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Morning Headlines 1/30/23

January 29, 2023 Headlines Comments Off on Morning Headlines 1/30/23

Start-Up Raises $200 Million to Speed Up Drug Trials

Clinical trials data and patient-matching platform startup Paradigm launches with $200 million in Series A funding.

Smile Digital Health Closes $30 Million in Series B Funding to Progress Innovation as World-Leading Health Data Fabric

Health data infrastructure company Smile Digital Health raises $30 million in a Series B funding round, bringing its total raised to $50 million.

Engage Technologies Group and APX Platform Announce Merger to Form Full-Service, Medical Practice Management, Business Insights, and Patient Engagement Solution

Patient engagement software vendor Engage Technologies Group acquires practice employee optimization company APX Platform.

Comments Off on Morning Headlines 1/30/23

Monday Morning Update 1/30/23

January 29, 2023 News 1 Comment

Top News

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The New York Times profiles Paradigm, which launched last week after raising $203 million in a Series A funding round.

The company has developed a platform that it says will merge the disciplines of clinical care and research. It does this by transforming EHR information into clinical trials data. It also helps doctors match patients to active studies.


Reader Comments

From Natty Boh: “Re: mistake in the 1/27 post. You confused Inspirata with Imprivata. It was Imprivata that acquired Caradigm.” The post is correct. Imprivata acquired just the identity management business of Caradigm from GE Healthcare in October 2017. Inspirata acquired the actual company Caradigm, including its core business of analytics and population health tools, from GE Healthcare in June 2018. Caradigm was formed as a 50-50 joint venture between Microsoft and GE Healthcare in 2011, with Microsoft bowing out in 2016. Caradigm’s identity management business came from Microsoft, which had acquired Sentillion in 2009, renamed it Vergence, and then rolled it into Caradigm along with the ExpreSSO single sign-on product. That’s what Imprivata acquired.

From I’ll RxPass: “Re: Amazon’s flat-fee monthly generic drug RxPass. Odd that patients in eight states can’t participate even though Amazon Pharmacy operates in them.” Odder still is that customers who are covered by Medicare, Medicaid, or any other government-sponsored insurance aren’t eligible, which is strange since it’s a cash-only, unsubsidized business. Although you can probably just answer “no” to the prompt knowing they can’t check – it’s easier to demand proof of existence rather than of non-existence.


HIStalk Announcements and Requests

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Quite a few poll respondents will not be able to take jobs with specific companies when they leave their current one. AT reasonably opines that while non-competes might be justifiable for employees who voluntarily take a job with a competitor, those restrictions should be waived if the employee is involuntarily shown the door for whatever reason. Frank suggests negotiating such agreements to require the company to pay severance for whatever amount of time they don’t want you working for a competitor, or failing to convince them to do that, at least insist that the agreement be narrowed down to performing specific tasks rather than broadly excluding even unrelated jobs with competitors.

New poll to your right or here: What are your plans for attending HIMSS23 in person? My supply chain of enthusiasm has been disrupted, but at some point I’ll need to choose go/no go and will probably end up fast-roping into Chicago for a day or two in the exhibit hall as a habit of seasonal migration.


We’re probably all sick of people showing off their ChatGPT results like proud parents, but it’s still fun to see the result of creative requests. It offered this when I asked it to develop a short story plot about a hospital computer programmer turned criminal:

Title: The Code Criminal

The story revolves around a hospital computer programmer named Jack who is highly skilled and efficient at his job. He is well respected by his colleagues and patients alike. But little do they know, Jack is not who he seems to be. In his off hours, Jack uses his knowledge of the hospital’s computer systems to carry out criminal activities. He steals sensitive patient information and sells it to the highest bidder on the black market. One day, the hospital’s IT department discovers that patient data is being leaked and they track it back to Jack’s computer. They confront him, and Jack is forced to flee the hospital. As Jack is on the run, he realizes that the stolen patient information has been used to carry out a string of identity theft crimes, causing harm to innocent people. Jack realizes the gravity of his actions and decides to make amends. He returns to the hospital and confesses his crimes to the authorities. He offers to help them track down the people who bought the stolen information from him, and use his skills to secure the hospital’s computer systems. In the end, Jack is sentenced to prison, but he feels a sense of redemption for using his skills to make things right. The hospital is able to recover from the breach, and patients are able to trust the hospital with their personal information once again.


Webinars

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


People

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AirStrip CEO Alan Portela announces that he will leave the company after 12 years.

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Industry long-timer Paul Valentine (Ncontracts) joins KPi-Tech Services as president.

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Michael Johnson (Enlace Health) joins Rialtic as chief growth officer.


Announcements and Implementations

Orbita announces Blaze, which provides care-finding and chatbot services to provider websites.

Optum Rx launches Price Edge for its pharmacy benefits manager customers, which shows customers the lowest available cash-only price for generic drugs along with what they would pay using insurance and then applies their payment toward their deductible when they buy.


Government and Politics

FDA Commissioner Robert Califf, MD says in a Society for Clinical Trials opinion piece that post-market clinical research is disaggregated and often fails to answer clinical care and public health questions. He recommends (a) integrating data from EHRs and wearables; (b) paying doctors and patients to participate in trials; and (c) developing policies for ethical data sharing.


Other

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University of Iowa surgeons remove a condom-wrapped banana from the small intestine of a man who, as paraphrased from the medical journal article by a British newspaper, an “unnamed bloke” had “gulped the fruity contraceptive whole during what he claimed was a fit of rage” and then was “unable to go to the loo.” The authors note that they had it easy compared to most cases of “body packing” where the condom or balloon contains cocaine or other drugs that, if mishandled, could kill the patient. I can’t envision the degree of rage that is required to swallow a whole banana, or why the swallower would expect to create an improved situation by doing so.


Sponsor Updates

  • Netsmart’s GehriMed EHR earns ONC Health IT 2015 Edition Cures Update certification via the Drummond Group.
  • Verato publishes a new case study, “GRIPA: Next-Generation EMPI for Healthier, Happier Community.”
  • Pivot Point Consulting A Vaco Company, describes how it implemented Epic for the 29,000 employees of UW Medicine.

Blog Posts


Contacts

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

Morning Headlines 1/27/23

January 26, 2023 Headlines Comments Off on Morning Headlines 1/27/23

Pearl Health raises $75M Series B led by a16z to accelerate growth and innovation in value-based care

Pearl Health, which offers population health analytics software for providers who participate in value-based care for Medicare patients, raises $75 million in a Series B funding round.

Elaborate Announces $10M in Funding to Modernize Lab Results

Elaborate, which uses EHR information to deliver contextualized lab result messages to patients, raises $10 million in seed funding.

Attorney General Merrick B. Garland Delivers Remarks on the Disruption of Hive Ransomware Variant

The Department of Justice says that it has infiltrated and dismantled the Hive international ransomware group, whose victims include at least one hospital that paid the demanded ransom to restore its systems.

IBM planning to cut almost 4,000 jobs from spin-off of company, divestment from analytics business

IBM will lay off 3,900 employees as it adjusts to the 2021 spinoff of its IT infrastructure company and the 2022 sale of Watson Health to Francisco Partners.

Comments Off on Morning Headlines 1/27/23

News 1/27/23

January 26, 2023 News 2 Comments

Top News

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Pearl Health, which offers population health analytics software for providers who participate in value-based care for Medicare patients, raises $75 million in a Series B funding round.


Webinars

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


Acquisitions, Funding, Business, and Stock

Oracle Health EVP and engineering lead Don Johnson, MS reportedly leaves the company after six months in that position and nine years with Oracle.

Fujifilm completes its purchase of the digital pathology assets of Inspirata, placing the former Dynamyx business under its US healthcare division and forming a pathology division of its medical informatics business. Cancer-focused Inspirata is best known in health IT for acquiring the former Caradigm from GE Healthcare 2018.

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Elaborate, which uses EHR information to deliver contextualized lab result messages to patients, raises $10 million in seed funding. The company says that sending friendlier, actionable lab results to patients reduces their anxiety and saves providers time.


Sales

  • Kansas City University College of Dental Medicine chooses the cloud-based electronic dental record of EClinicalWorks for training future dental professionals.

People

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Sonifi Health promotes 27-year employee Kelly Boyd, MBA to general manager.

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Todd Mingo, MBA (RLV Digital Health) joins Divurgent as SVP of client services.


Announcements and Implementations

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St. Margaret’s Health – Peru (IL) closes, at least temporarily, after its ED services contractor declines to provide services. The hospital’s CEO says that the organization’s finances have deteriorated because of staffing shortages that were caused by COVID-19 as well as a February 2021 cyberattack. 

Azara Healthcare will offer healthcare organizations access to AMA’s MAP BP metrics via its DRVS population health reporting and analytics platform.

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Researchers develop a wearable, continuous imaging sensor for cardiac ultrasound, which will allow real-time remote monitoring of cardiac function.

A Texas study finds that patients who were seen in a primary care visit within 30 days of hospital discharge had 53% fewer ED visits and and 61% fewer re-hospitalizations when the clinician looked up their records in a community HIE.

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CHIME announces its PRIME CHIME CIO Boot Camp Package, which offers members a discount on participating in its CIO Boot Camp when bundled with ViVE conference registration. Other ViVE discount packages are available for those who sit for a CHIME certification exam or register as a hosted buyer.


Government and Politics

VA facilities experience major system slowdowns of its Oracle Cerner system after DoD makes a change to their shared database that interrupts network connectivity. The problem also impacted half of the DoD’s Oracle Cerner users.

Ireland’s health service executive resigns, saying that his efforts to introduce new digital health solutions have been blocked by senior administrators, placing patients at risk for poor outcomes.

HHS OIG coordinates fraud charges against 25 people who it alleges provided fraudulent degrees and transcripts from three accredited, since-closed nursing schools in Florida – which were also involved in the scheme that generated $100 million — to 7,600 people who used them to sit for national RN and LPN exams. The announcement does not indicate how many of the buyers became nurses or whether their employers have been notified.

The Department of Justice says that it has infiltrated and dismantled the Hive international ransomware group, whose victims include at least one hospital that paid the demanded ransom to restore its systems (unnamed, but most likely Memorial Health System). DOJ says the group extorted $100 million in its first year.


Other

The journal Nature lays out its rules for authors who using AI tools such as ChatGPT in writing articles. AI tools can’t be listed as authors and researchers must explain how they used AI tools in the paper itself. Publisher Springer Nature is working on tools that can detect AI-generated text and hopes that AI companies will be able to embed watermarks in their output.

Canada’s Alberta Health Services experiences delays and resorts to paper charting as a network change creates a widespread outage.

The New York Times covers the practice of providers billing patients for answering their email messages. Cleveland Clinic says its patient email volume has doubled since 2019, but it is charging for less than 1% of the 110,000 emails that are sent to its providers each week. The article notes that CMS added Medicare billing codes in 2019 for responding to a patient’s inquiry that requires five minutes or more of time, and some private insurers have followed its lead. Cleveland Clinic says it isn’t charging Medicaid patients, Medicare patients pay a co-pay of $3 to $8, and patients with high-deductible private policies could owe up to $50 per exchange. AMA says the fees are a way to adjust healthcare models to new ways of interacting with patients.


Sponsor Updates

  • Bellin Health increases patient self-scheduling following its implementation of  Kyruus ProviderMatch on its website.
  • Experity will host its Urgent Care Connect Conference February 22-23 in Miami.
  • The Passionate Pioneers Podcast features Lumeon CEO Greg Miller.
  • Meditech publishes a new case study, “North Country Healthcare implements Meditech Expanse Surgical Services in Three Critical Access Hospitals.”
  • Meditech signs nine new clients in Q4 for its Meditech as a Service offering.

Blog Posts


Contacts

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

Morning Headlines 1/26/23

January 25, 2023 Headlines Comments Off on Morning Headlines 1/26/23

Computer problems slow Spokane VA after Defense Department update to electronic health record system

An update to the VA’s Oracle Cerner system caused a temporary “system degradation” that resulted in lag time for users in between clicks and screen advancement.

Digitisation of health service is being impeded by ‘bad actors’, former department head says

In Ireland, Health Service Executive Director Martin Curley resigns after four years, citing a lack of vision amongst his peers to implement a national EHR, despite funding being available for the past three years.

St. Margaret’s Health in Peru closing temporarily due to financial reasons

St. Margaret’s Health (IL) closes temporarily, citing financial hardship that some have attributed to a 2021 cyberattck that led to a slowdown in billing and payment processes.

Comments Off on Morning Headlines 1/26/23

Morning Headlines 1/25/23

January 24, 2023 Headlines Comments Off on Morning Headlines 1/25/23

St. Joe’s to go ‘fully paperless’ after misdirected faxes, privacy breaches

In Canada, St. Joseph’s Healthcare Hamilton implements a ‘digital first, no fax policy’ after an audit by Ontario’s privacy commissioner finds misdirected faxes were the cause of 563 privacy breaches in 2020.

Tiger Global-backed Innovaccer lays off 15% staff amid structural rejig

Innovaccer lays off 245 employees, 15% of its workforce, just four months after a layoff round that impacted 120 staffers.

Revive Health acquires virtual care services firm SwiftMD

ReviveHealth, a virtual care company that caters to individuals and employer groups, acquires competitor SwiftMD for an undisclosed sum.

Comments Off on Morning Headlines 1/25/23

News 1/25/23

January 24, 2023 News Comments Off on News 1/25/23

Top News

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In Canada, St. Joseph’s Healthcare Hamilton implements a “digital first, no fax policy” after an audit by Ontario’s privacy commissioner finds that misdirected faxes caused 563 privacy breaches in 2020.

A hospital staffing error led to patient health records being faxed to primary care physicians who had changed their numbers.

The privacy commissioner concluded, “Fax machines have no place in modern healthcare delivery.”


HIStalk Announcements and Requests

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Welcome to new HIStalk Platinum Sponsor Care.ai. The Orlando-based company is bringing the transformative power of ambient intelligence to healthcare, enabling healthcare organizations to become smart-care facilities. Its technology platform leverages advanced sensors and AI to create a neural network that reimagines clinical and operational workflows to power more human care. Deployed in over 1,500 healthcare facilities,Care.ai partners with health systems and long-term care facilities with a unique, integrated solution, including ambient monitoring and inpatient virtual care including virtual nursing and virtual sitting. Thanks to Care.ai for supporting HIStalk.


Webinars

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


Acquisitions, Funding, Business, and Stock

Innovaccer lays off 245 employees, 15% of its workforce.

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Amazon Pharmacy announces RxPass, a $5 per month flat fee, cash-only subscription for Prime customers that delivers all of the generic prescription drugs they take from a list of 50. Patients in eight states are not eligible for reasons that the company did not state.


Sales

  • Orlando Health selects hospital-at-home remote patient monitoring technology from Biofourmis.
  • Meditech will embed clinical direct messaging capabilities from MedAllies within its Expanse MaaS EHR.
  • The Michigan Department of Health and Human Services will offer Medicaid beneficiaries access to the Philips Pregnancy+ patient education and support services app.
  • Methodist Le Bonheur Healthcare (TN) will implement Epic.

People

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Colorado-based HIE Quality Health Network promotes Marc Lassaux to executive director and CEO.

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Sarah Bennight joins Carenet Health as VP of product marketing and sales enablement.

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AMC Health hires James Considine, MBA (Philips) as COO.

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MRO Corp. names Matt Wildman (Fortified Health Security) chief commercial officer and Moliehi Weitnauer (Cotiviti) chief product officer.

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Harry Totonis, board chair and former CEO of ConnectiveRx, returns to the CEO role in replacing Jim Corrigan.

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Tegria promotes Jennifer Montlary, MEd to SVP of marketing and communications.


Announcements and Implementations

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Amberwell Health (KS) goes live on Meditech Expanse at its Hiawatha and Highland facilities.

University of Maryland Medical System and CareFirst BlueCross BlueShield will pilot the use of Curation Health’s provider-plan collaboration platform for value-based care.


Government and Politics

The UK’s Competition and Markets Authority will review the planned $1.5 billion acquisition of healthcare software vendor EMIS Group by an affiliate of UnitedHealth Group’s Optum UK.

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The FTC asks a federal judge to hold pharma bro Martin Shkreli in contempt for failing to pay a $65 million fine and violating a lifetime ban from working in the pharma industry. Shkreli finished his stint in prison last May and launched a new company, Druglike, just two months later. The business bills itself as a “a Web3 drug discovery software platform co-founded by Martin Shkreli.”


Other

Researchers at Dartmouth, Harvard, and Yale determine that less than 33% of the pharmaceuticals most heavily advertised on television between 2015 and 2021 had high levels of therapeutic value. Pharma companies spent a combined $16 billion on advertisements for the 73 drugs analyzed in the study.


Sponsor Updates

  • AdvancedMD publishes a new e-guide, “2023 MIPS Improvement Activities.”
  • Baker Tilly releases a new Healthy Outcomes Podcast, “Corporate compliance for healthcare providers.”
  • HeiligHart Hospital in Belgium upgrades its Agfa HealthCare IMPAX PACS system to Agfa’s cloud-based enterprise imaging.
  • Bellin Health (WI) adds ProviderMatch digital appointment scheduling capabilities to its KyruusOne provider data management platform.

Blog Posts


Contacts

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

Comments Off on News 1/25/23

Morning Headlines 1/24/23

January 23, 2023 Headlines Comments Off on Morning Headlines 1/24/23

Rx Redefined Raises $8M in Funding to Improve the Experience for Patients Prescribed Recurring Use of Essential Medical Supplies

Rx Redefined, which offers group practices the tech-based ability to directly manage the ordering and mailing of medical supplies to patients, raises $8 million in a Series A funding round.

Elizabeth Holmes made an ‘attempt to flee the country’ after her conviction, prosecutors say

Disgraced Theranos founder Elizabeth Holmes reportedly attempted to flee the country after her January 2022 fraud conviction.

DCH Health System fires employee after medical records security breach

DCH Health System in Alabama notifies 2,530 patients of a series of data breaches over the last two years initiated by an unauthorized employee.

Comments Off on Morning Headlines 1/24/23

Curbside Consult with Dr. Jayne 1/23/23

January 23, 2023 Dr. Jayne 3 Comments

Non-compete clauses have been a hot topic around the virtual physician water cooler. I was glad to see Mr. H’s newest poll looking at the issue and am eager to see the results. Physicians are used to being stuck with non-compete clauses in their employment agreements, although they can be highly variable. Having been in the clinical trenches for a couple of decades now and having advised plenty of other physicians, I’ve seen quite a few variations on the non-compete.

In a solo practice where I was employed by a health system, the restriction prevented me from practicing with any corporate competitor within a 20-mile radius of the practice. However, it didn’t prevent me from staying in my same location and creating my own private practice entity. It also specified that if I wanted to do this, I would have to pay 50 cents for each chart, which seemed ridiculously cheap.

Many of my colleagues had similar clauses, and after establishing their practices, they went out on their own. Given the non-punitive nature of the exit agreement, they continued to remain on staff at the sponsoring hospital and referring patients for services. Overall, this arrangement seems like a win-win.

As an emergency department physician contracted with a physician staffing agency, I didn’t have a non-compete at all. At a given facility, those contracts often change every few years, which often results in the physicians remaining with the facility but being employed by or contracted by a different firm. This also happens quite a bit with anesthesia groups and critical care groups if the hospital outsources those services. In that situation, when the hospital’s contract changed and I was left in the lurch because the new agency didn’t want to employ part-time physicians, my group even worked to help me find a new placement at a competing health system.

As an urgent care physician working for a local practice with two locations, the non-compete clause only specified that I could not go on to own or have a management role at an urgent care center within 30 miles of either location. Since I knew there was no way I would want to do either of those things, I had no problem signing it. In fact, that employer’s contract was only three pages long, and was one of the smoothest contract negotiations I ever experienced. When I was ready to quit (which was quickly, once I realized that there were some interesting financial practices), it was also the easiest practice I ever left. I simply wrote a letter and said I was no longer available to be scheduled for clinical shifts. They acknowledged via email and I literally never heard from them again.

My most recent urgent care employer also had the prohibition against owning or managing a competing urgent care within a set mileage radius. However, it included a clause that specifically said employees were able to work elsewhere during their employment period, provided that scheduling didn’t interfere with their responsibilities. I thought this was unusual until I realized that a good chunk of the workforce was actually employed at multiple places – perhaps with an EMS agency and with the urgent care, or with an emergency department as well as the urgent care. It made for some interesting transitions as employees would try out other employers to determine whether the grass was greener elsewhere before giving notice.

As a consultant, I refused to do business with any organizations that tried to include anti-competitive clauses in their agreements. I was constantly amazed at the number of organizations that didn’t understand what it meant to be an independent contractor and that when you’re not an employee, it’s much more difficult to try to place restrictions on you. That doesn’t mean they didn’t try, however. I have no problem signing agreements around intellectual property and not using it elsewhere, but I wasn’t about to sign a contract that tried to block me from working with other organizations that might remotely be considered competitors. Engagements like I did as a consultant have to be based on trust, and if a health system trusts me enough to give me access to the information I need to do my job, they need to trust that I’m not going to use it inappropriately.

Among my physician peers, however, I still see some pretty terrible non-compete clauses. The worst are those that still apply even when a physician is downsized. A local health system had a “reduction in force” following COVID and terminated 10% of employed physicians. Those impacted included well-regarded physicians, a beloved pediatrician, and the health system’s only pediatric gynecologist. The latter had a packed schedule with a nine-month wait for appointments, so it didn’t seem to make a lot of sense. Rumor has it that the health system included reminders about non-compete language in the termination notices, but they immediately backed down when confronted with legal action. Honestly, I think that if someone is laid off due to a reduction in force, non-competes should never apply.

A friend of mine was recently impacted by a draconian non-compete that did not allow for any practice of medicine within 30 miles of any location where any employees of the health system practice. When she originally signed the contract, the health system was concentrated in a major metropolitan area and centered on its academic medical center, which didn’t seem like such a bad deal. However, during the intervening decades, the health system acquired hospitals across a 90-mile radius and opened satellite clinics up to 120 miles away. She never thought to renegotiate that non-compete, and when she wanted to open her own private practice, she was out of luck. Instead, as an empty nester, she has entered the world of locum tenens physicians, and practices all across the US. I have to say, I’m jealous of the side trips she has made from some of her assignments, including such national parks as Badlands, Acadia, and Theodore Roosevelt.

Health systems argue in favor of such restrictions because it’s expensive to recruit and retain physicians. I don’t disagree that it’s expensive. However, over the 20-year course of her employment, the health system certainly made enough money off of my colleague and her referrals as to make up for any expense of recruiting her and starting her practice. Even if a non-compete was limited to a certain period of time, perhaps five years, to allow an employer to recoup those startup costs, they could have the unintended consequence of forcing employees to stay who might not be a good fit for the practice. I’ve also seen physicians leave medicine entirely due to a non-compete, which is its own special kind of tragedy.

The real answer here is to eliminate non-compete clauses and other restrictions on clinical practice. There’s already a shortage of certain kinds of clinicians, such as primary care physicians, and that shortage isn’t going to improve any time soon. Forcing clinicians to stay in a situation where they’re burned out and unable to serve patients effectively because of a non-compete doesn’t help anyone. Unfortunately, corporate healthcare employers aren’t going to see it this way anytime soon.

What do you think about non-competes for clinical employees? Leave a comment or email me.

Email Dr. Jayne.

Readers Write: For Safety’s Sake, Healthcare Must Address Its Patient Matching Problem

January 23, 2023 Readers Write 2 Comments

For Safety’s Sake, Healthcare Must Address Its Patient Matching Problem
By Gregg Church

Gregg Church is president of 4medica of Marina del Rey, CA.

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Imagine if you log into your bank’s website to conduct a transaction, only to find that the bank can’t match your identity to your account. Not only are you unable to complete your transaction, you can’t even access your own information.

You rightfully would complain, and the bank almost certainly would move quickly to resolve the issue because, (a) it’s clearly unacceptable, and (b) the bank wants to continue benefiting from providing you with financial services.

Yet patient identification matching problems still proliferate in healthcare and are a major contributor to data integrity issues within electronic health records (EHRs). Average duplication rates among health organizations in America still range between 10% and 20%, with some duplication rates reaching as high as 30%.

At the 20% rate, this means one in five patients are at risk of having their medical records either duplicated or overlaid (when one patient’s data is placed in another patient’s medical file). It’s hard to imagine a bank or its customers tolerating a 20% error rate in customer records.

Wrong medical records accessed by providers and care team members could easily result in a wrong patient diagnosis, wrong medication prescribed, wrong lab test performed, wrong procedure or surgery conducted, and perhaps death due to a misdiagnosed condition. The problem is real, and the number of duplicate patient records is expanding as more clinical data is being moved digitally and shared across networks by hospitals, health systems, health information exchanges, labs and clinics.

What can healthcare organizations do to reduce patient identification matching problems and improve overall health data quality? Here are three things that could help healthcare organizations improve patient matching.

Standardize how data is collected at the point of care

Patient identification problems most commonly originate at registration. Busy staffers may make mistakes when entering data manually, or a lack of identifying information prompts the intake worker to create a new patient record, which can become a duplicate. Bad data can remain in an EHR for years, unbeknownst to clinicians or patients.

However, even if a healthcare organization is able to standardize data collection internally, other organizations with which they exchange data may have different processes, coding and data collection standards. The inevitable result for all stakeholders is low-quality data. Intelligent technologies such as artificial intelligence (AI), machine learning (ML) and referential matching can be used to identify and correct errors in patient data.

Patient ID to verify correct patient to medical record

Provider organizations lack a simple way to accurately identify patients. They are forced to rely on a combination of driver licenses, home addresses, Social Security numbers, phone numbers, and other non-medical identifiers. But what happens when a patient changes addresses or phone numbers? That’s when you see frustrated frontline staffers defaulting to creating a new (and duplicate) record for the patient.

A unified, single patient identifier would help resolve this problem. Unfortunately, a HIPAA proposal calling for the creation of a unique patient identifier (UPI), has been stalled by lack of funding. Until there is national patient ID, healthcare organizations must rely on technology to improve patient matching and mitigate related safety issues.

Data governance standards

Data governance is a framework for healthcare organizations to capture, process, normalize, use, store, and dispose of patient data. By consistently applying best practices to data, healthcare organizations can help ensure the accuracy of records in the EHRs and clinical systems is never comprised.

Effective data governance benefits healthcare organizations and patients in several ways. It improves the patient experience, leads to better clinical outcomes, and reduces healthcare costs through increased efficiency and better resource utilization. Finally, data governance can increase the value of a healthcare organization’s data because the governance process has improved its quality. This makes the data more attractive to prospective buyers such as pharmaceuticals and health policy researchers.

 

Accurately matching patients to their medical records is a daunting challenge to healthcare organizations as the volume of patient data – and the number of sources – continues to explode. Collecting and organizing patient data in a more standardized way will enable providers, labs, and other stakeholders to better serve patients while lowering costs and increasing the value of their data.

Morning Headlines 1/23/23

January 22, 2023 Headlines 1 Comment

Fitch Downgrades Marshfield Clinic Health System (WI) Ratings to ‘BBB+’; Outlook Negative

Fitch Ratings downgrades the bonds of Marshfield Clinic Health System, blaming its Oracle Cerner implementation for aging receivables, throughput errors, lower collections, and an unexpected level of productivity disruption that has impacted top-line revenue.

Electronic health record giant NextGen dealing with cyberattack

NextGen secures its network and returns to normal operations after a ransomware attack on Tuesday.

HealthLynked Announces Sale of ACO Health Partners

HealthLynked, a membership-based, tech-enabled healthcare network, will sell its ACO Health Partners subsidiary to PBACO Holding for up to $3 million.

Monday Morning Update 1/23/23

January 22, 2023 News Comments Off on Monday Morning Update 1/23/23

Top News

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Fitch Ratings downgrades the bonds of Marshfield Clinic Health System, blaming its Oracle Cerner implementation for aging receivables, throughput errors, lower collections, and an unexpected level of productivity disruption that has impacted top-line revenue.

Fitch says the conversion of several legacy systems to Oracle Cerner will eventually provide significant benefit once the implementation is complete.


HIStalk Announcements and Requests

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Most poll respondents have used some form of social media in the past week, with the most common platforms being LinkedIn, Facebook, and YouTube. Twitter places a surprisingly distant fifth place.

New poll to your right or here: Does your employment agreement limit who you can work for when you leave? If you have insisted that an employer change the employment agreement before signing, click the poll’s comments link and describe the changes you required and how you brought it up. You could probably get away with making an identical version, removing objectionable terms (or perhaps adding your own personal golden parachute or something), and then printing and signing a copy since the HR clerk probably won’t check every word.


Webinars

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


Acquisitions, Funding, Business, and Stock

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India-based telehealth and lab test startup MediBuddy reportedly lays off 200 employees, 8% of its headcount.


Sales

  • Seattle’s UW Medicine will implement cloud-based Visage 7 Open Archive, Workflow, and Viewer in replacing its legacy PACS.

People

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Tower Health promotes Tom Bartiromo to CIO.

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VantageHealth.ai promotes Brian Unell, MBA to CEO.

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Art Nicholas (Strata Health) joins Interlace Health as chief commercial officer.

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CareConnectMD hires Ray George (Third Eye Health) as chief growth officer.

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Steve Evans, MBA (LivePerson) joins Netsmart as VP of consulting sales.


Privacy and Security

NextGen Healthcare confirms a hacker group’s claim that its systems were attacked by ransomware on Tuesday. NextGen says it secured the network and has returned to normal operations.


Other

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In the UK, newly retired doctor poses beside the forms that are required to admit a patient to an NHS hospital, estimating that nurses spend 70% of their time on paperwork. He says every new issue results in someone creating a new form that then carries over to electronic systems. 


Sponsor Updates

  • The American Oncology Network and RxLightning partner to offer AON’s community oncology practices with an all-digital approach to financial assistance enrollment for specialty medications.
  • Veradigm adds Sphere’s TrustCommerce patient payment tool to its practice management software.
  • TigerConnect remains a leader in the Clinical Communication and Collaboration category on G2 for Winter 2023.
  • West Monroe releases a new This is Digital Podcast, “How to Shift from a Project to a Product Mindset.”
  • VisiQuate will exhibit at the HFMA Western Region Symposium January 22-25 in Las Vegas.
  • Zynx Health parent company Hearst Health, in partnership with the UCLA Center for SMART Health, is accepting submissions for the 2023 Hearst Health Prize through February 24.

Blog Posts


Contacts

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

Comments Off on Monday Morning Update 1/23/23

Morning Headlines 1/20/23

January 19, 2023 Headlines 1 Comment

Bayer acquires AI imaging company Blackford Analysis to bolster radiology portfolio

Bayer acquires Scotland-based Blackford Analysis, which offers radiology and imaging AI tools.

State proposes $105 million to update Medical College of Georgia’s electronic records

Georgia legislators consider approving $105 million to help Augusta University Health affiliate Medical College of Georgia implement Epic

Top 10 Health Technology Hazards for 2023 Executive Brief

Communication challenges around the notification of recalls by medical device manufacturers tops ECRI’s annual list of health technology hazards.

News 1/20/23

January 19, 2023 News 3 Comments

Top News

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Bayer acquires Scotland-based Blackford Analysis, which offers radiology and imaging AI tools.

The companies worked together previously in developing Bayer’s Calantic medical imaging AI platform.


Reader Comments

From Jobber: “Re: position seekers. Would you consider sharing a link to the LinkedIn profile of health IT people who are looking for jobs?” I might be willing to do that in a weekly roundup or something, but only for people who explicitly ask me to share their names, previous job, and sought-after position in the briefest of tables along with a link to their LinkedIn that contains all their other information. But first, a question – would this provide value to those who are listed and to readers, or would I just be creating another pointless task for myself?

From Oracular Degeneration: “Re: Oracle Cerner. Mike Sicilia assured the Senate in late July 2022 that the company would move the VA’s implementation to the cloud and rewrite its pharmacy module within six to nine months. We are at six months now, so is it just about done?” I haven’t heard anything about the self-imposed April 2023 deadline.

From Epic TS: “Re: HIMSS. All Verona-based Epic employees will have the opportunity to attend HIMSS this year, so it might have quite the large population of 22-24 year olds.” Interesting, if this report is accurate. It would seem hard to justify opening up conference attendance to 10,000+ vendor employees.

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From RunFromThis: “Re: vendor exec pleads guilty. See attached court record.” [Name redacted], senior partner of [health IT consulting company name redacted], was arrested on March 4, 2022 (at the Fontainebleau Hotel in Miami at the start of ViVE-CHIME) and charged with being captured on surveillance video punching the company’s EVP of sales in the nose at 2:00 in the morning at the hotel bar. The information is public record, but I’m still not entirely comfortable running his name and that of his company over a misdemeanor battery charge. However, should you want to read more, enter citation # 202200018175 on this page. The executive-slash-puncher was 6’2” and 300 pounds, according to his arrest report, and the punchee reports on LinkedIn that the blow required emergency surgery that was followed by a quick exit from the company.


HIStalk Announcements and Requests

The biggest challenge in system implementations or upgrades, at least in some hospitals, is working up the nerve to actually pull the trigger to bring the change live knowing that while some things won’t work right, at some point you have to stop maintaining two systems. That feeling arose with my recent HIStalk server upgrade, where I fully expected issues after dozens of applications and endless custom coding so it would work with new server and database software (the term “deprecated function” comes up a lot). Most everything has been upgraded and/or fixed; web scripts and programming have been modified to work with new versions of PHP, MySQL, and server OS; the virtual firewall is finally working properly; and the new server is faster with more capacity.


Webinars

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


Acquisitions, Funding, Business, and Stock

Teladoc Health lays off 300 employees, 6% of its headcount, as part of a cost-saving restructuring. TDOC shares have lost two-thirds of their value in the past 12 months versus the Nasdaq’s 26% loss.

Real-time benefits tools vendor Arrive Health (formerly RxRevu) acquires medication adherence tools from UPMC Enterprises and has received an investment from UPMC.


Sales

  • Highland Rivers Behavioral Health chooses Findhelp to help its clients to connect with local social care resources.
  • Eudora Medical Center implements EClinicalWorks Cloud EHR.
  • MultiCare Health system acquires Yakima Valley Memorial Hospital and will spend $100 million to replace its Cerner system with Epic.
  • Cleveland Clinic will implement Palantir’s Virtual Command Center.

People

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Hicuity Health hires Young Ahn, MD (Jiahui Health) as chief medical officer.

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Clarus Care hires Rick Stevens (SoftServe) as vice chair and head of strategic accounts.


Announcements and Implementations

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St. Bernards Healthcare (AR) upgrades to Meditech Expanse, assisted by the company’s professional services team. It replaces Meditech’s legacy system, three ambulatory systems, and a patient portal. (Questioning: since the health system is named after St. Bernard Tolomei, why does it incorrectly omit the apostrophe from its name?)

Fortified Health Security publishes its healthcare cybersecurity report for 2023.

Socially Determined partners with Datavant to offer patient-level social risk data to life sciences companies.

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My favorite health IT market review is from Healthcare Growth Partners, which just released its annual report, whose masterfully concise and authoritative writing style always makes me a little bit jealous. Tidbits:

  • Market sentiment is showing a glimmer of rebound as the Fed attempts to steer the economy to a soft landing with a resilient labor market. Health IT market activity has been falling, but remains at a healthy level historically.
  • The rising cost of capital and concerns about a recession have reduced the risk tolerance and thus acquisitive interest in investors, but seller interest remains strong and an economic uptick could create significant deal flow.
  • Investor pullback in health IT is not being driven by company or sector fundamentals, but rather hospital financial pressure (which is easing) that elongated sales cycles.
  • High-quality growth companies continue to command premium valuations, while buyers will find relative bargains in acquiring sound companies and those with strong bookings and recurring profits.
  • Health IT sectors with the strongest valuations, as reported publicly, are analytics, revenue cycle management technology, and telemedicine. 
  • Companies have three valuation inflection points – proof of concept, growth scalability, and mature scalability.
  • Notable take-private transactions as public market valuations plummeted include Cerner, Change Healthcare, Vocera, Tivity Health, Convey Health Solutions, Castlight, and SOC Telemed.

ECRI lists its “Top 10 Health Technology Hazards for 2023”:

  1. Communication challenges when medical device manufacturers notify users of recalls.
  2. A concerning number of defective single-use medical devices.
  3. Inappropriate use of automated dispensing cabinet overrides.
  4. Undetected dislodging of hemodialysis venous connections.
  5. Failing to manage the cybersecurity risks of cloud-based clinical systems.
  6. Inflatable pressure infusers for IV bags delivering air emboli.
  7. Cross-contamination in cleaning ventilators.
  8. Improper use of electrosurgical units.
  9. Overuse of cardiac telemetry on non-cardiac patients, which causes alarm fatigue, clinician cognitive overload, and unrecognized critical events.
  10. Underreporting of device-related issues.

Government and Politics

The State of Georgia’s proposed budget calls for $105 million for Medical College of Georgia to implement Epic. The college is part of Augusta University, which is negotiating the transfer of its assets to Epic customer Wellstar. I think the August University Health hospitals are using Cerner. The top reason given by the health systems for partnering was to expand digital health offerings to improve access to care and care personalization.


Privacy and Security

A ProPublica investigation finds that online pharmacies that sell abortion pills are sending potentially identifiable website user data to Google’s tracking tools, potentially exposing customers to prosecution in some states.


Other

A case study describes how Brigham and Women’s Hospital uses an electronic handoff tool when transferring patients from ED to inpatient, yielding high clinician utilization and a reduction in clarifying calls to ED clinicians from 51% of admissions to 10%.


Sponsor Updates

  • PeriGen supports a Virtual Learning Day for perinatal and neonatal nurses titled “Partners in Practice: Uncovering Solutions and Strategies for Staffing and Reproductive Justice” on January 26.
  • Netsmart achieves ONC Health IT Cures update certification for its human services EHR solutions.
  • Ascom Americas expands its partnership with reseller Newtech Systems so that its clinical workflow solutions are available to hospitals in Ohio and Pennsylvania.
  • EClinicalWorks publishes a new customer success story, “Brookhaven Heart & MD365: Streamlining Patient Engagement and Intervention with RPM.”
  • The Authentically Successful Podcast features Get Well CEO Michael O’Neil.
  • Censinet publishes a research report titled “The Impact of Ransomware on Patient Safety and the Value of Cybersecurity Benchmarking.”
  • GHX will present at the Contract Administration Conference February 6 in Cape Coral, FL.
  • Healthjump earns NCQA’s Validated Data Stream Designation.

Blog Posts


Contacts

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

EPtalk by Dr. Jayne 1/19/23

January 19, 2023 Dr. Jayne 1 Comment

Most workers in the healthcare IT trenches are familiar with the US Meaningful Use program and its successor, the Medicare Merit-based Incentive Payment System (MIPS). A new study in the Journal of the American Medical Association says that MIPS gets it wrong by penalizing physicians who care for patients with complex medical needs. Researchers from Weill Cornell Medical College noted that “MIPS scores were inconsistently related to performance on profess and outcome measures, and physicians caring for more medically complex and socially vulnerable patients were more likely to receive low MIPS scores even when they delivered relatively high-quality care.”

If there’s one thing I learned as a CMIO, it’s that the team needs to be top notch at collecting the right measurements, which may or may not align with what is really important to patients and their care teams.

I’ve watched patients be treated in ways that aren’t necessarily appropriate for their situation, in the name of satisfying measures. I’ve seen physicians trying to maintain tight control of blood sugar in elderly diabetic patients because they didn’t understand how to exclude them from the measures and the physicians didn’t want to get dinged on their clinical quality metrics. The sometimes-mindless devotion to metrics just illustrates how misaligned the incentives in the US healthcare system can be.

For the love of all those elderly patients who are being overtreated due to poorly implemented clinical decision support in the EHR, if you’re in clinical informatics, please make sure your clinicians know how to properly exclude a patient to whom the recommendations do not fully apply. It will be interesting to see what comes after MIPS – I know clinicians are sick of it and primary care practices waste countless hours on the program every year.

Speaking of primary care physicians, many of my colleagues have come together for regular conversations about how to prevent burnout and promote wellbeing among physicians and office staff. When I started in solo practice, I had 2.5 full time support staff just to run the office, and I paid for a central business office to handle the back end of the revenue cycle. Most of the primary care physicians in my area are employed by one of three large health systems or a large investor-owned provider group, so they’re no longer in charge of their own destinies.

Due to the staffing crisis everyone is seeing, most of them are down to 1:1 support with a medical assistant. One of the doctors I recently spoke with is allocated 40% of a medical assistant’s time to support her 3,000-patient primary care panel. It’s frankly absurd, and she’s looking to leave when the school year is over. She has to give 90 days’ notice, so she will be resigning soon, and I can’t imagine how they are going to be able to recruit a replacement if they let the candidates visit the office and see what’s happening.

She has one child in college and one who has been in the workforce for a couple of years. One of the hot topics with her family over the holidays was the idea of a “slow work” mindset. Her eldest child works at a company that has adopted a four-day work week, which evolved after a couple of years of “focus Fridays,” where employees were encouraged not to have meetings but to give their effort to priority projects or personal development. At that employer, meetings have been either compressed into 20-minute check-ins or expanded into multi-hour collaboration session where people are encouraged to get the work done as a team rather than individually push things along an inch at a time.

Her youngest is interviewing with companies that have been deliberate in their communications about workplace flexibility and how they don’t want to be in the business of babysitting their employees. Despite stories in the media announcing the death of remote work, it seems like a lot of companies are still offering it. I know from experience that I’m more productive in a remote environment. I have fewer interruptions and can use break time productively, whether it’s rotating loads of laundry, baking a loaf of bread, or knocking out a little yard work on my lunch break. Once I’m back at my desk, I’m more focused and it seems like time flies compared to when I was in an office and had constant face-to-face interruptions from co-workers. Sure, there are interruptions, but I can manage a Slack message and respond in 1-2 minutes when I’m finished with my current train of thought versus having to immediately turn to an in-person contact and let that train run right off the tracks.

I get a ton of unsolicited emails and calls, mostly from people trying to sell me services I don’t want or need. Pro tip for those folks responsible for composing corporate communications: starting your email with “Dear Dr. HIStalk,” will at least keep me reading, where “Hey Jayne,” is going to be a direct trip to the “Block Sender” button. Sales and marketing people everywhere, please take a look at your templates and let’s all agree to make professional communications a part of general business discourse again.

Frankly, the Girl Scouts coming to my door with their much-awaited cookie order forms are doing a better job than some of the sales reps who’ve approached me lately. If you’re wondering, Samoas (Caramel deLites ) are my favorites, followed by Tagalongs (Peanut Butter Patties). Depending on which baker services your region, names may vary. And if you’re interested in appropriate wine pairings for your cookies, may I suggest this handy guide.

Several of my friends are in academics, and we recently got into a discussion about sabbatical leave. I was telling them about the sabbatical programs at some well-known tech vendors and they were surprised that sabbaticals exist outside the university world. It’s an interesting idea for companies that want to differentiate themselves and who want to make a clear statement that they want employees to be with them for the long haul. A recent opinion piece talked about the lesser-known effects of sabbaticals, including providing an opportunity for coworkers and teams to shine. The author had spent 10 years at a marketing agency and received an eight-week paid sabbatical upon reaching that milestone. She notes that in addition to providing “a proactive hedge against employee burnout, an antidote for attrition, and a protection from career wanderlust” her time away made her more passionate about her work and workplace than before.

In observing that those who managed her workload while she was out, the writer found that upon her return, those co-workers had increased confidence and willingness to provide leadership for projects. Experts agree, and she cites several studies that have reaffirmed the benefits of sabbaticals. Proponents of the practice find that sabbaticals are an investment in employee wellbeing. According to sources cited in the article, only 5% of employers offered paid sabbaticals with 11% offering unpaid leaves. When you consider how much it would cost to replace a valued employee, two months’ salary seems a relatively economical investment.

There’s a lot of discussion about the value of time away from work, particularly with recent announcements from Microsoft that it is expanding its unlimited time off policy to all US-based employees. For many, such a policy makes it tempting to take days off here, which may lead to fewer employees taking longer vacations. Research from the travel industry indicates that many individuals need at least three days away from work to de-stress, which is nearly half of the traditional week off. For most of my friends, having several four-day holiday weekends in close succession made people feel a little spoiled, and it will be hard to have only two-day weekends for a while.

Does your employer offer sabbatical leave? How has the experience been, not only for the person on leave but those left behind? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 1/19/23

January 18, 2023 Headlines Comments Off on Morning Headlines 1/19/23

Arrive Health Creates First-of-Its-Kind Medication Access Solution with Acquisition of Pharmacy Technology from UPMC Enterprises

Arrive Health, which specializes in medication cost and benefits coverage data, acquires patient engagement and automation technologies from UPMC Enterprises and the UPMC Pharmacy Network.

Teladoc Health cuts 300 jobs to shave costs

Teladoc Health cuts 300 non-clinical jobs as it refocuses business development efforts on primary care, chronic conditions, and online counseling services.

Microsoft is laying off 10,000 employees

Microsoft, which acquired Nuance in 2022 for $18 billion, will lay off 10,000 employees through March in anticipation of slower revenue growth.

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Comments Off on Morning Headlines 1/19/23

Morning Headlines 1/18/23

January 17, 2023 Headlines Comments Off on Morning Headlines 1/18/23

VCU Health launches Home Hospital, the first hospital-at-home program in central Virginia

VCU Health develops a hospital-at-home program that will offer acute care patients the ability to receive care at home via video, remote patient monitoring, and house call visits from care teams.

Ferrum Health Raises $6 Million to Bring Artificial Intelligence into Healthcare

AI-powered healthcare analytics startup Ferrum Health raises $6 million.

Apps want to be your new doctor’s office. Is that a good idea?

The Washington Post looks at the use of smartphone apps that collect patient clinical measures and send them to doctors, concluding that if the AI/ML they use requires doctors to interpret the results, the apps can’t really solve access and cost issues.

Comments Off on Morning Headlines 1/18/23

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