep patients engaged, and identify issues before they require inpatient stay. These processes begin long before a patient is discharged from a hospital.

In today’s digital age, healthcare organizations have options that have only emerged within the last decade. Solutions like remote patient monitoring and telehealth garnered attention following the social distancing periods that took place during the COVID-19 pandemic. Ever since, the healthcare industry at large has seen how beneficial similar strategies can be when it comes to reaching more vulnerable patients. When given the right capabilities, clinical professionals can work at the top of their license and provide the highest quality care to patients, wherever they are.

Leveraging these tools and resources, transitional care management teams can automate repetitive tasks, streamline workflows, and reach more patients by engaging them at home. Some key aspects that can be further built into an efficient TCM program to increase patient engagement and reduce costs include:

• Coordinating with hospitals to notify care teams of discharges.
• Making the initial patient contact within 48 hours of discharge.
• Reviewing the discharge process and medication schedule with the patient.
• Scheduling a face-to-face visit within 1-2 weeks.
• Confirming all patient appointments to ensure continuity of care.
• Performing follow-up calls.
• Providing support for barriers to care by leveraging local, available resources.
• Supporting patients in the 30-day period post-discharge.
• Documenting all services throughout the patient’s TCM journey.

There are several reasons that transitional care management programs can fail. If providers are not able to identify high-risk patients with co-morbidities before they are discharged, these patients have a higher chance of developing complications that could result in further inpatient stay. TCM programs can also fail if clinical staff is not able to contact patients during crucial follow-up windows, especially the initial 48 hours post-discharge.

Noticing an increase in readmissions, post-discharge complications, and delays in interactive contact with patients may indicate that care teams are not reaching patients in a timely manner. If you notice these issues, it is important to find out the cause of the gap and to pinpoint the right solution, workflow, or strategy to close it.

Ineffective TCM programs cause patients to return to the hospital and drive avoidable costs into the billions. The first step to improve an inefficient TCM program is to arm healthcare staff with the tools and resources they need to reach out to patients, make an impact, and maintain engagement throughout their care journey. This can include investing in technology to streamline communication, leveraging analytics to identify high-risk patients, and enabling staff to work at the top of their license.

With the technology of today, healthcare organizations have access to solutions that weren’t available ten years ago. Outsourcing care coordinators extends the capabilities of care teams, while adopting tools like remote patient monitoring expands their reach.

Even when a TCM program possesses all these elements, it’s essential to assess their performance regularly, make process updates, and assess patient feedback and satisfaction. This can be done by tracking certain metrics, such as readmission rates, acute events, skilled nursing facility data, and more.

By understanding the elements of an efficient TCM program, identifying where gaps exist, and making necessary process changes, healthcare organizations can reduce readmissions, lower costs, and improve outcomes.

Readers Write: Return Data to Hospitals and Researchers for Patients

Return Data to Hospitals and Researchers for Patients
By Amanda Borens

Amanda Borens, MS is chief data officer of Aridhia Informatics of Glasgow, Scotland.

As a data scientist formerly working in global health, I have firsthand knowledge of how challenging it is to recruit patients for clinical trials and observational studies, and how transformational a culture of open collaboration and data sharing can be. I have cancer diagnoses in my history, accompanied by so much fatigue from being extensively examined and poked and prodded, but I’m also a scientist in the health technology industry with appreciation for the way that humans advance medical knowledge.

I have eagerly signed up for clinical studies and taken on extra burdens, such as blood draws and filling out forms, to help researchers as well as those in training. Even when that means being examined by a nervous medical student and then repeating myself to a physician.

Then why did I balk when my health system asked me to participate by openly sharing my EHR data for research?

I collaborated with renowned medical ethicists who taught me to embrace the idea that a patient owns their data. That idea was cemented in me when I became a participant in various studies that led to peer-reviewed publication. I had been working in my non-profit world to aggregate data from multiple sources to learn more about rare diseases. I became frustrated that companies would keep shareable data confidential to avoid letting competition find insights that they had missed. I was shocked to learn that many scientists in academic settings hoard data in the same way, fearing that someone might find something they missed in the data and publish it.

In all cases, the stewards of the data seemed to forget that patients sacrificed time, blood, energy, and more to help all humanity, not the personal careers of their physicians or the bottom lines of sponsoring drug companies. That intention matters, and is worth honoring.

This brings me to my personal hesitation when asked to share my EHR data for research. I’ve been to data science conferences where abstracts were presented by employees of this health system. I know the kinds of questions my data would answer. Those questions tend to be focused on how to keep hospitals profitable. While I know that this is a valid concern for administrators in hospitals, I want my personal health information to be used to help other patients like me have a better experience, and I don’t much care what that would cost.

I want to be a piece of data that led to a cure for this, a better treatment for that, an earlier detection of my cancer for others, a less-invasive surveillance journey, or a better experience with caregivers. I want to share my EHR data with my incredible team of oncologists and researchers so they can learn. I want my data to be compiled with that of others so that they can learn more and faster.

However, I know that my doctor won’t be able to access aggregated data that way in my clinic. I know he had to use an Excel spreadsheet to keep track of data in the landmark oncology study he recruited me to join.

Conversely, aggregated claims databases can be used to answer questions about health economics. Some cost money to access, and sometimes researchers can access those external data sources with cost waived. Beyond payer-aggregated data sets, Epic has a respectable database and Cerner does too, both of which are valuable for review of de-identified patient data. But what about empowering researchers and clinicians in their unique patient communities? Shouldn’t we be honoring the patients’ commitment to advancing medical science by empowering clinicians and researchers to more easily use more data in their own hospitals? What does that look like?

The US government mandates that healthcare IT developers like Cerner and Epic provide their customer base with a certified FHIR API to support patient access to health information by December 31, 2022 as part of the 21st Century Cures Act Final Rule. This mandate requires that certified health IT developers publish “service base URLs” or “endpoints” for all customers in a machine-readable format at no charge. I hope this will be an inflection point.

Additionally, patient-focused drug development mandates are demanding greater listening to the voice of the patient, and that means tighter connection between pharmaceutical companies and real-world data from clinical settings. Hospitals with an investment in a next-generation research environment will be able to procure industry funding to collaborate in a secure, audited cloud environment that is dynamic and connected to anonymized EHR data alongside observational or interventional study data. A nice side benefit? That same (already funded) environment may provide a subset of hospital researchers with identifiable patient data that can be used to implement research findings into clinical practice in a timelier fashion.

As a patient, I’d donate my data to that hospital in a heartbeat.

Imagine a world where patients and clinicians collaborate to improve healthcare, then take a look at what Great Ormond Street Hospital for Children is doing with their research environment for a wonderful example. Pediatricians there have been studying precision dosing regimens and collaborating across continents to share dosing models where pediatric populations were excluded from clinical trials. This isn’t happening in one hospital’s data warehouse, and it isn’t happening with access to a single EHR or aggregated repository. It’s possible because of connecting different types of data of across borders and across time, but all in a next-generation research environment that connects people.

The transformative possibilities do not end there. What if a research hospital was able to collect clinical data from EHR and combine it with multiomics data from an academic research university where bioinformatics pipelines are optimized to provide a list of variants for each patient? How might they learn about patient subpopulations and disease progression or predict responses to interventions? That sort of collaboration should be the norm, but it requires us to think bigger than one data warehouse, one data type, or one organization at a time. Let’s make it happen.

HIStalk’s Guide to MUSE Inspire 2023

Access EForms

Booth #413
Contact: Landon Light, national sales representative for Meditech accounts
landon.light@accesseforms.com
972.897.2877

Access is the preferred ESignature partner for Meditech hospitals, and for good reason. Our relationship with Meditech goes beyond just being a “partner” – it’s a deep integration that enables our solutions to seamlessly integrate with Meditech’s ecosystem. By expanding Meditech’s capabilities, we empower hospitals to provide patients with convenient ESignature solutions on their own devices anywhere, anytime. With Access, Meditech hospitals can streamline their workflows, reduce errors, and improve the overall patient experience. Join the many Meditech hospitals that have already chosen Access as their trusted ESignature partner and revolutionized their patient ESignature solutions. And, discover Focus by Access, the solution that simplifies patient intake by extending ESignature and intake capabilities directly to your patients’ devices, providing the experience and convenience they expect in today’s modern world.

CereCore

Booth #418
Contact: Jillian Whitefield, business development manager
Jillian.Whitefield@CereCore.net
248.891.5557

Your top priorities at MUSE are ours, too. Visit to see all the ways you can connect with CereCore about providing an EHR that best supports patient care, including educational sessions and career opportunities. Our team is ready to connect. Making the move to Meditech Expanse? Let’s talk about your journey to one EHR, navigating a multi-EHR health system, and more. Optimizing Meditech one of your priorities? Help us understand your goals, because we have helped health systems across the nation 0improve efficiency from clinical operations to revenue cycle. Looking for secure Meditech hosting and backup solutions? Sometimes this needs to be your first step. Let us help you determine the most cost-effective solution by comparing your options. Wanting to grow in your career? Career-changing, industry-shaping job opportunities are on our horizon, and possibly yours. Talk with us about your career plans.

CloudWave

Booth #512
Contact: Christine Mellyn, VP of marketing
cmellyn@gocloudwave.com
781.636.8169

Visit us in booth #512 to learn how CloudWave can help with your cloud strategy or how to advance your cybersecurity readiness. The company will also be sponsoring the Charging Station. Also at the event, members of CloudWave’s team will be presenting the following educational and showcase sessions:  

• “Best Practices for Securing Healthcare IT Across Public, Private, and Cloud Edge Environments.” Thursday, June 8 3:10 p.m. MT. Moderated by Tim Quigley, chief client officer, CloudWave. Presenters include Matt Donahue, chief technology officer, CloudWave; John Gomez, chief security and engineering officer, CloudWave; and Eric Gasser, RN, CHCIO, vice president and CIO, information systems, Wooster Community Hospital Health System.
• “Take Advantage of Emerging Healthcare Cybersecurity Trends to Advance Your Security Strategy.” Saturday, June 10, 8:30 a.m. MT. Presented by John Gomez.
• “Product Showcase: Cybersecurity-as-a-Service – Advance Your Cybersecurity Program and Remove the Burden from Your IT Team.” Thursday, June 8, 1:30 p.m. MT. Presented by John Gomez.

Elsevier

Booth # 609
Contact: Clint Jones, senior director of partnerships
w.jones.2@elsevier.com
816.262.6634

As a global leader in information and analytics, Elsevier helps physician and nurse professionals advance science, reduce care variability, engage patients, and improve health outcomes for the benefit of society. For over 140 years, healthcare professionals have trusted our content to support education, training, development, and decisions about patient care. We offer solutions and services that help customers utilize and integrate content to improve practice, reduce care variability, engage patients, and promote a culture of quality, safety, and satisfaction.   

We invite MUSE attendees to stop by our booth #609 to discuss how Elsevier’s advanced clinical knowledge solution, ClinicalKey, streamlines access to consistent, evidence-based information to help clinicians, as well as hear your thoughts and input on future development, your needs, skills learning, and integration. Let’s talk about where you want to expand your own Meditech relations and where we can offer help. Elsevier is participating in the MUSEO prize drawings, so bring your game card with you when you come to visit us, and we’ll give you a MUSEO sticker to help you become eligible to win great prizes!

Fortified Health Security

Booth 218

Contact: Rob Pullins, growth manager
rpullins@fortifiedhealthsecurity.com
615.600.4002

Fortified Health Security provides a wide variety of purpose-built services to help healthcare organizations evaluate their unique risk appetite, strengthen their cybersecurity posture, and improve operations throughout their security journey. The company is committed to creating a stronger healthcare landscape that benefits more clients, protects more patient data, and reduces more risk.   

Fortified activities and team member talks: 

• “Incident Response Program Maturity: How to Prepare for the Worst Day Ever,” Thursday, June 8 at 2:20 pm with Russell Teague, VP, advisory services and threat operations.
• Networking event and cocktail hour at the Après Ski section of the Pinyons Lobby Bar, Thursday, June 8, from 6-9 pm.   
• Stop by our booth to play MUSEO.

Tegria

Booth #409
Contact: Mark Valutkevich, senior account executive
mark.valutkevich@tegria.com

Tegria is a full service, READY-certified consulting and technology services firm. We offer comprehensive end-to-end solutions including advisory, consulting, and managed services to help clients maximize technology, transform operations, improve financials, and optimize care. Please stop by Booth #409 to say hello and speak with our Meditech experts.  

Tegria is hosting a subterranean happy hour at the Rockies Grotto in the Grand Lodge on Wednesday, June 7 from 4:30 to 7:00 p.m. MT. The event will feature an open bar and a variety of light bites. Prepare to unwind and connect with fellow MUSE attendees in this unique space. Tegria team members will be mingling and are ready to chat all things Meditech, including how you can best navigate the road to Expanse. We hope to see you there! RSVP here.

Tegria team members will be participating in two educational sessions:   

• “Hardware Planning – Do’s and Don’ts When Moving to Expanse.” Thursday, June 8, 1:30 – 2:10 p.m. MT. Presenters: Priscilla Sandberg (Pure Storage), Nassim Abouzeid (Meditech), and Frank Tollefson (Tegria). Room: Red Rock 8. If you are planning on going to Expanse from Magic, Client/Server, or 6.x, there are few challenges you need to understand about the new infrastructure you will be running. Join us to discuss the major differences in platform infrastructure and some of the adjustments that customers can anticipate making when moving to Expanse. We will also be discussing the best practices behind the infrastructure design, data protection, and ongoing system support.   
• “A Study in Moving to Expanse – Pre, Intra, and Post-LIVE.” Friday, June 9, 1:20 – 2:05 p.m. MT. Presenters: Mike Bartman (Tegria), Mark Valutkevich (Tegria), Todd Prellberg (RML). Room: Red Rock 8. This session aims to provide attendees with a comprehensive understanding of the key principles and best practices involved in successfully implementing Meditech Expanse in a hospital setting. By the end of the session, attendees will be able to apply these principles and practices to their own healthcare organizations, identifying opportunities for improving their current EMR systems or adopting new ones.

Morning Headlines 5/31/23

Carrum Health Raises $45M in Series B Funding

Carrum Health, whose platform helps employers manage employee healthcare costs, raises $45 million in a Series B funding round.

Anatomy IT Acquires Iris Solutions to Expand Presence in Ambulatory Healthcare

Health IT and cybersecurity solutions vendor Anatomy IT acquires dental and medical software company Iris Solutions.

Florida Bans Offshoring of Certain Patient Information

A new Florida law prohibits the state’s providers from storing EHR data outside the US, its territories, or Canada, including those patient records that are hosted in the cloud or by a third party.

News 5/31/23

Top News

Carrum Health, whose platform helps employers manage employee healthcare costs, raises $45 million in a Series B funding round.

HIStalk Announcements and Requests

Poll respondents aren’t convinced that the VA will finish its Oracle Cerner implementation.

New poll to your right or here: Did you sell $10,000 or more in products or services from your own company in the past year?

Listening: new from Yes, a 55-year-old band with no original members left whose recent live shows have been innumerable but awful. I walked out on them a couple of years ago because they sounded like a bad tribute band (which they kind of are) in playing their old album cuts slower, lower, and lazier in a seemingly desperate money grab, but this new music is actually pretty good even if a bit wimpy compared to their sweeping epics of yesteryear. I still prefer old concert videos, such as original singer Jon Anderson doing “Awaken” with Iceland-based rock band Todmobile (gets me every time) and the the full band’s symphonic live version of “Soon.” For me, Yes scores high in the all-important “what music would you want played at your funeral” test. It will outlive the many band members who wrote, recorded, and performed it over decades.

Webinars

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

Acquisitions, Funding, Business, and Stock

Health IT and cybersecurity solutions vendor Anatomy IT acquires dental software company Iris Solutions.

Dock Health, which specializes in automated healthcare task management, raises $5 million in funding. The company was created from Boston Children’s Hospital’s innovation department in 2020.

Weight loss app Noom launches a telemedicine service to offer consumers access to prescription weight-loss medications like Ozempic and Wegovy.

A new KLAS report looks at remote patient monitoring technology vendors.

Sales

• Niagra Health in Ontario will implement Sectra One enterprise imaging.
• Corterra Healthcare (KS) chooses Medsphere’s Wellsoft EHR and RCM Cloud for a new behavioral health hospital.

People

Rebecca Manne, RN (Optimum Healthcare IT) joins Continuum Health IT as EVP of EHR Implementation.

Announcements and Implementations

Premier launches SmartPO, digital supply chain procurement and inventory management technology that will enable continuum of care providers to better identify cost savings and use staff resources more effectively.

A University of Michigan national poll of people aged 50-80 finds that 78% have a patient portal (half of those have more than one), 55% used it in the past month, half provided access to family members, and most were comfortable logging in and navigating it. People preferred the portal over the telephone for getting test results, updating personal information, getting medical records copies, and requesting refills, but they liked the telephone better for reporting symptoms, scheduling appointments, and requesting referrals.

The former Cerner Continuous Campus is under purchase contract to be turned into apartments and commercial space, although no companies have expressed interest in the campus’s 660,000 square feet of vacant offices.

A small study finds that smart watches and wristbands do a good job of correctly detecting atrial fibrillation even though they don’t have access to outside algorithms.

Government and Politics

VA Secretary Denis McDonough promises to look into reports that the VA medical center in Spokane will be forced to cut staff due to a budget shortfall caused by the troubled EHR Modernization program. He reiterated that he stands by statements made by VA Under Secretary for Health Shereef Elnahal that budget concerns related to the Oracle Cerner system will not result in layoffs.

Former Theranos CEO Elizabeth Holmes reports to a Texas prison after her losing her bid to remain free while appealing her conviction for investor fraud, which led to an 11-year sentence.

Privacy and Security

A new Florida law prohibits the state’s providers from storing EHR data outside the US, its territories, or Canada, including those patient records that are hosted in the cloud or by a third party.

Other

The bankrupt, non-profit Idaho Health Data Exchange replaces its executive director. The organization launched in 2009 using federal grants and ongoing funds from the HITECH act that ran out in 2021.

Mayo Clinic and University of California, San Francisco researchers determine that pairing AI imaging and volumetric breast density algorithms can help in predicting long-term risk of breast cancer, particularly invasive diseases. Their study used Volpara Health’s TruDensity algorithm and ScreenPoint Medical’s Transpara image-based risk tool.

In perhaps the first incident of AI leading to professional embarrassment or worse, defense attorneys ask to have a man’s personal injury lawsuit dismissed after noticing that most of the legal citations it included were not real. The plaintiff’s lawyer, who has practiced for 30 years, admitted that he had used ChatGPT for the first time and was not aware that it could generate false information. He even asked ChatGPT if the citations were real and was assured incorrectly that the cases “are real and can be found in reputable legal databases.”

Sponsor Updates

• Wolters Kluwer Health wins the NorthFace ScoreBoard Service Award for the twelfth consecutive year for superior customer service.
• OptimizeRx CEO Will Febbo provides a mid-year strategic update.
• Nordic Consulting names Samara Lattimer (Akkodis) a new client partner in the UK and Ireland.
• Aridhia Informatics Chief Data Officer Amanda Borens, MS is featured in an “Engineering Field of Dreams” podcast titled “Spelunking Adventures in Data.”
• Spok will join the broad-market Russell 3000 Index on June 26.
• West Monroe releases a new podcast, “Why All Companies Should ‘Shift Left’.”

Blog Posts

• COVID-19 Interoperability Alliance Retrospective (Clinical Architecture)
• AONL 2023: Drawing inspiration to fuel the future of nursing (Meditech)
• Amplifying Success: How Integrated Behavioral Health Programs Can Achieve the Quintuple Aim (NeuroFlow)
• How Can Healthcare Providers Improve Their Data Integrity to Achieve Better Insights? (NTT Data)
• 360Dx: Legislation Would Provide Medicare Coverage for Pharmacy-Based Testing (OmniSys)
• Safeguarding security and privacy in the age of generative AI (Orbita)
• Healthcare Coding Series: LOINC Codes (Pivot Point Consulting)
• Partnering with a Revenue Cycle Management Company to Tackle Hospitalist Billing (PMD)
• Young Upstart to Four-Star Admiral: The Chance Events of Dr. Brett Giroir (Surescripts)
• Designing a Comprehensive Caregiver Support Strategy: Empowering the Unsung Heroes of Healthcare (Trualta)
• 4 Signs Your PT Patient is About to Drop Out (WebPT)
• Jump to the Front of the Line for National Network Access (Zen Healthcare IT)
• What is the Focus of a Care Plan? (Zynx Health)
• Healthcare CIOs Talk: How to Navigate AI, Analytics, and Automation (CereCore)

Contacts

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

Morning Headlines 5/29/23

Walgreens’ Profit Drive: Employee Cuts Amid Transformation to Consumer Healthcare

Walgreens will lay off 504 mostly corporate employees as the retail pharmacy shifts its focus to more patient care.

Health startup Noom is now adding Ozempic and other weight loss injectables to its offerings, says ‘outcomes are so much better’

Weight loss app Noom launches a telemedicine service to offer consumers access to prescription weight-loss medications like Ozempic and Wegovy.

$1 million donation will expand Montana Pediatrics’ after-hours telemedicine program

Montana Pediatrics will use a $1 million donation to expand its after-hours pediatric telemedicine program.

Morning Headlines 5/26/23

Healthcare Triangle, Inc. Announces 1-for-10 Reverse Stock Split as Part of Nasdaq Compliance Plan

Shares of Healthcare Triangle, Inc. drop sharply on the news that it will conduct a 1-for-10 reverse stock split to meet Nasdaq’s share price requirements.

Quovis, a health tech startup in Cleveland, lands $1M investment

Cleveland-based health information exchange startup Quovis raises $1 million.

VA secretary says Spokane VA’s budget won’t suffer as result of flawed records system

VA Secretary Denis McDonough promises to look into reports that the VA medical center in Spokane could be forced to cut staff due to a budget shortfall caused by the troubled EHR Modernization program.

TA Announces Strategic Growth Investment in Alpha II

RCM software vendor Alpha II secures an undisclosed amount of funding from TA Associates.

Dock Health Secures $5M in Funding Led by MassMutual with Participation from DaVita Venture Group and August Capital

Dock Health, which specializes in automated healthcare task management, raises $5 million in a funding round led by MassMutual.

News 5/26/23

Top News

Mobile patient intake form platform vendor Florence acquires Zipnosis, which sells a white label asynchronous telehealth solution that is based on questionnaires.

Florence launched in March 2023 with $20 million in seed funding.

Failing insurer Bright Health acquired Zipnosis in April 2021.

Webinars

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

Acquisitions, Funding, Business, and Stock

Shares of Healthcare Triangle, Inc. drop sharply on the news that it will conduct a 1-for-10 reverse stock split to meet Nasdaq’s share price requirements. HCTI shares are down 50% in the past 12 months to $0.26, valuing the company at $11 million. Shares have lost 93% of their value since the company’s IPO in October 2021.

Vodafone creates Vodafone in Health to accelerate the use of healthcare technology in the UK.

Sales

• Health information sharing non-profit Contexture will implement Verato’s healthcare master data management solution for patient matching.

People

Nicole Kerkenbush, RN, MN, MHA (Monument Health) joins CHIME as VP of education.

Carteret Health (NC) promotes VP of general services / CIO Kyle Marek, MS to president and CEO.

Announcements and Implementations

Conduent releases a provider data management solution to help insurers keep their physician directories current.

Synapse Medicine and CompuGroup Medical will partner to offer clinicians prescription support.

In Canada, Meditech will support electronic prescribing for Expanse EHR users by connecting to the PrescribeIT national prescribing service.

UK-based Acurable earns US FDA clearance for its self-applied wearable that diagnoses sleep apnea without a polysomnography study.

Government and Politics

Rep. Cathy McMorris Rodgers (R-WA) demands that the VA avoid reducing headcount or services at its Spokane and Walla Walla facilities to offset a $35 million shortfall caused by its Oracle Cerner implementation. She says the VA should redirect the money that it would have spent to implement the system in other facilities since those go-lives are on hold, and instead move those funds to those hospitals that are already live.

Husband and wife doctors who are charged with sharing the medical records of US military officials with Russia to support its invasion of Ukraine were recorded by FBI agents who were posing as Russian operatives. Johns Hopkins anesthesiologist Anna Gabrielian, MD is accused of sharing her laptop screen containing patient records with the undercover agent. Her spouse, Army Major Jamie Lee Henry, MD – who was one of the first active duty US military officers to come out as transgender in 2015 – reportedly described themselves as a “coward” over potential HIPAA violations, struggled with technology problems in trying to share their screen with the undercover agent, and ending up giving the agent a paper notebook of records. The doctors, who are charged with conspiracy and HIPAA violations, argue that they were entrapped.

The American Hospital Association asks HHS OCR to stop considering the IP addresses of hospital website visitors as protected health information under HIPAA. AHA says pending lawsuits over pixel tracking have pushed website technology providers such as Google to stop supporting hospital websites, making regulation unnecessary, but if HHS OCR disagrees, then IP addresses should only be considered PHI if they are used from within patient portals.

Privacy and Security

Medical practice services vendor Practicefirst will pay $550,000 to the state of New York for failing to protect patient records that were exposed in a 2020 cyberattack. The breach, which involved the records of 1.2 million people of which 428,000 were New Yorkers, happened after the company failed to apply firewall software updates.

Sponsor Updates

• IntegrityCheck, the house band of InterSystems, wins $100,000 for the ALS Foundation in a Boston battle of the bands for charity.
• Healthcare Growth Partners advised Intelligent Medical Objects in its acquisition of Melax Technologies.
• InterSystems launches HealthShare Health Connect Cloud in AWS Marketplace.
• Healthcare Triangle sponsors CalvertHealth’s annual golf tournament in Lothian, MD.
• Indiana Health Centers reduces onboarding errors by using the EClinicalWorks Business Optimizer.
• Tegria CMO Ray Gensinger, MD joins Symplr’s effort to “Advance Healthcare Operations.”
• Nordic releases a new episode of its In Network podcast, “Designing for Health: Dr. John Whalen.”
• Netsmart earns top user satisfaction rankings among home health technology vendors, according to a Black Book survey of 2,285 end-users.
• Dimensional Insight publishes a new case study featuring Children’s Hospital of the King’s Daughters.
• In Europe, elder care organization Korian Benelux selects AI-powered enterprise solutions from Juniper Networks, including wireless and wired access, to optimize network performance and reliability.
• Konza National Network congratulates over 200 Konza-powered members that have been awarded accreditation through the NCQA Data Aggregator Validation program.
• The Patient Journey Pioneers Podcast features Kyruus CEO Graham Gardner, “Find a Physician & Beyond: Guiding the Digital Patient Journey.”

Blog Posts

• What IT advancements are needed to improve value-based care (Optimum Healthcare IT)
• A Different Point of View: The Age of TEFCA and QHINs Mandate Point-of-Care Diagnostic Filtering and Interoperability (Medicomp Systems)
• 10 Best Interview Questions to Ask Candidates (Direct Recruiters)
• Why Healthcare Needs Organizational Change Management (Divurgent)
• The pros and cons of using ChatGPT in clinical radiology: An open discussion (Elsevier)
• An inch deep and a mile wide (Nordic)
• Does Your Data Analytics Solution Find Patients Missing from Cohorts? (First Databank)
• Single sign-on vs. multi-factor authentication: Do you know the difference? (Fortified Health Security)
• Managed Services: The Case for Externalizing Aspects of Health System IT Operations (HCTec)
• Expanding After-Hours Virtual Care Options for Children (Health Data Movers)
• Am I Information Blocking? (With Examples!) (HealthMark Group)
• Five Key Considerations for a Successful EHR Optimization (HealthTech Resources)
• Does Your Patient Education Experience Pass the Accessibility Test? (Healthwise)
• When to Consider an Oracle Cerner Optimization Assessment (Healthcare IT Leaders)
• From raw to refined: Striving for high quality data in healthcare (Intelligent Medical Objects)
• How AI-Driven User Experience Testing Enhances Digital Health Accessibility (Keysight)
• Patients Need More Than a Better Compass to Navigate Healthcare (Lumeon)
• How EHRs Enhance Care Planning for Nurses (Medhost)

Contacts

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

EPtalk by Dr. Jayne 5/25/23

A recent article in the American Academy of Family Physicians’ journal FPM summarized “Clinical Workflow Efficiencies to Alleviate Physician Burnout and Reduce Work After Clinic.” The first of their four suggestions was for EHR users to make use of macros and defaults in their systems so that they can easily insert content into their visit notes.

I continue to see physicians who won’t take advantage of basic system personalization. When I was in traditional primary care practice, my goal was to be able to do visits using as few clicks as possible and there’s no way I could have been as fast as I was without defaults for common physical exams and orders. It’s still difficult for me to understand the psychology where a user will waste time visit after visit, day after day, week after week, but won’t spend 90 seconds to create a default. The article even includes a link to a blog with a starter list of EHR macros for those who might have users who are reluctant to take steps to make their lives easier.

One of their other recommendations was to “consider cutting note bloat by writing in short phrases rather than full sentences and including only what is essential.” My first EHR made it easy to create notes in a format that was more akin to a bulleted list than beautiful, flowing prose. For many, reading a list like that is easier than reading a block of text, so I agree that it’s a valid strategy.

They also go on to mention that the EHR should be used as a database and not as a way to recreate the paper chart. Providers are encouraged to ask for help and to take advantage of organizational resources such as clinical informaticists, or even to get help from more efficient colleagues.

Even as a CMIO, I’m always willing to sit down with our clinicians to coach them through more efficient workflows. One of my early clinical informaticist roles involved implementing some challenging users. I miss the days when I could work with them and watch the proverbial light bulb go on when they had figured out how to breeze through their visits.

Many of the organizations I work with are big on telehealth, and I hope all organizations are making their plans to move to HIPAA-compliant telehealth technologies now that the public health emergency has ended. Organizations have had three years to move to compliant tools, but there are always going to be groups that wait until the bitter regulatory end before they do the right thing for patient privacy. The Office for Civil Rights is providing a 90-day grace period, but penalties for HIPAA violations will resume on August 10.

In the interim, organizations should look at their telehealth programs and technology, conduct a risk assessment, and confirm that they are using HIPAA-compliant tools. I suspect some purchases may be on the horizon and can imagine some vendors salivating at the organizations that left their transitions until the bitter end.

From Jimmy the Greek: “Re: marketing. Check out some of the language on this corporate website. ‘We create value by making sustainability an integral part of our vectors of superiority.’ There’s also ‘Improving lives for generations to come with irresistible superiority that is sustainable.’” Wow.” Any time I see the word “vectors,” my infectious disease brain immediately thinks of rats, flea bites, ticks, and other disease vectors. These linguistic gymnastics are found on the Procter & Gamble investor site, which is an otherwise interesting read if you’re so inclined. Given their product lines, I suggest that P&G might be better served by a tagline such as, “Assimilation through personal care, one buzzword at a time.”

Speaking of buzzwords, I’m currently disliking this one the most: omnichannel. The way I keep seeing it used, it falls squarely into the “I do not think it means what you think it means” category more often than not. I’ve also recently run into a resurgence of “circle back,” which I think should be eradicated from the business lexicon, along with “synergy,” “new normal,” and “out of the box.”

I had a visit at my primary care physician’s office this week. I scheduled it online and had my choice of a next-day visit that didn’t work for my schedule or one the following week, which I booked. Online check-in was a breeze, and the patient questionnaire related to my issue was easy to navigate.

The only blemish in the workflow was when the medical assistant had to free text every field when documenting my vaccine administration. At a minimum, I would have hoped the EHR would have had a vaccine inventory management system that would have presented things like the lot numbers and expiration dates as dropdowns or pick lists to help reduce errors and manage inventory. Even the site had to be free texted despite the fact that there are generally only six places on the human body where intramuscular injections are administered. She also had some kind of paper sheet that she was performing dual entry on, so I’m not sure what was going on with that and was afraid to ask.

When I arrived home, I was pleased to see that my patient-visible note contained an accurate History of Present Illness and that the exam matched what was actually performed, which is a big contrast to a visit I had with a specialist in the group last year. However, as I was reading my note, I realized that they never asked to collect my co-pay. Since they’re owned by my former employer, I know that collecting the co-pay at the time of service is a requirement. It’s also an industry best practice that everyone should know about. It helps avoid statement costs as well as the risk of never receiving the co-pay.

This means that I’ll get an annoying statement in the mail (I haven’t been able to turn off paper statements despite trying) and then have to go online and make a payment. Usually, I don’t receive an electronic statement notification until after the paper one has arrived, which seems to be a less than optimal way to configure your revenue cycle.

What makes you cringe when you visit a healthcare facility and see that best practices aren’t being used? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 5/25/23

Florence Acquires Zipnosis to Solve Clinical Capacity Constraints and Create Omnichannel Transformation Across Telehealth and Hybrid Care

Patient enablement and workflow automation startup Florence acquires white-label virtual care company Zipnosis from Bright Health.

McMorris Rodgers Demands VA Secretary Commit to Preventing Cuts at Spokane, Walla Walla Medical Centers

Cathy McMorris Rodgers (R-WA) calls for VA Secretary Denis McDonough to commit to preventing staff cuts at Mann-Grandstaff and Jonathan M. Wainwright VA Medical Centers in light of budget shortfalls and impending staffing cuts caused by the roll out of Oracle Cerner.

Attorney General James Recoups $550,000 from Erie County Medical Management Company for Failing to Protect Patients’ Data

Practicefirst Medical Management Solutions will pay $550,000 in penalties for failing to update its firewall software – a vulnerability that enabled hackers to steal the data of 1.2 million patients.

Healthcare AI News 5/24/23

News

Microsoft will integrate ChatGPT into Windows 11, where it will run in its own Copilot window as a personal assistant to perform Windows commands and summarize documents that are dragged into it. The user rollout will start in June.

Tell, whose app allows users to seek advice from medical experts, integrates ChatGPT to translate medical jargon into accessible language.

OpenAI says that AI systems will exceed expert level in most domains within 10 years and recommends steps to mitigate its risks:

• Coordinate development efforts across countries and hold companies to a high standard of responsibility.
• Create an organization similar to the International Atomic Energy Agency provide oversight and inspection AI efforts that exceed a specific level of capability or resource requirements.
• Develop technical capabilities to make superintelligence safe.

OpenAI launches a ChatGPT app for the IPhone.

In Pakistan, the government of Punjab launches a two-hospital pilot of using AI to assist in diagnosis.

Google launches the Google for Startups Growth Academy: AI for Health program for companies based in Europe, Middle East, and Africa. Startups from seed to Series A will be offered a three-month virtual program of tailored workshops, collaboration, and mentorship.

Business

Alicja AI offers a $500 per month enterprise clinical documentation tool that integrates with EHRs. 

Research

ChatGPT has passed several medical exams, but researchers find that it falls just short of passing the American College of Gastroenterology Self-Assessment Tests.

A University of Arizona Health Sciences-led study finds that participants are almost evenly split in preferring a human doctor versus AI for diagnosis and treatment. The authors recommend further research about how AI can be incorporated into the work of physicians and the decision-making process of patients. 

Other

Business Insider profiles ED physician and two-company VP of innovation Joshua Tamayo-Sarver, MD, PhD, who says that it “probably should be embarrassing” that has sometime uses ChatGPT to explain medical issues in patient-friendly terms. He concludes that ChatGPT is “the most brilliant, talented, often drunk intern you could imagine” that is great at explaining concepts but not good at diagnosis or other tasks that require clinical reasoning.

Kaiser Permanente ED doctor and technologist Graham Walker, MD pens an excellent piece on how he views AI as a physician:

• AI can pass a medical school exam, which involves basic multiple choice questions, but that capability is not very related to interacting with patients to determine their multiple issues and their viewpoints about options.
• Doctors know how to successfully address a patient problem up to 95% of the time due to their specialization, residency training, and repeated exposure to the same common issues, and therefore would see no value in asking a “medical bot” for recommendations.
• Where AI could help is to differentiate among possible problems that exhibit similar symptoms.
• AI might offer a convincingly objective second opinion to a patient who is told, for example, that they don’t need antibiotics for a viral infection.
• He says he would “virtually hug and kiss a digital agent” that could generate discharge instructions, describe the logic behind the chosen medical plan, and answer questions are likely to have.
• AI could help identify and correct confirmation bias, where the doctor needs fresh perspective to see that evidence might not support the suspected diagnosis.
• AI could help steer an ED patient to local sources of help that might be better than the ED.
• AI could help doctors and patients understand why lab tests may not be indicated and how to react to positive or negative results.

Contacts

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

Morning Headlines 5/24/23

Norton Healthcare still reeling 2 weeks after cyber attack

Norton Healthcare in Kentucky works to recover from a cyberattack two weeks ago that is still causing “delays in network-related capabilities” including patient portal messaging; imaging, lab, and test results; and prescription fulfillment.

Medisolv Receives Strategic Investment from BVP Forge

Healthcare quality data management company Medisolv secures an unspecified amount of funding from BVP Forge.

Website Notice of Unauthorized Access to PillPack Accounts

Amazon Pharmacy’s PillPack reports that an unauthorized person logged into its website using individual user credentials that were identical to those shared from other breaches, with 3,600 of those accounts containing prescription information.

News 5/24/23

Top News

Clinical terminology management and data quality vendor Intelligent Medical Objects acquires Melax Technologies, which specializes in data extraction using AI and natural language processing.

The acquisition, IMO’s first, will help extend its market reach to payer, life science, and pharmaceutical companies.

HIStalk Announcements and Requests

Welcome to new HIStalk Platinum Sponsor Aridhia Informatics. The Glasgow-based company offers the Aridhia Digital Research Environment (DRE), a combination PaaS/SaaS offering that addresses challenges that are associated with the scale and sustainability of biomedical data science. It is used by research hospitals, pharma, and global consortia across nearly 100 countries. Adherence to FAIR data principles gives researchers and innovators the ability to discover and understand data through dataset search, classification, and efficient metadata browsing capabilities. Researchers can request access to datasets, while data owners get access to configurable and orchestrated data governance while making approval decisions within their own specialized pipelines. Principal investigators can invite team members who can securely upload, access, and analyze project data while taking advantage of an audited environment that is furnished with analytical tools, scalable compute resources, and virtual desktops. All of this is underpinned by comprehensive auditing, secure data management, reliable infrastructure that scales to user needs, and world-class analytics capabilities. The company manages high-level security accreditation, leaving the team to focus on the science using a personalized, next-generation research environment. Thanks to Aridhia for supporting HIStalk.

YouTube has an intro video for the Aridhia DRE.

Webinars

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

Acquisitions, Funding, Business, and Stock

Nuance Communications CEO Mark Benjamin notifies employees of an unspecified number of layoffs as the Microsoft subsidiary adjusts to changing market conditions and a renewed focus on healthcare. Microsoft, which acquired Nuance in early 2022 for $20 billion, announced a separate round of 10,000 layoffs in January.

Sales

• Fifteen-bed Eureka Springs Hospital (AR) selects Oracle Cerner.
• Palouse Specialty Physicians (WA) will implement CureMD Oncology’s EHR and practice management software.
• Tampa General Hospital (FL) will roll out Navina’s AI-powered clinical data summary capabilities for primary care.
• Atlantic Health System selects NeuroFlow’s caseload management software to support behavioral health screenings within its ACO.

People

Zyter|TruCare names Joanne Berrios (Salesforce) VP and chief value officer.

Holly Urban, MD, MBA (Oracle Cerner) joins CliniComp as VP of clinical product design.

CRISP Shared Services promotes practicing pediatrician Marc Rabner, MD, MPH to chief medical officer.

Jordan Bazinsky (Cotiviti) joins Intelerad Medical Systems as CEO, replacing the newly retired Mike Lipps.

Telemetrix promotes Nancy Beale, RN to president.

Cynerio names Rasu B. Shrestha, MD, MBA (Advocate Health) as board chair.

Brooklyn Hospital Center promotes SVP/CMIO Sam Amirfar, MD, MS to chief medical officer.

Avalon Healthcare Solutions hires Pamela Stahl (Sidekick Health) as president.

Tegria hires Jen Morgan (Senta Partners) as CFO and Prasanna Gunjikar (HTC Global Services) as chief growth officer.

Aaron Green(Optum) joins OneMedNet as president.

Lanie Schenkelberg (Spring Health) joins Inovalon as VP of product marketing.

Announcements and Implementations

Gillette Children’s (MN) implements Notable’s automated Registration and Intake Assistant and Scheduling Assistant software across 11 multispecialty clinics.

Garden City Pediatric Associates (MA) implements EClinicalWorks.

Box Butte General Hospital (NE) goes live on Meditech.

Epic lists 26 of its customers that have pledged to join the TEFCA information sharing framework.

A new KLAS report on US EHR market share finds that Oracle Cerner saw its first double-digit net gain in hospitals since 2018, but 49 of its 50 wins were in under-200 bed facilities, giving it the biggest drop in total bed count of all vendors. Meditech gained 120 hospitals in 2022 via net-new sales and migrations, more than any other vendor, but still showed a decrease in total beds and total hospitals. Epic was the only vendor that gained both facilities and beds.

Government and Politics

Mann-Grandstaff VA Medical Center (WA) Director Robert Fischer says the facility will need to reduce staff by 15% over the next several years to make up for an anticipated $35 million budget deficit it attributes to the rollout and use of its Oracle Cerner system. The software’s well-documented deficiencies have hampered the facility’s ability to keep up with patient demand, resulting in decreased funding, while its billing inefficiencies have delayed payer reimbursements. Surges in staffing for the system and pay raises and bonuses to help with recruitment and retention have also contributed to the budget shortfall.

Privacy and Security

Norton Healthcare in Kentucky works to recover from a cyberattack two weeks ago that is still causing “delays in network-related capabilities” including patient portal messaging; imaging, lab and test results; and prescription fulfillment. Hackers reportedly sent a fax with threats and demands shortly after breaching the hospital network on May 9.

Amazon Pharmacy’s PillPack reports that an unauthorized person logged into its website using individual user credentials that were identical to those shared from other breaches, with 3,600 of those accounts containing prescription information.

Sponsor Updates

• AdvancedMD sponsors the Gratitude Gala in Chicago, benefiting The Bette D. Harris Family & Child Clinic.
• Princeton Brain, Spine & Sports Medicine transitions to EClinicalWorks Cloud.
• KeyCare pledges to adopt the TEFCA framework.
• InterSystems launches its HealthShare Health Connect Cloud in the AWS Marketplace.
• KLAS Research recognizes Availity as a co-recipient of the KLAS Points of Light Award.
• AvaSure establishes a chief nursing executive advisory board.
• Azara Healthcare publishes a new case study, “Improving Equity in Healthcare Access through Improved Data Exchange.”
• Nordic publishes a technical paper titled “A New Horizon for IT Strategy: Prioritizing the Patient Experience Through Digital Transformation.”
• Bamboo Health will exhibit at AHIP 2023 June 13-15 in Portland, OR.
• Black Book survey-takers give Xifin top customer and user satisfaction ratings in nine out of 18 RCM KPIs.

Blog Posts

• 2023 CHIME CIO Survey Results: Managed Services Opportunities? (CereCore)
• Documenting to Meet MEAT (AGS Health)
• Behavioral health providers face staffing and reimbursement challenges as demand grows for services (Baker Tilly)
• Workplace Injury Prevention: The Coach in Your Corner (Not the Boss Over Your Shoulder) (Bardavon)
• Advanced, affordable, accessible: Augmenting the patient experience with remote care at home (Biofourmis)
• Improve Your Patient Attribution Rates and Your ACO Performance (ChartSpan)
• What Are CIOs and ITSM Teams Looking For? ROI (Clearsense)
• What Healthcare CISOs Want to Know About Digital Health Technology Security (Clearwater)

Contacts

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

Morning Headlines 5/23/23

Intelligent Medical Objects Announces the Acquisition of Melax Technologies Inc.

Clinical terminology management and data quality vendor Intelligent Medical Objects acquires Melax Technologies, which specializes in data extraction using AI and natural language processing.

Layoffs hit Nuance after Microsoft acquisition

Nuance Communications CEO Mark Benjamin notifies employees of an unspecified number layoffs as the Microsoft subsidiary adjusts to changing market conditions and a renewed focus on healthcare.

VIPC’s Virginia Venture Partners Invests in Kinometrix to Provide Healthcare Workers With Real-Time Risk Assessments

Fall risk assessment software startup Kinometrix secures funding from Virginia Venture Partners.

Curbside Consult with Dr. Jayne 5/22/23

I’m a big fan of experiential learning, especially after having just finished teaching some Outdoor Classroom sessions for a local youth organization. It’s great to see people use the skills you’re teaching as they interact with each other and try to solve problems. It works best, however, when you have a good blend of instructional time with practical or application time.

Having hands-on time can be great if you at least understand the concepts that are being presented and the goal is to either learn them at a deeper level or become more capable in performing them. I liken it to a surgical skills lab. First, you learn about wound repair, and make sure you understand how skin will heal depending on the repair technique and how different types of sutures will work in different ways. Then, you actually practice either with a simulator, or back in the dark ages, we practiced with pigs’ feet. You don’t just start throwing stitches into live patients without understanding the fundamentals.

I have a couple of certifications on EHR products that I rarely use, but for which I like to stay up to speed. One of the vendors rolled out a new product that I’ve not been certified on. Given my past work with the application, they offered me the opportunity to take the certification classes for the new product.

I was excited about the opportunity and ready to prepare for the classes. Unfortunately, there wasn’t any kind of preparatory work – no pre-class readings or training videos. There was a PDF for the class, but what was in there looked mostly like exercises without any foundational content. I wasn’t sure if I was missing materials or whether it was intentional, but I decided to head to class with an open mind.

I have to say that it was one of the most frustrating classes I’ve ever taken. The entire thing was taught in a hands-on fashion, with no structured presentations or materials that summarized the functionality. Each module was a situational vignette, and after reading it, we were expected to go into the application and figure out how to take the necessary steps.

It was completely frustrating. I knew the general layout of the application and the main menus, but I didn’t know all the shortcuts that this class apparently expected us to not only know, but use. It was made worse by the fact that many of the desired tasks had more than one way for them to be accomplished, but you only deduced this after working through the scenario a couple of times. At no time did the instructor explain why one might want to embrace one workflow over another.

Not having any kind of initial summary or teaching also made it difficult to figure out what the various options were. I felt like I was more focused on writing things down in my notes so I could try to put it together in a cohesive manner rather than trying to understand how to manipulate the different scenarios. Because of that, I found myself missing key information because I was still trying to figure out something that happened a minute or two earlier in the simulation scenario.

Even if I would have been given a one-page summary that listed the different workflow possibilities and explained why a user would select one compared to another, it would have been a significant step up. A handout of the system’s keyboard shortcuts would have been helpful as well. After completing the class, I ended up spending several hours in the system’s demo environment running through common scenarios and seeing if I could figure out how to execute them on the platform.

At the end of the course, there was an evaluation that contained a couple of the question formats I hate the most. The first was what my medical school used to call “multiple-multiple choice” questions, which typically had four answer options (A, B, C, D) but then would have additional options like “A and B” or “A and B and C” and other combinations. Inevitable you’d find more than one thing on the list that was likely to be correct, but you spent excess time trying to psych yourself out about which items to exclude.

The other most hated question format (which unfortunately continues to also be present on my medical specialty board certification platform) is the “choose the best answer” type question. “Best” is really a subjective question, especially when you’re talking about patients and how they might take or not take a medicine. There have been campaigns for many years to get those kinds of questions off the recertification exams, so I’m used to seeing them more rarely. However, those questions were all over this software training, with the problem being that finding the “best” solution depends on many more factors other than just the test taker.

For patient care, the best solution might be one that balances clinical effectiveness with cost and makes it easier for patients to take their medications they way they intended. Best could also mean the treatment that will give a patient the most longevity, or the highest quality of life. But it can also represent treatments that might save your life, but that also might cause horrific side effects and deterioration in your quality of life at the same time.

This can also be true in the healthcare IT side of the house. The term “best” might represent the solution that has the most bang for the buyer’s buck. It could also be the solution that has the lowest risk of patient care errors. Or perhaps the one that takes the least amount of time for nurses to complete their workflows. When you put on your client hat while reading test items like that, one can’t help but overthink them or overanalyze similar decisions you’ve made in the past.

After feeling like I had been led astray but the hands-on training and then burned by the confusing test questions, I was ready to give up. Sure, I could follow the instructor to perform a bunch of different tasks, but I had no idea how the application would help my daily work or benefit my organization. I’m a pretty decent test-taker, so I ended up passing the evaluation step, but I still don’t feel like I know anything as far as being able to operationalize the functionality.

One of my co-presenters at Outdoor Classroom has dyslexia, and working with him made me think about how others would perceive the class. Similarly, people who learn best from reading rather than watching an instructor perform tasks and then try to emulate them might be out of luck. Organizations need to do more thought around different learning styles and need to spend time crafting strategies that will work for the diverse groups of users that their products will certainly encounter.

What are the best and worst types of software training you’ve experienced? Any advice that you’d give those who create the strategies? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 5/22/23

Notice of Auction Results for the Sale of the Debtors’ Assets

The assets of bankrupt digital therapeutics vendor Pear Therapeutics fetch $6 million at auction.

Aspirion Announces Acquisition of FIRM Revenue Cycle Management Services, Inc.

RCM vendor Aspirion acquires Firm Revenue Cycle Management Services.

Spokane VA director warns budget trouble caused by computer system is forcing staff cuts

Mann-Grandstaff VA Medical Center (WA) Director Robert Fischer says the facility will need to reduce staff by 15% to make up for an anticipated $35 million budget deficit attributed to the roll out and use of Oracle Cerner software.

Internal Health P.E.I. emails reveal EMR glitch led to 1,770 ‘missed’ referrals

In Canada, a Prince Edward Island review finds that 1,700 patient referrals were missed when clinic staff forgot to fax them as required by the Telus EHR.