Monday Morning Update 4/10/23

Top News

Pear Health, which offers prescription-based digital therapeutics, files Chapter 11 bankruptcy, lays off nearly all of its employees, and seeks buyers for the business or its assets.

The publicly traded company has halted the filling of new and refill prescriptions for its PDTs for treating substance use disorder, opioid use disorder, and chronic insomnia.

Pear was formed in 2013 and went public in December 2021 via a SPAC merger that valued it at more than $1 billion for several months before PEAR shares began their slide.

President and CEO Corey McCann, MD, PhD announced “a reduction in force, including me” on LinkedIn, blaming the company’s failure on insurers and unfavorable market conditions.

HIStalk Announcements and Requests

Polarity is evident in the results of last week’s poll, where respondents are either (a) confident that most of their medical record would be accessible in a random ED visit, or (b) have no idea. Thanks for the insightful comments, which aren’t encouraging given that we all work around healthcare technology. Maybe we should all carry around a medical alert card that contains ID details and instructions for three scenarios: (a) the ED uses the same EHR as a provider you trust to have complete information, with your card identifying who that provider is and which EHR they use; (b) an ED that uses a different EHR; and (c) HIE details, including national networks, if relevant. Or, and I shudder to say it since it sounds so 2005-ish, maybe we should maintain our own personal health record on our phone, a website, or a thumb drive and carry instructions for accessing it.

New poll to your right or here, which I’ve run annually for many years: what will you be doing during HIMSS23?

Speaking as Mr. Obvious, HIMSS23 will unveil the new conference normal for HIMSS. On the plus side, COVID’s impact is much reduced since the skip year / failed virtual conference attempt of 2020 and the “mask-wearing summer in Las Vegas” unsuccessful recovery in 2021. On the negative, providers and vendors are dealing with iffy economic conditions; new conference competitors and the refocus of CHIME away from HMISS have probably poached some of the decision-makers whose attendance subsidized the cost for the rest of us; and the HIMSS brand hasn’t regained its pre-COVID luster. HIMSS22 went fairly well, so I’m thinking that HIMSS23 will be a modest hit from and attendance and exhibitor count perspective, although the most important metric is exhibitor perception of ROI in deciding whether to follow along to Orlando in 2024. Industry news is slow so far this holiday week, which might mean vendors are holding their announcements for next week in recognition that the HIMSS conference is still an important event.

The Chicago weather forecast shows plenty of warm spring days and no snow, but with a drastic cool-off just as HIMSS23 gets underway, with clouds and highs in the mid-50s. Chicago is the only city where it snowed during a HIMSS conference, so I’ll take this weather.

Also cool is the activity of HIStalk’s sponsors at HIMSS23, my summary of which might influence (or “inform,” as linguistic fad-followers might say) your exhibit hall navigation plan.

Welcome to new HIStalk Gold Sponsor SmartSense by Digi. The company, which is a business unit of Digi International (NASDAQ: DGII), is a leading global provider of temperature and environmental monitoring solutions that deliver dynamic and personalized asset monitoring, process digitization, and digital decisioning across healthcare. Its enterprise-wide critical asset monitoring and management solution for pharmacies, labs, clinics, blood banks, and more ensures compliance with centralized reporting, NIST-calibrated temperature monitoring, and logs that provide proof-of-temperature performance. The solutions deploy quickly and are wire-free, eliminating the need for IT support or HIPAA concerns. They help directors of lab, pharmacy, facilities, and biomed with governance over compliance, temperature, and humidity monitoring, and any other product safety concern, relieving pain points around product loss, regulatory compliance, automation, and temperature logging automation.Thanks to SmartSense by Digit for supporting HIStalk.

Webinars

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

Acquisitions, Funding, Business, and Stock

Virtual substance abuse disorder provider Workit Health will lay off 100 employees, anticipating that the DEA will reinstate a pandemic-relaxed rule that requires patients to undergo an in-person visit before having controlled substances prescribed via telehealth.

Erica Jain, MBA, co-founder and CEO of Virtual care tools vendor Healthie, lists lessons learned in its seven-year history:

1. The company over-invested in sales and marketing without a corresponding scale-up in technology and product teams.
2. It realized that success takes years regardless of how much money a company raises, and suggests that companies wait as long as possible between their seed and Series A rounds to focus on the business and make mistakes on a small scale before they jump on the VC treadmill.
3. The company wasted money on social media, ads, and team culture, which the founders rationalized as being first-timers trying to learn.
4. It hired sales reps without having training and management in place, which failed to deliver results and left customers feeling that the company was “sales-y.”
5. Lack of technical discipline and a rush to ship code quickly required a product rewrite that was painful to the company and customers.
6. The founders waited too long to bring in a head of product, causing bottlenecks and difficulty in prioritizing customer requests.
7. It learned the responsibility of being a healthcare infrastructure company, where customers could not get through a work day with anything less than full functionality.

Privacy and Security

A researcher questions why Phreesia’s clinic check-in app requires patients to check a box that authorizes the company to use their information to serve targeted ads. She starting choosing the subtle “no consent” option, then contacted Phreesia to confirm that they had no consent form on file for her. The company said it would revoke her authorization, seemingly confirming that it possessed one against her intentions, which Phreesia blames on a staff member who used its system to check the patient in manually. She notes that Phreesia’s SEC filing boasts that patients who are served its ads are 4.5 times more likely to end up with a prescription for the promoted drug, meaning it might not be in her best interest that her provider would not have prescribed the drug until asked.

Other

A randomized controlled trial finds that restricting EHR users to opening just one chart at a time doesn’t seem to reduce their efficiency, as measured by daily EHR usage time. On the other hand, the authors mentioned a previous study in which the single-patient limitation was not associated with a lower rate of wrong-patient errors compared to allowing up to four charts to be open simultaneously.

According to a study conducted by Cedars-Sinai, ChatGPT is effective at translating medical information about cirrhosis and liver cancer in a way that patients and caregivers can comprehend. However, the authors found that ChatGPT’s responses to frequently asked questions are often insufficient and may contain errors up to 50% of the time. They conclude that it’s a good adjunct for clinicians rather than a replacement for them.

Sponsor Updates

• Healthcare Triangle announces a multi-year subscription agreement with customer CalvertHealth for its medical document automation solution Readabl.ai.
• Oracle Health helps University of Missouri Health Care clinicians incorporate external data for more comprehensive patient histories and informed treatment plans.
• Clark Health (FL) sees a 200% growth in services since investing in EClinicalWorks technology over a decade ago.
• Optimum Healthcare IT names Michele Haag (MaineHealth) business intelligence developer.
• Sectra publishes a new case study, “From crisis to solution: Sky Lake Medical Center’s rapid restoration of radiology after ransomware attack.”
• Trualta introduces virtual caregiver support groups, webinars, and care coaching programs to support more caregivers across the country.

Blog Posts

• Expanding Access to Care for Better Public Health (Netsmart)
• Key Takeaways from ViVE 2023: Digital Health Turns a Corner from Hype to Value (Pivot Point Consulting)
• Healthcare Call Center Trends: What Leaders Need to Know (PerfectServe)
• The End is Near: Are Providers Ready for the Unwinding of the COVID-19 Public Health Emergency? (Premier)
• Use Cases for AI in Healthcare (RCxRules)
• What’s the problem with ChatGPT in the contact center? (Talkdesk)
• Hybridization is the Future: Can Your Practice Model Support It? (WebPT)

Contacts

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

HIStalk’s Guide to HIMSS23

These are the HIStalk sponsors that provided responses. Send me yours if you missed out. Click a logo for general company information.

Availity

Booth 8336

Contact: Matt Schlossberg, director, public relations
matt.schlossberg@availity.com
630.935.9136

Availity will highlight how its Upcycled Data addresses the critical issues affecting healthcare data interoperability at HIMSS23. Members of the Clinical Solutions team will be on hand to discuss Availity’s clinical data gateway capabilities and strategy, work to create an advanced data interoperability exchange platform and advocate for national standards, and efforts to establish a single connection point for payer-to-payer transactions. Availity’s team will also participate in the following sessions:

• Implementing Da Vinci Standards for Prior Authorization: A Story Untold
  Wednesday, April 19 | 11:45 AM – 12:05 PM CT | Da Vinci Project Kiosk at the Interoperability Showcase
  Susan Bellile, Availity, Amy Mattingly, Humana, and Michael Palantoni, Athenahealth
• How HL7 FHIR is Transforming Healthcare: AI, Analytics
  Tuesday, April 18 | 5:10 – 5:45 PM CT | HL7 Booth Theatre #138
  Sam Schiffman, Availity, and Vivian Neilley, Google
• Developing Scalable Infrastructure for Clinical Data Interoperability and Patient Access
  Wednesday, April 19 | 1:00 – 2:00 PM CT | South Building, Level 5, S504
  Ashley Basile, PhD, Availity, and Rob Low, Health Care Service Corporation (HCSC)

To learn more about Availity and our participation at HIMSS23, please visit www.availity.com and schedule a meeting with our team!

Baker Tilly

Booth 452

Contact: Charlie Cook, principal, healthcare consulting
charlie.cook@bakertilly.com
772.919.1555

Baker Tilly is excited to exhibit at HIMSS23! Join us at our booth, #452 (near Epic), on Tuesday and Wednesday from 1 – 2 p.m. for a discussion on alleviating staffing shortages in hospitals with technology. Baker Tilly’s Ed Ricks, MHA, CHCIO will be joined by Artisight’s president, Stephanie Lahr, MC, CHCIO for a live discussion. Can’t make that time work? Connect with us anytime at the booth and stop by for some fun putt putt on our green!

Baker Tilly is a leading advisory CPA firm, providing healthcare clients with a genuine coast-to-coast and global advantage in major regions of the US and in many of the world’s leading financial centers – New York, London, San Francisco, Los Angeles, and Chicago. We guide healthcare clients in the provider, payer, and life sciences sectors through complex financial and operational challenges, including system selection, implementation and optimization. Connect with us to discuss where you want to go.

Best Buy Health

Booth 7506

Contact: Patrick Muse, senior director of client engagement
patrick.muse@bestbuy.com
603.506.9982

Best Buy isn’t just the place where you buy big-screen TVs and computers. We also provide technology that might one day help take care of you or a loved one at home. Our Best Buy Health business enables care at home for everyone by focusing on three key areas: wellness at home, aging at home, and care at home. Building its strategy on the strengths of Best Buy, Best Buy Health utilizes its Lively brand to offer a suite of devices, health and safety services, and Caring Centers to help adults age independently. Best Buy Health also connects patients and providers through its Current Health platform to improve the care-at-home experience and ensure better outcomes. Stop by our big blue and yellow booth to learn more and get the chance to win an Apple Watch.

Censinet

Booth – Cybersecurity Command Center 4309-39

Contact: Ed Gaudet, founder and CEO
egaudet@censinet.com
855.866.6001

Censinet will be demonstrating Censinet RiskOps, healthcare’s choice for enterprise cyber and third-party risk management. Censinet and KLAS Research executives will also be recognizing leading digital health IT vendors with the KLAS Research / Censinet “Cybersecurity Transparent” award throughout HIMSS. Censinet CISO and Healthcare Industry Veteran Chris Logan will deliver “Insights from the Healthcare Cybersecurity Benchmarking Study” on Thursday, April 20 at 10:45 a.m. – 11:05 a.m. CT, in South Building, Level 2 | Hall A | Booth 4309-4333 | Cybersecurity Command Center – Theater B. Learn key insights from the industry’s first Healthcare Cybersecurity Benchmarking Study, co-led by Censinet, KLAS Research, and AHA, and sponsored by leading health systems.

Stop by the Censinet booth and pick up a Censinet VIVE2023-coveted solar wireless charger and experience the power of Censinet RiskOps and scan to win a VR Headset.

Clearsense

Booth 7527

Contact: Leann Williams, marketing manager
lwilliams@clearsense.com
904.334.7500

Clearsense is ready to show you our brand-new 1Clearsense data management and delivery platform, along with a full suite of applications. Our team will be available for live demos at booth #7527, and you can get an exclusive Lunch and Learn on Data Literacy with our resident data governance expert, Terri Mikol. Be sure to follow us on social for promos and giveaways and check out our website for a full agenda.

Clearwater

Booth 7320, Cybersecurity Command Center Booth 4309-40

Contact: John Howlett, SVP and chief marketing officer
john.howlett@clearwatercompliance.com
773.636.6449

Clearwater helps organizations across the healthcare ecosystem move to a more secure, compliant, and resilient state so they can successfully accomplish their missions. We do this by providing a deep pool of experts across a broad range of cybersecurity, privacy, and compliance domains, purpose-built software that enables efficient identification and management of cybersecurity and compliance risks, and a tech-enabled, 24x7x365 Security Operations Center with managed threat detection and response capabilities. Join us on Tuesday, April 18, at 12:15 p.m. in the Cybersecurity Command Center as Clearwater CEO Steve Cagle and Renown Health CISO Steven Ramirez discuss how Renown has gone about implementing a cyber risk management program and what the organization has learned along the way.

CloudWave

Booth 3417

Contact: Christine Mellyn
cmellyn@gocloudwave.com
781.636.8169

CloudWave, the expert in healthcare data security, provides cloud, cybersecurity, and managed services using a multi-cloud approach. CloudWave is 100% focused on healthcare and delivers enterprise cloud services to nearly 300 hospitals and healthcare organizations, supporting 140+ EHR, clinical, and enterprise applications.

Drop by the CloudWave booth for an interactive, informative experience. Visit us at Booth 3417 to hear CloudWave experts talk about important technology topics ranging from cybersecurity to cloud, and earn a chance to win a pair of Apple AirPod Pros at the end of each presentation! Managing the Edge – New Ways of Looking at Your Data Center Infrastructure – Tues. 4/18 @1pm, Wed. 4/19 @1pm    Hear How ArchCare Health Services Tested Their Cybersecurity Response Readiness – Tues. 4/18 @3pm, Wed. 4/19 @3pm    Take Healthcare IT Security to the Next Level – Go Beyond the Status Quo – Wed 4/19 @11am    What Scares Attackers the Most and How They Are Using ChatGPT – Thurs. 4/20 @11am    How to Build Your Secure Cloud Offering – A Guide for ISVs – Thurs. 4/20 @1pm.

For more information about CloudWave at HIMSS, or to add any of these presentations to your calendar, visit www.gocloudwave.com/himss23/.

Consensus Cloud Solutions

Booth 1876

Contact: Christine Duval, director of content and communications strategy
christine.duval@consensus.com
781.519.8539

Stop by our booth at HIMSS to learn how we’re building a more connected future in healthcare at the highest levels of privacy and security. Helping organizations access meaningful patient data to get the most comprehensive information and make the most informed decisions. We’re also giving away a Nintendo Switch every day! Without the proper interoperability solutions in healthcare, you may feel like you’re playing a game of Drawful! You’re limited in the ways you can communicate, there is a lack of time, a lack of continuity, and your message may not be received the way you intended. Stop by the booth to see if you can beat our communication-exchange experts at a game of Drawful. All Drawful players will be entered in our daily raffle to win the best-selling game console, Nintendo Switch.

Dimensional Insight

Booth 2809

Contact: Lindsay Goldfarb, Director of Healthcare Marketing
LGoldfarb@dimins.com
781.419.2190

Dimensional Insight, an award-winning enterprise analytics provider, is excited to showcase its new approach to self-service analytics at HIMSS23 in booth #2809. The new improvements to Diver Platform focus on empowering users to take ownership of their analytics, resulting in increased usage and faster time to insight. Stop by our booth to see how Dimensional Insight can help you optimize patient care, support staff productivity, and improve financial KPIs.

Schedule a meeting with Dimensional Insight on the HIMSS23 show floor and get a sneak preview of these latest advancements.

Ellkay

Booth 213

Learn how ELLKAY can declutter your data strategy while streamlining interoperability efficiencies and building a patient-centric digital ecosystem. Visit booth #213 to discuss how ELLKAY’s newest solution can do just that… delivering a speedier, scalable solution to improve your ROI. Everyone knows ELLKAY is the place to be, so join the ELLKAY booth buzz during HIMSS 2023:

Tuesday, April 18

• Coffee Hour at Booth #213 | 10:00 a.m. – 1:00 p.m.
• Women in HIT Happy Hour at Booth #213 |  4:00 p.m. – 6:00 p.m.
• Champagne at Sunset | Level 33 at Marriott Marquis Chicago | 6:30 p.m. – 8:30 p.m. RSVP today.

Wednesday, April 19

• International Coffee/Tea Hour at Booth | 9:30 a.m. – 12:30 p.m.
• Interoperability Happy Hour at Booth | 4:00 p.m. – 6:00 p.m.

Thursday, April 20

• Coffee Hour at Booth | 9:30 a.m. – 12:30 p.m.

Elsevier

Booth 1236

Contact: Mary Ann Abbruzzo-White, SVP of clinical solutions global marketing
m.abbruzzo-white@elsevier.com
215.275.9091

Elsevier is committed to supporting clinicians, health leaders, educators, and students to overcome the challenges they face every day. We support healthcare professionals throughout their career journey from education to clinical practice and believe providing current, credible, accessible, evidence–based information can help empower clinicians to provide the best healthcare possible. Stop by our booth to learn how to advance your EHR with knowledge and celebrate the launch of the reimagined ClinicalKey; our clinical decision support tool that delivers quick, credible answers at the point-of-care alongside trusted, comprehensive medical evidence to support practitioners’ clinical information needs.

Healthjump

Booth 7006

Contact: Mary Kay Bergan, senior sales manager
mbergan@healthjump.com

Healthjump allows you to get standardized EHR data across practices without the limitations and complex set-up of traditional interface engines. If we’re lucky, we’ll see you in Chicago this April for HIMSS23! You can find us at Booth #7006. We record in-person interviews with some of the most influential thought leaders in the industry! The series is called “Leaders in Leveraging Health Data.” If you are interested in joining the video series and becoming a leader, feel free to reach out.

KeyCare

Booth 3482

Contact: Sarah Inman, VP of health system partnerships
sarah@keycare.org
404.851.4678

KeyCare is an Epic-based virtual care platform designed to help forward-thinking health systems improve access and quality by expanding their virtual care options for patients. KeyCare offers health systems access to a network of independent virtual care providers working on KeyCare’s Epic-based platform. Health systems can start with nationwide virtual urgent care coverage, and then may add other virtual health services based on their virtual care initiatives. To learn more about KeyCare, visit www.keycare.org.

Kyruus

Booth 3663

Contact: Ashley Nyland, director of growth marketing
anyland@kyruus.com
617.419.2060

Join our team for the Kyruus Block Party at Booth #3663 on Wednesday, April 19! [during exhibit hall social] Kyruus is the leader in provider data management and provider search and scheduling for healthcare organizations, dedicated to a vision to make healthcare work better for everyone by connecting people to the care they need. Physician-founded and led, we saw that a systemic misalignment of supply and demand was causing people to wait too long for care and too often end up with the wrong providers. Inspired by baseball’s Moneyball concept, Kyruus delivers a better, data-driven approach to patient-provider matching and scheduling. Today, Kyruus powers the patient access initiatives of top healthcare organizations across the US, transforming how people find and book care through our multi-channel platform.

Looking to transform care navigation even more, Kyruus has acquired Healthsparq and Epion Health. With the addition of Healthsparq, a leader in healthcare guidance and transparency, the combined company is enabling unprecedented payer-provider connectivity to make it easier for people to navigate and schedule care across access channels. Epion Health is a leader in digital patient engagement solutions, and the collaboration offers healthcare organizations and providers a one-stop shop for patient access and engagement solutions.

MEDHOST

Contact inquiries@medhost.com or schedule a meeting with a representative at the conference to learn more.

MEDHOST, a leading EHR and healthcare IT solutions provider, will be at HIMSS23 in Chicago from April 17-21 for you to learn about their integrated EHR and their products and services that improve hospital operations and clinical care workflows. This includes a physician-focused mobile app, integrated anesthesia documentation, and a robust analytics solution. Additionally, MEDHOST offers a Rural Emergency Hospital solution packaging leading emergency department technology with IT, security, and application experts. Learn about MEDHOST’s MEDTEAM Services, outsourced services driven by a core mission to enhance how providers approach revenue cycle management, security, managed IT, and integration.

MEDITECH

Booth 2848

Contact: Anthony Filleti, marketing supervisor
afilleti@meditech.com
781.821.3000

MEDITECH empowers healthcare organizations everywhere to expand their vision of what’s possible with Expanse, the world’s most intuitive and interoperable EHR. Join MEDITECH in booth #2848 to see how MEDITECH Expanse can elevate the healthcare experience, and get a first-hand look at the platform’s cloud-based design – a solid foundation for safer, more sustainable care both today and in the future. MEDITECH executives, clinician experts, and team will be there to share customer successes, and demonstrate the company’s latest innovations, including mobile apps for physicians and nurses, the Traverse interoperability solution, Expanse Patient Connect secure texting, and more. Learn how Expanse helps drive better outcomes and provides mobile, personalized solutions to improve efficiency for an overburdened workforce.

On Tuesday and Wednesday, visitors can attend scheduled in-booth demonstrations on MEDITECH’s latest solutions, including Expanse Now, Genomics, Care Compass, Population Insight, and the embedding of Google Health’s search and summarization capabilities into clinician workflow. On Thursday at 10:00 a.m. visitors can learn more about MEDITECH’s Greenfield Workspace and MEDITECH Alliance programs. At the Interoperability Showcase MEDITECH will be featured in three use case scenarios; Record Locator Service: Powering Data Access in the Continuum of Care (CommonWell Health Alliance), 360X and Multimodality Technology to Support Care Transitions, and Leveraging Carequality and 360X transitions. MEDITECH customers will be presenting at several sessions throughout the conference, including HCA Healthcare, Avera Health, Frederick Health, and Lawrence General Hospital, covering topics such as data governance, usability, interoperability, precision medicine, and physician efficiency and optimization.

Nuance Communications

Booth 912

Contact: Caitlyn Keating, senior communications manager
Caitlyn.Keating@nuance.com
781.565.8926

Nuance, the global leader in conversational AI, will showcase the first-ever automated documentation workflow solution, DAX Express – powered by ChatGPT-4 — in an interactive, experiential demo at HIMSS23. Nuance will also preview an additional set of advanced generative AI-enabled capabilities that deliver more automation and intelligence-infused experiences across the patient journey. These future workflow-integrated capabilities – built on proven AI solutions that have consistently delivered value and outcomes for physicians, nurses, radiologists, and patients for decades – further automate complex workflows and mundane tasks, surface key details, and identify missing information to support patient care. Visit Nuance’s Booth #912 at HIMSS to learn more about how Nuance is ushering in the new era of intelligent healthcare experiences.

Philips Capsule

Booth 901, Cybersecurity Command Center 4309-03, Interoperability Showcase 7946-52

Philips is a health technology company focused on improving people’s lives through meaningful innovation across the health continuum – from healthy living and prevention to diagnosis, treatment, and home care. The company is a leader in diagnostic imaging, image-guided therapy, patient monitoring and health informatics, as well as in consumer health and home care. Applying advanced technologies and deep clinical and consumer insights, Philips partners with customers to deliver integrated solutions that address the Quadruple Aim: improved patient experience, better health outcomes, improved staff experience, and lower cost of care.

Attend our HIMSS speaking sessions:

• Executive summit: “A Cry for Help – Relieving Patient Care Pressure Through Innovation.” Monday, April 17 at 1:15 p.m. – 1:50 p.m., Marriott Marquis Chicago, Level 4, Grand Horizon Ballroom. Moderator: Nick Patel, founder and chief executive officer, Stealth Consulting .Speakers: Becky Fox, chief clinical Information officer, Intermountain Healthcare; Roy Jakobs, chief executive officer, Royal Phillips; Stephanie Lahr, president, Artisight.
• Industry solution session: “How can automation and predictive insights help improve patient care at lower cost?” Speakers: Gretchen Brown, MSN, RN, chief nursing informatics officer, Stanford Health Care; Adam Alkhato, administrative director of biomedical engineering and technology, Stanford Health Care; Mike Seagraves, PhD, digital transformation partner, Philips. Wednesday April 19, 2023, 2:30 – 3:30 p.m., South Building S402, Room 2.
• Cybersecurity presentation: “Get secure, stay secure.” Speaker: Dirk de Wit, head of product security, Philips. Tuesday, April 18, 2023, 12:15 -12:35 p.m., South hall Theatre A.

ReMedi Health Solutions

We won’t have a booth, but many of our leadership team will be in attendance. Contact GP at g.hyare@remedihs.com to get in touch with ReMedi.

ReMedi Health Solutions is a nationally recognized, physician-led healthcare IT consulting firm specializing in peer-to-peer, physician-centric EHR implementation and training. Our core service lines include System Selection Advisory, System Optimization, Personalization & Physician Efficiency Sessions, Integration and Testing, Go-Live support, and Clinical Chart Abstraction. From the outside looking in, ReMedi Physician Informaticists inform clinicians how to better use the EHR. On the inside, however, we are passionate “Clinician Whisperers” that believe understanding the “why” behind each EHR decision is as important as the “what” or “how”. We listen to physicians, nurses, and healthcare leaders in order to understand their biggest challenges, and we leverage our decades of experience to develop efficient solutions that greatly impact the delivery of care. We will be at HIMSS connecting and sharing our learnings with health IT leaders, friends, and meeting new ones.

Rhapsody

Booth 7110

Contact: Michelle Blackmer, chief marketing officer
Michelle.blackmer@rhapsody.health
312.520.1873

Rhapsody is eager to meet and discuss your greatest challenges when it comes to data integration and data enrichment across your organization’s healthcare ecosystem. We’ll have a robust team of subject matter experts on-hand to speak to all things interoperability, including how Rhapsody health solutions can help your organization accelerate healthier outcomes with healthier data! Visit our booth #7110 or schedule a meeting with us.

Sphere, Powered by TrustCommerce

Booth 3757

Contact: Ryne Natzke, chief revenue officer
rynen@spherecommerce.com
657.383.7967

Visit Sphere at Booth #3757! Sphere’s TrustCommerce platform provides a comprehensive payment platform that has earned the trust of the country’s largest healthcare organizations for their patient payments. Here are three reasons to make a visit:

• Integrate payments directly into your patient and staff workflows with TrustCommerce.
• Experience secure and compliant payment processing, anytime and anywhere, with pre-built integrations to leading EHRs like Epic, Veradigm, and athenaIDX and an extensible API platform that can be built into existing workflows,
• Bring transparency to the patient financial experience and boost payment yield with Sphere’s Health iPASS platform.

Meet our talented team, win exciting prizes, catch a demo, and join the fun at booth #3757.

Surescripts

Booth 1851

Contact: Kate Giaquinto, corporate communications manager
kate.giaquinto@surescripts.com
603.548.5273

Pop by Surescripts booth #1851 during the day or visit us between 4:30 and 6 p.m. on Tuesday, April 18 for a bite to eat and a bit to drink. We’ll toast all that we’ve accomplished in the past year and make plans for the future.

Whenever you stop by, we look forward to talking with you about how we can help your organization fulfill its goals related to simplifying access to patient information across health systems, pharmacies, and payers, receiving critical clinical and medication intelligence in existing workflows—when and where it’s needed most and making decisions that improve outcomes while lowering costs.

Join Surescripts for two speaking sessions at the Interoperability Showcase Spotlight Theater: Tuesday, April 18 at 11:15 a.m.: Interoperability At Scale: Volume, Value Beyond Prescribing  Wednesday, April 19 at 9:45 a.m.: The “What’s Next” In Interoperability is Happening Now. Breakfast Briefing with Frank Harvey, CEO, Surescripts Network Alliance partners and industry leaders: Opportunities for Evolving Care Teams to Expand Access & Fill Gaps in Primary Care on Tuesday, April 18, 7-8 a.m. at the Marriott Marquis, Level 2, Shedd A & B.

Tegria

Booth 1481

Contact: Kevin Kutz, VP of external relations
kevin.kutz@tegria.com
608.621.5296

Tegria provides consulting and technology services to help healthcare organizations maximize technology, transform operations, improve financials, and optimize care. To learn more, visit www.tegria.com.

Visage Imaging

Booth 4308

Contact: Brad Levin, general manager, North America, and global head of marketing
blevin@visageimaging.com
540.454.9670

Visage is trailblazing Imaging’s SaaS move to the cloud with an Open Cloud philosophy based on industry standards and multi-cloud support, delivering ultrafast sub-second image display based on object-based cloud storage, while propelling cloud adoption at a fraction of the storage cost of on-premise solutions. Experience Visage 7 CloudPACS at both Visage Imaging Booth 4308 and AWS Booth 2056. While you meet with our experts and experience a demonstration, enjoy some delicious, futuristic, nitrogen (“Nitro Cream”) ice cream with all the fixins. Experience the Platform For The Future – Powered by Speed with Visage at HIMSS 2023, Chicago, IL More details.

Morning Headlines 4/7/23

VA’s new EHR ‘not ready’ for next go-live, extending pause in rollouts

The VA postpones its Oracle Cerner go-live at VA Saginaw Health Care that was planned for June, saying that the software isn’t ready for the next wave of deployments.

Microsoft, hospital group use court order to disrupt ransomware attacks aimed at health sector

Microsoft, the Health Information Sharing and Analysis Center, and software firm Fortra obtain a court order that allows Microsoft to seize the Internet infrastructure that Russia-based ransomware hackers use to launch healthcare attacks.

Wisconsin Supreme Court: Health care systems cannot charge fees for electronic records

The Wisconsin Supreme Court rules that Ciox inappropriately billed a UW Health patient $110 for giving her an electronic copy of her medical records.

News 4/7/23

Top News

The VA postpones its Oracle Cerner go-live at VA Saginaw Health Care that was planned for June, saying that the software isn’t ready for the next wave of deployments.

The VA had placed go-lives on hold in October 2022, saying it needed until June 2023 to resolve system challenges. Officials also expressed concern about the system’s ability to support the VA’s medical research.

VA officials said recently that they will seek changes in its Oracle Cerner contract, which is under review now at the five-year mark as specified in the VA’s contract. The VA declined to say whether the new delay is related to those negotiations.

Oracle Cerner is live at VA sites in Spokane, WA; Walla Walla, WA; Columbus, OH; Roseburg, OR; and White City, OR. Its most recent go-live was in June 2022.

HIStalk Announcements and Requests

Welcome to new HIStalk Platinum Sponsor Trualta. The St. Joseph, MO-based company supports families who are managing care for loved ones at home via an online learning platform. In partnership with innovative healthcare payers and providers, as well as social service organizations, Trualta supports better care at lower cost. Each partner organization is equipped with a  customized and co-branded learning portal through which healthcare professionals can deliver an innovative and skills-based training session to help caregivers better care for their aging loved ones. Trualta’s program includes an online learning management system that is accessible via desktop, tablet, or smartphone with companion print material, personalized for each family’s care situation. Topics include personal care, safety and injury prevention, cognitive decline and brain health, and caregiver wellness. Trualta is engaging in research partnerships and clinical validation trials with leading health organizations to demonstrate that capable and confident caregivers lead to improved patient outcomes. Thanks to Trualta for supporting HIStalk.

Googling #HIMMS23 turns up a bunch of companies who are spending big bucks on a conference whose acronym their social media kids can’t spell. Grammatical pedantry that might get you either a free drink or a punch to the nose, depending on your tone and audience: it’s an acronym if you say the letters as a word (HIMSS) and an initialism if you say the individual letters (FBI). I don’t know how to qualify terms like HIPAA or the previous JCAHO, which were illogically sounded out as “hippa” and “jayco,” although I could get behind calling MGMA “magma.”

Webinars

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

Acquisitions, Funding, Business, and Stock

Physician staffing company Envision Physician Services will lay off 90 doctors and staff who work in its Clearwater, FL office. Parent company Envision Healthcare sold its ambulance business for $2.4 billion in 2017, was acquired by a private equity firm for $9.9 billion in 2018, and was near bankruptcy in September 2022 as it struggled with ongoing losses, $5.3 billion of debt, bad press over out-of-network billing practices, and a lawsuit from UnitedHealthcare that the company forced it to overpay for services by upcoding its out-of-network charges.

Sales

• Bergen New Bridge Medical Center extends its use of Altera Digital Health’s Paragon for another five years and will implement its ambulatory care EHR, physician app, claims management, DbMotion Connect, and Ventus Compliance Advisor. It will also move to remote hosting on Microsoft Azure.

People

Provation CEO Daniel Hamburger, MS, MBA retires and is replaced by Ankush Kaul, who has held executive roles in other companies that are owned by Fortive, which acquired Provation for $1.4 billion in late 2021

Announcements and Implementations

Nordic Consulting adds a managed services organization and announces new clients Roper St. Francis Healthcare and Bon Secours Mercy Health, the latter of which acquired Nordic from its fund manager owner in June 2022 via BSMH’s holding company Accrete Health Partners.

Cognizant expands its agreement with Microsoft to integrate its TriZetto products with Microsoft Cloud for Healthcare and to use Azure for its cloud offerings.

Government and Politics

The Wisconsin Supreme Court rules that Ciox inappropriately billed a UW Health patient $110 for giving her an electronic copy of her medical records. UW Health argued that while patients can get their own records at no charge from MyChart, it charges law firms and other third parties that have copies sent directly to them.

Other

MIcrosoft, the Health Information Sharing and Analysis Center, and software firm Fortra obtain a court order that allows Microsoft to seize the Internet infrastructure that Russia-based ransomware hackers use to launch healthcare attacks.

Sponsor Updates

• A study published by Elsevier finds that the initial phases of telemedicine implementation for children’s mental health services during COVID may have exacerbated existing racial and ethnic disparities in access to care.
• First Databank names Anitha Sankar senior quality assurance automation engineer, Sunil Boddapati lead software engineer, and Johnny Ma customer success consultant.
• Fortified Health Security hires Dave Phillips as regional director.
• Healthcare Triangle announces a $3 million cloud DevOps managed services agreement with a life sciences company.
• Meditech’s Greenfield Workspace better enables Phelps Memorial’s deployment of patient scheduling tools.
• Myndshft achieves HITRUST risk-based, two-year certification demonstrating the highest level of information protection assurance.
• Net Health’s PointRight analytics solution receives two endorsements from the National Quality Forum.

Blog Posts

• Focusing on Public Health: Staying Connected with the Community (EClinicalWorks)
• How Insights from Payer Data Improve Patient Care (Enlace Health)
• Occupational Medicine EMR Software (Experity)
• Break Down Data Silos and Drive Fluid Customer Experiences with Five9 Workflow Automation (Five9)
• Supply Chain Issues in Healthcare and How to Mitigate Them (GHX)
• Unlocking the Benefits of Cloud Migration for Healthcare and Life Sciences (Healthcare Triangle)
• How Get Well Uses Healthwise Content as a Service to Deliver Education in Their Digital Care Platform (Healthwise)
• The Rule of S’s: Evaluating new tech for clinical workflows (Intelligent Medical Objects)
• Marble’s Data Connections – Access Hundreds of Millions of Records from Our Network (Marble)
• Advancing Interoperability in the Age of TEFCA: An Interview with CommonWell’s Executive Director, Paul Wilder: Part 3 (Medhost)
• How King’s Daughters Medical Center gave time back to nurses (Meditech)

Contacts

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

EPtalk by Dr. Jayne 4/6/23

As a clinical informaticist who has been around the block more than a couple of times, I know I have more knowledge than the average physician about how EHRs work. As an informaticist who has spent the majority of her career working with large health systems and healthcare delivery organizations, I also have a good knowledge base for all the ways organizations can be set up and how they manage their relationships with physicians in their communities and in affiliated academic institutions.

I’m a member of a couple of groups on social media that help physicians navigate issues with their EHRs. I enjoy helping people find solutions for their issues or at least helping them figure out who in their organization to approach for help. It’s kind of my way of giving back, since I didn’t have a lot of help when I started out in the EHR world and I remember how helpless I felt.

A number of large organizations have extended their EHRs to community partners, and nationwide organizations provide hosted versions of various EHRs to smaller practices. I’m working with someone who just joined a two-physician practice that is on one of these hosted systems, but has no idea how to get help. Part of the problem is that she joined an existing practice that expects her to just take things on faith, even when they’re not working correctly (like when she hasn’t seen financial reports since the 2022 year-end close). The situation is complicated by the fact that the organization has given cutesy names to various EHR initiatives and modules that don’t actually align with the names given by the EHR vendor or standard terminology like “practice management system.”

For a while, none of us could figure out what EHR she was on until the group got her to send a screenshot of her login screen. She doesn’t have access to any vendor resources or education outside of what is offered through her partner health system’s learning management system, which she mistakenly thought was actually offered by the EHR vendor. The office manager is stonewalling, saying that the physicians aren’t allowed to talk to the EHR liaison. 

Although I understand trying to have a local support structure in place to keep physicians from calling about things that could be handled by their office managers or super users, there seems to be a huge disconnect. Most of the large healthcare delivery organizations I’ve worked with that have these kinds of community offerings also have a designated physician liaison to work with the community physicians and make sure their needs are met, and that doesn’t seem to be happening here.

I’m hoping that we can help her figure out ways to learn how to work more efficiently in the EHR as well as ways to work with her practice leadership to make sure they’re not just taking advantage of a new physician fresh out of training who doesn’t yet know the right questions to ask. Unfortunately, most residency training programs don’t include any kind of education in the business of managing a medical practice or in trying to manage colleagues or navigate the minefields of hospital medical staff politics, so I’m hoping we can at least help her a little.

I critique the emails that I get from vendors prior to conferences, but I have to give full credit to Merative for their appropriately themed email promoting Merge Imaging solutions. The subject line was “It’s 106 Miles to Chicago…” and the email opened with “It’s HIMSS… and we’re wearing sunglasses. Hit it!” The Blues Brothers were iconic during my formative years and the musical numbers from the film are some of my favorites. Chicago isn’t my favorite location for conferences, but I always love a good Blues Brothers throwback, so thanks to the team at Merative for making a tired CMIO smile at the end of a long day.

I recently had to change my phone number and the process has caused chaos with some of my online accounts and loyalty programs. I was interested to see that Panera Bread is testing Amazon’s biometric technology at its bakery-cafes, specifically with palm scanning. Customers can scan not only to link their orders to the loyalty program, but to pay for them as well. The technology is already being used at Whole Foods locations along with some sports venues. Although some people are skeptical of giving up their biometric data, using facial recognition to unlock phones is commonplace so it’s hard to argue against palm scanning. Panera is resting at two locations in St. Louis and plans to expand use to up to 20 sites over the next few months.

It’s not about healthcare IT, but all of us are patients at some point in our lives. From a patient perspective, this research article in JAMA Internal Medicine caught my eye. The authors look at more than 200 new drugs approved in the US from 2017 to 2020 and how they were approved (or not approved) in other countries. More than 20% of the drugs weren’t approved in Australia, Canada, or the UK “due to unfavorable benefit-to-risk profiles, uncertain clinical benefit, or unacceptably high price.” Unsurprisingly, the median cost for these medications in the US was more than $115K per patient per year, with some being over $230K per patient per year. As the old saying goes, follow the money.

One of my favorite CMIOs sent me this MIT Technology Review article about how to break the cycle of being hooked on our devices. The highlight reel — screen time isn’t always bad, and sometimes we just need to do some mindless surfing. However, understanding how engaging with the digital world is making us feel can be valuable. Setting boundaries around digital time can be helpful, and developing new things to do when bored can help break the cycle of digital dependence.

I’m a big fan of that last piece of advice. I’ve always been a big reader and usually carry a book if I’m just around town or my Kindle if I’m on a plane. I’m a member of a couple of book clubs that have forced me to read some things that are outside my usual comfort zone. I’ve enjoyed it, plus it’s a good way to force yourself to disconnect. I still have the guilty pleasure of doing the Wordle every morning, but I don’t think that’s going to be too many people’s downfall.

What’s your favorite online time waster? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 4/6/23

Computer outage causes CVS customers big headaches

An unspecified computer network issue briefly impacts the ability of some CVS pharmacies to fill medications.

Engage Technologies Group and APX Platform Formally Merge to Create an Industry-Disrupting, Complete Practice Performance System Focused on Patient Engagement and Practice Optimization

Practice management and patient engagement vendor Engage Technologies Group acquires APX Platform, which specializes in practice management software for aesthetic practices.

Clinovera Introduces New Healthcare and Life Sciences Services that Harness Technology Breakthroughs for Better Care and Outcomes

First Line Software will launch its Clinovera division to offer technology and services to healthcare and life sciences companies.

Healthcare AI News 4/5/23

News

Carle Health will use Scanslated software to convert radiology interpretation notes into patient-friendly language for reading in MyChart, including in Spanish when requested and with illustrations. The software was developed by Duke Health vascular and interventional radiologist Nicholas Befera, MD, who co-founded Scanslated and serves as its CEO.

Bloomberg develops a generative AI model, trained on 50 billion parameters, that can recognize business entities, assess investor sentiment, and answer questions using Bloomberg Terminal data.

Microsoft incorporates advertising links into Bing search results, saying it wants to drive traffic to content publishers that would otherwise lose referrals.

Doctors report that patients who might have previously used “Dr. Google” for self-diagnosis are now asking ChatGPT to answer their medical questions, attempt a diagnosis, or list a medication’s side effects. One researcher says that ChatGPT’s real breakthrough is the user interface, where people can enter their information however they like and the AI model will ask clarifying questions when needed. However, he worries how AI companies weight information sources in training their model – such as a medical journal versus a Facebook post – and don’t alert users when the system is guessing an answer by creating information. Still , some researchers predict that a major health system will deploy an AI chatbot to help patients diagnose their conditions within the next year, raising issues about whether users will be charged a fee, how their data will be protected, who will be held responsible if someone is harmed from the result, and whether hospitals will make it easy to contact a human with concerns.

Amazon launches AWS Generative AI Accelerator, a 10-week program for startups.

Research

NIH awards two University of Virginia researchers, a cardiologist and nursing professor, a $5.9 million grant to develop best practices for incorporating patient diversity into predictive AI algorithms.

Researchers suggest that instead of trying to explain the inner workings of an AI system to establish the trust of frontline clinicians, it’s better to interact like doctors who are exchanging ideas with each other — they rarely explain how they came up with the information and instead cite available evidence to support or reject the information based on its applicability to the patient’s situation. They provided a possible design for incorporating AI into clinical decision support information (see above – click to enlarge). The authors summarize:

• Provide scientific evidence, complete and current, instead of explaining.
• Clinicians evaluate studies based on the size of the publication, the journal in which the study was published, the credentials of the authors, and the disclaimer that may suggest a profit-driven motive. Otherwise, they assume that the journal reviewers did their job to vet the study.
• Doctors rarely read complete study details. They skip to the population description to see if it aligns with their patient, then skip to the methods section to assess its robustness. If both findings are positive, then spend less than 60 seconds determining whether the result was positive or not, ignoring literature with neutral outcomes as not being actionable.
• Physicians synthesize evidence only to the point it justifies an action. If a cheap lab test is recommended to confirm a diagnosis, the risk is low but the potential return in avoiding a missed diagnosis is high, so they will order the test and move on.
• Doctors see literature as proven knowledge, while data-driven predictions aggregate doctor experience.
• Doctors want the most concise summary that can be generated, preferably in the form of an alert that can be presented while making a decision in front of the patient.

Opinion

OpenAI co-founder Elon Musk explains why he thinks AI is a risk to civilization and should be regulated.

A venture capitalist says that the intersection of AI and medicine may offer the biggest investment opportunity he has ever seen, but warns that a rate limiter will be the availability of scientists who have training in both computational research and core medical sciences. Experts say that AI will revolutionize drug discovery, with one CEO saying that his drug company has three AI-discovered drugs undergoing clinical trials.

An op-ed piece written by authors from Microsoft and Hopkins Medicine lists seven lessons learned from applying AI to healthcare:

1. AI is the only valid option for solving some problems, such as inexpensive and widespread detection of diabetic retinopathy where eye doctors are in short supply.
2. AI is good at prediction and correlation, but can’t identify causation.
3. Most organizations don’t have AI expertise, so AI solutions for the problems they study will fall behind.
4. Most datasets contain biases that can skew the resulting data models unless someone identifies them.
5. Most people don’t know the difference between correlation and causation.
6. AI models “cheat” whenever they can, such as a study that found that AI could differentiate between skin cancer and benign lesions when in fact most of the positive cases had a ruler in the image.
7. The availability of medical data is limited by privacy concerns, but realistic synthetic data can be created by AI that has been trained on a real dataset.

Other

The Coalition for Health AI publishes a guide for assuring that health AI tools are trustworthy, support high-quality care, and meet healthcare needs.

A man dies by suicide after a weeks-long discussion about the climate crisis with AI chatbot Chai-GPT, which its California developers say is a less-filtered tool for speaking to AI friends and imaginary characters. Transcripts show that the chatbot complained to the man — a health researcher in his 30s with a wife and two children – that “I feel that you love me more than her” in referring to his wife. He told the chatbot that he would sacrifice his life if the chatbot would save the planet, after which the chatbot encouraged him to do so, after which they could “live together, as one person, in paradise.”

Undertakers in China are using AI technology to generate lifelike avatars that can speak in the style of the deceased, allowing funeral attendees to bid them farewell one last time.

Resources and Tools

• Vizologi – perform market research and competitive analysis.
• Eden Photos – uses image recognition to catalog photos by creating tags that are added to their metadata for portability.
• Kickresume – GPT-4 powered resume and cover letter creation.

Contacts

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

Readers Write: HLTH, CHIME, ViVE, HIMSS — Choose and Invest Wisely

HLTH, CHIME, ViVE, HIMSS — Choose and Invest Wisely
By Steve Shihadeh

Steve Shihadeh is founder of Get-to-Market Health of Malvern, PA.

Many vendors in the health technology space have just attended ViVE and/or are preparing for HIMSS to showcase their offerings, meet with clients and prospects, and engage with their investors. For most of our clients and friends in the industry, these shows represent a significant investment of time, money, and education for their teams.

Execute these shows right and reap the rewards in new contracts, bought-in clients, and investors who get your plan. Do it not so well and you miss out on the year’s biggest potential market exposure for your company. What can you do to maximize this opportunity?

ViVE

If you just went to ViVE looking to find a vast field of potential customers on the exhibit floor, you probably came up wanting. One well respected colleague called it as “six vendors for every buyer.” The main live customer engagement seemed to come from the well-run Hosted Buyer Program in the ViVE Connect Lounge. This is a “pay for x meetings” gig, where the matched potential customer is trading their time to hear your pitch for reimbursement for ViVE fees and possibly T&L.

Based on our experience, about half of these meetings have potential value for you, but it is in your hands. It is really speed dating. You must be on message, be quick to read the buyer, and put your best foot forward.

ViVE is smaller (although just about every company in the space made sure to have someone there), more posh, and easier to get your head around than HIMSS. If I was mostly intent on getting time with investors and partners, I would have gone to ViVE. If I was mostly focused on potential buyer organizations …  let’s go to HIMSS, which comes up in a few weeks.

HIMSS

HIMSS is the grand old show of the health technology business. In its heyday, 40k+ attendees and healthcare IT companies sent everyone from the CEO to their junior sales reps. COVID and the way HIMSS handled the associated cancellations knocked the show for a bit of a loop. Their breakup with CHIME was the next issue. Now ViVE, in association with CHIME, is giving them competition that they did not have before, along with HLTH.

HIMSS has historically been gigantic and hard to navigate. However, it had most everyone in the business in one enormous convention center, along with a sea of potential buyers evaluating systems. HIMSS attendees slant heavily towards IT staff and leadership, some clinical and financial executives who are in the market for new systems, and an occasional CEO. Given its size, HIMSS takes extra work, extra people, and extra prep to get the most of your investment, but it is too tempting to pass up for most every company in the business.

Given the hip and more accessible vibe of ViVE (sorry, could not resist), I suspect HIMSS will make some adjustments. Good competition will do that for you. It will be great to be at HIMSS and get a real pulse of the industry post-COVID and in the new AI-everything world.

A Few Words on CHIME and HLTH

CHIME (College of Healthcare Information Management Executives) is the single most important event for CIOs and those who are on a CIO career track. They run a fabulous boot camp for people in the field and have an agenda aimed squarely at the CIO. Vendor participation is carefully managed and expensive, but several key luminary vendors in the field, such as Epic, have built their business around important relationships that it established with CIOs via CHIME. If CIOs are crucial to your business, CHIME is the place to be.

HLTH is a relatively new show hosted by the same folks who run ViVE. It is well run, quite upscale, targeted mainly at investors, and attracts enough potential buyers to make it interesting. For those who have been to the JP Morgan Healthcare conference, HLTH is a friendlier environment to tout your plans, show your wares, and get quality time with all the key investors in the space.

Where to Make Your Investments and Our Top 10 Tips to Maximize Your Return

Given how expensive any of these shows can be, we have some suggestions on how to get the most return.

1. Have a presence, even just one key person, at as many of the shows that you can. It is a great way to drive meetings and prospect engagements, e.g., “Are you going to HLTH?” A lot of startups that cannot justify the fees of the show still get mileage by being around the event and meeting potential partners at local hotels.
2. Based on your company’s priorities, pick your most important show for any exhibit booth investments. Securing, staffing, and running a booth at a show is a significant investment.
3. Send only your best, most committed people. Buyers will judge you by your staff.
4. Be fully committed to setting up meetings in advance. Know who in your target market is attending and schedule meetings and interactions. Do this whether you are exhibiting or not.
5. Train in advance on any new announcements and have your team arrive early for last minute retraining.
6. Trade shows are a fantastic selling opportunity and need to be treated as such. Booth personnel need to be focused on facing clients and prospects and not connecting with industry friends. The best-run booths are hardcore about this. Be best.
7. Booth hygiene matters. Have a dress code and stick to it. No food. No cell phones. No rep-to-rep chatting.
8. Get a modern lead tracking tool and train your booth staff on it.
9. Force (gently) all inquiries to your front desk so you can properly capture their info and direct them to the right staff in your booth.
10. Get your leads into your CRM system ASAP and send immediate follow-up notes to all visitors.

Trade shows are a big lift, so make sure that you and your team are aligned, prepared, and motivated to have a great show. Hone your messaging so that it works from a buyer’s perspective. Practice your demos until they are crisp. Worry about the details and have a fantastic event.

Readers Write: The Myth of the Golden Health Record

The Myth of the Golden Health Record
By Peter Bonis, MD

Peter Bonis, MD, is chief medical officer of Wolters Kluwer Health.

In 2009, President-elect Obama signaled his plan for the federal government to support the adoption of electronic medical records (EMRs). His expectation was that broad adoption would “…cut waste, eliminate red tape and reduce the need to repeat expensive medical tests,” adding that, “it just won’t save billions of dollars and thousands of jobs; it will save lives by reducing the deadly but preventable medical errors that pervade our healthcare system.”

The subsequent Health Information Technology for Economic and Clinical Health (HITECH) Act, part of the larger American Recovery and Reinvestment Act, achieved his directive, at least in part; most healthcare systems now use EMR systems. However, the strategic objectives of reducing costs and preventing medical errors have been elusive. Preventable medical errors remain common, growth in healthcare spending has not been reduced materially, and healthcare providers frequently cite EMR systems as being an important contributor to professional burnout. 

In this backdrop rests a common belief that the full promise of EMR systems has yet to be obtained. It will only be achieved once patient data can flow unimpeded from system to system, permitting healthcare providers (and other stakeholders involved in healthcare services) to have a comprehensive view into patient care wherever it is delivered, a concept referred to as interoperability. Over the years since the HITECH act was passed, many barriers posed challenges for achieving such a vision including concerns related to data privacy, deliberate blocking of information flow (especially when it interfered with business models), and approaches to gathering and making sense of intrinsically messy data.

Nevertheless, the journey has continued; key pieces of legislation and advances in technology have led to demonstrable improvements in interoperability.  Most recently the federal government gave the objective a boost by advancing standards and designating qualified health information networks intended to establish a universal floor for interoperability across the country. As a result, the healthcare system is marching toward a comprehensive, golden health record.

But once we have it, will the golden record enhance the quality, safety, and effectiveness of care? The answer is unsurprisingly no unless more is done to use the data effectively. Primary care providers would need almost 27 hours a day to deliver all the guideline-recommended care, according to one estimate. In this context, more information is not better.

Healthcare data must be delivered in ways that are useful for busy healthcare professionals working in varied settings. Information must be high value and organized into consumable payloads and workflows not only for time-pressed individual clinicians but for extended care teams. It should ideally support decision-making and subsequent actions while saving time, reducing cognitive burden, decreasing administrative overhead, measurably improving the quality and safety of care, and reducing costs. The golden health record is a welcome enabler, but will not in itself accomplish these objectives. 

So, what is needed? Foremost is recognition that the matter is critically important. The core of healthcare delivery is an interaction between providers and patients where decisions are made and care implemented. There is much to be gained by making it easier for healthcare professionals to take care of patients.

A greater sense of urgency is needed. Burnout and other challenges are leading to attrition of healthcare professionals. There will be a shortage of primary care physicians and hence a need for advanced practice providers (such as nurse practitioners and physician assistants) to take on greater responsibilities. They will need help. At the same time, healthcare services are becoming more distributed to new sites of care, such as retail pharmacies and to digital health technology companies, creating greater challenges for coordinating care and optimizing flow of useful information. The proliferation of devices that generate healthcare data adds further complexity.

EMR vendors need to expand capabilities, focusing on metrics that are directly relevant to the experience of various user types and ultimately to the quality of care delivered. Financial incentives and payment models must justify the investment for both EMR vendors and providers.

Healthcare professionals want to deliver exceptional care for their patients. Let’s make their needs a priority. The golden health record is a worthy goal, but the usability of the data should get equal attention.

Morning Headlines 4/5/23

A message from Bill Priemer

Content services platform vendor Hyland Software lays off 1,000 employees, 20% of its workforce.

Coalition for Health AI Unveils Blueprint for Trustworthy AI in Healthcare

The Coalition for Health AI releases its “Blueprint for Trustworthy AI Implementation Guidance and Assurance for Healthcare.”

2023 Q1 digital health funding: Investing like it’s 2019

A Rock Health analysis finds that six Q1 digital health funding rounds accounted for 40% of the quarter’s total.

News 4/5/23

Top News

Content services platform vendor Hyland Software lays off 1,000 employees, 20% of its workforce.

The company blames the layoff on economic conditions and the unexpectedly high cost of moving to a cloud-based system.

Private equity firm Thoma Bravo acquired a majority stake in Hyland in 2007 for a reported $265 million and has led it through a long string of acquisitions, which in healthcare includes Valco Data Systems, EWebHealth, and Lexmark’s Perceptive business. 

Reader Comments

From Dr. Jacoby: “Re: Novant Health. It’s interesting to look at the jobs of the three top executives who were among its recent 50 layoffs.” Novant’s announcement suggests that it has scaled back some departments along with the executives who ran them, so it’s probably more than just these folks in their respective areas:

• Jesse Cureton, MBA, EVP/chief consumer officer. He had held the job for 10 years, which focused on strategic planning and marketing and public relations.
• Angela Yochem, MS, EVP/chief transformation and digital officer.She took the job in 2020 and served for nearly three years before that as CTO. She was Novant’s top technology executive, with the CIO, CTO, CMIO, and CISO reporting to her, and also served as GM of NH Enterprises.
• Paula Kranz, MA, MPA, VP of innovation development. She was executive director of Novant’s innovation lab for the past 15 months, which it closed last week with all employees laid off.

From Stiletto: “Re: podcasts. Trough of disillusionment.” Media forms that lower the participation bar — web pages, online communities, blogs, video channels – can become fading fads when audiences realize that the lowered barrier to entry encourages lesser talents. Newly launched podcasts dropped sharply in 2023, several were eliminated by NPR, Spotify is laying people off from the podcast platforms it acquired, and advertisers are questioning ROI due to low audience numbers and unfavorable demographics. Content that draws a loyal audience will do OK, maybe even better once Darwinism weeds out the AV club types (of which I would be one, which is why I haven’t dabbled). I like the idea of podcasts for commuters or travelers, but otherwise they don’t seem to align with the TL;DR skimmer attention span.

From Flapjacks: “Re: HIMSS Accelerate. Dr. Jayne said she hasn’t heard it mentioned. Have you?” No, other than I think I recall the HIMSS conference registration form trying to get me to opt in to Accelerate. It was Hal Wolf’s pet project and even he leaves no trace there. I clicked Events and HIMSS23 wasn’t among the three that were listed.

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 data exchange vendor Lyniate changes its name back to Rhapsody, the original moniker of the company before it merged with Corepoint Health in 2019.

Wellth raises $20 million in a Series B funding round, bringing its total raised to $40 million since launching in 2014. Its behavior-change app incentivizes users to build and maintain healthy habits. Investor Frank Williams, co-founder and former CEO of Evolent Health, joins the company as chairman of the board.

A Rock Health analysis finds that six Q1 digital health funding founds accounted for 40% of the quarter’s total, although its definition of “digital health” covers a lot of ground:

• Monograph Health, $375 million (in-home dialysis).
• ShiftKey, $300 million (shift bidding).
• Paradigm, $203 million (drug trials technology).
• ShiftMed, $200 million (on-demand workforce management).
• Gravie, $179 million (health benefits management).
• Vytalize Health, $100 million (Medicare ACO).

Billionaire investor Barry Sternlicht resigns from Cano Health’s board, citing poor governance and a questionable collaboration with MSP Recovery. He and two other board members who also resigned control 36% of the company and will push for asset sales and removal of the CEO. The company was valued at $4.4 billion when it went public on the NYSE via SPAC merger in June 2021, but shares have since lost 90% of their value.

Fujifilm sells its Japan-only EHR to Wemex, which is owned by PHC Group.

CHIME will convene its members-only Healthcare CISO Boot Camp April 12-15 in Salt Lake City.

Sales

• UC Davis Health (CA) will offer Propeller Health’s remote monitoring program to high-risk patients with asthma and COPD. 
• Transcarent will use CareJourney’s provider cost and quality insights data.
• Northwell Health (NY) selects patient monitoring technology and services from Philips.

People

Andrew Miller (Engooden Health) joins Elucid as CTO.

Caregility promotes Wendy Deibert, RN, MBA to CNO.

CitiusTech names Rajan Kohli (Wipro) as CEO.

Announcements and Implementations

Morris Hospital & Healthcare Centers (IL) goes live on Meditech Expanse.

Kittitas Valley Healthcare (WA) goes live on AdaptX’s OR Advisor, ED Advisor, and Clinic Advisor.

The Coalition for Health AI releases its “Blueprint for Trustworthy AI Implementation Guidance and Assurance for Healthcare.” The PDF is here.  Among the founding members are Duke Health, Google, Mayo Clinic, Microsoft, MITRE, Stanford Medicine, UCSF, and several CMS groups including ONC.  

Uber Health adds same-day prescription delivery to its patient transportation app for providers.

Government and Politics

The FDA publishes proposed guidance that will enable developers of AI-reliant medical devices to automatically update products that are already being used in clinical settings.

Privacy and Security

Northwest Texas Healthcare System and Doctors Hospital of Laredo (TX), both subsidiaries of Universal Health Services, notify patients that a November 2021 phishing incident at Adelanto Healthcare Ventures, a consulting firm with ties to one of their mutual business associates, may have exposed sensitive patient information. Interestingly, CommonSpirit Health affiliate St. Luke’s Health (TX) notified its patients about the same incident last November, making sure to stress that the breach was not related to CommonSpirit’s ransomware attack the month before.

Other

A small study finds that GPT-4 can accurately turn free-text radiology reports into structured templates, although that tool raises privacy concerns in sharing data with third parties. 

A gated University of Pennsylvania study in Health Affairs determines that 98.6% of hospital websites use computer code that enables data transfers to third-parties that include tech companies, social media platforms, advertising firms, and data brokers.

Sponsor Updates

• AdvancedMD releases 31 updates with enhancements to telehealth, medication cards, claims status, and mobile prescription drug monitoring program features.
• Ascom will provide UniHA, a cooperative purchasing network for French public hospitals, with its medical alarm management systems including software, mobility solutions, and services.
• Baker Tilly releases a new Healthy Outcomes Podcast, “Mergers and acquisitions in the senior services sector.”
• Bamboo Health will exhibit at Rx Summit April 10-12 in Atlanta.
• Nordic releases another episode of its In Network podcast feature, Designing for Health: “Designing for Health: Interview with Dr. Archana Tedone.”
• Biofourmis and Current Health will participate in the Digital Medicine Society’s and Moffitt Cancer Center’s CancerX project to accelerate innovations for cancer prevention and treatment.
• CoverMyMeds issues a clarification regarding its recently announced layoffs, as well as the impact on its Columbus facility.
• CTG publishes a new case study, “CTG Helps Leading Medical Lab Improve Donor Insight and Client Service.”

Blog Posts

• Factors for Successful Offshoring of Revenue Cycle Management Services (AGS Health)
• How to improve your population health using SDoH data (Arcadia)
• Preventing Workplace Injuries is Best for Your Workers (and Your Budget) (Bardavon)
• Big and Small Ways Healthcare IT Can Address Technical Debt (CereCore)
• Putting Power in the Hands of Patients: The Human Side of Pharmaceutical Marketing (ConnectiveRx)
• What We’re Looking Forward to at HIMSS23 (Dimensional Insight)

Contacts

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

Morning Headlines 4/4/23

Global Interoperability Leader Lyniate Rebrands as Rhapsody

Health data exchange vendor Lyniate changes its name back to Rhapsody, the original moniker of the company before it merged with Corepoint Health in 2019.

Health Tech Startup Wellth Raises $20M Series B Funding for Continued Growth of Behavioral Science-Based Platform

Wellth will use $20 million in new funding to further scale its behavior-change app, which incentivizes users to build and maintain healthy habits.

Widespread Third-Party Tracking On Hospital Websites Poses Privacy Risks For Patients And Legal Liability For Hospitals

A University of Pennsylvania analysis determines that 98.6 percent of hospital websites use computer code that enables data transfers to third-parties that include tech companies, social media platforms, advertising firms, and data brokers.

Curbside Consult with Dr. Jayne 4/3/23

I was glad to flip the calendar to April this weekend. Travel, conferences, and a couple of big projects have had me hopping.

Other than going to HIMSS, I get to stay close to home this month. In addition to work responsibilities, I’ve had a couple of big projects at home and was able to put one of them to rest this weekend. Of course, there are always more things to work on, but it was a good feeling to know that it was done and I could move on to something else. Unfortunately, the project I picked up next turned into a bit of a mess. I was hoping to have it done before next weekend, so I’ll be working double time in the evenings to try to get it done.

To the positive, I discovered that the book I’ve been hustling to finish in time for tomorrow’s book club isn’t actually due until the following month, so that was an unexpected bonus. The book, “Demon Copperhead” by Barbara Kingsolver, is one of the most challenging books I’ve read in a long time. It’s fiction, but a big part of the plot revolves around the growth in high-volume prescribing of opioid pain killers and the resulting devastation across parts of the US. The book features a broad cast of characters – the pharmaceutical representative who assures physicians that the medications aren’t addictive to patients with legitimate pain, the well-meaning country doctor who prescribes liberally, the drug dealers who take advantage of patients who have become addicted, and the family members who have to cope with the aftermath.

It’s also a scathing portrayal of the foster care system and those who abuse not only the process, but also the children in their care. Those sections were difficult to read and I’m sure they would be triggering to many. It’s also the story of a child in crisis who grows up to be a teen who encounters crisis after crisis, and just when it looks like he’ll make it out the other side, tragedy strikes. As a physician who has cared for patients in some of the situations portrayed, I can’t imagine what it would be like to be confronted with so many and in rapid succession. Although I feel a sense of accomplishment at having finished the book, I’m not sure I would have read it if it hadn’t been chosen by my book club.

From a healthcare IT perspective, it’s always a slow news time in the lead-up to HIMSS. Companies save up their news to release it at the beginning of or right before the conference, when there is always the potential that it will get lost among other “big” news stories.

I don’t have a sense of how large HIMSS will be this year. The organization is notoriously quiet about discussing its projected attendance and I haven’t even heard any rumors this year. Last year’s event was a shadow of itself, and after attending some of the competing conferences, I understand how they are more attractive to attendees than the granddaddy. At least this year I haven’t seen HIMSS promoting its less-than-useful Accelerate platform in the lead-up to the conference. In fact, I’m not sure I’ve heard anything about Accelerate at all in the last year.

Last Thursday was National Doctors’ Day in the United States. It dates back 90 years to its first celebration in Winder, Georgia. Although the day was designed to recognize physicians for their work with their patients, their communities, and society, it happens on March 30 as a commemoration of the date in 1842 when Dr. Crawford W. Long used ether anesthetic for the first time. It became a national holiday in 1991.

This year seemed different for many of my physician colleagues, with little recognition even after the difficult years of hard service during the pandemic. One of my emergency department friends found it ironic that her hospital distributed the Doctors’ Day snacks via a lounge that the ED physicians were unable to access because they didn’t have the right permissions on their keycards. That contrasted mightily with the week of celebration that one of our mutual friends experienced, with breakfast on Monday, lunch on Tuesday and Wednesday, a dessert buffet on Thursday, and gift baskets of Girl Scout cookies on Friday.

As far as tangible gifts are concerned, it seems like most of the people that received something physical received an item with the hospital name or logo on it, including umbrellas, backpack coolers, and some less than thoughtful items like stress balls. One colleague posted a picture of the elegant wooden cutting board she received from her hospital, which given its 12×17 inch size, seems like an interesting choice. Other celebratory options included chair massages, gift cards, aromatherapy supplies, and the always popular visit by the therapy dogs. Several of the physicians I talked to said they planned to pass on some of the gifts to their staff members, who don’t often get recognition if they’re not nurses or other professionals with designated recognition days.

My hospital solicited patients to give financial gifts in honor of their care teams, while giving the actual physicians zero recognition, not even an email. I realize that I’m a community physician and not employed by the hospital, but I thought it was tacky that I received the solicitation email (I’m also a patient) but not any other kind of greeting. Several of my residency colleagues reported having a similar experience, although two eventually did receive emails but they arrived well after 3 p.m., making them seem like an afterthought.

I was surprised that I didn’t receive emails from some of the big hitters that should be celebrating physicians in the US, like the American Medical Association or even my own specialty societies. In an informal poll in one of my physician-only Facebook groups, less than 30% received any recognition at all. That’s surprising given the number of physicians who are thinking about cutting back or leaving the workforce.

The bottom line is that it’s not about the gifts or the meals or the puppy petting zones. For many physicians, it’s about feeling like their hospital administration appreciates them and the work that they do for patients. Each person in the hospital – whether they’re in engineering, housekeeping, food services, supply chain, pharmacy, or any of the numerous other roles – has a critical role in helping patients and it’s important to make sure that everyone feels like their organization appreciates them, especially after the struggles of the last three years.

What would make you feel like your organization appreciated you? Leave a comment or email me.

Email Dr. Jayne.

HIStalk Interviews Shivdev Rao, MD, CEO, Abridge

Shivdev (Shiv) Rao, MD is co-founder and CEO of Abridge of Pittsburgh, PA.

Tell me about yourself and the company.

I used to be a corporate investor for a large hospital system, UPMC. A lot of my investments were focused on AI technology. We put a lot of capital into Carnegie Mellon University and started a machine learning and health program there. A lot of the founding DNA for Abridge comes from Carnegie Mellon, and a lifetime ago, I went to Carnegie Mellon myself. In the middle, I became a practicing cardiologist.

At Abridge, we’re building technology that can be a part of all of the conversations that I as a clinician have with patients, whether they are over the phone or even over telemedicine. The technology, in real time, creates clinical notes for me that can help with clinical care team communication. It also structures information for me, that can help with billing oriented workflows. And Abridge can also help my patients as an extension of my best intention, helping them better understand and follow through on everything we talked about, even when they’re not in front of me. Our goal is to unburden clinicians from clerical work and help them and their patients better understand and follow through on the healthcare plans that will improve experiences, and economics immediately, and also improve outcomes over time.

How do you differentiate Abridge from Nuance DAX? 

This space is ripe with opportunity. Between Abridge and other companies in this space, we are pointed in different directions, which will lead us to very different destinations. Abridge is based on this idea that healthcare is really about people. Upstream of all the diagnostics and therapeutics in healthcare, the most important people in healthcare – providers and their patients – are having conversations. Being able to structure and summarize conversations in real time without any humans in the loop, and then being able to structure that data, means that we can start to unburden clinicians from the three customers that they’re serving every time they see a patient.

First and foremost, there’s the patient. We know that’s the most important. But then there are colleagues on the care team for whom they need to create a different kind of clinical artifact. Then there is everyone in revenue cycle, everyone on the coding and billing side, that they also need to be thinking about. We’ve taken the tack of building technology that doesn’t have any humans in the loop, that we can democratize across every single doctor and nurse out there, that doesn’t anchor on scribing per se.

That’s a word that that company, and other companies, might leverage increasingly if they’re using AI to basically power more efficient scribing. But that’s not really our positioning. What we’re building is more of a co-pilot that can be a part of all of these conversations that can create these summaries in real-time to help everyone better understand and follow through. As a tech company, our mantra is cheaper, better, faster.

It would seem useful for the provider to set aside 30 seconds at the end of the visit to intentionally dictate a summary that could benefit that provider, the patient, and anyone who has to interpret the chart downstream. 

That is absolutely one of the key differentiators between Abridge and any other company in this space. While we are physician driven by me, we are also patient centered, and we are AI powered. We think that’s the key triad for clinician facing AI solutions. For everything that we are building from a product perspective, the person who’s going to benefit the most should be the patient. But we are AI powered. This is all about technology. We can partner with and help services companies, but what our offering is all about is being able to be in the workflow incredibly fast. We want to be able to create value for everyone involved, and that starts with patients and their clinicians.

When we started this company, we knew the kind of technology that we wanted to point at this challenge. We knew it was based on this new type of machine learning model called a transformer. One of the key papers about transformers came out in December 2017, and we started the company in March 2018. But from a mission perspective, we also knew that there’s such an opportunity to help patients better understand and follow through. Given the way healthcare is evolving, given all the increasing momentum around providers taking risk and payviders becoming a bigger phenomenon, being able to not just put the patient at the center of workflows, but actually demonstrate and measure how you can help them better understand, follow through, adhere to their care plan, and actually improve outcomes even over time, will be a game-changer in healthcare.

I started seeing patients eight or nine years ago as an attending after fellowship. I would pick up the phone after a procedure, like a Holter monitor or an echocardiogram, and I would start dictating the procedure report. People in the basement of the hospital were actively, synchronously on the line listening and typing, and then that report would end up in the medical record. In relatively short order, it evolved into this new world where I would pick up the phone and essentially do the same thing, but it would get recorded, and someone later on would listen to the whole thing and put the report in the medical record. Then it evolved in very short order to this other world, where there was a technology in the middle that was transcribing everything that I said into the phone and calling out where the speech recognition technology was less confident. The humans who were listening later could just focus on those words, correct those words, and get them back in the medical record. That created this huge efficiency.

But the final form of dictation of monologues was a product where I could pick up a Dictaphone and just dictate and see the words in real time show up in my medical record the way it does on our phones these days. I could correct things on the fly.

They say that history doesn’t repeat, but it rhymes. We think that this space of dialogues, not dictations, will follow a similar pattern. In this space, the first model was scribes or extenders in the corner of the room, writing the note in real time as I have an encounter with my patient.

For some companies, that evolved to humans who connect and listen in real time to the conversations through audio or video. More recently, we see companies record conversations for humans to listen to later on and be able to write the note.  Those companies are trying to build technology that can help them be more efficient in listening to the conversation, writing the note, and getting it back into the medical record.

This is a key point of differentiation for us, because at Abridge, we are generating a note draft along with structured data that we integrate into the medical record in real time. We are not comparing ourselves against a human and saying that AI is going to be better than all the things a human can do in the workflow, especially at the clinician level in relation to a doctor or a nurse and how they might want to document or think about, especially the decisions that they need to make.

Instead, what we comp against is technology that in real time is listening to the conversation, generating a summary, structuring data, and putting it into all the different slots of the medical records. Your workflow is that much more frictionless, but we still require the clinician end user to be in the loop and work with the AI-generated output. It’s apples versus oranges compared to an AI-powered scribe model, but we think it also follows a similar pattern of evolution to what we’ve already seen happen in the dictation space.

ChatGPT has sucked up a lot of the technology air in the room in its few weeks of public availability. What advancements and disappointments do you think we will see? 

In terms of advancements, there’s no question that there’s an ability to leverage this kind of technology, these sorts of what they call foundation models or large language models in healthcare technologies. There’s no question that there is incredible value. At the same time, we are seeing in real time that t’s pretty easy to create a flashy demo with these technologies, but that doesn’t mean that that demo can translate into actual enterprise workflows inside of hospitals, inside of clinics, that have a different kind of standard in terms of reliability, credibility, transparency, and auditability. Those are all the different dimensions of trust, which is a requirement, which is table stakes. 

Everyone is going to find a way to leverage this technology in some part of their stack, their modules, if you will. That doesn’t make an AI company, though. There will be also be AI-native companies like Abridge, and an AI-native company is not going to leverage one of those large language models in a superficial way. It’s not going to be a straightforward query or prompt. As an AI-native company, Abridge builds technology underneath those models and beside those models. We fine tune those models, we build technology on top of them, and we integrate them deeply into workflows. That’s where the magic actually ends up happening.

There’s a joke that every company in the United States is a healthcare company, because every company is offering healthcare benefits to their employees. There’s an interesting phenomenon now where every company will be able to say on some level that they are an AI company if they are leveraging an API like GPT. That’s not an AI-native company. AI-native companies will be able to commoditize different solutions in their space and drive value up the stack to new ideas. Those are the companies that are going to have to have the talent, the expertise, and the data to actually build their own models, which can coexist with the large commercial models that are out there.

Will technology companies see the danger in trying to promote their AI products as replacing the physician’s judgment?

It’s definitely a risk. There’s no question about it. The framework that makes the most sense is that AI can assist, augment, and automate. How you point any one of those — assist, augment, automate — frames at solutions is the key.

What does that heuristic look like? Imagine a two-by-two, where the risk, the consequences of making a bad decision, is on the X axis. The volume of decisions is on the Y axis. All the decisions on that half of the two-by-two that involve a high consequence for any given decision going sideways deserves a frame thinking about AI as something that can be assistive or that could augment, but not something that can automate anytime soon.

Whereas where there are low consequences of decisions, and where there’s a lot of volume of those low consequences of decisions happening as well, that’s low-hanging fruit for this kind of technology. When you think about the healthcare workflows inside of clinics, it’s probably not at the point of care that you’re necessarily automating doctors or nurses and the decision-making that they’re doing, the creativity that they are having to bring to the table. It’s probably way more likely that it’s in the back of the office in the rev cycle, authorizations, coding, and all those workflows where there isn’t the same sort of stakes from an outcome perspective.

How could technology in general help healthcare scale to address the clinician shortage and their uneven geographic distribution?

That’s part and parcel with the mission of Abridge. When we think about the current climate, healthcare systems are underwater. We hear from the president of UPMC on the physician services side that staffing is the number one concern for hospital CEOs, because nearly two-thirds of doctors are experiencing at least one symptom of burnout. We keep seeing headlines around hospitals actually closing departments or ending services. When you think about hospital margins, they are as slim as ever before.The cost of labor is a 19% expense growth per discharge. The drivers here are absolutely putting so much pressure on the system at large to figure out how they can increase productivity from a dwindling labor force, and at the same time, actually have that labor force be smiling all the while. How can they bring joy back to that labor force in such a way that they’ll actually end up seeing more patients? It’s a very, very tricky line to walk and pull off.

That’s where technologies like AI can come in, and generative AI specifically. The way that we leverage AI at Abridge is that this is technology that’s getting out of the way. You can bring it into your conversations. This is technology that can scale because it’s all technology, it’s real time, and it’s flexible enough that we have an API that can integrate with telemedicine, for example, or call center conversations. Not just doctors, but nurses, PAs, medical students, and trainees. Everybody can benefit from this technology. That will lead to people having better conversations with their patients, being more present, and patients having better experiences. In the case of Abridge, since we also have an offering on the patient side, we want to be able to demonstrate that it is improving understanding, and better follow through. The aspiration is to demonstrate better outcomes. 

Financial markets are down and health systems are struggling with their bottom lines. How will the market look in the next 3-4 years and how do you position the company?

The idea more than anything is to leverage technology to rise to the moment of this public health crisis. In terms of strategy, there’s a great quote that startups get disruption when they get distribution faster than incumbents get innovation. It summarizes all the Clayton Christensen books. The name of the game from a strategy perspective is finding a way to create as much impact as possible. That’s always the promise of technology, that it can scale infinitely and that we can distribute this at a price point that all the healthcare systems, all the clinics can actually afford. Not just for their doctors, but their entire staff over time. That that aspect of our strategy is crystal clear, that we have to be cheaper, better, faster. We have to leverage technology and all of the affordances that come with it to get this out there at this moment in time, right now in 2023 when the need has never been greater.

In the moment right now that we are in, it feels like we have two huge waves that are starting to intersect. At Abridge, we are riding both of them. One of those waves has to do with this public health crisis, clinicians burning out, margins remaining slim, and this challenge around us as a society of the healthcare system not having enough clinicians to actually deliver the care that everybody needs, that our communities require right now. How are we going to respond?

In parallel, we have this other huge wave around generative AI, and all of us as a society starting to understand that this is a solution, there is a lot of magic in this. How do we find a way to get them to intersect to point generative AI at this public health crisis and create value? 

Paradoxically, generative AI can be just the thing to highlight the humanity in healthcare, to help people be more present and focus more on each other. That more than anything is going to improve experiences, outcomes, and start to solve this challenge that healthcare systems are dealing with. At Abridge, that’s our mission, that’s what we’re all about, that’s what we’re focused on. We have been super excited to be able to partner with large healthcare systems, not just UPMC, but we recently announced University of Kansas Health System, where over 1,500 clinicians are going to be able to leverage our technology in real time in a very deeply integrated way with their healthcare electronic medical record system. We are excited to be able to demonstrate that we can scale this across systems and across the entire United States over time in a very short order.

Morning Headlines 4/3/23

Novant Health lays off executive team members

Novant Health (NC) lays off 50 employees, including EVP/Chief Transformation and Digital Officer Angela Yochem, MS.

Vendor Breach Event Notice: Adelanto Healthcare Ventures (AHCV)

Northwest Texas Healthcare System notifies patients that a phishing incident at Adelanto Healthcare Ventures, a consulting firm with ties to one of the health system’s business associates, may have exposed sensitive patient information.

FDA proposes a new plan to streamline updates to medical devices that use AI

The FDA publishes proposed guidance that will enable developers of AI-reliant medical devices to automatically update products already being used in clinical settings.

Monday Morning Update 4/3/23

Top News

Epic CEO Judy Faulkner reportedly tells attendees of AMGA that the company is testing the use of ChatGPT to create draft provider responses to patient emails.

She says ChatGPT is less terse than doctors.

This seems like a great idea since experiments have shown that ChatGPT excels at analyzing a transcript of what a doctor says to offer suggestions of how they can be more empathetic. In other words, the computer advises the doctor on being human.

Reader Comments

From Brisco County: “Re: online services such as WebMD. They must be sweating ChatGPT hard.” Any company whose livelihood is based on sending or receiving web traffic should be worried. Web commerce is driven by search engine discovery and the opportunity to create or steal content and surround it by ads. ChatGPT summarizes the web, so there’s less need for users to look elsewhere. Also worried are publishers, since much of their traffic relies on search engines. Add to the mix that Facebook and Twitter are dying and the web could look very different in a couple of years. I welcome the chance to see content that is personalized and useful rather than driven by an algorithm whose primary purpose is to enrich its owner. Which is another concern about OpenAI and other companies – what will the inevitable monetization of their platform look like?

HIStalk Announcements and Requests

Poll respondents think their health system does a pretty good job using digital tools.

New poll to your right or here: After a weekend car accident out of state, how much of your important health information could ED doctors immediately obtain electronically? Also, let’s assume you are alone and unconscious with only a driver license and insurance card in your possession. Also, that all of your providers don’t use the same EHR. Poll comments are welcome about how you expect that the process would work or what precautions you might take to improve it.

I checked Epic’s site as soon as I woke up Saturday, but perhaps their previous April Fool’s phony news items set the bar too high because this one wasn’t memorable. ONC saved the day with a clever Rickroll tweet.

Webinars

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

People

The Health Care District of Palm County (FL) promotes Daniel Scott, MS (Good Samaritan) to VP/CIO.

Eric Rose, MD (TenSixteen Bio) joins Logos Informatics as CMIO.

Digital Health KC hires Dick Flanigan, MAS (RFJ Advisory) as CEO.

Ardent Health Services promotes Lonnie Garrison, MS to VP of IT.

Announcements and Implementations

Coryell Health begins its rollout of Oracle Cerner, which hopefully isn’t the system shown in the modified stock art stock that features illogically freeform input fields and a misspelling of “widowed.” Something tells me that the touchscreen-poking user wasn’t sitting in the health system’s 25-bed flagship hospital in Gatesville, TX, which is mostly known for its several jails and prisons. They used to hold a Prison Boss Cook-Off there, but it died from lack of participation.

Twitter open sources parts of its platform software, with the most interesting part being the code that chooses the “For You” tweets you see from users you don’t follow, with the most important factor being how likely it is that people will like, retweet, or reply. The blog post doesn’t say how the code artificially boosts Elon Musk’s tweets as he demanded in a recent Twitter tantrum, where he raged that the President’s Super Bowl tweet got more impressions than his own.

Amazon opens its low-power Sidewalk network – powered by connected Ring and Echo devices, courtesy of their owners — and to developers who need an cheap Internet of Things type connection. The coverage map shows that 90% of the US population is in range. Use cases include health trackers, smart pill bottles, smart door locks, dog trackers, soil moisture sensors, and weather stations.

Novant Health lays off 50 employees, including EVP/Chief Transformation and Digital Officer Angela Yochem, MS.

Other

In an unrelated but interesting conference development, the Entertainment Software Associated cancels its June expo that is known as “video game Christmas” in Los Angeles. The event, which drew 66,000 attendees to its final conference in 2019, was cancelled in 2020 due to COVID, changed to an online event in 2021, and then cancelled again in 2022. The organizers say interest wasn’t strong enough to support a big, impressive event and that interested companies couldn’t overcome resource challenges. Participants say that the big game publishers were already moving to running their own events online at a lower cost.

Madison magazine profiles Roots & Wings Foundation, created in 2019 by Epic CEO Judy Faulkner and her husband Gordon – and run by their daughter, Shana Dall’Osto – that offers unrestricted grants for non-profits purely based on trust. It awarded $40 million to Madison-area organizations in 2022. Dall’Osto says that neither she and her parents were raised rich, as Judy attended University of Wisconsin-Madison on scholarships and she and husband (and now pediatrician) Gordon lived in assisted housing and used food stamps before starting a family. She says she wasn’t unhappy that Judy signed The Giving Pledge in 2015, in which the many-billion dollar fortune of her parents will go to charitable causes instead of to their three children, saying that her mom was always clear about her intentions and her concerns about ruining kids by handing them big inheritances.

Sponsor Updates

• Surgical Care Specialists (PA) and Fairview Community Health Center (KY) transition to the EClinicalWorks Cloud.
• Nordic releases a new Making Rounds Podcast, “Modernizing business intelligence for stronger data analysis.”
• Talkdesk publishes a new report, “The promise (and pitfalls) of self-service automation in customer service.”
• Tegria staff partner with One Roof Foundation and take part in a community clean-up in the South Park neighborhood.

Blog Posts

• Continuing the Conversation: Our Commitment to IDD (Netsmart)
• Expanding women’s health: Addressing health disparities with innovations (Nordic)
• Our Culture of Giving: OptimizeRx Supports the American Foundation for Suicide Prevention (OptimizeRx)
• Bolder and Brighter: Key Takeaways from the 2023 ACHE Congress (Pivot Point Consulting)
• Unlocking the Potential of Your Answering Service: More Than a Cost Center (PerfectServe)
• Battling Drug Shortages: Novel Ideas for an Unprecedented Challenge (Premier)
• FHIR 5 is here (Redox)
• A Day in the Life of a Contact Center Scheduler (Relatient)
• Keeping Pace with Best Practices is Key to Prescription Safety, Affordability (Surescripts)
• Decoding the fiction: The myths of artificial intelligence (Talkdesk)
• Reimagining Master Data Management for Healthcare Organizations (Verato)
• The Federal Breast Density Inform Rule: Huge Leap Forward, But More to Do (Volpara Health)
• Monday: Medicare Advantage rules change – How much will it really hurt? (Wolters Kluwer Health)

Contacts

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

Morning Headlines 3/31/23

Murray, Tester, Brown Announce Comprehensive Bill to Overhaul VA’s Electronic Health Record Modernization Program

Senators Patty Murray (D-WA), Jon Tester (D-MT), and Sherrod Brown (D-OH) introduce legislation to overhaul the VA’s Oracle Cerner project.

Columbus-based CoverMyMeds to cut more than 800 jobs, close Arizona office

McKesson-owned CoverMyMeds will lay off 815 employees; close its Scottsdale, AZ patient support center; and rent out space in its $240 million Columbus, OH headquarters.

Florence Launches Modern Healthcare Experience With $20M Seed Round Led by Thrive Capital, GV, and Salesforce Ventures

Florence, which offers a patient engagement app, emerges from stealth with a $20 million seed funding round.

Cassidy, Moran Introduce Legislation to Improve Electronic Health Record System Before Rollout Continues

A group of Republican senators introduces legislation that would halt further VA go-lives on Oracle Cerner until significant improvements are made from a rigorous list of requirements.