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Morning Headlines 4/22/22

April 21, 2022 Headlines No Comments

Netsmart Expands the CareFabric Platform to Support Physical Therapy, Rehabilitation and Wellness Providers

Netsmart acquires TheraOffice, an EHR/PM for physical therapy and rehabilitation practices that will be incorporated into Netsmart’s CareFabric platform.

Mendel Raises $40 Million Series B Round to Expand its Team and Grow Product Offering

Mendel, which uses natural-language processing and AI to transform unstructured clinical data into analytics-ready information, raises $40 million in a Series B funding round.

Reify Health Raises $220M Series D to Bridge the Diversity Gap in Clinical Trials

Clinical trials solutions vendor Reify Health raises $220 million in a Series D funding round that values the company at nearly $5 billion.

NexHealth Raises $125M Series C at $1B Valuation

Healthcare API developer NexHealth raises $125 million in a Series C funding round, bringing its total raised to $177 million.

News 4/22/22

April 21, 2022 News 8 Comments

Top News

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Clinical trials solutions vendor Reify Health raises $220 million in a Series D funding round that values the company at nearly $5 billion.

The co-founders, who attended the Johns Hopkins University School of Medicine and served a three-month stint as Rock Health fellows, are Ralph Passarella, MD, PhD and Michael Lin.


Webinars

April 22 (Friday) 1 ET. “CMIO 3.0: What’s Next for the CMIO?” Sponsor: Intelligent Medical Objects. Presenters: Becket Mahnke, MD, CMIO and pediatric cardiologist, Confluence Health; Dale Sanders, chief strategy officer, IMO. The relatively short history of the CMIO role includes Version 1.0 (EHR implementation, Meaningful Use, and regulatory compliance) and Version 2.0 (quality and efficiency). Version 3.0 is at the forefront of predictive analytics, population health initiatives, and optimization of data-driven tools. The presenters will discuss the digital revolution’s impact on CMIO responsibilities; the connection between clinical informatics, analytics, population health and the CMIO; and how CMIO 3.0 will be involved in the adoption of advanced technologies.

April 28 (Thursday) 2 ET. “Undercoded and Underpaid: Making It Easier to Document to Optimize Reimbursement.” Sponsor: Intelligent Medical Objects. Presenters: Deepak Pillai, MD, physician informaticist, IMO; June Bronnert, MSHI, RHIA, senior director of informatics, IMO; Nicole Douglas, sales engineer, IMO. The presenters will discuss how to simplify precise documentation for clinicians; the effects of imprecise coding on reimbursement; why accurate code capture at the point of care can have positive downstream impact on population health initiatives; and how third-party solutions integrated with the EHR can reduce documentation burdens.

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


Acquisitions, Funding, Business, and Stock

Amwell expands its virtual services to include musculoskeletal and dermatology.

Remote patient temperature monitoring technology vendor Blue Spark Technologies raises $40 million in growth funding. I interviewed President and CEO John Gannon last May.

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Netsmart acquires TheraOffice, an EHR/PM for physical therapy and rehabilitation practices that will be incorporated into Netsmart’s CareFabric platform.

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Venture capitalist Aike Ho explains why she doesn’t invest in healthcare AI companies:

  • AI doesn’t really exist in healthcare. It is really just machine learning (“glorified big data”) with no deep learning or neural networks.
  • It takes months or years, at startup burn rates, to get agreements from health systems and universities to provide data for training models.
  • The data is often low quality or in need of cleaning.
  • The total addressable market for most AI applications is small because it involves ancillary services such as diagnostic help and workflow automation and most US healthcare revenue involves services.
  • Gaining adoption is hard unless you are also delivering care. That’s her preferred model for AI/ML – digital health companies that use AI/ML to improve their own care delivery. No AI/ML company that sells to provider groups has had a breakout so far.
  • It’s hard to get risk-averse providers to use a solution without documenting superior clinical outcomes.
  • Insurance rarely pays, so that leaves patients and providers to foot the bill. That’s harder if the value proposition is saving money rather than boosting revenue.
  • Workflow friction and training costs must be minimal.
  • Charging for usage is great, but only if you can figure out adoption, while a flat cost is harder to sell.

People

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New Zealand-based breast imaging screening AI vendor Volpara Health promotes advisor Teri Thomas, RN, MSN — who spent 21 years through 2016 as an Epic executive — to CEO. She replaces founder Ralph Highnam, PhD, MSc, who will transition to chief science and innovation officer.

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Health system-owned interoperability vendor Graphite Health hires Ted Gaubert, PhD, MBA (Dunn & Bradstreet) as CTO.

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Ed Marx resigns as Tech Mahindra’s chief digital officer for health and life sciences.


Announcements and Implementations

A study performed by the Australian New South Wales Health Service finds that use of Net Health’s wound imaging and analysis platform resulted in better documentation, more engaged patients, and improved wound measurement and management.

Golden Valley Memorial Healthcare (MO) goes live as the first site running Meditech Expanse Genomics.

Kyruus and Upfront partner to offer provider search, match, and scheduling with continued personalized and omnichannel engagement.

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A new KLAS report looks at health system compliance with CMS’s requirement to post prices for common services, as revenue cycle leaders express doubt that the regulation – which they say was poorly executed, is confusing, and requires extensive labor for compliance — will improve financial outcomes. Respondents say that posting a master list of prices may benefit payer and provider organizations more than patients. Epic was the most-often used vendor to comply with the requirement, while Experian Health, Vitalware, and NThrive/FinThrive led the third-party solutions list. 


Government and Politics

Healthcare waste management company Stericycle – which also owns patient engagement technology vendor Stericycle Communication Solutions — pays $84 million to settle DOJ charges that it bribed officials in Brazil, Mexico, and Argentina to earn waste management contracts.

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The VA congratulates Hardeep Singh, MD, MBA of the Houston VA for earning Joint Commission’s patient safety and quality award for safety related to diagnostics and health IT.


Other

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Adventist Health Mendocino Coast Chief of Staff William Miller, MD outlines lessons learned from its implementation of Cerner in its clinics in a local newspaper opinion piece:

  • Timelines were extended due to COVID-caused staff resignations and shortages.
  • System bugs prevented the prescription refill function from communicating with local pharmacies and impeded referrals to specialists.
  • The problems increased phone call abandonment and hold time.
  • Moving data to Cerner required more time than expected, extending appointment scheduling time from weeks to two months.
  • The hospital didn’t do a good job of communicating the transition to patients and the community.

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Economist and sociology professor Juliet Schor discusses four-day work weeks at the TED2022 conference, citing her consulting work with non-profit Healthwise last year. She says Healthwise employees are happier and the company is enjoying higher revenue and outstanding customer satisfaction scores after the change. Healthwise CEO Adam Husney says employees picked up the pace to complete a week’s worth of work in four days, shifting personal tasks to their off days and using more time-efficient messaging so they can enjoy their downtime as a whole day off instead of occasional breaks.

The New York Times looks at the use of robots in nursing homes and the development of “virtual assisted living” in which technology – medication reminders, social engagement, fall prevention and response, food delivery, and toilet-powered health analysis – gives seniors an alternative to cash-strapped, understaffed nursing homes. The director of MIT’s AgeLab says Best Buy and Amazon are offering senior-friendly mobile phones that detect falls, connect to hospital systems, access electronic medical records, and give one-touch access to call centers that are prepared to contact doctors, arrange transportation, and notify caregivers.

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Redesign Health provides yet another unwanted glimpse into the marketing sausage-making in being “thrilled to share our rebrand, which embodies both our aspirations for the future and the urgency that this moment in healthcare demands.” New logo, new color scheme, got it … but those responsible can’t resist pontificating in violating the “show, don’t tell” principle in mandating an eye-rolling journey through a self-congratulatory backstory (imagine if they had painted the Mona Lisa):

The symbol tells us where we want to go and what we want to be, beyond where we are now. And as the omnipresent fixture in our branding and the world we create, it will be something we use to tell our story forever … Ultimately, we hope our brand becomes a symbol in the world of health. We hope it influences not only how we continue to approach our work, but also the type of people that want to join us and the way our industry tackles big challenges — namely, with more ambition, urgency, and perspectives.

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Is this how editors role?


Sponsor Updates

  • Healthcare Triangle will present at NobleCon18 April 21 in Hollywood, FL.
  • LexisNexis Risk Solutions announces that it has been named a leader in the “IDC MarketScape: US Provider Data Management for Payers 2022 Vendor Assessment.”
  • InterSystems offers prizes for applications that use its FHIR services as part of MIT Hacking Medicine’s Grand Hack 2022.
  • OSIS, which provides NextGen Healthcare technology services to Community Health Centers, chooses Well Health as a preferred vendor of digital patient communications.
  • Clearsense publishes a case study of a data archiving project that saved a 93-hospital IDN $23 million in annual cost savings.
  • Steve Shihadeh of Get-to-Market Health posts the second part of his conversation with digital health investor Lee Shapiro of 7wireVentures, which includes tips for co-existing with Epic, Cerner, and Meditech.
  • Medicomp Systems releases a new episode of its Tell Me Where It Hurts Podcast featuring Greenway Health CMO Michael Blackman, MD.
  • Meditech President and CEO Michelle O’Connor and EVP/COO Helen Waters will offer a May 17 keynote at the MUSE conference in Dallas titled “Looking to the Future of Digital Healthcare and MEDITECH.”

Blog Posts


Contacts

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

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EPtalk by Dr. Jayne 4/21/22

April 21, 2022 Dr. Jayne 1 Comment

Telehealth company Amwell adds two new clinical programs to its platform. Payers can brand the offerings as part of their digital engagement strategies. The dermatology program offers sessions with board-certified dermatologists in an effort to alleviate delays in dermatologic consultations which can be several months in many parts of the country. The press release notes that it offers “most diagnoses returned in just 24 hours,” which makes me wonder if it’s an asynchronous offering versus a virtual visit with a dermatologist. The musculoskeletal program will help payers address challenges with physical therapy access, disrupted productivity, and downstream costs. It will provide patients with a personalized physical therapy plan, telehealth visits, digital sensors for guided exercise sessions, behavioral health support, and patient engagement services.

This article about non-fungible tokens (NFTs) caught my eye since it’s not often that you see them mentioned in the same sentence as “medical ethicists.” It raises important points about the fact that EHR data is being sold without patients being fully aware of it. How many of us actually read the documents given to us at medical appointments such as the Consent to Treat, Assignment of Benefits, and HIPAA Notice of Privacy Practices? The numbers are likely low because we just want to be treated and aren’t going to walk away regardless of what’s in there, for the most part. The last time I was at my local academic medical center, I was asked to sign a signature pad saying I had received the documents despite not having been actually offered the documents.

The premise is that a patient could own an NFT of their medical information, which could be stored in a secure database that would track access requests and approvals. The piece also points out that patients could maintain ownership of their biological specimens, from blood to tissue and even down to the cellular level. When you learn about the cell lines used in research and where they came from, there’s been tremendous injustice. (“The Immortal Life of Henrietta Lacks” is a great read if you’re curious.) Some ethics professionals disagree, saying that ownership of such data is shared between patients and the physicians and health systems who are involved in their care. The article notes that there needs to be a balance between privacy and public health along with greater understanding of why patients might not want to share their data.

There are also sustainability concerns around the creation of NFTs and maintaining the blockchains used to track them, as well as the risks of data making it outside of the public ledger or it moving to the black market. One researcher points out that “you can’t de-identify something with a genome,” reminding us of the uniqueness of each and every one of us. I would settle for greater attention to how patients are informed of the ways in which their information is used, and protections for those who want to opt-out of having their data become part of anonymized data sets that lead to profits for others. I’m not sure what the other potential answers are here, but will be interested to see how things evolve over the coming years.

With as much time as I’ve spent recently with marketing and branding exercises, I was surprised to learn that “debranding” is also a thing. Upon further review, it’s an extension of branding, but with a focus on simplicity and cleaner design. Examples include removing complicated color gradients or shadows in order to make logos cleaner. Increased use of mobile devices is a driving factor, as is a drive towards a more professional appearance. It’s fun to look at certain brands and see how their presentation has changed over time, especially in the consumer space.

A recent KLAS publication looked at the causes of clinician turnover. Although nurses are most likely to leave in the next year, other types of clinicians are close behind. EHR and IT tools are cited as a major cause, along with burnout, chaotic work environment, lack of personal control over workload, and more. I recently joined an online physician forum for EHR issues and have been shocked that the majority of questions are actually operational and management questions rather than technology issues, but physicians are turning to technology hacks to try to fix deeper issues.

I feel like I’m yelling into the void every time I say something along the lines of, “This is an operational issue requiring a policy and procedure to keep your practice staff from dumping on you, not something that needs another macro or preference or configuration in your EHR.” One physician confided in me that her two partners have left because the practice, owned by a large health system, is so chaotic and mismanaged. Rather than hiring a locum tenens physician until they can fix the problem and find permanent hires, the employer expects her to manage a panel of over 10,000 patients by herself with only a front desk staffer and two medical assistants. This is in a semi-rural area, and I’ve seen the complexity of her case mix. She’s to the point where she’s ready to resign if she doesn’t get some help, and the health system doesn’t seem to care. From a couple of decades in practice management and healthcare operations, I’d bet on the fact that better EHR templates and macros to respond to patient portal messages are not the answer. Shame on the health system for letting it get to this point and especially for thinking this is an acceptable solution.

When people are under stress, they turn to different diversions – often during the workday. If my Facebook feed is any reflection, there are many people are into playing the New York Times Wordle game. There have been plenty of imitators as well as specialty games. If you’re looking for some brain-stretching timewasters, I offer for your consideration:

Ever gotten the Wordle on the first try? How fast can you transcribe Morse code? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 4/21/22

April 20, 2022 Headlines No Comments

MetroWest Medical Center Turned Away Ambulances & Patients Earlier Today

MetroWest Medical Center and St. Vincent Hospital – facilities in Massachusetts owned by Tenet Healthcare – divert patients for several hours in response to a likely cyber attack.

CDC Launches New Center for Forecasting and Outbreak Analytics

The CDC has launched the Center for Forecasting and Outbreak Analytics to enhance the federal government’s ability to respond to outbreaks using data, models, and analytics.

CentralReach Leases Space at Bell Works

CentralReach, a behavioral health EHR vendor based in New Jersey, will relocate its headquarters to build out a remote-first hybrid work space for its 400 employees.

HIStalk Interviews Steve McDonald, President, Interbit Data

April 20, 2022 Interviews No Comments

Steve McDonald, MBA is president of Interbit Data of Natick, MA.

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Tell me about yourself and the company.

I’ve enjoyed a rewarding 30-year career in healthcare IT, where I’ve worked with some of the largest EMR vendors and some of the greatest minds, such as Neil Pappalardo and Neal Patterson. I also worked with two leading consulting companies.

A lot of your followers have seen significant progress made in the industry. I’m encouraged by the advancements in digital health and move to the cloud. Even AI is showing some promise. CMS is putting teeth around their policies with bundled payments and value-based care and it looks like commercial payers are following suit. I was naturally attracted to the opportunity to join Interbit because we help hospitals that are dealing with some of those challenges

What are the benefits of having a report delivery system that is driven by rules?

We’re a subscription-based service, we’ve been around 25 years, and we have about 500 clients. We simplify communications by being able to send information out to a variety of people on the care team with value-based care contracts. We’re able to send information based on their preference. If a doctor wants to receive abnormal results via text message, we can send it that way. We can send by Direct message. This is all of the care teams. If a skilled nursing facility wants to receive emails or secure texts via an API, we could send things out via FHIR. The value is broad distribution of information to the care team in whatever format that they want to receive it in.

That’s one of our solutions, but the bulk of our value that we drive is on the care continuity side, in being able to provide information at the point of care for situations where the EMR is not available. Things like your EMAR, labs, radiology, pharmacy, and census open orders. If the EMR is not available, we have a snapshot of that information that can be readily available for care teams to access that information to provide care continuity.

Patient engagement uses the word “omnichannel” in giving people information in whatever form they prefer. When you look at the big picture of interoperability, what is the role of those different channels, where people may have legitimate reasons to prefer information sent by fax or PDF?

Healthcare is individual preference, and one size does not fit all. To the extent that a person or a provider wants to receive their faxes or a secure text message — let’s say for abnormal results, which is a great example — we can send it that way. It’s critical that we’re able to accommodate the wishes of our providers. Care teams are expanding with value-based care and bundled payments. You have physical therapists and skilled nursing facilities. They all want to receive it in different formats.

We allow the hospitals to send it to us and then we’ll take care of the distribution. Obviously if we need to put in HL7 or FHIR, we can send it to CommonWell and Carequality to push it out that way. But what we specialize in is operational communications, where we can pull it out of the EMR and then push it out in whatever format that the care teams want it.

How should a downtime solution work to support the continued provision of safe care while mission-critical applications are offline?

That is our sweet spot. If you have a scheduled or unscheduled downtime, you have the luxury of pre-planning for it and identifying the kinds of reports that should be made available. Your med administration record, labs, NPI, nursing, open orders, forms, even your employee contact list should be available house-wide in your hospital.

We have two varieties. One is a server that, during a planned or unplanned downtime, can still be on your network. We would be able to parse the EMR data and send the EMARs up to 2 West and to the pharmacy to allow for documentation, in the case of the EMR not being down. If it’s a full-blown cyberattack, we have an air gap server off your trusted network that contains that same type of information, but it is secure behind a firewall. It would only be accessed in a break-the-glass situation to allow for care continuity even in a case of a cyberattack.

Do hospitals anticipate these needs, or are prospects people who have had an incident that needs to be prevented in the future?

Cyberattacks doubled last year despite all the great efforts in trying to prevent them. The bad guys still get in. Hospitals request a way to have that critical information available even during an attack. We developed that solution about a year ago, to allow for access to that critical information so that they can at least have some level of care continuity. Ours is not a full-blown disaster backup plan,but is a safety net until the systems get restored. Nurses have visibility into a patient’s latest lab tests, for example.

Do hospitals recognize the clinical problems that are caused by that downtime gap even when it is shortened by good technology planning?

Most hospitals go to a paper-based backup in case of a full-blown cyberattack. That’s manual, and affects patient safety. We also see a lot of lost charges occur in that scenario. We are automating that solution to minimize the amount of effort when you reconcile back and your system’s up and running, to sync up all of that information that occurred during the downtime period.

What factors will be important in the company’s future?

The biggest factor we have is the ability to focus in on the human element of delivering care. People get caught up in all these technologies. Our focus is on simplifying operational communication, pushing that information out to the caregivers in the format that they can digest. Because at the end of the day, this is about the sanctity of the relationship between the doctors and the providers and the patient, that human element. We want to continue to deliver information in a format that they can use to deliver care.

A lot of people will say, “Healthcare IT will solve this.” Healthcare IT is great, but it’s not a substitute for that human intervention. Our operational communications approach is still at the ground level of delivering care. We also support the mobile user. We can push information out so that people who aren’t tethered to the internet have information available to make intelligent decisions in the care delivery process. Then once they are back online, we can help sync up to the major EMR system that they are using. 

I’m excited about the industry. I have a deep passion for it. It has been my entire life’s mission to try to improve healthcare by leveraging technologies, and I’m excited that the industry is getting an incredible amount of external capital as Wall Street is taking notice. We are a privately held, cash flow positive company and we don’t necessarily need any of that outside capital, but it’s great that the industry is progressing to help bend the cost curve and deliver higher quality care.

Morning Headlines 4/20/22

April 19, 2022 Headlines No Comments

The Chartis Group Welcomes National Health Equity Advisory Firm Just Health Collective

The Chartis Group acquires health equity advisory firm Just Health Collective, whose founder and CEO Duane Reynolds, MHA has worked in inclusion and diversity executive roles with UnitedHealth Group and the American Hospital Association.

Protenus Granted New Patent “Methods and Systems for Analyzing Accessing of Drug Dispensing Systems”

The US Patent Office awards patient privacy monitoring company Protenus a patent for “Methods and Systems for Analyzing Accessing of Drug Dispensing Systems.”

RevX upgrades MHS GENESIS at Puget Sound Military Health System

Puget Sound Military Health System, Madigan Army Medical Center, Naval Health Clinic Oak Harbor, the Air Force’s 62nd Medical Squadron, and Naval Hospital Bremerton upgrade their Cerner-powered MHS Genesis EHR software with Revenue Cycle Expansion features.

News 4/20/22

April 19, 2022 News No Comments

Top News

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Clipboard Health, an online marketplace that matches nurses and other healthcare professionals with staffing opportunities, raises $80 million over two previously unannounced funding rounds.

The company, launched six years ago, serves 30 US cities. It offers instant payment after shifts, a benefit that sets it apart from competitors like IntelyCare, which recently raised $115 million in a Series C funding round.


HIStalk Announcements and Requests

Deborah Kohn has been retired from consulting for a few years and finally decided it was time to cancel her HIStalk email updates, so she provided a Donors Choose parting gift that, with matching funds applied, funded these teacher projects:

  • A diversity library for Ms. D’s elementary school class in Houston, TX.
  • Geography tools for the ninth grade Advanced Placement class of Ms. P in Fresno, CA.

Webinars

April 22 (Friday) 1 ET. “CMIO 3.0: What’s Next for the CMIO?” Sponsor: Intelligent Medical Objects. Presenters: Becket Mahnke, MD, CMIO and pediatric cardiologist, Confluence Health; Dale Sanders, chief strategy officer, IMO. The relatively short history of the CMIO role includes Version 1.0 (EHR implementation, Meaningful Use, and regulatory compliance) and Version 2.0 (quality and efficiency). Version 3.0 is at the forefront of predictive analytics, population health initiatives, and optimization of data-driven tools. The presenters will discuss the digital revolution’s impact on CMIO responsibilities; the connection between clinical informatics, analytics, population health and the CMIO; and how CMIO 3.0 will be involved in the adoption of advanced technologies.

April 28 (Thursday) 2 ET. “Undercoded and Underpaid: Making It Easier to Document to Optimize Reimbursement.” Sponsor: Intelligent Medical Objects. Presenters: Deepak Pillai, MD, physician informaticist, IMO; June Bronnert, MSHI, RHIA, senior director of informatics, IMO; Nicole Douglas, sales engineer, IMO. The presenters will discuss how to simplify precise documentation for clinicians; the effects of imprecise coding on reimbursement; why accurate code capture at the point of care can have positive downstream impact on population health initiatives; and how third-party solutions integrated with the EHR can reduce documentation burdens.

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


Acquisitions, Funding, Business, and Stock

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The US Patent Office awards patient privacy monitoring company Protenus a patent for “Methods and Systems for Analyzing Accessing of Drug Dispensing Systems.”

The Chartis Group acquires health equity advisory firm Just Health Collective, whose founder and CEO Duane Reynolds, MHA has worked in inclusion and diversity executive roles with UnitedHealth Group and the American Hospital Association.


Sales

  • Scripps Health (CA) and UT Health San Antonio (TX) select Oncora Medical’s oncology patient care and analytics software.
  • Medical University of South Carolina will implement Andor Health’s ThinkAndor AI virtual assistant to optimize its virtual health services.

People

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Ryan Smith, MBA (Intermountain Healthcare) joins Graphite Health as COO. The non-profit digital health solutions company was formed in October 2021 by Intermountain, Presbyterian Healthcare Services, and SSM Health.

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Cedars-Sinai Health System (CA) promotes Craig Kwiatkowski, PharmD to SVP of enterprise information services and CIO.

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Providence (WA) promotes Sara Vaezy to EVP and chief digital officer.

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Strata CEO Dan Michelson, MBA will leave the company after 10 years to create a for-purpose company that will address divisiveness and isolation. He will be replaced as CEO by COO/CFO John Martino.


Announcements and Implementations

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Providence Community Health Center implements Bluestream Health’s virtual care platform-as-a-service to provide telehealth services to its 12 facilities across Providence, RI.

Mankato Clinic (MN) has adopted CareSignal’s deviceless remote patient monitoring technology as part of its chronic care management programs for patients with COPD, congestive heart failure, diabetes, hypertension, and depression.

Pomona Valley Hospital Medical Center rolls out digital wayfinding capabilities from Eyedog.US.

The Reactive Emergency Assessment Community Team associated with Ipswitch Hospital in the UK adopts Current Health’s remote patient monitoring technology.

Suki expands the voice capabilities to its digital assist to help physicians retrieve patient information to access it untethered from the EHR.

Riley Children’s Health and Configo Health will co-develop pediatric hospital benchmarking solutions.

Change Healthcare releases InterQual 2022.


Government and Politics

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Puget Sound Military Health System, Madigan Army Medical Center, Naval Health Clinic Oak Harbor, the Air Force’s 62nd Medical Squadron, and Naval Hospital Bremerton upgrade their Cerner-powered MHS Genesis EHR software with Revenue Cycle Expansion features. The Washington-based providers were among the initial wave of facilities that went live on MHS Genesis in 2017.

California’s digital vaccination records may not include some shots that were documented on the paper vaccination card. The state says the problem is caused by organizations that administer vaccine without capturing complete recipient information, which leaves its digital system unable to match a patient’s records from multiple providers.


Other

An OptimizeRx medication access survey of 102 specialists finds that 60% of respondents don’t have access to real-time insurance benefits information, a contributing factor to the nearly four hours each day physicians and their staff say they spend on helping patients gain access to prescriptions.


Sponsor Updates

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  • CereCore staff sort 6,174 pounds of food at Second Harvest Food Bank of Middle Tennessee to provide 5,122 meals to Nashville families.
  • The Slice of Healthcare Podcast features About CEO Angie Franks.
  • BakerTilly releases a new Healthy Outcomes Podcast, “Private equity trends within the healthcare provider industry.”
  • Bamboo Health will exhibit at the 2022 Blue National Summit May 2-5 in Orlando.
  • “IDC MarketScape: U.S. Provider Data Management for Payers 2022 Vendor Assessment” names LexisNexis Risk Solutions as its only market leader.
  • Biofourmis will present at the Reuters Digital Health 2022 Conference April 26 in San Diego.
  • CHIME releases a new Digital Health Leaders Podcast, “Children, Teens, and the Pandemic with Theresa Meadows.”
  • CoverMyMeds will exhibit and present at Asembia22 May 2-5 in Las Vegas.
  • Dina will exhibit at the NAACOS Spring 2022 Conference April 27-29 in Baltimore.
  • PeriGen names Kimberlee McKay, MD a physician consultant.
  • Change Healthcare releases InterQual 2022, the latest edition of its flagship clinical decision support solution.

Blog Posts


Contacts

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

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HIStalk Interviews Ashley Glover, CEO, WebPT

April 19, 2022 Interviews No Comments

Ashley Glover, MBA is CEO of WebPT of Phoenix, AZ.

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Tell me about yourself and the company.

I started this job in November 2021, so I’m a few months in. I spent the last 15 years in real estate software with a company called RealPage that is similar to WebPT, in that we wanted to be a vertical software provider providing all solutions to people who largely owned and managed department communities. We grew RealPage from about a $30 million company to about a $1.3 billion revenue company and it sold a year ago for a little over $10 billion. I was president of that company at the time.

That gave me an opportunity to look at something new, and I got very interested in WebPT’s story. WebPT is the number one provider of outpatient rehab software, covering physical therapy, occupational therapy, and speech therapy solutions. Most of our clients are in the outpatient space, although we have a large and growing business in what I would call integrated businesses, like hospital systems that have PT clinics, that sort of thing. 

WebPT has a little over 800 employees and over $150 million of revenues. We recently bought Clinicient and Keet, which were also leading edge providers of similar software in our space. In the last couple of months, we’ve been integrating the companies.

What challenges of outpatient rehab therapy providers can technology address?

Two cases drive most of the reasons people go to rehab. One is that they are recovering from an incident. That could be an injury. Athletes or weekend warriors often need rehab, or they’re coming in related to surgical recovery. The other thing that drives a lot of our patients is it age-related conditions, or other health conditions that drive the need for rehab to support people’s mobility.

From a software perspective, we started out as focused on allowing the clinician to provide leading edge documentation, plan of care, and monitoring of recovery through the plan of care. Ensuring that it is compliant, a best-in-class way to document, and easy to bill. Over the last several years, we’ve added additional solutions, like billing software. That facilitates billing and collections and software that enables the front office to better serve the patient largely through digital solutions. Think digital patient intake, electronic benefit verification, and marketing type solutions that manage communications with the patient.

Is the measuring of outcomes and patient satisfaction more pure than in a health system, where the care environment is less focused?

Absolutely. It’s pure in the sense that people really do want to know that they are delivering good outcomes. One of our biggest issues is that patients drop out of therapy at three or four visits, when they might really need 12 visits. So we talk about the need for patient engagement solutions, which is to keep them engaged through the plan of care, which ensures a better outcome, and frankly measuring the outcomes themselves.

Early in our business, we bought a company and integrated it into our solution that allowed us to manage patient engagement and increase the probability that they would move through their plan of care through better engagement with them digitally. We did not own an outcomes solution, but through this acquisition with Clinicient, we have picked up an solution called Keet that a lot of our members used and that we integrated with, but now we own.

What’s great about Keet is it’s in the musculoskeletal program and it’s a Qualified Clinical Data Registry, or QCDR. That allows for the Medicare reporting, but we think there’s a broader opportunity in using it as an outcomes tool to manage quality of outcomes and promoting that use case within the businesses, because obviously not everybody’s getting Medicare. Often the payers want to know if people are receiving better outcomes as well, and Keet will facilitate that.

What are the main reasons that so many patients don’t complete their course of therapy?

There are two things that just kill us, and if we could solve for it, our clients could make a lot more money and people would have better outcomes. One is that there’s a lot of evidence that people who should get PT are not getting PT at all, or OT or speech therapy. That’s an issue with a gap with people’s awareness of how effective PT, OT, and speech therapy can be in lieu of surgery or drugs, for example. Often, it’s not the first place even a doctor will send people.

I’m a great example of this. I’ve had an autoimmune arthritic condition for years and have had the best of care. Initially, it was misdiagnosed and I was sent in for knee surgery, which turns out that didn’t fix it, and then I got put on probably a three- to four-year cycle of trying to find the right drug. We did find a really good drug, but it was only after I fell off a horse and broke six bones. I’m a horse person, and when I went into PT to deal with my horse injury, my PT told me, “By the way, I can help you with your arthritis.”

I still go to PT even though I fell off that horse almost a year and a half ago. It has wound up being more effective than all the other courses of care I’ve had. I’ve had doctors, but there’s a blind spot to it, in the patient population and medical provider population, that it can be a way to go in lieu of other options. We have an initiative we call Get PT. Our advocacy group, APTQI, is working to increase awareness of people trying PT as a solution in lieu of some other solutions. 

Our second issue is that people will enter PT and not want to continue a course of care because they feel better, or it’s a hassle.

I believe, and many people in our industry believe, that the true evolving model is going to wind up as a hybrid model. It is not going to be all virtual and it’s not going to be all in-person. People are playing around with models and our software supports this, where you might have an initial in-person evaluation and maybe a couple of courses of care, then you might have the option to do home exercises or a virtual visit where that’s tracked through the application, and then come back for periodic check-ins. You’re not having to get in the car, go to the clinic, do your course for 12 sessions. Maybe you’re only doing four or five in-person, but you’re doing some virtually.

I think personally that’s the future to ensure that people stick with a course of care, because you’ve got to reduce the hassle factor and you’ve got to make every visit meaningful when they do have to come in for that in-person visit. The key to that is having software that supports the hybrid model. We have that and we think we can better enable it. The key is RTM code billability, which we’re making sure that virtual visits are billable. Then the key is also monitoring outcomes, because we need to be able to measure that the outcomes in these situations are as good or better than if people came into that in-person care.

The hottest thing years ago was companies that were using Xbox and other consumer gaming consoles to show patients how to do exercises at home and then to monitor whether they were doing them correctly. Do you still see that or other technologies, such as video, that support at-home treatments?

It’s more than video, and we are looking very hard at RTM codes right now. I’m not a lawyer and I’m less than six months into this industry, so I’m not an authority and I am consulting with outside advisors. But there are rules around what defines a medical device. Does the stuff that we are providing qualify as a medical device? We don’t want to go awry on the compliance perspective, as you can imagine.

Remote therapeutic monitoring could be a virtual visit, but it also could be something as simple as people having check-ins through software that measures their current parameters or conditions. It can literally be self-monitoring your condition, working with your provider, checking in, and providing measurements along the way. RTM can be defined in a lot of ways. Before we release anything that does this, we want to make sure that we’re doing it right and that we are supporting all the possible use cases. During COVID, virtual visits were billable, then they weren’t, and now they are saying that they are billable in some cases. This is an area where even the payer and Medicaid rules change frequently.

What does the therapy practice landscape look like? Does it have similar M&A activity that we see in hospitals and medical practices and are private equity firms involved?

There is absolutely a consolidation activity in this space, and that has been going on for a long time. We think of the industry distribution looking like a barbell. There’s a lot of small practices, then there’s quite a bit of consolidation in the top 20-to-50 providers on the larger side, and the middle market is getting smaller. The middle market is getting smaller obviously because these private equity consolidations love to buy larger 10- to 30-practice middle market providers that consolidate into their several hundred practice larger company. If you are doing a consolidation exercise, it’s easier to buy somebody who is managing 10 to 30 clinics versus one clinic.

The middle market is ripe for consolidation activity, so we’ve seen it getting smaller over the years. But there are also, and this is good, a lot of new therapists coming out into business. Many of them are starting out as solo or small group practitioners. There’s also constantly new therapists coming into market and feeding that small business side.

There’s a very large small market side, where one to five people are running a practice together, and then there’s a very large what we would call enterprise, where there’s hundreds of clinics. They’ve negotiated national deals with payers and they’re running more like you a large corporate entity. Their needs are different. In the small practice, the clinician is doing everything. They’re managing patient intake, they’re getting their insurance, they’re diagnosing them, they’re managing their course of care, and they’re billing insurance. We need to provide that all-in-one solution to them.

The larger enterprise area is more specialized. The therapist who is touching the patient isn’t having to worry about the front office activity, the billing activity, compliance, or the financials. They are focused on the course of care. But that means your software has to be able to specialize and handle all the different roles in those organizations effectively. We’ve been working to make sure our software meets the needs of both segments, but they’re very different.

What communication is involved with making and accepting a patient referral and then reporting back the therapy outcomes, especially if there’s a value-based component?

Historically, the practices would build relationships with doctors who would refer patients in for care, either surgeons or general practitioners, all the different reasons why people might come in. You build relationships. If you think about a small practice, that could be local relationships. The larger practices get, the more likely they are to build referral relationships with local hospital systems, local payers, or even unions. We’ve seen people build relationships with unions or other groups that handle populations.

The trend towards value-based care and payment on outcomes is slower in PT and OT than it has been in other industries, but we see that trend still coming. It will still come our way. The models now are more experimental, but there’s a high demand for tighter integration in the referral network for us to be able to automate the receiving of the patient referral, which even in today’s environment is largely manual intake, and automate pushing back what the plan of care is and what the outcomes are.

We are trying to drive a lot more interoperability in the industry with this two-way integration so that we can better monitor the course of care. That’s one place that we’re seeing our business grow. We’re going to continue to push is making sure that we have that tight integration with that broader ecosystem that the patient exists in. Historically, we thought of the patient only in the lens of the person who was treating them in our business, the physical therapist or the occupational therapist, for example. But increasingly we are aware that patients are actually receiving care from multiple providers and there’s a need to see how their outcomes are being managed holistically. Our goal is to support that.

What is the strategy for the company over the next 3-5 years?

This industry is ripe for a more integrated model from a technology perspective. A lot of point solutions were built in the last 15 years and they solved individual problems. If you look at our practices that are buying the software, they are now assembling all these point solutions and trying to integrate them together to get to the answer they need. But no one solution is doing everything or even 80% of what they need to do as a practice, so it’s hard. Imagine that you’re managing a practice, you’ve got your physical therapy degree, and now you’re running a business and you have to be an IT person. That’s just not sustainable. The winners in this model will sit in the captain’s chair as if they were one of these company leaders — whether they were small, mid-market, or enterprise — and think about where people are having their broadest challenges from an integrated solution perspective. Then they will solve those challenges.

I’m not saying I have to be the only provider of software to these companies, but I think there’s ample room to integrate more pieces of the solution so that we take some of the burden off of our customers. Where I saw a lot of innovation in my last business, and I see now sparks of innovation that we can push forward, is how do we fully automate that patient experience? Imagine that our patient went to their general practitioner, they got diagnosed with a problem, they wound up in a hospital, and maybe they had surgery. Then they have to get therapy, medication, et cetera. But in today’s environment, the patient is managing all those interactions disparately because those systems don’t talk to each other and the patient is deciding if the outcomes are coming together.

My goal is that we integrate that patient experience and make it easy for them to cross through all the providers that they need to access. It allows those providers to easily communicate with each other as to what’s going on with that patient. Not the case, but the patient. They key to the value-based care model is making sure that we are looking across all of the modes of treating the patient and ensuring that we are optimizing them. The company that nails that will get a lot of traction.

Our goal is to be part of that ecosystem, to have a high degree of interoperability with the hospital network or the systems that the doctors might be using and make it easy for overall monitoring of the patient and not that individual problem that the therapist is trying to solve, because it exists generally in the scope of more problems. Our business is unique in that very rarely is that problem an isolated problem. Most of the time, we’re treating someone in the context of a larger course of treatment. Our industry has a huge opportunity to connect better to the broader course of treatment, and that’s where I think the future will go. You are integrating that from the patient perspective and you are integrating that from the clinician perspective.

Morning Headlines 4/19/22

April 18, 2022 News No Comments

Clipboard Health, which matches health workers with facilities, raises $80M

Clipboard Health, an online marketplace that matches nurses and other healthcare professionals with staffing opportunities, has raised $80 million over two funding rounds.

Addiction treatment startup shutters amid pandemic troubles

Online substance use disorder treatment clinic Halcyon Health announces via LinkedIn that it will shut down.

Cedars-Sinai Selects Chief Information Officer

Cedars-Sinai Health System (CA) promotes Craig Kwiatkowski, PharmD to SVP of enterprise information services and CIO.

Curbside Consult with Dr. Jayne 4/18/22

April 18, 2022 Dr. Jayne No Comments

A client I haven’t worked with in a couple of years reached out to me over the weekend, asking if I had copies of some materials that I had created for them. The project I originally worked on had been shelved because the company decided to take its solution in a different direction.

I wasn’t surprised when the work was mothballed. When you’re working on the vendor side, priorities can change drastically. Sometimes it’s a new regulatory requirement or the need to keep up with a third-party certification. Other times it’s a high-profile client with a contractual request. I’ve also seen projects get shelved when a competing solution turns out to be more work than originally scoped.

As a clinical content creator, you can’t get your feelings hurt when things change and your work winds up on the chopping block. Sure, as a physician you can be offended that your peers aren’t the priority, but it’s the nature of the beast when you’re working in the vendor space.

Fast forward and the company is trying to land a big client who needs content along the lines of what I created. There’s been a fair amount of turnover among the product and development teams, and although they remembered having content, no one could find it on any of their shared drives, SharePoint sites, email archives, or anywhere else. Despite corporate IT policies that discourage it, unless it is expressly prohibited, I keep copies of all my work product, so I was able to find it easily.

A quick glance reminded me that some clinical guidelines have changed over time and it probably needs a good going-over. I asked the representative from the vendor whether they had done any requirements gathering sessions with the prospective client or how they planned to approach the project. Although I don’t have capacity to work on it personally, I’ve got some informatics colleagues who could step in and get them moving.

I was surprised to hear that despite the fact that the client wasn’t able to find my content and therefore really didn’t have a good handle on what it contained, that they were planning to put it in front of the prospect and hope for the best. Apparently the buzzwords used by the prospect seemed in harmony with what was in the project charter (which they were able to find), so they assumed it was appropriate.

Since the product owner who reached out to me knows me pretty well, I shared a couple of thoughts on the idea of putting half-baked content in front of a high-value prospect without doing any requirements gathering. Without really understanding what the customer needs, how can you hope to hit the mark?

Unfortunately, I see this all too often in the healthcare IT industry these days. There’s a lot of tail wagging the dog between sales and product organizations, and ultimately the customer suffers when they have been promised something that doesn’t exist or that is quite a bit farther down the roadmap than they are led to believe. Having been in the CMIO trenches for longer than I sometimes care to admit, I’d much rather have honesty about what might or might not be available than to be the victim of a bait and switch. I know what my priorities are and what things I can bend on if it comes to that, but if the vendor isn’t interested in documenting my needs, I’m not sure why I’d want to be working with them in the first place.

The product owner was sympathetic to my recommendations, but mentioned that she’s under a lot of pressure from her leadership to make it look like they already had this content (even though they couldn’t even locate it). She knows she’s in a bind and is unhappy with the approach, but as we all know, the mess rolls downhill and sometimes you just have to do things you don’t want or like to do if you want to make those above you happy. Particularly if you’re in an organization that’s strongly top-down and feedback isn’t seen as something positive, you can feel pretty stuck.

I’ve spent plenty of time in organizations like that over the years, so I don’t envy her position. I sent her the files and the contact information of a couple of informaticists that used to work for me. Although I hope they’ll do the right thing (not only for the prospective client, but for the vendor’s own future success) but I’m not optimistic. I know my colleagues will let me know if they hear from the vendor, and it should be good for some stories over cocktails if they do start an engagement together.

While I was digging through my file archive, it was kind of fun to have a blast from the past and remember some of the projects I’ve worked on during my wild ride through the clinical informatics world. I think I’ve worked for clients that use just about every major EHR vendor as well as dozens of bolt-on solutions and even quite a few homegrown ones. I’ve worked with some amazing people who would bend over backwards to make sure that their projects delivered maximum benefit for patients and clinicians, and they’ve made even the most difficult projects rewarding. I’ve also worked with people who were only focused on how to make themselves look good and often did so at the expense of their teams and their colleagues. Those are the most difficult projects because even if you’re a consultant, no amount of experience or advice can make a difference unless there’s higher executive stakeholders who are willing to accept the fact that there’s ego-driven nonsense going on.

I also found some hilarious pictures of go-lives, some of which involved themes and costumes. One involved camouflage and a “M*A*S*H” theme and I think that was probably one of my favorites. I had forgotten coming up with IT-themed nicknames for everyone on the project, including General Release, General Ledger, Colonel Memory, Major Cluster, Major Milestone, Major Conversion, Major Problem, Captain Cloverleaf, Captain CCOW, Lieutenant Login, Sergeant Surescripts, Sergeant SAN, Private Practice, and of course Commodore Sixty-Four. One of the project team fired up her Cricut and made frames to go around our ID badges with our new credentials. That client produces stories that become legends, and I’m glad I got to have that experience.

What’s the most fun healthcare IT project you’ve worked on? What kind of things have you taken from it to enhance your current work? Leave a comment or email me.

Email Dr. Jayne.

HIStalk Interviews Christopher McCann, CEO, Current Health

April 18, 2022 Interviews No Comments

Christopher “Chris” McCann, MBChB is co-founder and CEO of Current Health of Boston, MA.

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Tell me about yourself and the company.

I’m originally from the west coast of Scotland, now based in Boston. My background is in computer science and medicine. I started Current Health in 2015 based on the experiences of my grandmother. She was repeatedly hospitalized for things that could have and should have been managed at home. Current Health was built to be a one-stop partner for any healthcare organization to deliver care in the home, using our technology platform, our services, and our knowledge and operational models.

What financial models support hospital-at-home and remote monitoring services?

The biggest thing holding back care at home, care outside the hospital, is the financial model across the industry. It’s just too immature and nascent. The CMS acute care at home waiver has obviously been very relevant to our business. That is just a waiver. It is due to expire when the public health emergency expires. There is a bill in the Senate right now to extend that and we’ve been working hard to see that bill passed.

We are reimbursed under Medicare RPM codes. But to be honest, we don’t see many hospital systems that see that as a driver of delivering more care at home. They’re more focused on using us for total cost of care reduction within alternative payment model populations that maybe they set up locally with a payer or on the post-discharge side, helping to improve patient flow and manage capacity, particularly when they’ve been capacity-constrained over the last 18 months between staffing shortages and, in some cases, capacity with COVID patients inside the hospital.

Does the market offer enough FDA-cleared sensors to give clinicians an adequate view of a patient at home?

Yes, absolutely. Not only do I not believe that there is a monitoring gap any more, I think the data that we see from hospital-at-home programs that we manage shows that patients are achieving, in some cases, better safety outcomes in home than they do in hospital. There is not a monitoring gap at the moment. That isn’t the problem that exists in the market.

In terms of scalability, is proprietary expertise involved in identifying the relevant information from a constant stream of home monitoring device data so that a clinician can get involved when needed?

There is. That’s partly why I would say that we are not a remote patient monitoring company, because simply getting monitoring data and dumping that on the physician is not helpful to anyone, particularly when you are managing a multi-thousand patient population. 

The key thing is actionability. How can you identify that one patient, or that group of patients, who require an intervention and get that actionable insight to the right person at the right time? That is, to be honest, even more important than capturing the monitoring data in the first place.

The staffing crisis is probably the biggest issue we have in healthcare right now. We don’t have enough registered nurses. We don’t have enough doctors. So we have to be able to help those staff that we do have — who are already overworked, who are already burned out – and help them focus on the patients who need them most and make their lives easier

How can the industry address the last-mile problem of patients who are being monitored at home who require blood draws or other in-person services?

As a company, we have made it clear that we don’t see ourselves as an RPM company. Remote monitoring is a feature of how care is delivered in the home, but it doesn’t actually, on its own, solve any particular problem. Because as you just said, you need that ability to go out into the home and do something about a patient who needs action or intervention. Even before that, for some patients, you need the ability to go out to set those patients up and help deal with technical support problems. Many of the patients we deal with are seniors. Half of them don’t have internet access and half of them don’t have smartphones.

We need to resolve that, firstly to partner with ancillary in-home services for things like labs and pharmacy and new delivery. We orchestrate that. We have our own clinical command center to provide virtual RN and MD services to support our clients in particular shifts, overnights, or on weekends. We can also do across the threshold logistics and technical support. Combining the technology with those services is, in our view, part of what is needed to solve the market problem.

An important part of in-hospital care is asking the patient how they are feeling or observing their level of discomfort, and that happens by people popping into their room at all hours. Can patient-reported outcomes and E-diaries adequately capture the patient’s perceptions?

EPRO symptom reporting, the capturing of contextual data like that, is critical. Many times patients readmit or come to the ER for things that are difficult to measure through biometric data. Pain is quite a good example of that. Pain is subjective, and in some cases, doesn’t measure on any biometric reading. But pain can absolutely bring someone back to the ER and absolutely massively affect quality of life. Being able to capture that is critical, and we incorporate that into our alarming system.

We also have to make sure that there is an accessible presence from an RN or a physician. It is certainly part of the acute care home waiver that patients need to be able to access a physician or RN if they need to.

I’ll say one other thing, which is that this is one of the reasons we were attracted to the Best Buy acquisition of Current Health. They have the caring centers. While Current Health focuses on the clinical side, the caring centers focus on the social side. They have social workers. They look more holistically at the individual and provide a wider range of social support. That is going to be important to how healthcare at home programs develop in the future.

How do you see Best Buy proceeding in healthcare and how will your company change under its ownership?

I’ve sat with the Best Buy Health senior leadership team and I report to the president of Best Buy Health. Our strategy is split into three parts, and this is all in the latest standings call. The first one is consumer health, which is, let’s get every health and wellness device into Best Buy’s flows and on Bestbuy.com. Interestingly, Best Buy is a larger channel for some devices than anywhere else. The second one is active aging, which was the acquisition of GreatCall. That’s more about how we help seniors age in their own home and a place of their own choosing. The last one is virtual care, and that’s where Current Health sits.

Best Buy is using its capabilities — such as Geek Squad, access to consumer and medical health devices installs and online, the caring centers that I mentioned before — to offer services to hospital systems and healthcare organizations to help them deliver care through the home. Best Buy is not trying to be, and never will be, a healthcare provider. That’s not what they want to do. They are there to help hospitals and healthcare provider organizations deliver healthcare to the home.

What technologies and services could change how life sciences research is performed via home-based clinical trials and monitoring?

Pharma has exactly the same issue as hospital systems. They want to move more clinical research into the home. They want to better the level of drugs and therapies in the home over the long term and do so with better outcomes for their patients. They want to be able to better measure how those therapies are actually doing for those patients, both clinically and from a quality of life perspective.

That last one has become important to regulators and payers. That’s where an organization like ours comes in. We enable better data capture in the home to understand how a patient is doing on a drug and what their quality of life is while taking it. But we also allow them to deliver drugs in new ways, taking drugs that would have been delivered in the hospital and delivering them in the home instead, at lower cost and with greater and greater access.

I would it sum up in saying that in the same way that we are seeing this decentralization of clinical care away from the tertiary bricks and mortar facilities, we’re also seeing a decentralization of clinical research. That  is fundamentally a good thing, because we can deliver better care if we can look at that patient longitudinally across a normal segment of their life when they are at home.

How do you see the market and the company’s role in it changing over the next few years?

Care at home will be the biggest area of strategic growth within healthcare over the next three or four years. Everyone has identified it as a strategic priority. Few organizations really know how to get there yet. To your point at the start, the financial model is still a little bit opaque. Current Health is trying to help make that financial model more transparent, and operationally and technically, make it turnkey for a hospital to stand up a program like this for any population. I hope, and I expect, that we can continue to be a major part of doing that across the US.

Morning Headlines 4/18/22

April 17, 2022 Headlines No Comments

Effectiveness of Email Warning on Reducing Hospital Employees’ Unauthorized Access to Protected Health Information

A JAMA-published study finds that sending warning emails to professional staff who were detected by monitoring technology inappropriately accessing patient EHR information reduced repeat incidents by 95%.

Mental health startup Ahead got behind

Virtual ADHD treatment provider Ahead, which launched in 2019, announces it will shut down after raising $9 million.

Furious patients hit out as doctors’ chief dismisses concerns about the difficulties of getting face-to-face GP appointments as ‘a lot of noise’

In England, the president of the Royal College of GPs – who holds an ownership stake in a telehealth technology vendor – takes heat for saying in a conference that the most positive development of the pandemic was a huge boost in telehealth.

Monday Morning Update 4/18/22

April 17, 2022 News No Comments

Top News

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A JAMA-published study finds that sending warning emails to professional staff who were detected by monitoring technology inappropriately accessing patient EHR information reduced repeat incidents by 95%.

The study involved sending same-day emails to staff who accessed EHR charts outside of approved work purposes, as identified by Protenus technology.

Two percent of those who received the email warning committed unauthorized access a second time, while 40%  of those who were not warned did so repeatedly over several months.


HIStalk Announcements and Requests

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Health systems and the American Hospital Association claim that hospital mergers and acquisitions should be allowed to flourish because they improve the cost and quality of the care delivered, but only 20% of poll respondents agree. Most say the acquired hospitals have higher costs, reduced services, and lower quality.

New poll to your right or here: What media-related activities have you spent at least an hour on after HIMSS22? I haven’t taken even a casual glance at conference-related audio, video, and HIMSS Accelerate postings, so I’m trying to determine whether I’m among a slothful minority.


Webinars

April 22 (Friday) 1 ET. “CMIO 3.0: What’s Next for the CMIO?” Sponsor: Intelligent Medical Objects. Presenters: Becket Mahnke, MD, CMIO and pediatric cardiologist, Confluence Health; Dale Sanders, chief strategy officer, IMO. The relatively short history of the CMIO role includes Version 1.0 (EHR implementation, Meaningful Use, and regulatory compliance) and Version 2.0 (quality and efficiency). Version 3.0 is at the forefront of predictive analytics, population health initiatives, and optimization of data-driven tools. The presenters will discuss the digital revolution’s impact on CMIO responsibilities; the connection between clinical informatics, analytics, population health and the CMIO; and how CMIO 3.0 will be involved in the adoption of advanced technologies.

April 28 (Thursday) 2 ET. “Undercoded and Underpaid: Making It Easier to Document to Optimize Reimbursement.” Sponsor: Intelligent Medical Objects. Presenters: Deepak Pillai, MD, physician informaticist, IMO; June Bronnert, MSHI, RHIA, senior director of informatics, IMO; Nicole Douglas, sales engineer, IMO. The presenters will discuss how to simplify precise documentation for clinicians; the effects of imprecise coding on reimbursement; why accurate code capture at the point of care can have positive downstream impact on population health initiatives; and how third-party solutions integrated with the EHR can reduce documentation burdens.

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


Sales

  • Revo Health  implements revenue cycle automation from RCxRules.
  • Canada’s Saskatchewan government chooses a virtual care platform from Lumeca Health in a three-year, $3.8 million deal.

People

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Michael Dunn (SAS) joins Glytec as AVP of hospital sales.

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OmniSYS hires Ann Howard, MBA (GoNoodle) as EVP of product management.

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HCA Healthcare promotes Jared Mabry, MS to VP of digital patient experience.

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Mike Murray, founder and CEO of healthcare cybersecurity company Scope, died April 6 at 46.


Other

In England, the president of the Royal College of GPs – who holds an ownership stake in a telehealth technology vendor – takes heat for saying in a conference that the most positive development of the pandemic was a huge boost in telehealth. The head of a senior citizens’ group disputed the assertion of Professor Dame Clare Gerada that patients prefer visits by phone or computer to those conducted in person.

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Aledade CEO and former National Coordinator Farzad Mostashari, MD, MSc describes on Twitter the challenges he encountered as he and his family members fell ill with COVID-19:

  • Confirmatory PCR tests are hard to get scheduled, are often available only from for-profit companies at high prices, and require several days to receive results.
  • Paxlovid for treatment is widely available, but his father’s academic medical center PCP was unresponsive to messages sent via the patient portal and telephone answering machine.
  • Unable to reach the PCP, he booked a virtual visit to get a Paxlovid prescription, but prescribing it requires a recent renal function test.
  • He got the prescription, but the instructions were confusing, involving multiple tablets in two colors that had dosage adjustments listed on an add-on sticker.
  • He tried to get bebtelovimab for his mother, and despite being in ample supply, PCPs don’t have access to it. He was able to get the monoclonal antibody infusion through the Massachusetts Department of Public Health.
  • He does not agree with CDC’s recommendation that people can leave isolation five days after without requiring a negative antigen test. He says that it’s widely misunderstood by professionals that while PCR tests can keep showing positive long after the person is no longer infectious, a positive antigen test almost certainly means the person can still spread COVID-19.
  • His mother tested positive a week after his father returned home with a negative antigen test, most likely due to his father’s viral shedding.
  • Farzad tested positive until Day 15.
  • He concludes that even people who have financial means and the knowledge and persistence to work the system may still not receive adequate treatment.

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The Onion resurfaces a fine year-ago item.


Sponsor Updates

  • Clearsense releases a new Tech Talk video, “Finding Value in Data by Enterprise Application Rationalization.”
  • OptimizeRx will sponsor the MedDev E-Marketing Summit June 7-9 in San Diego.
  • Olive, an official sponsor of the Boston Marathon, will donate proceeds from its Boston Marathon Fan Fest activities to Boston’s Children’s Hospital.
  • Vocera releases a new podcast, “Leading the Evolving Healthcare Workforce – Rose O. Sherman.”
  • Well Health names Istvan Kadar-Toth (Play’n Go) engineering director and Hungary site lead.
  • West Monroe releases a new report, “The Future of Due Diligence in Private Equity.”

Blog Posts


Contacts

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

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Morning Headlines 4/15/22

April 14, 2022 Headlines No Comments

MedTrainer Announces $43 Million Series B Funding Round Led by Vista Equity Partners

Healthcare compliance and learning platform vendor MedTrainer raises $43 million in a Series B funding round.

Iris Telehealth Raises $40 Million in Series B Funding to Combat Behavioral Healthcare Crisis

Virtual mental health company Iris Telehealth raises $40 million in Series B funding.

9am.health Raises $16 Million Series A To Build a Comprehensive Virtual Diabetes Destination Nationwide

Virtual diabetes clinic 9am.health raises $16 million in a Series A funding round.

News 4/15/22

April 14, 2022 News 1 Comment

Top News

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A CB Insights Q1 digital health report finds that:

  • Digital health funding dropped 36% over Q4, a much larger decrease that the financial and retail tech sectors. Funding was down across all global regions.
  • Mental health tech funding dropped 60%, while telehealth was down 32%.
  • Mega-round funding dropped in contributing to the overall funding decrease.
  • Just one company launched an IPO in Q1 versus 23 in the previous quarters, and zero SPAC deals occurred, likely because of poor IPO returns in 2021. IPO activity was the lowest in years.
  • Six new companies attained billion-dollar “unicorn” valuation in Q1, less than half of the previous quarter’s number.

HIStalk Announcements and Requests

I apologize that several companies sent urgent phone and email messages to Lorre on Tuesday after I mentioned that my top-of-page ad banner is available for the first time in years. I didn’t expect that much interest in committing immediately. The fairest way we could think of was to go with the earliest timestamp.

I had plans to offset my slacking off at HIMSS22 by watching some recorded education sessions online, but I’m finding that my indifference has transformed from in-person to virtual. I haven’t looked at anything related to the conference since I left Orlando and most likely won’t. Beyond official education sessions being recorded, it seemed like half of the conference attendees were bantering with the other half for their dopey podcasts and video interviews, so I doubt the limited interest in consuming them is increasing as weeks go by.

Speaking of HIMSS, I checked to see if anything was happening on Accelerate (not much that I saw), but I was surprised to see a newly posted pitch for a paid networking group by HITLAB that costs from $99 to $1,999 per year. I’m not sure the industry needs another option “for individuals in healthcare looking to amplify their brand impact” or how that business might compete with that of HIMSS, and if so, why it is being promoted on a HIMSS platform. I don’t know anything about HITLAB except they used to run an innovation contest with AARP.


Webinars

April 22 (Friday) 1 ET. “CMIO 3.0: What’s Next for the CMIO?” Sponsor: Intelligent Medical Objects. Presenters: Becket Mahnke, MD, CMIO and pediatric cardiologist, Confluence Health; Dale Sanders, chief strategy officer, IMO. The relatively short history of the CMIO role includes Version 1.0 (EHR implementation, Meaningful Use, and regulatory compliance) and Version 2.0 (quality and efficiency). Version 3.0 is at the forefront of predictive analytics, population health initiatives, and optimization of data-driven tools. The presenters will discuss the digital revolution’s impact on CMIO responsibilities; the connection between clinical informatics, analytics, population health and the CMIO; and how CMIO 3.0 will be involved in the adoption of advanced technologies.

April 28 (Thursday) 2 ET. “Undercoded and Underpaid: Making It Easier to Document to Optimize Reimbursement.” Sponsor: Intelligent Medical Objects. Presenters: Deepak Pillai, MD, physician informaticist, IMO; June Bronnert, MSHI, RHIA, senior director of informatics, IMO; Nicole Douglas, sales engineer, IMO. The presenters will discuss how to simplify precise documentation for clinicians; the effects of imprecise coding on reimbursement; why accurate code capture at the point of care can have positive downstream impact on population health initiatives; and how third-party solutions integrated with the EHR can reduce documentation burdens.

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


Acquisitions, Funding, Business, and Stock

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Biofourmis will reportedly receive an investment from General Atlantic that will value the company at over $1 billion.

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Healthcare compliance and learning platform vendor MedTrainer raises $43 million in a Series B funding round.

Virtual mental health company Iris Telehealth raises $40 million in Series B funding.

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Virtual diabetes clinic 9am.health raises $16 million in a Series A funding round.

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Drugmaker Pfizer offers $74 million to acquire Brisbane, Australia-based ResApp, whose smartphone app analyzes coughing sounds to diagnose COVID-19 with 92% accuracy. The app is already being used to diagnose asthma and pneumonia during telehealth visits.


Sales

  • Fraser Health will upgrade its Meditech Client/Server system to Expanse.
  • North York General Hospital chooses Sectra’s radiology and breast imaging modules and VNA.
  • Howard Brown Health selects Pivot Point Consulting, a Vaco Company, to provide project management, resourcing, and advisory services for its OCHIN Epic implementation.
  • Senior care technology support vendor UpStream Healthcare chooses Innovaccer’s Health Cloud, Data Activation Platform, and application suite.

People

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Kevin Dias, MS (TransUnion Healthcare) joins Myndshft as chief customer officer.

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Laurance Stuntz (Massachusetts EHealth Institute) joins Xealth as SVP of customer success.


Announcements and Implementations

Northwell Health and startup studio Aegis Ventures launch Ascertain, which will develop and commercialize healthcare AI companies. The company will use $100 million in seed funding to develop product ideas, commercialize scientific developments, and partner with foreign companies to bring their offerings to the US.

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A large KLAS Arch Collaborative clinician survey looks at turnover and the EHR experience:

  • Nurses are the clinicians who are most likely to leave at more than 20%.
  • Burnout, the factor most strongly correlated with planned departures, is most often fueled by chaotic work environment, time required to complete bureaucratic tasks, lack of teamwork, no personal control over workload, and lack of shared values with leadership.
  • One-third of clinicians who think their organizations perform poorly on EHR implementation training, and support say they are likely to leave within the next two years.
  • Suggested EHR actions include reducing after-hours charting, optimizing nurse workflows to reduce duplicative charting, and offering workflow-specific EHR training,

Government and Politics

HHS Secretary Xavier Becerra, JD asks ONC to review possible bias in healthcare AI algorithms and its impact on health equity. 


Other

Mayo Clinic launches an observational study to determine if Apple Watch ECG and symptom reporting, as sent to an Epic dashboard, are good enough to support AI-powered diagnosis of cardiovascular problems.

ED doctors diagnose a 20-year-old man with breathing problems and chest pain with a lung air leak problem that is usually caused by violent coughing or strenuous exertion. His etiology was the latter, with an asterisk – he admitted that he was stricken during a vigorous session of self-gratification. He went home four days later, having learned unknown lessons.


Sponsor Updates

  • Aleris-Hamlet in Demark implements Agfa HealthCare’s digital radiography technology.
  • EVisit becomes a top-level member of the American Telemedicine Association.
  • Conversational AI vendor Hyro will offer its healthcare customers provider search, match, and scheduling functionality from Kyruus.
  • Wolters Kluwer Health’s Ovid medical research platform now offers access to the Astute Doctor Communicate Program, a collection of interactive and evidence-based online courses.
  • LexisNexis Risk Solutions publishes a new customer success story, “Delivering ROI with De-Identified Medical Claims Data.”

Blog Posts


Contacts

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

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EPtalk by Dr. Jayne 4/14/22

April 14, 2022 Dr. Jayne 3 Comments

I wrote at the beginning of the pandemic about the increased visits my practice was seeing for sexually transmitted disease testing. A recent Washington Post piece covers the increase in syphilis and gonorrhea during 2020, partly attributable to clinic closures and delays in seeking care. Scarce public health resources were focusing on COVID-19 and availability of testing services was variable. I was distressed to see a significant rise in cases of congenital syphilis, which rose 235% since 2016 and hit a new high of 2,148 cases. Pregnant patients who are infected can experience pregnancy loss and infants who are born with syphilis can have devastating health issues.

Other diseases were also on the rise in 2020, including gonorrhea. Surprisingly, chlamydia was on the decline, although that may be due to decreased testing and delays in seeking care. Many infected patients don’t have symptoms and are only diagnosed on routine screening, so a decline in face-to-face visits might also be a driver. With the power of all the data we have in our electronic health records, organizations should be able to do a better job of identifying patients who are eligible for STD screening and can use patient engagements solutions for outreach. Depending on configuration, there may be barriers to outreach because it’s a sensitive topic; but that doesn’t mean we shouldn’t do our best to address an entirely preventable category of illness.

Many of us in healthcare IT cringe when healthcare workers incorrectly cite HIPAA as the reason that they can’t provide patients with their own health information. As a field consultant, I shuddered every time someone claimed a regulation wouldn’t let us configure the EHR in a certain way or modify a workflow so that the site would run more efficiently. The American Medical Association has created a series of articles that debunk regulatory myths. Hot topics that impact our field:

  • HIPAA does not explicitly state that physicians can’t respond to online reviews from patients. However, they must maintain privacy, even if the patient has revealed personal information. Responding may however violate community guidelines for review sites, so physicians and practices should do their homework before responding.
  • Clinical support staff who perform non-clinical tasks in the EHR are not required by federal or state law or regulation to log out and back in when switching back and forth between clinical and non-clinical tasks. They also don’t have to log out/in when switching back and forth from a scribe role to a clinical support role.
  • The Joint Commission does not support or prohibit the use of documentation assistants such as scribes.
  • Medicare doesn’t require physicians to re-document information captured by the staff, only to verify it, as long as there are no state or institutional policies to the contrary. This includes documentation completed by medical students.
  • There is no federal rule that physicians are the only clinicians that can enter orders via computerized provider order entry. Other members of the care team are permitted to pend or send orders as requested by the physician, as long as state law allows.

One of the most often cited (and incorrect) myths is that The Joint Commission and/or OSHA prevent food and beverage at clinical workstations. I’ve seen dozens of nursing supervisors tell people that the hospital will fail a Joint Commission inspection if there are cups at the nursing station. In reality, The Joint Commission does not address where food or drinks can be located. Even the Occupational Safety and Health Administration doesn’t determine specific locations where workers can eat or drink. They do, however, prohibit eating and drinking in places where one could be potentially exposed to blood or infectious materials.

Hopefully, organizations aren’t allowing blood, urine, or stool specimens at the nursing station, not only because it can lead to contamination, but because it’s simply gross. Employers can make their own rules, and certainly it’s a good idea not to allow open drink containers in areas where a spill would damage electronic equipment or patient records, and people shouldn’t be eating by the computer and dropping crumbs in the keyboards. The reality of healthcare staffing these days is that often people don’t get dedicated meal breaks and sometimes scarfing a granola bar while you’re giving report on patients is the only way you’re going to power through. But when employers decide to put the hammer down, they need to not blame other organizations that have no opinion on the matter.

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Speaking of regulations, I’m spending part of this week working on my bucket list. Despite being in a helmet-optional state for the week, I’m glad that my course requires reasonably adequate helmet coverage. I always feel a little squirrely when I participate in activities that have inherent risk since I know that I’m likely the highest trained medical professional available if something goes wrong. I’ll be glad to not have to manage the consequences of failing to protect against head trauma. The weather is looking rather frightful, so I’m hoping for the best.

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I ran across a solution today called JustAskEvie. It offers real-time EHR support for clinicians, powered by a network of fellow clinicians who provide peer-to-peer support. Services include coaching on specialty-specific workflows either during a physician’s onboarding process or during their first days using the EHR. Their goal is to be complimentary to the training offered by organizations or as a replacement option for those who might not have been able to attend scheduled training. They also offer go-live and upgrade support as well as after-hours coverage.

The company is hiring “Evies” for a variety of EHRs. I like the idea, but I imagine there might be some challenges when working with organizations who have heavily customized their EHRs. Several physicians who were part of the conversation voiced interest in checking it out as a potential side gig, with two noting that their organization doesn’t offer compensation for those physicians who agree to be super-users or to provide peer-to-peer support. It reminds me of the staffing equation we’re seeing in nursing and elsewhere in healthcare. Rather than pay for in-house resources who know the local system and climate, organizations are willing to give money to a third party to achieve a similar outcome. I understand why it happens, but on some level, it is still baffling.

How does your organization compensate clinician super-users? Or does it expect them to do it out of the goodness of their hearts? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 4/14/22

April 13, 2022 Headlines No Comments

Northwell Health and Aegis Ventures Launch Ascertain – Healthcare AI Company Creation Platform to Improve Quality and Access to Care

Northwell Health (NY) and Aegis Ventures launch Ascertain, a joint venture devoted to developing and commercializing healthcare AI companies.

Healthtech firm Biofourmis to earn unicorn status with General Atlantic funding

Sources say that upcoming funding from General Atlantic will give virtual care and digital therapeutics vendor Biofourmis a valuation of over $1 billion.

Top Integrated Practice Management, Revenue Cycle & EHR Solutions Rating Awarded to ModMed by Surgical Specialists, Black Book Annual Physician Survey

ModMed achieves the top customer ranking for its integrated practice management, EHR, and RCM software, according to a Black Book survey of end users working in surgical specialties.

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