Readers Write: The Cost of Doing Nothing: Five Learnings from the Build versus Buy Debate

The Cost of Doing Nothing: Five Learnings from the Build versus Buy Debate
By Kimberly Hartsfield

Kimberly Hartsfield, MPA is EVP of growth enablement at VisiQuate of Santa Rosa, CA.

It’s a conundrum that health system executives regularly face. Build a much-needed software solution in-house or buy it from a vendor?

Once hospital leaders identify the need for a solution that requires new functionality, the debate is on. Revenue cycle management (RCM) solutions are no different.  While many hospital IT departments are no doubt capable of designing, constructing, and implementing new RCM solutions, leadership must decide whether taking this route is likely to yield the best business results.

Often, it starts with hospital leaders surveying vendors, seeing the price tag, and deciding to embark on the journey to complete the project internally, with the premise that it will be at a much lower cost. The decision frequently backfires. Rather than making the investment and having the technology that hospitals need to support their RCM operations efficiently, do-it-yourself health IT projects often end up taking years to fail and costing hospitals far more than if they would have signed with a vendor in the first place.

Health IT leaders see a pretty Tableau or Qlik dashboard and think, “We can do this ourselves.” When it comes to data visualization, they probably can. What they don’t consider is that the data aggregation, normalization, and transformation work that happens under the hood is actually the challenging part of RCM transformation.

The following are factors to consider when considering whether to build or buy a new RCM solution.

Complex health IT projects require more than health IT

IT departments sometimes believe that because they have their own developers and analysts, they can design, build, and implement complex health IT systems on their own. However, complex health IT projects require far more than technical skills. There must be business knowledge and experience married to that technical skill. Frequently that is where the projects break down because the people with the business knowledge already have full time jobs in the organization that are not related to building a platform.

Indeed, the reality of large IT projects is that they frequently exceed timelines, go over budget, or sacrifice important functionality. For example, one in six large IT projects have an average cost overrun of 200% and a schedule overrun of almost 70%, according to Harvard Business Review. Similarly, 56% of IT projects fall short of the original vision, according to a study by McKinsey.

It’s all about speed to value

Leading RCM vendors have been waking up every day for years thinking about how they can work to evolve revenue cycle analytics and deliver value and ROI to clients. Vendors have the benefit of having seen and evaluated RCM systems from healthcare organizations of many different shapes and sizes across the country. They understand best practices, having implemented RCM solutions alongside numerous electronic health records systems. This experience enables the ability to identify idiosyncrasies that hide within data and frequently uncover gaps that clients didn’t know existed.

While hospital do-it-yourself RCM projects may take years to complete, leading vendors can perform an installation in 90 days, delivering immediate insights and ROI.

RCM processes are broken and technology is the fix

It’s an unprecedented time for healthcare. There is no model for the circumstances the industry is undergoing, given labor shortages, supply chain constraints, and the financial after-effects of the COVID-19 pandemic. Across the nation, hospitals are pushing for more automation to augment staffing issues, letting their staff focus on tasks that require decision making, not repetition.

In many cases, RCM processes are broken, and technology is the only route hospitals can take to do more with less. Hospitals must lean into technology and automation, leveraging data to build predictive models and using artificial intelligence and machine learning to boost efficiency.

Unless hospitals are large, mature, and complex, they typically don’t have the resources to handle a large RCM project internally. Smaller hospitals often lack resources like a database administrator, a data warehouse, and data scientists who can build predictive analytics models, for example.

RCM processes continually evolve

It’s easy to forget that RCM projects typically are not “build it and you’re done” solutions. In addition to building RCM solutions, hospital IT departments must provide ongoing support and maintenance. These projects continually evolve, with new requests for additional reports or functionality upgrades. This often requires analysts, engineers, and other highly paid technical resources that are difficult to find and are only growing more expensive.

Further, it’s an open question as to whether build-it-yourself solutions deliver enough value and differentiation to be worth the time, expense, and effort. For example, if all an organization’s competitors can simply build their own systems to accomplish a certain objective, then that system is hardly a source of competitive advantage.

Move from descriptive to predictive

RCM employees cannot manage by spreadsheets. The industry is moving beyond rows and columns. RCM employees need to be able to visualize data to detect patterns to quickly identify outliers and manage by exception. Additionally, hospitals must move their RCM processes beyond descriptive analytics to predictive and prescriptive analytics.

It is no longer acceptable for hospital leadership to simply understand what happened yesterday. Hospital leaders must look to the future with the ability to anticipate and predict what will happen tomorrow, next month, or even in six months. Through automation and advanced data analytics, leading RCM solutions drive those insights.

Readers Write: Making a Case for Digitizing HICS Protocols and Emergency Notification Processes

Making a Case for Digitizing  HICS Protocols and Emergency Notification Processes
By Dave Sinkinson

Dave Sinkinson, MBA is VP of mobile at Rave Mobile Safety of Framingham, MA.

Patient safety is and always will be at the forefront for healthcare systems. While planned events such as a move or community open house warrant and receive pre-planning by hospital officials, emergency situations can and do arise in the healthcare setting at a moment’s notice. Whether it is a global pandemic, natural disaster, system malfunction, or a violent incident, hospitals must plan for and respond quickly to adverse events, not only for the sake of their patients, but also because they have a duty of care to safeguard employees and visitors to their facilities.

That’s where the Hospital Incident Command system (HICS) comes in. HICS offers hospitals and other healthcare organizations a standardized framework for managing complex emergencies and helps health systems prioritize safety. But meeting the various HICS requirements in the midst of an already busy role can be arduous for health system emergency managers and those they rely on during crisis events. Healthcare safety practitioners are ditching outdated tools and technologies — such as printed manuals, paper phone tree lists, or legacy communication systems — in favor of digital solutions that streamline work, automate compliance, meet quorum requirements, and improve notification capabilities.

Digital transformation is certainly not new in the healthcare sector. Healthcare safety leaders have been using technology to improve patient care processes and outcomes for years, and to help with emergency notification. However, healthcare safety practitioners are realizing the benefits of using these same tools to digitize incident command protocols and to enhance operational efficiencies.

The Mayo Clinic is using technology to tackle the manual, time-consuming tasks on their HICS to-do list. Their automated approach to industry compliance is not only ensuring that all HICS team members are on the same page, in real time, it is ticking the box on staff accountability, notification, and reporting. Emergency management professionals at the world’s top hospital recognized how unrealistic it was for key personnel to access hard copies of crisis plans with detailed responsibilities or to search for materials in times when seconds matter. They digitized safety protocols, resources, and benchmarks in a handy, one-stop app that not only helps them to accomplish necessary HICS steps, but allows them to do even more, for example, further leveraging the Common Alerting Protocol (CAP) for a more integrated approach to safety.

By automating HICS activations, healthcare safety professionals can lay out emergency response plans in the order they need to be carried out, manage permissions, reassign responsibilities if they are not undertaken swiftly, and notify certain audiences about an event unfolding and steps that need to be taken. Technology also captures important data including when an emergency alert was sent, who received important messages, and which HICS team members performed emergency response actions.

Health systems are also tapping into these tools for non-emergencies. They are being used to communicate about staffing shortages and to share severe weather updates that may impact employees coming to work or leaving their shift. They are also being used more often as digital resource centers. In the past, it may have been sensible to house emergency preparedness and response materials on a hospital website or intranet portal, but when you consider how many of us are tethered to our phones these days, it just makes sense to prioritize safety apps.

As with anything worthwhile, it is not simply a matter of building it and they will come. Hospitals must consistently communicate about safety tech solutions via signage, during meetings, and as part of staff onboarding to raise awareness and encourage usage during crisis situations and as part of the health system’s engagement culture. They must commit to training staff at different intervals throughout the year so that personnel can take an active role in their own personal safety by using anonymous tip-to-text technology and two-way communication components, or simply just so they know where to go for important hospital updates. Reviewing page visits and other digital data can also help hospitals to better understand what is resonating with employees and what may need tweaking or highlighting.

Communication and collaboration are the foundation for any HICS plan. With the push of a button, safety apps can effectively connect hospital leaders with people in the trenches while simultaneously informing first responders of an emergency situation.

Morning Headlines 3/8/23

Gang leaks Lehigh Valley Health Network cancer patient photos as part of data hack

BlackCat hackers post pictures of Lehigh Valley Health Network (PA) cancer patients on the dark web after the health system refused to meet the group’s ransomware demands last month.

Virtual Education Center Provides Health Information to Patients

The Defense Health Agency launches a six-month pilot of its Virtual Education Center, a tool offering validated health information to patients and providers that will eventually be integrated with the MHS Genesis EHR.

Best Buy will set up in-home hospital care through a new deal with Atrium Health

Best Buy will set up in-home virtual care systems for Atrium Health in a three-year deal that will enable the health system to remotely monitor up to 100 patients.

VA expects its legacy EHR to be ‘around for a long time’ as it troubleshoots replacement

VA officials tell members of the House Committee on Veterans’ Affairs, Subcommittee on Technology Modernization that its legacy VistA system will be utilized for at least another five to 10 years while the new Oracle Cerner EHR is implemented across the department’s remaining facilities.

News 3/8/23

Top News

Transcarent will acquire virtual primary care company 98point6’s care delivery division — which includes an AI-powered chatbot, physician group, and self-insured employer business — for $100 million.

Transcarent, which has relied on contracted clinicians, will gain 98point6’s 150 directly-employed doctors and support staff.

98point6 has raised $270 million in funding.

After the acquisition, 98point6 will stop providing patient care and will develop and sell technology to health systems. MultiCare Health System has signed on as its first software customer.

HIStalk Announcements and Requests

Hear ye, HIStalk sponsors participating in ViVE 2023 — send me your details for inclusion in my conference guide. It’s easy, free, and fun (well, maybe “fun” is a stretch) but why not tell reader attendees why they should drop by your expensive booth?

Webinars

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

Acquisitions, Funding, Business, and Stock

WW, known as WeightWatchers until a 2018 name change, will acquire telehealth-based weight management company Sequence for $132 million. Sequence’s $99 per month membership plan provides prescriptions for high-demand weight loss drugs such as Wegovy and Ozempic, a price that does not include the $1,000+ monthly cost of the drugs themselves. Sequence touts its prior authorization technology as a differentiator. WW shares, which have slimmed down 57% in the past 12 months versus the Nasdaq’s 12% loss,  jumped 79% on the news, valuing the company at $489 million.

Best Buy will set up in-home virtual care systems for Atrium Health in a three-year deal. Atrium expects to monitor 100 patients remotely, buying devices from Best Buy and having them installed by its Geek Squad. Best Buy Health’s president is Deborah DiSanzo, MBA, who was formerly GM of IBM Watson Health and CEO of Philips Healthcare.

Newly launched Opkit announces GA of a health insurance verification platform for telehealth companies and virtual clinics.

Sales

• De Baca Family Clinic (NM) selects EHR and patient engagement software from EClinicalWorks.
• CareView Communications adds Sonifi Health’s interactive communications technology to its patient video monitoring software, giving patients the ability to communicate with care teams from bedside smart TVs.

People

Healthcare identity management vendor Verato hires Avi Mukherjee, MBA (Verily Life Sciences) as chief product officer.

Waystar promotes Missy Miller to chief marketing officer.

Direct Recruiters promotes Shayla Jastrzebski to partner.

Cookeville Regional Medical Center (TN) promotes Tim McDermott, MBA to CIO.

Kyruus promotes Heather Berndt, MA to VP of mid-market and client sales.

Announcements and Implementations

The Medical University of South Carolina takes over management of Regional Medical Center and will convert it from Cerner to Epic.

Vitalchat announces GA of AI-Enabled E-Sitter, virtual nursing technology that enables clinicians to remotely monitor up to 100 patients from a central hub.

Weill Cornell Medicine (NY) uses AI-powered ProviderIQ technology from Hatchleaf to more effectively match patients with best-fit providers across specialties.

A study of procedure documentation modalities for hand surgery – AI-based virtual scribe, medical scribe, transcription service, and EHR voice recognition –  finds that all four generate acceptable results. The AI scribe required the least amount of surgeon time and was able to identify most of the elements needed, but the plans it generated required clinician review.

An NYU School of Medicine study finds that prescribing rates for mineralocorticoid receptor antagonists doubled when cardiologists were presented with an EHR banner alert reminding them of the appropriateness of the treatment for their heart failure patients. MRAs can greatly improve survival rates but are ordered for only one-third of eligible patients, resulting in an estimated 20,000 preventable deaths in the US each year.

A new KLAS review of small-hospital patient accounting finds that Meditech Expanse tops the list, with Epic coming in second because service quality varies under the CommunityConnect model in which the host hospital provides services instead of Epic.

Government and Politics

The Defense Health Agency launches a six-month pilot of a tool that offers validated health information to patients and providers.

The House Committee on Veterans’ Affairs, Subcommittee on Technology Modernization held the first of a series of oversight hearings on the VA EHR program Tuesday afternoon. Notes:

• Chair Rep. Matt Rosendale (R-MT) said that VA IT systems exist to improve care, not to “turn out cushy contracts to technology companies.” He says that all EHR projects or options will be evaluated on patient safety, reliability, user satisfaction, and cost.
• Rosendale says that some elements of VistA will be used for at least 10 years, and some parts that aren’t addressed by Oracle Cerner may never go away, so VistA must be maintained.
• Rosendale said Mann Grandstaff VA Medical Center has become “the most dangerous VA hospital in the country” based on its post-Oracle Cerner patient safety reports of 500 per year versus an average of 55 per year from VistA-using facilities.
• Former VA CIO Roger Baker says concrete evidence exists that veterans have better outcomes from facilities that use the VA’s legacy VistA system instead of Oracle Cerner.
• Baker says that lobbyists are falsely claiming that VistA can’t be improved because of age, complexity, and technology. He says that big modernization improvements were made under his tenure even though VA had cut off VistA improvements for 16 of the last 24 years.
• Baker says that replacement of VistA Laboratory with the cloud version of Cerner’s laboratory system in 2007 was a failure that never expanded beyond the first hospital because of the cost and timelines required to customize it using available parameters.
• Baker says Oracle Cerner is the VA’s third attempt to replace VistA, following HealtheVet and IEHR, and all have failed because the VA’s culture values local control rather than software standardization.
• Baker says that studies have shown that only 16% of large US government IT projects succeed, and as the largest federal IT project, “VA has no chance of actually succeeding on this program.”
• Former VA executive Peter Levin testified that the billions of dollars that have already been spent on Oracle Cerner cannot scale to enterprise-wide clinical services. He said that DoD fared better because they had already transitioned to a centrally administered workflow, they planned better, and predecessor system AHLTA was a mess that made Cerner look like an improvement to users.
• Asked about Cerner being awarded a no-bid contract, Levin says he doesn’t think the selection was unfair, but there were “political exigencies.”
• VA IT executive Daniel McCune says that the annual cost of maintaining VistA has ranged from $418 million in 2018 to $891 million in 2022, and the cost will continue to increase until Oracle Cerner is fully implemented.

Privacy and Security

The FBI and Cybersecurity and Infrastructure Security Agency release a Cybersecurity Advisory to help healthcare providers protect their networks from the Royal ransomware variant.

Other

A Black Book survey of 2,500 health IT leaders finds that 30% plan on investing in health data integration solutions this year. Reducing duplicate and unnecessary procedures, increasing volume of consumer health data, patient demands for nearly immediate health results, and gaps in clinical device connectivity were cited as top reasons for investment. Innovaccer took top marks for its data integration solutions.

CNBC profiles Denmark-born Ida Tin, whose company launched popular menstrual health app Clue. She coined the term “femtech” to describe the trillion-dollar market to attract investors who would not have been comfortable with “a company that helps women not pee their pants.” She stepped down as CEO of birth control app vendor Clue in 2021, explaining that, “I could see that the things that I would have had to learn to really serve the company were things I’m not that good at, and I was not so interested in a lot of very serious operational stuff and that didn’t excite me as much.” She became interested in business when she got lost at the college where she was studying art and ended wandering by mistake into a business course interview.

Sponsor Updates

• Sam Larson, head of marketing for Philips Capsule, and his family will take a team to Jamaica’s Mustard Seed Communities this summer to complete several work projects.
• AdvancedMD publishes a new e-book, “2023 MIPS Attestation Guide.”
• Bardavon Health Innovations acquires injury prevention company Preventure and launches a Safety Intelligence Suite for employers and insurers.
• CarePort publishes an e-book, “5 levers for hospital success under value-based care.”
• ChartLogic will exhibit at the American Association of Orthopedic Surgeons Annual Meeting March 8-10 in Las Vegas.
• ConnectiveRx will sponsor the Point-of-Care Marketing Summit March 22 in New York City.
• AdvancedMD publishes a new e-guide, “2023 CPT/HCPCS Codebook.”
• Netsmart will integrate the CAMS-care Collaborative Assessment and Management of Suicidality Framework and Suicide Status Form with its CareFabric platform.
• Nordic releases a new podcast, “Making Rounds: The Big Squeeze in Healthcare.”
• Optum will exhibit at the Academy of Managed Care Pharmacy Conference March 21-24 in San Antonio.
• Sectra publishes a new case study, “AI frees up valuable time for radiologists in a Swedish healthcare region.”
• Spok earns top honors for the sixth consecutive year in a recent Black Book survey for its secure communications platform.
• Verato publishes a new case study, “Large Texas non-profit health system avoids costs, enhances productivity, and improves scalability.”
• West Monroe promotes 16 new managing directors.

Blog Posts

• Is Hospital Pre-Registration Possible Without Portal Adoption? (Access)
• Understanding the HHS-HCC Risk Adjustment Model (AGS Health)
• Healthcare disrupted: How to keep pace in a rapidly changing world (Arcadia)
• Ascom Workflow Technology Designed for Interoperability to Make 1+1=3 (Ascom)
• 7 Step Roadmap to Developing a Virtual Nursing Program (AvaSure)
• Using Real-Time Insights to Improve Value-Based Care Outcomes (Bamboo Health)
• Why Double Down on Injury Prevention? CEO Matt Condon Talks About Our New Safety Intelligence Suite (Bardavon Health Innovations)
• Epic Go-Live Planning: Keys to Successful HOD Implementation (CereCore)
• What is a Care Manager? (ChartSpan)
• Enabling Value with Interoperability & Analytics Using the 1Clearsense Platform (Clearsense)
• Harnessing Big Data for Suicide Prevention (Dimensional Insight)
• The 21st Century Cures Act and its Impact on Interoperability and Healthcare (HealthTech Resources)
• Long-Term Cost-Saving Opportunities in Healthcare (Divurgent)
• Key Tips for Successfully Managing and Optimizing Your Revenue Cycle (Vyne Medical)
• Beyond the call: How to differentiate your telehealth experience post-visit (Wolters Kluwer Health)
• Using EHRs to Increase Employee Satisfaction and Retention (Netsmart)
• Be the Poison Control (or help desk) operator your colleagues need you to be (Nordic)
• Combatting Burnout and Fatigue in Healthcare (Optimum Healthcare IT)
• So, Food is Medicine, What Does That Mean for Pharmacy? (OmniSys)
• Break the Backlog: 6 Strategies to Reduce Report Queue Backlogs (Pivot Point Consulting)
• How Clinical Communication Helps Critical Access Hospitals Improve Patient Outcomes (PerfectServe)
• Three Ways Premier is Supporting Continuum of Care Providers (Premier)
• How to Succeed in Value-Based Care Without In-House HCC Coders (RCxRules)
• FAQ: How do healthcare organizations define optimal provider-patient communication? (Relatient)
• Why your hospital should be using patient discharge checklists (Sonifi Health)
• 5 hospital contact center trends to watch (Spok)
• Tegria on Techquity (Tegria)
• The Value of One Integrated Clinical Communication Platform (TigerConnect)
• Advancements in PT Technology and Emerging Digital Trends (WebPT)
• How Evidence-Based Care Leads to Value-Based Care (Zynx Health)

Contacts

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

Morning Headlines 3/7/23

Transcarent To Acquire Part Of AI-Powered 98point6 In $100 Million Healthtech Deal

Transcarent will acquire virtual primary care company 98point6’s AI-powered chatbot technology, among other assets, in a deal CEO Glen Tullman says could be worth up to $100 million.

Cybersecurity incident impacts Houston Healthcare’s operations

Houston Healthcare (GA) works to restore its computer systems after a cybersecurity incident March 3 forced it to use established back-up processes and downtime procedures to continue caring for patients.

WeightWatchers to Acquire Sequence, a Digital Health Platform for Clinical Weight Management

WeightWatchers will acquire Sequence, a telehealth company specializing in chronic weight management, in a deal valued at $132 million.

Curbside Consult with Dr. Jayne 3/6/23

Jayne Goes to ATA

I have arrived at the American Telemedicine Association meeting in San Antonio, escaping the freezing rain of the Midwest for the blindingly bright sun of Texas.

Since it’s been a number of years since I’ve been to the downtown area, I did my usual walkabout. I’m always stunned by how small the Alamo is and how surreal it is to be in the middle of downtown surrounded by tourist shops and a wax museum. Although the Riverwalk was bustling Friday night, the surface streets were more subdued. I saw police responding to two restaurants, one near the Alamo and the other on the Riverwalk, due to disorderly patrons. By 7 p.m., Alamo Plaza was all but deserted, but the Riverwalk was bustling.

Saturday morning, I got my four miles in along the Riverwalk before many tourists were up and about. Most people don’t realize that the touristy section of the San Antonio River is made possible by a dam, which can control the height of the pool in the Riverwalk section. I grew up along a major river and had many trips to the lock and dam complexes with my dad, so I’m more prone to notice these kinds of things than the average tourist.

San Antonio is definitely doing its part to keep the area clean, with ample service workers out hosing off sidewalks and picking up trash during the early morning hours. It’s a shame that people have to throw trash in the river in the first place, but maintenance workers were fishing it out nonetheless.

On the way to registration, I stumbled upon San Antonio’s own “love locks” bridge near one of the less traveled sections of the Riverwalk.

At the convention center, I found a street artist working on this piece using paint pens. It was fascinating to watch how they controlled the lift with one hand and painted with the other.

Registration was a breeze, and the friendly check-in agent even asked me about the marathon shirt I was wearing. The conference bags were minimalist in nature and I like that. This is the kind of bag I keep in my suitcase for grocery runs when I’m traveling. It contained the usual flyers and postcards, along with a COVID-19 test kit from sponsor EMed, which is a great thing to include in a conference bag since many people have decided COVID is “over” and I suspect that a lot of the allergies people are complaining about might just be COVID.

On the other end of the useful spectrum is this single sock from ProAssurance. Attendees have to go by the booth to get the other one. Although it seems clever, it has the potential to generate a significant amount of waste, and attendees are becoming more attuned to that. Given the pattern on the sock, I’ll probably go by to get the other one for my favorite MD/JD, however. There were a couple of flyers in the bag, along with a couple of white papers, but none of the random junk I’ve gotten at other conferences, which was much appreciated.

After a brief sojourn to my hotel room to catch up on some of the working hours I missed while traveling yesterday, it was time to head back to the conference for a “Deep Dive” session on the business aspects of telehealth. It was a great session with lots of detail and a ton of attendees, resulting in standing room only conditions and people sitting on the floor around the edges of the room. Topics included compliance, professional liability, cyber liability, and the new proposed DEA regulations on controlled substances within telehealth.

I liked the seating arrangements – large round tables in the front for those who prefer that configuration, and standard rows of chairs in the back. The audience seemed engaged, with few people leaving until the end. I found the event photographers distracting, though. They were constantly in the room and would move around to take a new round of photos every time new panelists took the stage, often blocking the view of the speakers. A couple of them were also using 360-degree flash units even when shooting photos from far away, and although I don’t think they did much to illuminate the subjects they did a great job of blinding the audience momentarily. I wasn’t super keen on them taking long slow video panoramas of the audience, but I guess that’s just the nature of the beast these days.

From there we were off to the opening session which included speakers from the ATA, Optum, Google, and Microsoft. Topics were far ranging and there was a lot of discussion about how telehealth should evolve and expand in the post-COVID era. The presenters were largely industry folk. I overheard some people talking afterwards that it would have been good to hear from some patients whose lives had been touched by telehealth or whose care was made better through the technology. It’s nice to understand how the work we do impacts people at the point of care, whether they are clinicians, patients, or their families. Maybe ATA will consider incorporating something like this next year.

After the opening session, there was a casino night-themed social event with food and beverage service, although based on the attendance, I think a lot of people ventured out for dinner. I’m not much of a gambler, but it was fun to watch people celebrating at the craps table and to catch up with people I don’t normally get to see in person.

I’ve got some sessions picked out for the next couple of days of the conference, including ones on health equity, telehealth reimbursement, policy and advocacy, interoperability, and usability. I’ll also be hitting the exhibit hall and checking out some potential vendors as well as meeting up with a couple of old friends.

Hopefully there will be some time to soak up a little bit of sun in between sessions because the weather is certainly nicer here than it is back home. My step count was off the charts for today, so it’s now time to put my feet up and settle in with a good book to ensure I’m ready for what looks to be a pretty long day.

What kinds of things do you most like to experience at conferences, and what do you like the least? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 3/6/23

Epic Systems to add 1,700 jobs as it expands its Wizards Academy campus in Verona

Epic will add 1,700 employees to its current headcount of 11,600 in the next 12 months, housing them in two new office buildings that it will build within its Harry Potter-themed Wizards Academy complex.

MUSC invested $15M into RMC partnership; CEO says system focused on quality

The Medical University of South Carolina invests $15 million in its management of Regional Medical Center, which will include expanding telemedicine services and switching the hospital over from Cerner to Epic.

#StopRansomware: Royal Ransomware

The FBI and Cybersecurity and Infrastructure Security Agency release a Cybersecurity Advisory to help healthcare providers protect their networks from the Royal ransomware variant.

Monday Morning Update 3/6/23

Top News

Epic will add 1,700 employees to its current headcount of 11,600 in the next 12 months, housing them in two new office buildings that it will build within its Harry Potter-themed Wizards Academy complex.

Two-thirds of poll respondents think that restrictions banning physicians from opening or operating hospitals should be lifted.

New poll to your right or here: Have you used telehealth to obtain a prescription for a drug that you wanted knowing that few questions would be asked?

I’ve done nothing to prepare for HIMSS23 except book a hotel, so I fired up the Meta Quest 2 and Wander, which has become my most-used VR app. I searched for my hotel by name and then could take a virtual stroll through Chicago to check out nearby restaurants, points of interest, and the Riverwalk. It brought back memories of previous HIStalkapalooza events that were in Trump Tower and the House of Blues, the latter of which is still my favorite venue of those I’ve used.

I am amused annually by the American Telemedicine Association, which advocates virtual care to those who attend its in-person conference.

A doctor friend received a PET scan report with good numbers last week, but the dictated summary said that he had heart damage and could expect a significantly shortened lifespan. He spent 12 hours researching the test and its interpretation, then messaged the doctor that the report didn’t make sense. He got a quick response saying that the doctor had pressed the wrong keys in Epic, then received a corrected report indicating that he’s fine after all. He raises these points:

• What if he was a layperson?
• Had he been referred, would a specialist had paid attention to the numbers, or would they use the erroneous summary to make medical decisions?
• Will his medical record reflect that the initial report was incorrect or that the doctor didn’t check the report carefully?
• Does this happen often?

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Webinars

March 7 (Tuesday) noon ET.  “Prescribe RPA 2.0 to Treat Healthcare Worker Burnout.” Sponsor: Keysight Technologies. Presenters: Anne Foster, MS, technical consultant manager, Eggplant; Emily Yan, MPA, product marketing manager, Keysight Technologies. Half of US health systems plan to invest in robotic process automation by the end of this year, per Gartner. The concept is evolving to help with staff burnout and physician productivity. The presenters will introduce RPA 2.0, explain how to maximize its value, demonstrate how to quickly start on RPA 2.0 and test automation in one platform, and answer questions about healthcare automation.

Previous webinars are on our YouTube channel. Contact Lorre to present your own.

People

Stuart Miller (Infor) joins Craneware as VP of sales.

Jamie Coffin, PhD (Sema4) joins Nature’s Toolbox as CEO.

Evernorth Health Services hires Sean Tuley, MBA (Global Medical Response) as Evernorth utilization management CIO.

Integra Connect promotes Marie Finnegan, RN to VP of product management.

Government and Politics

Teladoc Health-owned virtual mental health company BetterHelp pays $7.8 million to settle FTC charges that it shared the information of website and app users with Facebook and other social media platforms. Teladoc, which acquired the company in 2015 for around $5 million, says it’s a billion-dollar business.

Other

Telehealth-based weight loss startup NextMed is using fake reviews and before-and-after photos to promote its services to prescribe trendy diabetes drugs like Ozempic and Wegovy, often omitting government-mandated warnings. The company, whose founder just graduated college, outsources clinical work to telehealth companies and customer service to offshore firms. It touts as a competitive differentiator its software that quickly process prior authorizations for the expensive drugs. Customers complain that the company is slow to respond to cancellation requests and offers Amazon gift cards for taking down negative reviews.

Contacts

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

Morning Headlines 3/3/23

Joint Statement of Chair Khan, Commissioner Slaughter, Commissioner Wilson, and Commissioner Bedoya Regarding Amazon.com, Inc.’s Acquisition of 1Life Healthcare, Inc.

The FTC warns Amazon that it will be monitoring its use of patient data following its acquisition of primary care provider One Medical, noting that it will judge pre-acquisition privacy promises by the standard of a “reasonable consumer” rather than that of a HIPAA expert.

Bright Health Group Reports Fourth Quarter and Full Year 2022 Results

Health insurer Bright Health – fresh off layoffs, the exiting of most lines of business, an impending delisting of shares on the NYSE, and a $1.4 billion loss in 2022 – warns that it has overdrawn its credit and expresses doubt that the company can continue as a going concern.

Fertility player Kindbody gets $100M at $1.8B valuation

Fertility-focused provider Kindbody will use $100 million in new funding to open 10 additional clinics, and acquire virtual health and fertility companies.

FTC moves to ban BetterHelp from sharing mental health data for ad targeting

Online counseling company BetterHelp will pay $7.8 million back to consumers to settle FTC charges that it shared health data with third parties for advertising purposes.

News 3/3/23

Top News

VA Deputy Secretary Donald Remy, JD, who oversees the VA’s Oracle Cerner implementation and other initiatives as its equivalent to COO, resigns as of April 1.

Remy’s departure follows that of VA EHR Executive Director Terry Admirim, MD, MPH, MBA, who left the agency last week.

The VA will nominate a replacement for Remy for Senate confirmation.

Meanwhile, Rep. Mark Takano (D-CA), ranking member of the House Veterans’ Affairs Committee, warns that the VA’s Oracle Cerner project “is on its fourth director in five years, and continues to burn money and disrupt care.” The head of the GAO told the committee that while the VA has addressed some challenges, its bureaucratic, decentralized structure makes positive change difficult and EHR project requires a more disciplined approach. 

HIStalk Announcements and Requests

I invited HIStalk sponsors who are participating in the ViVE conference to send me details for my online guide (I should call it a “curated” guide since that’s a crutch word for ViVE). I feel the need to repeat that invitation because I received only one response, and that was from a company that isn’t a sponsor, so I’ve curated them out. I’m amused at the intersection of ViVE’s commercial ambitions versus its attempt to come off as breezy and unorthodox, such as its lengthy “brand guide” that includes a section on making “key messaging” resemble casually created graffiti, murals, or doodles. That is some excellent curating.

I get a lot of feedback from teachers whose classes have benefitted from the Donors Choose donations of HIStalk readers, including Ms. S in California, who provided this update after receiving hands-on STEM tools:

My amazing scholars not only use, but enthusiastically ask for, “Fun Friday” every single week in order to explore the STEM materials YOU helped provide for them! They are building worlds using their imagination, and solving problems as they arise while using the engineering design process. They utilize critical thinking skills, and collaborative skills to learn science through creative fun spaces. Never were so many rowdy 5th graders ready to get their hands moving and brains working so late on a Friday afternoon. They always see these items on TikTok and never have gotten the chance to explore it for themselves. Thank you for giving them that that joyful opportunity!

Today I learned about the Dunning-Kruger Effect, which describes the “unconscious incompetence” in which people who lack knowledge or skill also lack the intelligence to realize just how incompetent they are.

Welcome to new HIStalk Platinum Sponsor Five9. The San Ramon, CA-based company is an industry-leading provider of cloud contact center solutions, bringing the power of cloud innovation to more than 2,500 customers worldwide and facilitating billions of customer engagements annually. Five9 provides end-to-end solutions with digital engagement, analytics, workforce optimization, and AI to increase agent productivity and deliver tangible business results. The Five9 platform is reliable, secure, compliant, and scalable. Designed to help customers reimagine their customer experience, the Five9 platform connects the contact center to the business while delivering exceptional customer experiences that build loyalty and trust. Thanks to Five9 for supporting HIStalk.

Here’s an intro video on Five9’s The Intelligent Cloud Contact Center and Workflow Automation.

Webinars

March 7 (Tuesday) noon ET.  “Prescribe RPA 2.0 to Treat Healthcare Worker Burnout.” Sponsor: Keysight Technologies. Presenters: Anne Foster, MS, technical consultant manager, Eggplant; Emily Yan, MPA, product marketing manager, Keysight Technologies. Half of US health systems plan to invest in robotic process automation by the end of this year, per Gartner. The concept is evolving to help with staff burnout and physician productivity. The presenters will introduce RPA 2.0, explain how to maximize its value, demonstrate how to quickly start on RPA 2.0 and test automation in one platform, and answer questions about healthcare automation.

Previous webinars are on our YouTube channel. Contact Lorre to present your own.

Acquisitions, Funding, Business, and Stock

Veradigm, formerly Allscripts, delays its Q4 and annual results reports because a software problem caused it to overstate earnings going back to Q3 2021. Veradigm has also lowered its annual  revenue expectations by 2% and adjusted earnings per share by 10%. MDRX shares dropped nearly 13% on the news. They have lost 27% in the past 12 months versus the Nasdaq’s 15% loss, valuing the company at $1.6 billion.

Health Catalyst reports Q4 results: revenue up 7%, adjusted EPS –$0.05 versus –$0.19, beating estimates for both. HCAT shares have lost 46% in the past 12 months versus the Nasdaq’s 16% loss, valuing the company at $780 million.

Walmart will open 28 new Walmart Health locations in 2024, increasing its count to 75 as it expands into Missouri and Arizona. The 5,750-square foot centers, housed in Walmart Supercenters, offer primary care, dental care, behavioral health, labs, X-ray, audiology, and telehealth.

Health insurer Bright Health – fresh off layoffs, the exiting of most lines of business, an impending delisting of shares on the NYSE, and a $1.4 billion loss in 2022 – warns that it has overdrawn its credit and expresses doubt that the company can continue as a going concern. Its valuation is down 97% since its IPO peak of $11 billion in June 2021. Bright Health paid its CEO $181 million in 2022.

UnityPoint Health and Presbyterian Healthcare Services announce their intention to create a parent company for their health systems, which will operate as a 40-hospital, 40,000-employee organization while retaining their existing brands.

Sales

• Genomics England deploys enterprise imaging from Sectra.
• University of Kansas Health System will implement AI-powered medical documentation from Abridge, which was created at the Pittsburgh Health Data Alliance that includes Abridge investor UPMC. 
• Compass Health Network chooses NextGen Behavioral Health Suite.
• Deaconess Health System will implement Health Catalyst’s enterprise analytics and outcomes improvement.
• Bryan Health selects Health Catalyst for population health analytics and value-based care performance improvement.

People

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

Adam Terzich (Redox) joins MediQuant as RVP of sales.

Announcements and Implementations

Wolters Kluwer Health launches Coder Workbench, a high-productivity risk adjustment solution based on the Health Language Data Platform.

A small consumer survey commissioned by KeyCare finds that two-thirds of respondents who needed minor but urgent medical services during out-of-state travels chose telehealth visits with their regular clinicians over urgent care and telehealth visits with non-affiliated providers.

Epic will incorporate patient experience functionality from Press Ganey, initially into MyChart and Cheers, and eventually into other modules. Former Cedars-Sinai SVP/CIO Darren Dworkin joined Press Ganey as president and COO in August 2022 .

HealthBook+ launches to offer a care and guidance platform for healthcare workers that aggregates patient data to offer next best health steps.

Louisiana Children’s Medical Center goes live with Sapphire Health’s AWS-based Epic Cloud Read-Only ransomware recovery tool. Sapphire Health’s founder and CEO is Austin Park, who served two stints as interim CTO at LCMC.

Virtual care technology company Biofourmis and Chugai Pharmaceutical Co. will develop digital solutions for objective assessment and management of endometriosis pain, pairing the Biofourmis Biovitals platform with data that has been collected in studies involving Chugai’s investigational drug product for endometriosis pain.

The Australian Digital Health Agency launches My Health, which provides mobile access to My Health Record’s medical history, lab results, vaccination management, allergy tracking, hospital discharge summaries, and prescription information.

Privacy and Security

The government of Ireland fines provider Centric Health $490,000 for GDPR violations following a 2019 ransomware attack. The personal health information of 2,500 patients was permanently deleted from Centric’s Primacare systems, which is was in the process of replacing. Centric paid an unspecified ransom, but was too late to prevent the data loss.

The Federal Trade Commission warns Amazon that it will be monitoring its use of patient data following its acquisition of primary care provider One Medical, noting that it will judge pre-acquisition privacy promises by the standard of a “reasonable consumer” rather than that of a HIPAA expert.

Other

Osama Alswailem, MBBS, MA, an informaticist who is CIO at King Faisal Specialist Hospital & Research Centre in Saudi Arabia, lists technologies that are driving healthcare in the Middle East: virtual health, AI, wearables, blockchain, 3D printing, and personalized medicine. He says the CIOs have been redefined to chief digital officer as healthcare organizations rely more on data-driven decision-making. His hospital is using AI to improve resource management via a unified command center, working with 3D-printed prosthetics, and using virtual reality for staff training and patient education.

A New York Times opinion piece asks the question, “Why are ketamine ads following me around the internet?” as telehealth startups are taking advantage of pandemic-relaxed rules to aggressively tout the drug for questionable uses, underplaying the abuse potential and potentially dangerous side effects (permanent bladder damage, anyone?) The author brings up an interesting point: the US is one of two countries that allow drug companies to pitch their wares directly to consumers – increasingly, via social media – but even those companies, unlike telehealth companies, are required to stick to FDA-approved uses. Unmentioned in the article is a review of why telehealth-paid doctors are willing and able to ignore science to give customers whatever they want.

An orthopedic surgeon whose planned surgery was denied by the patient’s insurer finds that the company’s peer reviewer is a surgeon who was permanently banned from the OR by the state medical board. The surgeon dug up what he believes is an X-ray from the case that triggered the board’s action against the peer reviewer, in which an artificial hip was implanted backward. Stunned Twitter doctor commenters question whether the surgeon was impaired or incompetent, noting that (a) he also performed two follow-up corrective surgeries without fixing the problem, which was finally caught when the patient was seen by a new surgeon; and (b) horrifically botched surgery or not, the doctor kept his medical license and can practice however he likes outside the OR.

Sponsor Updates

• EClinicalWorks achieves Google’s Chrome Enterprise Recommended designation.
• Experity recognizes three urgent care leaders with Limelight Awards at its Urgent Care Connect Conference in Miami.
• Vyne Medical publishes a new case study, “How to Save Time and Increase Profitability with Auto-Indexing.”
• CloudWave’s OpSus Live cloud hosting for healthcare infrastructure as a service achieves a ‘Best Practice’ rating after completing the Meditech Infrastructure and Supporting IT Process audit.
• The Health Plan Innovation Roundtable honors Enlace Health with the Fall 2022 Innovator Traction Award.
• Nordic publishes a podcast titled “Making Rounds: The Big Squeeze in Healthcare.”
• Fortified Health Security names Dylan Storm (Optiv) renewals specialist, Benjie Graham (Corpay) client success manager, and Jason McKellips (Allied Universal) regional director.
• Get Well honors Product Manager Andrew Todtenkopf with its Heart Award for his extraordinary contribution to company performance and culture.
• Kyruus publishes a new guide, “Successful Online Scheduling in 5 Steps.”

Blot Posts

• Where Does the Fax Machine Fit in 2023? (Vyne Medical)
• Enabling Value with Interoperability & Analytics Using the !Clearsense Platform (Clearsense)
• Equity, Environment, Resiliency, and Risk: Future Considerations for Healthcare Value Analysis (GHX)
• 5 Reasons You Could Benefit from Out-of-Pocket’s Healthcare 101 Course (Healthjump)
• NeuroFlow Helps Organizations Address the Youth Mental Health Crisis with Innovative Solutions for Adolescent and Pediatric Populations (NeuroFlow)
• EHR Advancements for 2023 and Beyond (HealthTech Resources)
• Combatting Burnout and Fatigue in Healthcare (Optimum Healthcare IT)
• The push for patient-friendly terminology (Intelligent Medical Objects)
• Advancing Interoperability in the Age of TEFCA: An Interview with CommonWell’s Executive Director, Paul Wilder: Part 1 (Medhost)
• Confronting maternal mortality with Phoebe Putney Memorial Hospital (Meditech)
• The future of ambulatory care documentation, part 1: It’s time to challenge the status quo (Nuance)

Contacts

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

EPtalk by Dr. Jayne 3/2/23

The hot topic around the virtual water cooler this week was the National Labor Relations Board (NLRB) decision this week that employers can no longer use two specific strategies to silence laid-off employees. Employers are not permitted to include overly-broad confidentiality clauses as terms of a severance agreement. Additionally, they are not permitted to include broadly written non-disparagement clauses that prohibit discussion of previous employment with third parties.

The case involved hospital employees in Michigan who were furloughed when non-essential services were halted during the early days of the COVID-19 pandemic. The decision applies to all US employers with the exception of railroads and airlines. There’s always the chance of an appeal, but for now, the decision is in force. It’s 23 pages of dense reading if you are looking for a sleep aid at the end of a long day.

I’ve mentioned that I’m on the teaching staff for a leadership seminar for one of my volunteer organizations. The participants will be spending five days with us and we’ll be covering a variety of topics around project planning, team development, managing diverse people, and effective communication. I’ve been prepping for some of my sessions and have three presentations on communication, so I was excited to see the Grammarly State of Business Communication report hit my inbox. It was conducted by Harris Poll on behalf of Grammarly Business and surveyed 1,000 knowledge workers and 250 business leaders. The respondents were full-time workers at corporations with 150 employees or more and were across a mix of industries and job functions. Business leaders were at the director level or higher with decision-making authority over strategy, development, customer experience, budgeting, or hiring.

Findings that caught my attention:

• The time spent on written communication is up 18% from 2022, but the quality of written communication is waning. This aggregate of 21.4 hours per worker includes writing and responding to written communications, creating materials to be shared, reviewing and editing the work of others, revising materials, and other writing tasks.
• Effectiveness of written communication has declined 10% over the past year.
• Miscommunication is frequent, with 100% of respondents reporting miscommunication at least once per week, 66% reporting it once per day, and 48% reporting multiple instances per day. Miscommunication costs US businesses $12,506 per employee per year and comes with decreased productivity and increased worker-reported stress.
• One in five business leaders feel that inadequate communication has eroded brand reputation, with 19% reporting lost deals due to poor communication. Conversely, one in three leaders feel that effective communication has helped them gain new business.
• Confident writers are more likely feel confident in their work and engaged in their roles than non-confident writers. They also report higher mental well-being at work.
• Increases in asynchronous work creates greater urgency for projects aimed at improving the quality of written communication.
• More than one in five workers report that they have considered finding a new job due to poor communication.

There’s such a great push for many industries to bring workers back to the office that I think people sometimes lose sight of the benefits of asynchronous work. The majority of respondents felt asynchronous communication made their jobs more flexible. Additionally, a good percentage of workers in key demographics felt asynchronous work made them feel more included: 40% each for millennial and Latinx workers, and 39% for neurodivergent workers.

I was particularly interested in learning the details of people’s specific struggles with written communication. The majority of respondents (71%) struggle to choose words that don’t offend others and with finding the balance between formal and casual written speech. Additionally, 63% say they spend too much time trying to convey their message in the right way. There are additional challenges for workers with English as their second or less familiar language, who report higher levels of uncertainty than their primarily English-using colleagues on things like tone, word selection, communication length, jargon, and idioms.

The long and short of it is that communication is key, and I’m looking forward to being part of a leadership development experience that puts some useful skills and well-accepted methodologies in front of people who might not otherwise receive formal communication training. As a side bonus, this is an outdoor leadership program so I get to do all of my teaching in front of a picnic table rather than in front of a Zoom screen. There will also be some sleeping in a tent, which is fine by me, although I’m crossing my fingers for beautiful spring weather rather than the rain and hail I’ve had teaching previous outdoor leadership courses.

From Bianca Biller: “Re: March is Colorectal Cancer Awareness Month. Look what greeted me on a practice visit. Hopefully the patients will identify with it and get their tests scheduled. The practice had a whole ‘Patient Communication’ wall with at least 10 signs taped to it.” Bianca included a picture of that wall that I can’t run due to the practice letterhead being all over the documents. Some of them are laminated, and based on the photo, they range from knee height (diabetes) to about seven feet from the ground (Affordable Care Act and preventive visits). The fonts were pretty small and I can’t imagine anyone being able to actually read it all. Hopefully they are using other methods to communicate with patients such as their website, patient portal, email outreach, and chatbot campaigns.

The practice also uses a super fancy inventory management system for the exam rooms, placing the burden of managing inventory on the people who are in direct contact with patients and using the supplies in the rooms. I guess the days of having the staff clean and restock rooms at the end of each day have passed. I understand the “just in time” approach here, but I guess the idea of working at the top of your license might not be top of mind in this practice. Compared to regular checks by support staff, this also increases the risk that you could run out of something if you inadvertently let supplies get lower than the time it takes for someone to notice that the magnets have moved and to find the time to get an item and restock it.

At my last clinical location, there was a designated support staff member that started going through the office with a supply cart in the final hour before closing. Despite seeing up to 20 patients in each exam room each day, we never ran out of anything, we always had what we needed for patient care, and delays were nonexistent. It’s a brave new world, I guess.

As I get ready to head to the American Telemedicine Association’s 2023 Annual Conference & Expo in San Antonio for the first time, I have to reflect on the fact that it is the spammiest conference I’ve ever attended. There are only 220 exhibitors on the list and it feels like I’m getting emails from all of them. Some have a tone of increasing urgency, asking if I missed their previous email and pushing for a response. I understand the sales strategy here, but it’s annoying and actually makes me less likely to consider you as a vendor when you do this. I also loathe emails that address me as “Hey Jayne.” An email isn’t a formal letter and personally I don’t think it needs a salutation. I’d rather receive one with no salutation than one with the “Hey” at the top.

What’s your greatest pet peeve when it comes to email? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 3/2/23

Veradigm Inc. Update on 4th Quarter and Full Fiscal Year 2022 Reporting of Results

Veradigm adjusts its 2023 revenue projections after discovering that a compliance software error has caused incorrect revenue reports over the last six quarters.

Press Ganey Announces Collaboration With Epic to Advance Integration of Patient Experience Insight Into Electronic Medical Records

Epic will incorporate Press Ganey’s patient experience data into its MyChart patient portal and Cheers CRM.

VA Deputy Secretary Donald Remy to depart

VA Deputy Secretary Donald Remy will step down from his post, which has included oversight of the department’s troubled EHR modernization program.

Agilon health Announces Acquisition of MphrX, a Leading Healthcare Technology Company

Agilon Health, a physician network development company, acquires FHIR-enabled health data vendor MphrX for $45 million.

Readers Write: Social Determinants of Health and Interoperability

Social Determinants of Health and Interoperability
By Jada Parker

Jada Parker is a public health graduate student at George Washington University.

Social determinants of health (SDOH) have a huge impact on population health. SDOH can be defined as the conditions and environments where individuals are born, live, learn, work, play, worship, and age. Political determinants of health, such as voting patterns, government makeup, and policies, have led to SDOH and the resulting population health inequities.

SDOH can be divided into five domains: economic stability, education access and quality, healthcare access and quality, neighborhood and built environment, and social community context. These factors heavily influence health, functioning, and overall quality of life. Care management and community partnerships allow healthcare organizations to address patients’ social needs in areas such as housing, food security, financial assistance, and intimate partner violence.

Health IT can help physicians and clinicians address and understand how SDOH impact their patients’ overall health. Investments in health IT can also support care management in better addressing SDOH to improve patient health.

Interoperability across IT systems plays a pivotal role in addressing SDOH. When organizations can share patient healthcare data, community partnerships are strengthened and providers are able to provide more streamlined referrals to and better coordination with social service resource providers. Resource providers and care management teams are better able to help patients manage chronic conditions as well through care coordination with healthcare providers allowed by interoperability.

Patients who are experiencing homelessness provide a prime use case of how interoperability facilitates care coordination to address SDOH. Homelessness heavily influences overall health, as it may interfere with a patient’s ability to take their medication as prescribed. Homelessness can also result in multiple hospital readmissions for a number of reasons, including poor health management and that a night at the hospital may provide better conditions than a night at a shelter or outside.

Care coordination, improved by interoperability, allows physicians to make social care referrals and share information with necessary outside resource providers. Without interoperability between health IT systems, much of the burden of obtaining and keeping up with paper referrals and records falls on the patient.

Organizations like Administration for Community Living (ACL) provide IT solutions to support healthcare and community-based organizations partnering in order to provide social and whole-health care for the elderly and individuals with disabilities. ACL incorporates open application programming interfaces to provide resource directories through their Open Referral Initiative. These types of IT solutions streamline the referral process, improve care coordination, and strengthen community partnerships .

SDOH data gaps pose limitations to interoperability. However, there are emerging standards for using and sharing SDOH. The Gravity Project is working to define SDOH information so that it may be documented and shared across digital health and human service platforms. ONC Health IT Certification Program and ONC Interoperability Standards Advisory provide many of the current interoperability standards.

Readers Write: How Healthcare is Using AI to Address the Staffing Shortage

How Healthcare is Using AI to Address the Staffing Shortage
By Ed Ricks

Ed Ricks, MHA is managing director of healthcare consulting for Baker Tilly US of Chicago, IL.

One of the greatest challenges facing healthcare providers in 2023 is staffing shortages, particularly among medical doctors and nursing professionals. This stems from a variety of factors, including shifting demographics with an aging Baby Boomer population that is increasing the demand for medical care, a generation of nurses and doctors retiring, the education system not being equipped to create enough new medical professionals, and the demands of the profession that was exacerbated from the coronavirus pandemic.

With staffing shortages not going away any time soon, patients are continuing to experience adverse effecting, including a greater chance for errors, higher morbidity and mortality, employee burnout and dissatisfaction, and patient dissatisfaction, which create a spiraling expense to provider organizations.

Nonetheless, many experts predict that the influence of AI can help address the shortage, so I thought I would ask an AI engine to tell me a story of how AI could help. Here is the response from ChatGPT:

Once upon a time, in a world filled with endless technology, healthcare was facing a major problem. The nursing shortage was plaguing hospitals and nursing homes, leaving patients without proper care.

But then, a group of tech geniuses decided to put their minds together and come up with a solution. They created AI robots designed specifically for the healthcare industry. These robots were programmed with all the knowledge and skills necessary to be a nurse, and they could work 24/7 without taking breaks or getting tired.

At first, people were skeptical about the use of robots in the healthcare field. But as soon as the AI robots started working, everyone was blown away by their efficiency and care. They could do everything a human nurse could do, and they did it better! They never made a mistake, and they never complained about working overtime.

The nursing shortage was soon a thing of the past, and hospitals and nursing homes were able to provide the best possible care to their patients. Everyone was happy, except for the nurses who had been replaced by the robots. But they eventually found other jobs, and they were happy too.

And that, my friends, is the story of how AI robots fixed the nursing shortage in healthcare and made the world a better place. The end.

While this sounds cool, the reality is that proven methods already blend AI technology using computer vision and other input feeds with a repeatable change management framework. By doing so, providers can apply advanced analytics to determine ROI and the best impact opportunities that will lead to dramatic results for their patients and their margins.

Using this type of technology can help harmonize workflows, automate documentation tasks, and simplify communications to give nurses time back to spend with their patients. This leads to reducing friction from the act of providing care. When this type of automation is coupled with a remote nursing and care strategy across an organization with appropriate change management, the results can be far greater.

When combining the use of a proven technology platform with proven outcome driven change management strategies, health systems can see a dramatic impact on reductions in staffing costs, nursing turnover and associated costs, and patient falls. They can also see improved patient outcomes and increased staff and patient satisfaction.

We don’t have to wait for the day that we really have the sentient robots running around delivering full care in health systems. Let’s use the available processes and AI tools now to help providers make a difference on their transformational journey.

Morning Headlines 3/1/23

Local Leaders Announce Plan to Strengthen Health Services in Imperial County

UC San Diego Health considers sharing its EHR with El Centro Regional Medical Center as part of its proposal to temporarily take over operational, clinical, and financial management of the financially troubled hospital.

BetterNight Raises $33M Growth Financing Round led by NewSpring.

Virtual sleep care provider BetterNight raises $33 million in a funding round led by NewSpring.

Vouched raises $6.3 million to expand its AI driven identity verification offering to telemedicine and healthcare providers

Vouched will use $6 million in new funding to market its AI-powered identity verification software to virtual and in-person healthcare providers.

News 3/1/23

Top News

Cerebral announces its third round of layoffs in the past few months as the beleaguered direct-to-consumer telemedicine company attempts to reorganize and streamline its services.

Cerebral has struggled since the federal government launched an investigation of its prescribing practices for mental health issues, especially its heavily promoted prescribing of Adderall.

Cerebral’s valuation reached nearly $5 billion just over a year ago.

Reader Comments

From Pete Drucker; “Re: Quil Health. To exit the market, with the last day for employees being February 10 and for executives February 24.” This was sent to me on February 7, but I didn’t mention the company’s name pending verification. Quil’s web page has been taken down and CEO Carina Edwards has updated her LinkedIn with a February 2023 end date and references to the company changed to past tense. Philadelphia-based Quil was formed in 2019 as a joint venture between Independence Health Group and Comcast, offering medical alert and monitoring tools to support care-at-home for seniors. I interviewed Carina Edwards 10 months ago.

From Plural Effusion: “Re: plural words. I see examples daily where someone sticks in an unneeded apostrophe.” Plurals shouldn’t have apostrophes except for one-letter items, such as the Oakland A’s or minding your p’s and q’s.

From You Interviewed Me: “Re: my HIStalk interview. It received lots of attention. You have certainly built an engaged group of readers.” Thanks to this CEO for giving me a rare post-interview report. I’m always up for talking to CIOs, clinician executives, frontline people, or anyone who would be interesting to readers who comes from the non-vendor side of the table. If that’s you and you can spare 30 minutes for a call, let me know.

From Pshaw: “Re: attrition goals. Epic in a nutshell.” Former Amazon managers say that the company meets its attrition goals by rating decent performers as not meeting its expectations. The company refers its “unregretted attrition rate,” where it expects managers to rank 5% of employees in the lowest tier that the company wouldn’t mine losing, voluntarily or otherwise. Amazon replaces a set percentage of less-performing employees annually. UPDATE: I’m changing this since while I was thinking that Epic stack ranks employees and I thought I read long ago that the company’s philosophy was to intentionally replace the bottom tier, I’m not sure that employees in that tier are fired. Perhaps some who works at Epic can elaborate further.

HIStalk Announcements and Requests

HIStalk sponsors benefit from being listed in our guide to major conferences, which provides on-site details for those that are exhibiting or attending so attendees can seek them out. Send me your ViVE 2023 information  by Wednesday, March 15 to be included. The ViVE 2023 exhibit hall floor plan shows 169 exhibiting companies, with separate musical stages for pop, hip hop, bluegrass, classics, and country (the latter being the largest by far, which wouldn’t be a plus for me). Glancing down the exhibitor list, I see a few dozen HIStalk sponsors, so those remaining dozens are welcome to contact Lorre to extend their reach beyond occupying a small patch of carpet for a half week.

Speaking of ViVE, I just got an email saying that the Clearsense-sponsored industry night entertainment is the Black Crowes. Two perpetually feuding brothers are all that’s left of the original lineup that formed 40 years ago, also the only two who played on their monster 1990 album “Shake Your Money Maker” or on their last new album in 2009.

Webinars

March 7 (Tuesday) noon ET.  “Prescribe RPA 2.0 to Treat Healthcare Worker Burnout.” Sponsor: Keysight Technologies. Presenters: Anne Foster, MS, technical consultant manager, Eggplant; Emily Yan, MPA, product marketing manager, Keysight Technologies. Half of US health systems plan to invest in robotic process automation by the end of this year, per Gartner. The concept is evolving to help with staff burnout and physician productivity. The presenters will introduce RPA 2.0, explain how to maximize its value, demonstrate how to quickly start on RPA 2.0 and test automation in one platform, and answer questions about healthcare automation.

Previous webinars are on our YouTube channel. Contact Lorre to present your own.

Acquisitions, Funding, Business, and Stock

Automated coding technology vendor CodaMetrix raises $55 million in a Series A funding round. The company was spun out of Mass General Brigham in 2019 and is led by former LifeImage CEO Hamid Tabatabaie.

Sales

• Baptist Memorial Health Care (TN) selects LookDeep Health’s Clinical Action Platform to enhance its inpatient video monitoring capabilities.
• Augusta University Health (GA) will expand its Virtual Care at Home program using technology from Biofourmis.
• Southwestern Health Resources (TX) selects referral management software from LeadingReach.
• Yale New Haven Health (CT) will implement RxLightning’s automated pharmacy workflow software.
• Sheffield Teaching Hospitals NHS Foundation Trust in England will replace its Dedalus EHR with Oracle Cerner’s Millenium software next year.

People

Engooden Health, the former Cohort Intelligence, names Tom Frosheiser, MBA (Nvolve)  as CEO.

Dan Michelson, MBA joins 7wire Ventures as entrepreneur-in-residence, rejoining his former Allscripts executive colleagues Glen Tullman and Lee Shapiro. He was CEO of Strata Decision Technology through May 2022.

Leah Ray (Jvion) joins Linus Health as chief customer officer.

Chris Belmont, MBA (Memorial Hospital at Gulfport) joins Ochsner Health as SVP/CIO, a position he held from 2009 to 2013.

Announcements and Implementations

Southern Illinois Healthcare implements PocketHealth’s diagnostic image-sharing software for patients and providers.

NIH-funded researchers from Cleveland Clinic and MetroHealth will use digital twins, created from de-identified EHR data, to understand healthcare disparities based on living location.

A pre-print journal article finds that ChatGPT performs well in suggesting improvements to the logic of clinical decision support alerts.

Practice management software end users give EClinicalWorks, ModMed, NextGen, and Veradigm top customer satisfaction marks in Black Book’s latest annual survey.

Government and Politics

HHS OCR renames its Health Information Privacy Division to the Health Information Privacy, Data, and Cybersecurity Division as part of a reorganization that will better enable the office to more effectively respond to complaints. An OCR report published earlier this month pointed out that the office lacks the financial resources it needs to investigate HIPAA complaints and enforce penalties, both of which increased considerably between 2017 and 2021.

Privacy and Security

Researchers at Duke University’s public policy school find that since technology companies, app  vendors, wearables manufacturers, and social media platforms aren’t covered by HIPAA, they are legally selling the health data of their users to data brokers without their knowledge or consent. The authors looked specifically at at mental health data:

• Some data brokers are offering user health data on the open market, with minimal vetting of customers and few stated limits on its use.
• Brokers don’t always make it clear whether their health data is de-identified, and some seem to imply that they are willing to provide identifiable data.
• The most active brokers offered data of people with depression, ADHD, insomnia, ADHD, and bipolar disorder that also included ethnicity, age, gender, ZIP code, religion, number of children living in the home, marital status, net worth, credit score, and data of birth.

Other

It’s not just doctors who are burned out, a Times article says, citing evidence that patients are being burned out by poor healthcare customer service that includes long appointment lead times, short visits, high prices, surprise bills, insurance aggravation, and too much focus on the EHR. Experts say to watch how patients vote with their feet as they flock to non-traditional settings that offer same-day appointments, walk-in visits, flat-rate memberships, and telehealth.

A Stat review of the boards of 15 top-ranked academic medical centers finds that 44% of board members come from the financial sector, while 13% are physicians and 1% are nurses. The authors conclude that board composition may explain why non-profit health systems focus on revenue instead of community need and employee satisfaction. They cite previous surveys showing that a big percentage of hospital board members are white males.

Sponsor Updates

• Ascom Americas gives Fairchild Communication Systems the ability to re-sell Ascom clinical workflow solutions in the additional market of Toledo, OH.
• Azara Healthcare and Bamboo Health will exhibit at Rise National March 6-8 in Colorado Springs.
• Availity will present and exhibit at State HIT Connect March 6-8 in Baltimore.
• Baker Tilly names Kat Mako (IMethods) and Cindy Kmiecik (Uniper) business development directors of healthcare IT.
• Bardavon Health Innovations partners with the Gray Institute to offer discounted CEUs to its BNotes customers.
• Biofourmis, Care.ai, Clearwater, EVisit, and Optum will exhibit at ATA 2023 March 4-6 in San Antonio.
• CTG publishes a new case study, “CTG Improves Gundersen’s Patient Portal Support with Amazon Connect.”

Blog Posts

• Survey: Your Practice is Losing Almost a Month to Financial Busy Work (AdvancedMD)
• Robotic Process Automation & Artificial Intelligence in Healthcare: Two Distinct Technologies with Distinct Benefits (AGS Health)
• Population health trends across the United States (Arcadia)
• Part 4: Supporting the Patient Experience with Pharmacy Technology (Arrive Health)
• We Must Dramatically Streamline Clinical Workflows: Here’s Why. (CareMesh)
• Voice of the Assessor (Censinet)
• Building a Unified EHR with Meditech Expanse: A Look Back at Key Decisions (CereCore)
• 7 Ways to Minimize Privacy Risk Created by Online Tracking Technologies (Clearwater)

Contacts

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Morning Headlines 2/28/23

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