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Healthcare AI News 7/31/24

July 31, 2024 Healthcare AI News Comments Off on Healthcare AI News 7/31/24

News

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OpenAI launches user testing of SearchGPT, which returns attributed web links from trusted publishers and can answer follow-up questions.

OpenAI begins rollout of Advanced Voice Mode for ChatGPT, which can conduct natural conversations, allows the user to interrupt, and tailors its responses based on speech cues about the user’s emotions.


Business

Bloomberg reviews Google’s healthcare projects – which include high-profile failures – and its work with HCA to use AI for nurse handoffs and ED physician documentation.

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Cleveland Clinic hires Ben Shahshahani, PhD (SiriusXM) as its first chief AI officer.

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Writer Inc. launches Palmyra-Med-70b, a large language model that the company’s benchmarks indicate is the most accurate available. Palmyra-Med named Vizient, CirrusMD, and Medisolv as Palmyra-Med users.


Research

Study participants trust medical advice less if AI was involved in its creation — even if they know that humans have reviewed the AI draft — and are less likely to follow any advice in which AI played a part.

Researchers find that AI can predict chronic pain in breast cancer patients, which could support early identification and personalized management.


Other

Doctors at University of Vermont Health Network are saving three hours per day in using Abridge for ambient documentation.


Contacts

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

Comments Off on Healthcare AI News 7/31/24

HIStalk Interviews Manny Krakaris, CEO, Augmedix

July 31, 2024 Interviews Comments Off on HIStalk Interviews Manny Krakaris, CEO, Augmedix

Manny Krakaris, MBA is president and CEO of Augmedix

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Tell me about yourself and the company.

I spent the first 12 years of my career in banking. I then made the transition to industry because I wanted to get more of a hands-on experience in business. I’ve been a serial CEO, COO, and CFO of a variety of technology companies in semiconductors, solar, enterprise software, and SaaS. I came to Augmedix via the board. I had previously worked with two of the board members who were representatives of VC firms whose portfolio companies I had worked for. I had just sold my previous company.

I was intrigued by the opportunity. My doctor was a customer well before I met with the board, and she just loved the service. She had told me in no uncertain terms that this had changed her life. I found that intriguing and compelling. When I did a little bit more homework, I came to realize that this was a pervasive problem. Having been new to healthcare, I had no idea that this was a problem in the first place, but it was pervasive and huge. I felt that this is an area where I could contribute, given my background, to help bring a little bit more efficiency into the healthcare sector.

How did the pending acquisition of Augmedix by Commure happen?

We share a common customer, HCA. We provide different services to HCA. HCA gently encouraged us to start talking about how we might be able to stitch together a more comprehensive suite of solutions that addresses a wider swath of the patient journey when it comes to healthcare. The more we talked, the more interesting it became. It ultimately culminated in Commure making the offer to acquire us last month.

Commure had announced its own free ambient scribing solution three months before the acquisition announcement. How does that fit with its strategy?

They did have that offer out there and they still do. The idea is that by offering a platform with a whole suite of products, you can bundle things so that a specific offering can be made available at a seemingly low price or even free in some cases. I don’t think Commure is the first to come up with that concept. Microsoft has been pursuing that strategy for forever, it seems, and quite successfully. In our case, they have an ambient AI scribe product, but it caters to a different care setting than the ones that we focus on, so they are quite complementary. Down the road, will we share similar back ends? Probably, but time will tell.

How do you differentiate your product from the several competing ones?

At last count, I think there are 42 companies that are purporting to be able to generate a note using large language models without any human intervention. The reality is that you can create a draft medical note from the use of automatic speech recognition to convert an audio recording into a transcript, and then large language models take that transcript and convert that into a structured medical note. But the structured medical note that comes out of the back end is a rough draft that requires human intervention to complete it, to edit it, and to make sure that there are no hallucinations in it. The state of the technology is not perfect yet.

What differentiates us from the vast majority of those companies is that we approach this problem organically. We pioneered the whole concept of ambient medical documentation 11 years ago, when no one had ever heard of it. It was revolutionary to basically tell the industry, look, we can repurpose the conversation that occurs between a doctor and a patient and use that as the primary input source to create a medical note. What technology has helped us do in the last couple of years is automate that last step using large language models. If you simply try to modify the technology to this particular use case, you’re won’t get good quality output.

We understand clinician workflows better than pretty much anybody, with a possible exception of one company. We also understand the differences of clinicians’ needs based on care setting, specialty, and the complexity of the encounter. We incorporate that into the portfolio of solutions that we offer today. One size fits all does not work in healthcare.

How important is being able to complete the note quickly, ideally just before the visit ends?

Obviously speed is important. You don’t want to have your customer waiting for minutes or hours for their medical note, because they need to move on to the next patient. For the self -serve products that are fully AI capable, you want to be able to get that draft note to the clinician within a half a minute or so.  Several players have been able to reach that milestone.

Will low switching costs encourage customers to change vendors?

Switching costs with software of this type, which is downloadable application from Google Marketplace or the App Store, are going to become less significant than they were in the past. It all depends on how deeply integrated the application becomes in the clinician’s workflow.

For independent practices, the degree to which the application is integrated in the workflow is pretty low. I would imagine that for that segment of the market, switching costs are going to be insignificant. But for the enterprise, there are significant points of integration with the EMRs, RCM, and patient intake that would make switching costs much more prohibitive for the incumbent to have a greater moat established around their business.

How does the ability to take action from the user’s voice commands overlap with ambient documentation?

They’re pretty much the same thing. Ambient is all about voice. It’s taking the voice recording between a doctor and a patient and using that to generate a medical note. Voice commands, in terms of requesting data from different parts of a healthcare system, are just an extension of the ambient technology. I think that is going to become more and more prevalent. It’s already pretty pervasive in some healthcare systems. I don’t see that reversing. That’s a big efficiency gain for the healthcare industry.

Ambient documentation seems to have higher physician acceptance than most technologies. What is the rationale of those who choose not to use it?

I think we have to stratify the market, which is true of any industry, not just healthcare. When you introduce new technology, you’re going to have some enthusiastic early adopters who want to see change and want to help shape that change. That’s what we’re seeing today in healthcare. The preponderance of users of self-serve AI tools today, whether they are our customers or customers of our competitors, are for the most part early adopters. They are willing to put up with some imperfections in the technology and provide input to make that technology better.

For mass adoption to occur, you need to remove any kind of friction points or imperfections in the technology. I think we’re going to see more and more of that towards the end of this year and certainly in 2025 as the technology matures a little more. It’s not quite there yet, but it’s getting there.

Is it hard to make ambient documentation work as well for specialists and nurses as it does for primary care physicians?

The technology is only as good as the input that you put into training it when it comes to large language models. GPT-4 is a very powerful general purpose tool. If you prompt it with a general question such as “create a structured medical note in these four different segments based on this transcript,” it will do that for you. It will be OK, but not great.

However, if you start asking it more refined questions — for example, if you do what we do with proprietary models that identify in the transcript the key elements of that transcript that you believe are relevant to the medical note — and then you ask it specific questions for each one of those elements, you narrow the variables that the LLM has to deal with to generate a response. The fewer variables you ask the model to work with, the more accurate your output is going to be. That’s what we do. We ask very specific questions of each of the key medical elements that we identify in the transcript in order to optimize accuracy.

Beyond reducing after-work chart completion, does ambient documentation reduce the cognitive load of physicians who otherwise would need to listen and type at the same time or try to recall parts of the conversation to create documentation after the fact?

Yes. We conducted a study with one of our largest customers. It was a pretty broad study that included primary care physicians and a variety of specialists, well over 100 clinicians whom we studied over a year.

We discovered that for primary care physicians, the biggest source of improvement in their WRVUs — their work relative value units, which is a standard measure of performance of a physician — did not come from increased patient throughput. Rather it came from higher capture rates, which then resulted in higher reimbursement.

It’s not intuitive at first, but if clinicians have to try to remember everything that they did during an encounter when they subsequently do the medical note, several things may slip through the cracks. That is, in fact, what has happened, in our study at least. Those slippages, those things that were omitted, represented about 80% of the lift, and the lift was significant. You can add value beyond increasing patient throughput or reducing pajama time.

What is the near-term future for using AI in healthcare?

AI has the capacity to learn quickly. The rate at which it learns really depends on the rate at which you can feed it relevant data. It will be incumbent on healthcare systems to ensure that the data that their vendors are using to train their models is representative of the patient population of that particular healthcare enterprise. It’s not good enough, and in fact is  counterproductive in many ways, to use generalized data from the general population. If you’re trying to cater to a regional healthcare network that caters mostly to foreign-speaking people or people of a certain ethnicity who are not represented equally within the general population, that will skew how the model interprets certain information. It’s important to tailor the data that you use to train your models to the patient population that your customers are serving.

Second, as you train the models, you can actually help the model mimic the preferences of the individual clinician, looking at what the clinician does from an editing perspective after the draft note is delivered to the clinician. Take those edits that the clinician makes to what the technology generated and put that back into your training data. That will generate a note that better reflects the preferences and stylistic preferences of the doctor. That’s going to be welcomed by many doctors, because they have their own unique ways of documenting their interactions with patients. AI has the ability to to learn from that as long as we can get that that feedback and incorporate that into the training models.

What does the post-acquisition future of the company look like?

This is my first foray in healthcare, so I come into this with a naive perspective, but if you follow the patient journey, it has many steps. Each one seems to be provided by a different entity that is providing a very specific task. If you look at it holistically, to go from patient intake to final reimbursement, there are way too many disjointed steps in between.

What I think the healthcare industry could benefit from greatly, which is lacking so far, is compressing as many of those steps as possible by integrating them on a singular platform that seamlessly transfers information from one functional area to another to another to avoid what happens today, which is a lot of manual intervention to clean up imperfect input from the preceding functional step in that journey. That introduces a lot of cost in the system. That’s something that the healthcare industry really can no longer afford to do. Commure’s vision is to be the first in the industry to be able to do that. I think we play a central role in that strategy.

The healthcare industry is intriguing. It’s massive. There are a lot of challenges in front of us, but I think the people that run the big hospital systems, healthcare networks, and IDNs, are of the mindset today that doing the same thing is not going to yield the kind of results they need to generate in order to be able to continue to deliver healthcare to a growing and aging patient population. They are a lot more willing today than they were six years ago, when I got into this industry, to explore these new opportunities and new technologies. I find that very encouraging.

Comments Off on HIStalk Interviews Manny Krakaris, CEO, Augmedix

Morning Headlines 7/31/24

July 30, 2024 News 2 Comments

Flo Health Secures More than $200M Investment from General Atlantic to Revolutionize Women’s Health; First Purely Digital Consumer Women’s Health App to Achieve Unicorn Status

England-based period and fertility app vendor Flo Health raises a $200 million investment from General Atlantic that values the company at $1 billion.

Skeptical judge sides with smaller analytics firm against giant PointClickCare over data blocking tactics

A federal judge grants analytics firm Real Time Medical Systems a preliminary injunction against EHR vendor PointClickCare for implementing CAPTCHA-controlled system access, ruling that the company violated 21st Century Cures.

VitalHub agrees to acquire MedCurrent Corporation for up to $34 million

Health and human services software vendor VitalHub will acquire clinical decision support company MedCurrent, both of which are based in Toronto.

News 7/31/24

July 30, 2024 News 2 Comments

Top News

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England-based period and fertility app vendor Flo Health raises a $200 million investment from General Atlantic that values the company at $1 billion.


HIStalk Announcements and Requests

Yes, I monitor odd things. Epic has run its “Hey Judy” column like clockwork each month since August 2021, but hasn’t posted one for June or July.


Webinars

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


Acquisitions, Funding, Business, and Stock

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Acute virtual care company AvaSure will acquire Ouva’s AI-enhanced care automation technology, which it has already been using as a part of its Intelligent Virtual Care Platform. Ouva will continue to operate its pediatric and wayfinding business.

Health data management and research insights company OneMedNet announces $4.6 million in new funding.

Mercy will open three primary care clinics in former Walmart Health locations in Arkansas, where Walmart is headquartered, later this summer.

Kansas City tax authorities say that Oracle Health has met the requirements for incentives that are related to the former Cerner Innovations Campus, although the company has 6,400 Missouri-based employees versus the 16,000 new jobs that were promised by Cerner before Oracle acquired the company.


Sales

  • MedStar Health (MD) will use risk management solutions from RLDatix to enhance analysis of patient safety events.
  • Loma Linda University Health (CA) selects specialty pharmacy-focused analytics and market access services from Loopback Analytics.
  • Multi-state Sound Physicians will implement AmplifyMD’s virtual specialty care software for its tele-hospitalist services.

People

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Ben Shahshahani, PhD (SiriusXM) joins Cleveland Clinic as VP/chief AI officer.

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Alpha II hires Jon Danielson, MBA (Biscom) as CFO.

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Erik Moore, MS (Optum) joins Bamboo Health as CTO.


Announcements and Implementations

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Artera announces that a dozen FQHCs — including Livingston Community Health (CA), Moses Lake Community Health Center (WA), and Bedford-Stuyvesant Family Health Center (NY) — have implemented its patient communications software.

North Arkansas Regional Medical Center implements Sunoh.ai’s ambient listening and clinical documentation technology.

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UAB Medicine describes how it is using remote patient monitoring to collect data from patients at home and alert clinicians of negative trends. Cellphone-connected blood pressure cuffs, glucose monitors, and weight scales from Withings Health are issued to patients who agree to take their measurements at least 16 times per month. 

Researchers find that 25 to 40% of people who use wearables to monitor their atrial fibrillation experience life-affecting stress and anxiety as a result.


Government and Politics

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A federal judge grants analytics firm Real Time Medical Systems a preliminary injunction against EHR vendor PointClickCare for implementing CAPTCHA-controlled system access, ruling that the company violated 21st Century Cures. PCC says it implemented the requirement to prevent web scraping by bots, noting that Real Time is the only one of its 1,900 partners that objected. Real Time says that PCC threatened its access to skilled nursing data because it was launching a competing service, also complaining that Real Time is HITRUST certified and should not be required to complete CAPTCHA challenges. 

MultiPlan CEO Travis Dalton has been meeting with Senate staffers to defend the company’s use of analytics to advise payers how much they should reduce billed charges from out-of-network providers, for which MultiPlan gets a cut of the savings and the patient sometimes receives a bill for the difference.


Privacy and Security

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CrowdStrike customers complain that they receive error messages when they try to use the $10 Uber Eats gift card that the company offered following its global outage on July 19. Uber’s system apparently canceled the vouchers due to what it deemed to be suspiciously high usage rates.

Penn Medicine SVP for Data and Technology Solutions Mitchell Schnall, MD, PhD (who likely didn’t receive an Uber Eats gift card) recounts some of the steps his team took once they became aware of CrowdStrike’s outage, including the nearly immediate decisions to revert to downtime procedures and cancel or reschedule elective surgeries and appointments: “Imaging was interesting because we could take a CT scan on the scanner but it couldn’t go anywhere else, so we had to take the radiologist to the CT scanner to be able to read the images.”

A former organ transplant coordinator faces 22 years in prison for accessing the records of Supreme Court Justice Ruth Bader Ginsburg while she was being treated for cancer at George Washington University Hospital in 2019, then posting them to conspiracy theory and anti-semitic message boards on 4chan. Trent James Russell explained to authorities that his cat must have run across his keyboard.


Sponsor Updates

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  • Arrive Health employees take part in Community Give Back Week by harvesting crops at Ohio City Farm to provide healthy food to CLE’s underserved residents.
  • The Sequoia Project launches a new Pharmacy Workgroup as part of its flagship Interoperability Matters program, through funding and collaboration with Surescripts.
  • Arcadia publishes a new guide, “Quality management tools to balance care and rising costs.”
  • Health plan XO Health selects Capital Rx as its pharmacy benefit administrator.
  • Clearwater announces growing adoption of its Managed Cloud Services, which help healthcare organizations maintain data and applications in the Azure cloud with reduced security and compliance risk.
  • UMethod Health incorporates Linus Health’s digital cognitive impairment detection software into its cognitive care planning solutions.
  • Alpha II appoints former OmniSys CEO John King and former Availity CEO Julie Klapstein to its Board of Directors.

Blog Posts


Contacts

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

Morning Headlines 7/30/24

July 29, 2024 Headlines Comments Off on Morning Headlines 7/30/24

AvaSure to Acquire Ouva’s AI-Powered Smart Room Solutions

Acute virtual care company AvaSure will acquire Ouva’s AI-enhanced care automation technology.

Concentra Shares Slump After $529 Million US IPO

Occupational healthcare company Concentra raises $529 million in its IPO, $56 million shy of its intended goal.

Optum laying off 364 California healthcare workers, shuttering urgent cares

UnitedHealth Group’s Optum care delivery business will lay off 525 employees and close several urgent care clinics and physician practices in California beginning in mid-September.

Comments Off on Morning Headlines 7/30/24

Curbside Consult with Dr. Jayne 7/29/24

July 29, 2024 Dr. Jayne 2 Comments

I had the chance to hang out with some OG healthcare IT friends this weekend, many of whom have been in the industry for more than 30 years. It was a chance to talk about where we started, how things have gone along the way, and the work that is yet to be done. There was a lot of conversation around the idea of disruption and whether it has worked to make patients healthier.

My first run with disruption was after completing residency. A large health system decided to try to shake it up by placing a number of startup primary care practices in an underserved area. There were plenty of primary care physicians in the city, they just weren’t sorted out in a way that matched physician locations to community needs. Patients in certain areas would have to travel too far to access a family physician, so they simply didn’t. For many, their health was worsening, and they didn’t even know it because many of the downstream effects of chronic conditions don’t become apparent for years.

The hospital that sponsored my practice was committed to building a primary care base and had plans to launch a dozen primary care physicians into the community over the following five to six years. They built attractive offices that were easy to access, often in strip malls next to retail spaces and restaurants. I had asked about how they determined where to locate the practices and was told they were using the “Walgreens method.” Essentially, after doing all kinds of market research and traffic studies, they determined that the best locations ended up being right near where Walgreens was building new retail pharmacies. Both organizations’ research had ended with similar conclusions for the first few planned practices, so they decided to just follow the pharmacy giant’s lead.

The phrase “If you build it, they will come” definitely applied, and as each practice opened, we were busier than expected. When I began seeing patients, I was the only primary care physician within 20 miles who was accepting new Medicaid patients, and before I knew it, my patient panel was overflowing. Unfortunately, in that fee-for-service world, the low revenues that were paid by the state didn’t cover my overhead, and my practice was losing money due to some cost-shifting shenanigans where I was being charged with the construction costs of building the new practice. In contrast, the new physicians who had joined practices in more affluent parts of town with a better payer mix were quickly making more than their guaranteed salaries, leaving those of us in the underserved areas struggling to stay afloat.

Additionally, the organization failed to understand the additional support that was needed to care for patients who had been without a physician for an extended time. Many patients came in with serious complications that had to be managed, leading to specialist referrals and the ability to get patients connected with someone who would see new Medicaid patients. The family physicians were left holding the bag, trying to do the best care they could but without subspecialists to share the load.

Our practices were staffed according to the organization’s standard ratios that assumed a mature practice and a stable patient population. They didn’t account for brand new physicians straight out of training, brand new staff straight out of a nine-month medical assistant program, and in particular for my practice, the added work of being the only practice in the health system that was implementing an EHR.

Over the next five years, the reality was that seven of eight new physician startups in my part of town failed as their physicians left for greener pastures, but hey, we disrupted things! We brought thousands of new patients into the health system and put them on waitlists with subspecialists as far as 30 miles away, even though we didn’t have the ability to coordinate transportation. We asked young, idealistic physicians to do everything possible trying to care for these patients, sometimes putting their licenses on the line managing conditions that they weren’t trained to manage. We deployed an EHR and were able to instantly report on our inability to care for patients the way they deserved, and how our outcomes measures were continually below the targets that had been set by group leaders at practices that had more resources, more staff, and more money.

The health system then decided that further disruption was going to solve the problem, so they replaced the departed physicians with nurse practitioners. These new providers quickly figured out that running a primary care practice was hard work, especially when your supervising physician was physically in your practice only one day per week. Instead of lasting four or five years, the nurse practitioners fled even faster, with most finding better salaries and work-life balance at retail clinics within two years of their start. Within a decade, the community was back to the same number of primary care physicians, with any gains being offset by retirements.

The next disruption was building “convenient care” clinics where patients could receive immediate care and primary care services as a strategy to address rising emergency department volumes. They may have helped shift the patient load, but they did little to reduce care fragmentation. Patients ended up being seen by a different provider at each visit, where the focus was typically on one problem and not on the whole person. If we couldn’t pull off appropriate longitudinal management in a primary care setting, with board-certified physicians specifically trained in the specialty, I’m not sure why they thought they could do it in that setting. Ultimately the clinics were a bust because they couldn’t keep them staffed.

By now, we were firmly in the digital era, when organizations thought they could just throw more technology at a problem to solve it. No available appointments? Let’s roll out a billion-dollar EHR so that patients can use the patient portal to access their physicians! I seriously wonder why it didn’t occur to leadership that spending that amount of money on a technology project when frontline staff had taken a pay cut was going to be a hot button issue. Once that patient portal was live, it was as if it had never occurred to anyone that asking physicians to provide uncompensated care was going to be a dissatisfier. Physician burnout climbed.

A neighboring health system had figured out how to crack the code, building a huge primary care base though generous salaries, capable staffing, and integration with multidisciplinary care teams. They were doing digital outreach, so of course the other systems in town had to keep up with the Joneses, launching campaigns that seemed to succeed at clogging the brand new digital front door due to lack of capacity. But then COVID came, and with it a whole new set of challenges, and ultimately here we are  with health outcomes that are only marginally better than they were 20 years ago despite tens of billions of dollars being spent.

What is the answer, people ask? I think there are a number of issues that need to be addressed and they start with understanding the concept of humanity. We need to treat our patients and their care teams like humans, each with their own dignity and potential. Let’s spend our money on things that matter. This isn’t something you can rebrand your way out of, and blowing money on efforts that just embitter the people working in the health system trenches every day. We need to select technology solutions that make sense and benefit caregivers and patients and not just the bottom line. Cheaper isn’t always better and a race to the bottom doesn’t help anyone. Let’s spend some money optimizing the solutions we already have rather than just going after the next shiny object. Let’s dip into those multi-billion-dollar endowments and fund things like school-based clinics, public health, and vaccines. Let’s celebrate primary care as a mechanism to save lives in the same way we celebrate cardiac and neurosurgeons.

We’re living in an era with tremendous potential, and we need people to elevate the dialogue instead of just pointing fingers. Who’s with me? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 7/29/24

July 28, 2024 Headlines Comments Off on Morning Headlines 7/29/24

US indicts North Korean hacker accused of helping extort US hospitals

The US State Department indicts an alleged North Korean government-backed hacker who it says was behind ransomware attacks on hospitals in Florida and Kansas, healthcare firms in Arkansas and Connecticut, and a medical clinic in Colorado.

Google drops Amazon’s One Medical

Google, the largest customer of Amazon-acquired primary care provider One Medical, will terminate its agreement with the company.

OneMedNet Announces $4.6 Million Private Placement

Health data management and research insights company OneMedNet secures $4.6 million in new funding.

Alphabet’s Health Tech Co. Verily Moves Headquarters from California to North Texas

Verily will re-locate its headquarters from San Francisco to its existing office in Dallas-Forth Worth, where it plans to double its employee headcount.

Comments Off on Morning Headlines 7/29/24

Monday Morning Update 7/29/24

July 28, 2024 News 5 Comments

Top News

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The US State Department indicts an alleged North Korean government-backed hacker who it says was behind ransomware attacks on hospitals in Florida and Kansas, healthcare firms in Arkansas and Connecticut, and a medical clinic in Colorado.

The government is offering a reward of up to $10 million for further information on Rim Jong Hyok.

Hyok is accused of leading a hacker group that works for for North Korea’s military intelligence agency. The state department says that the group generates ransomware proceeds that are used to conduct cyber operations that target the US government and defense contractors.


Reader Comments

From Board Stiff: “Re: Cerner. Judging from the mass customer defections, its board was smarter than they seemed in unloading to Oracle at an inflated price.” Cerner’s board made some awful decisions after Neal Patterson died, starting with his replacement and capitulating to an activist shareholder who held few shares. However, they may have offset all of that by selling the company to Oracle at premium valuation just as the wheels were starting to come off. It would not have been pretty to watch CERN’s share price tank as their big clients abandoned ship, and the insiders surely knew that Epic’s dominance and Cerner’s abject failure to fix its revenue cycle software problems was a big storm on its corporate horizon. The board’s fiduciary duty is to shareholders, not customers or industry pundits, and in that regard they performed magnificently. 

From Observer: “Re: Intermountain. Becky Fox is out as chief clinical information officer, per internal memo. CDIO, CHIO, and CCIO all out in the space of a month.” Unverified, but reported by a few folks. She took the position in December 2022 and previously shared time at Atrium Health with former CDIO Craig Richardville, who just left Intermountain. CHIO Diego Ize-Luwdlow, MD exited the health system last month.


HIStalk Announcements and Requests

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Most poll respondents report no major personal impact from the CrowdStrike attack.

New poll to your right or here: Has your employer conducted a workforce reduction that you would consider significant in the past 12 months?


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Steamy doldrums will end soon as noses reconnect with grindstones and companies get back to the serious business of selling, partnering, and acquiring. Decision-maker eyeballs are glued here, so contact Lorre to support HIStalk and gain competitive position. She loves working with startups, especially when it’s a company I’ve never heard of, which suggests they could use a booster rocket.

Another housekeeping announcement: sign up for the spam-free email notices that I send when I post something new (thus usually six skinny emails per week) and you’ll know stuff before those people who just cruise over when the mood strikes.

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The optometrist who conducted my annual eye exam in her Target-connected practice said that my prescription would print next door at Target Optical, which apparently believes that patients who touch their printer are violating HIPAA.


Webinars

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


Acquisitions, Funding, Business, and Stock

Remote patient monitoring software vendor CoachCare receives a $48 million strategic growth investment.

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Healthcare Growth Partners posts its first-half 2024 health IT market review:

  • M&A surged, with other positive notes being increased investment and the IPOs of Waystar and Tempus AI.
  • However, share price of those two IPOs is at or below the initial offering price and some of the increased M&A involved low-quality and distressed companies.
  • Transaction valuations are down 20% from pre-pandemic levels.
  • Valuations of public enterprise SaaS and health IT companies dropped 35% and 50%, respectively.
  • Recent take-private health IT transactions at a significant premium to share price suggest a disconnect between public market valuations and health IT market sentiment.
  • Health IT companies that claim AI capabilities are attracting 20% of the investment in the sector, but almost all of their output involves back-office tools that don’t improve patient care.

People

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Sonifi Solutions names Jerome Ajot, MS (EPAM Systems) as CTO.

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In Canada, Brightshores Health System hires Tim Pemberton, MBA (Queensway Carleton Hospital) as VP of digital health and technology, CIO, and chief privacy officer.


Announcements and Implementations

Google, the largest customer of Amazon-acquired primary care provider One Medical, will terminate its agreement with the company. Google was an early investor in One Medical and at one time made up 10% of its revenue. One Medical clinics that operate from Google’s campuses have already transitioned to Premise Health and its broader range of services, although One Medical will remain a Google in-network provider for employees who pay for their own memberships.


Privacy and Security

Philips discovers a vulnerability in its Vue PACS that could allow unauthorized users to view or modify data and install unauthorized software. Remediation involves changing network configuration until the company develops a patch.


Other

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Cell phone providers in Australia will shut down their 3G mobile networks next month, which could take some medical devices offline. The Royal Flying Doctor Service uses 3G for telehealth, security cameras, and employee duress alarms and says that some insulin pumps and pacemakers will also need to be replaced quickly. Queensland Senator Malcolm Roberts says the shutdown will be “CrowdStrike 2.0.”


Sponsor Updates

  • Tegria will sponsor the MUSE International Southeast Community Peer Group August 1 in Albany, GA.

Blog Posts


Contacts

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

Morning Headlines 7/26/24

July 25, 2024 Headlines Comments Off on Morning Headlines 7/26/24

HHS Reorganizes Technology, Cybersecurity, Data, and Artificial Intelligence Strategy and Policy Functions

HHS reorganizes to give ONC broader responsibility over technology, cybersecurity, data, and AI.

QuVa Pharma Completes Acquisition of LogicStream Health Combination Creates Integrated Platform of Compounded Medications, Distribution Services, and AI-Powered Data Solutions

QuVa Pharma acquires hospital pharmacy-focused predictive analytics company LogicStream Health.

Financial Management Systems: VA Should Improve Its Risk Response Plans

A GAO report finds that the VA is struggling with its implementation of a replacement benefits administration system, with estimates of total cost ballooning to $7.7 billion versus the VA’s estimate of $2.5 billion in 2019.

Astrana Health Enters Definitive Agreement to Acquire Collaborative Health Systems

Astrana Health (formerly known as Apollo Medical Holdings) will acquire Centene business Collaborative Health Systems, a management services organization for independent primary care practices.

CoachCare Announces $48 Million Investment Led By Integrity Growth Partners

Remote patient monitoring and virtual care company CoachCare secures $48 million in an investment round led by Integrity Growth Partners.

Comments Off on Morning Headlines 7/26/24

News 7/26/24

July 25, 2024 News 2 Comments

Top News

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HHS reorganizes to give ONC broader responsibility over technology, cybersecurity, data, and AI. ONC will be elevated to assistant secretary status:

  • ONC will be renamed to Assistant Secretary for Technology Policy and Office of the National Coordinator for Health Information Technology (ASTP/ONC).
  • National Coordinator Micky Tripathi will hold the newly titled role.
  • The newly created HHS positions for CTO, chief data officer, and chief AI officer will report to ASTP/ONC.
  • Cybersecurity activities will be moved from the HHS Assistant Secretary for Administration to ASTP/ONC.

Reader Comments

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From Larry’s Loss: “Re: Penn State Health. Replacing Oracle Cerner with Epic.” I haven’t seen an announcement, but this reader sent along a screen shot of an internal communication. Penn State Health operates eight hospitals totaling 1,600 beds, has 20,000 employees, and generates $4 billion in annual revenue.


HIStalk Announcements and Requests

Unrelated, but health tech news is slow today. Redditors weigh in on trendy terms that they dislike:

  • Calling everything a “journey.”
  • “Lean in.”
  • “I did a thing.”
  • Referring to children as “littles” or pets as “doggos” or “fur babies.”
  • Saying “a big ask” instead of a request.
  • Referring to a long time as “a minute.”
  • The means-nothing phrase “it is what it is.”
  • “Curated.”
  • “My bad” instead of saying sorry.

Webinars

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


Acquisitions, Funding, Business, and Stock

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Linus Health, whose platform offers tech-powered early detection of cognitive impairment and dementias, acquires Together Senior Health, creator of the Moving Together virtual therapeutic program for cognitive decline.

Humana-owned CenterWell will open 23 senior primary care centers in former Walmart Health clinics.

Ascension will sell nine Chicago-area hospitals to for-profit hospital operator Prime Healthcare.


Sales

  • Humana expands its agreement with Google to include Google Cloud and AI.
  • GE HealthCare chooses Amazon Web Services for developing new healthcare applications and applying AI.

People

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University of Chicago Medicine hires Yeman Collier (UT Health San Antonio) as SVP/CIO.


Announcements and Implementations

Northwell Health launches a movie and TV production company. According to Northwell, “This dedicated studio will better allow us to foster creative partnerships and establish Northwell Health as a leading voice on the issues that matter most — our health and wellness.”


Government and Politics

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Jeff Shuren, MD, JD, director of FDA’s Center for Devices and Radiological Health, announces his retirement after 15 years in that role. 

A GAO report finds that the VA is struggling with its implementation of a replacement benefits administration system, with estimates of total cost ballooning to $7.7 billion versus the VA’s estimate of $2.5 billion in 2019. GAO warns that the project’s planned 2030 completion is unlikely to be met because of delays in other projects such as its EHR and supply chain system replacements. The GAO also notes that the VA has not implemented two of its earlier recommendations related to cost and scheduling practices. The VA blamed a $600 million in increase in implementation costs on its underestimation of the unique challenges of each deployment.

Ukraine’s health ministry reports that 3 billion records have been entered into its electronic medical records system.


Sponsor Updates

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  • Healthcare IT Leaders staff volunteer with Meals on Wheels Greenville to deliver meals and care packages to 240 veterans.
  • EClinicalWorks will offer customers within Aledade’s network free access to Sunoh.ai’s AI medical scribe software.
  • Linus Health will present and exhibit at the Alzheimer’s Association International Conference July 28-August 1 in Philadelphia.
  • Medhost joins Health Gorilla’s QHIN to enhance access to clinical data and participate in TEFCA.
  • Findhelp welcomes Holzer Health System (OH), York County, PA, and Health First (FL) to its network.
  • Madison-based publication The Cap Times profiles consulting firm Cardamom Health and CEO Vivek Swaminathan.
  • Fortified Health Security publishes its “2024 Mid-Year Horizon Report.”
  • The VatorNews Podcast features KeyCare CEO Lyle Berkowitz, MD.

Blog Posts


Contacts

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

EPtalk by Dr. Jayne 7/25/24

July 25, 2024 Dr. Jayne Comments Off on EPtalk by Dr. Jayne 7/25/24

Although technology continues to advance, we are still leaving patients behind. The Washington Post reported recently that 40% of women are delaying their recommended health screenings. The top reasons cited include time constraints, cost, anxiety, and worries of pain during testing.

Other interesting findings: 31% of Gen Z respondents found it difficult to find relevant information on screenings, and 63% of respondents said they struggled to prioritize their own health. We talk a lot about insurance in the US and trying to make sure services are covered, but the reality is that a large number of workers don’t have paid time off for medical appointments or other health-related matters.

When you figure that a single preventive service can eat up a half day of time (travel, filling out forms, waiting, having the service, and returning home) and there are between five and 10 services needed each year for average-risk women, you can see how it adds up. Organizations should be doubling down on strategies to make screening services more accessible, whether it’s online scheduling, completing pre-visit forms from the comfort of your home at the time of your choosing, or reducing anxiety by providing an efficient results communication process.

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Given the number of healthcare conferences that are being held now, it seems like there is more competition to prove which will be hipper or cooler than the rest. HLTH has opened submissions for its Art Gallery, asking those on its email list “Could you be the next Andy Warhol?” The call for submissions notes that “this unique fusion of healthcare and artistic expression highlights the connection between wellbeing and art, creating a sanctuary where science meets the soul, and personal stories of hope come to life.” That’s quite an aspirational goal. Art will be displayed as digital prints and should be created by someone who has undergone medical treatment or works in healthcare. There are no prizes, and if you’re selected and want to see your work on display, you’ll have to buy a ticket at the then-current price. Registrations are $2,895 as of this week and will go up to $4,100 towards the end, so I hope all the artists are saving their pennies.

I learned a new word this week, as an article in the Harvard Business Review discussed AI-generated inaccuracies. According to the authors, “botshit” is “made-up, inaccurate, and untruthful chatbot content that humans uncritically use for tasks.” I have no issues with how they’ve defined it and am glad they added the last piece about the role of humans incorporating bad information into their workflows or decision making. I know of several clinical colleagues that are using commercially available nonmedical generative AI to help create clinical documentation, and it’s amazing how unconcerned they are with the potential for introducing errors into patient charts. Lest my jaw spend too much time on the floor, I remind myself that some of these individuals are probably those who had a macro added to their chart notes that said something along the lines of “Dictated but not read, signed by staff to expedite” or other such nonsense.

In my clinical practice, the greatest use I’ve found for generative AI tools is to help me confirm something that I suspect or already know, but haven’t encountered in a while. For example, is what I remember as the first-line drug for treating Lyme disease still preferred? Since I live in a state where Lyme is not endemic, I rarely see the condition, but on the other hand, it always seems to pop up as a board certification question, so I can’t let it fall too far by the wayside. It’s less useful for the situations where I think it could really be beneficial, such as trawling the world’s literature to try to figure out what is the next best step for a complex patient with certain parameters. As a physician, that’s where I really need help since the textbook answers rarely take into account such factors as the patient’s insurance coverage or ability to adhere to a treatment plan.

From Remotely Employed: “Re: return to office policies. They continue to plague tech companies. Check out this article about Dell employees who fought back in response to the company’s negative actions toward remote workers.” The annual Tell Dell employee engagement survey apparently got an earful, with the employee net promoter score dropping from 63 to 48 over the course of the last year. Of course, a Dell spokesperson tried to spin it, mentioning that “Dell is still well above industry averages.” The old “yeah, but other people are worse” deflection hasn’t worked well for many organizations in the past, so negative points for lack of imagination in their response. Dell had announced earlier this year that employees who were remote as opposed to hybrid would have fewer opportunities for career advancement. They also began color coding employees based on how often they were in the office.

The comments on the article are reflective of dissatisfaction with in-office roles that workers feel can be done equally well on a remote basis One noted that costs of commuting are a major concern, and another described the HR policies as “ham-handed” and recommended that the organization “focus on productivity and an individual’s contribution to the operation, and make personnel decisions based on that.” It’s a novel concept now that we’re seeing more organizations treating employees like children. One of my neighbors who worked remotely for years is on a team that has no other members in our city. Still, he dutifully goes to the office three days a week, attending video calls with others across the country. I’m guessing management thinks his quality of work is somehow better after an hour commute in stressful traffic.

I’ve been walking a mile in my patient shoes this week, waiting for pathology results that were significantly delayed. The practice is attributing the problem to CrowdStrike, although I’m not sure I’m buying that excuse. I know a lot of diagnostic vendors had problems with their dictation software, but where was the downtime plan? Did they just stop reading pathology slides while they waited for the dictation software to come back up?

Based on a phone call I received on Friday, my slides were being read that afternoon, so it’s been a maddening wait over the weekend and into this week. I encourage anyone who deals with healthcare IT systems to spend just a minute thinking about the patients on the other ends of all these transactions, and what it might feel like to them when something like this happens. Let’s get our downtime ducks in a row, folks. Would you really want your loved ones to be treated this way?

Email Dr. Jayne.

Comments Off on EPtalk by Dr. Jayne 7/25/24

Morning Headlines 7/25/24

July 24, 2024 Headlines Comments Off on Morning Headlines 7/25/24

Linus Health Acquires Together Senior Health to Expand its Platform to Better Serve Patients and Providers with End-to-End Workflow Capabilities

Linus Health, a digital health company specializing in the detection of cognitive impairment, acquires brain health company Together Senior Health.

CenterWell Announces Plans to Open 23 Senior Primary Care Centers at Walmart Locations in Florida, Georgia, Missouri and Texas

Humana’s chain of CenterWell primary care clinics for seniors will open new locations in 23 former Walmart Health clinics in Florida, Georgia, Missouri, and Texas.

Ochsner launches the Louisiana Innovation Fund to help health care entrepreneurs

Ochsner Health’s venture funding arm partners with Louisiana’s economic development agency to launch the $10 million Ochsner Louisiana Innovation Fund.

Comments Off on Morning Headlines 7/25/24

Healthcare AI News 7/24/24

News

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Mayo Clinic will implement an ambient nursing documentation system from Abridge that integrates with Epic’s nursing workflows. Mayo, which is participating in the technology’s development, hopes to have nurses using the tool by the end of the year.

OpenAI creates compliance and administrative tools for enterprise users of ChatGPT who work in heavily regulated industries such as healthcare, legal services, and finance. The API sends time-stamped user records to EDiscovery and Data Loss Prevention service providers to support archiving, audit trails, data redaction and retention, and policy enforcement. A key use case is HIPAA compliance related to detecting and deleting protected health information. The company will also roll out a system this week that syncs employee directories with ChatGPT to provision and de-provision user accounts.

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Sound Health announces Sonu, a $299, FDA-authorized, AI-powered wearable that analyzes the user’s sinuses and delivers acoustic waves that stimulate nasal vasoconstriction to treat rhinitis congestion.


Business

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Drug design technology vendor Insilico Medicine announces DORA, an AI-powered system for researchers that summarizes relevant published literature and then uses the researcher’s hypothesis to create a draft article with citations.

Drug maker Takeda will use AI models from Nference to identify patients who could benefit from advanced interventions for inflammatory bowel disease.

Microsoft will collaborate with Mass General Brigham and UW Health to develop Azure-powered medical imaging models that will extend Nuance’s imaging copilot applications.

B. Well Connected Health adds configurable AI architecture to its FHIR-based platform to support network access, health data summaries and queries, and a consumer cost-saving recommendations engine.

Meta announces the open source Llama 3.1, which it says is being used for drug discovery, personalized medicine, clinical trials administration, and creating voice and vision ambient medical documentation.


Research

Researchers raise concerns about using AI in medical publishing:

  • Real-world validity and clinical relevance needs to be improved and measured.
  • The “publish or perish” model may tempt researchers into writing low-quality and misleading articles that are already common in some environments, countries, and settings.
  • AI-created programming might increase errors when used by less-expert people.
  • AI can generate plausible but incorrect medical articles.
  • Future scientists may be hampered by homogenized articles, an increased number of published papers, and validity issues.

Other

HHS creates new positions for CTO, chief artificial intelligence officer, and chief data officer.

Hospitalist and AI-powered oxygen therapy platform company CEO Julio La Torre, MD, MBA says that output from always-on vital signs monitors is an untapped resource. He says that monitoring could make rounding and intermittent data capture obsolete and provide value to researchers. He notes challenges – data collection and standards, the need for robust security, developing the hospital infrastructure to integrate monitor data with existing systems, and developing a sustainable business model.


Contacts

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

Morning Headlines 7/24/24

July 23, 2024 Headlines Comments Off on Morning Headlines 7/24/24

Tech Mod Chairman Rosendale Delivers Opening Remarks at Latest Oversight Hearing on VA’s Electronic Health Record Project

Congressman Matt Rosendale (R-MT), chairman of the House Veterans Affairs Subcommittee on Technology Modernization, testifies on the rollout of the combined DoD/VA Oracle Health system at the Lovell Federal Health Care Center (IL) earlier this year, noting that pharmacy staff are only able to process about 40% of prescriptions due to poor software functionality.

Loyal Closes $33.5M Series B Funding and Announces Changes to Executive Leadership Team, Board of Directors

Patient engagement software vendor Loyal raises $33.5 million in a Series B funding round and announces that founder, CEO, and chairman Chad Mallory will transition to a senior advisory role.

Abridge, Mayo Clinic, and Epic Collaborate to Develop an Integrated Artificial Intelligence Documentation Solution for Nurses

Abridge, Mayo Clinic, and Epic will develop an AI-powered ambient documentation solution for nurses.

Comments Off on Morning Headlines 7/24/24

News 7/24/24

July 23, 2024 News 5 Comments

Top News

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Congressman Matt Rosendale (R-MT), chairman of the House Veterans Affairs Subcommittee on Technology Modernization, testifies on the rollout of the combined DoD/VA Oracle Health system at the Lovell Federal Health Care Center (IL) earlier this year. He notes that pharmacy staff are only able to process about 40% of prescriptions due to poor software functionality. Rosendale says that the pharmacy required 100 new employees with another 100 on the way to keep functioning.

He says that the VA should be required to lay out the cost to finish the Oracle Cerner rollout before committing to it, adding that he is certain the $16 billion figure that the VA previously supplied will be exceeded.


Webinars

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


Acquisitions, Funding, Business, and Stock

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HealthStream announces Q2 results: revenue up 3%, EPS $0.14 versus $0.13, beating Wall Street expectations for both. HSTM shares have risen 29% in the past 12 months versus the S&P 500’s 23% increase, valuing the company at $903 million.

Patient engagement software vendor Loyal raises $33.5 million in a Series B funding round and announces that founder, CEO, and chairman Chad Mallory will transition to a senior advisory role. Saurabh Sinha, founder and chairman of Emids Technologies, will take over as chairman of Loyal’s board and lead a search to fill executive roles.


Sales

  • NHS Norfolk and Waveney Acute Hospital Collaborative in England will implement Meditech across three trusts in 2026.
  • West Tennessee Healthcare selects automated perioperative scheduling and workflow software from Qventus.
  • Bon Secours Mercy Health will implement patient monitoring technology from Philips across its 49 hospitals over the next three years.

People

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Volpara Health CEO Teri Thomas, RN, MSN takes on the additional role of chief business officer of Lunit’s cancer screening group, while CFO Craig Hadfield takes on the additional role of chief customer officer. Becky Weber (Health Catalyst) joins Volpara as EVP of sales.


Announcements and Implementations

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Abridge, Mayo Clinic, and Epic will develop an AI-powered ambient documentation solution for nurses. The group hopes to have Mayo nurses using the system by the end of 2024.

Park Medical Centers in Detroit implements Kaid Health’s Whole Chart Analysis coding, quality monitoring, and clinical analytics software.

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Wolters Kluwer Health launches its ClinicalPulse continuing education app for nurse practitioners.

Owensboro Health Regional Hospital (KY) launches virtual nursing programs in its ortho-neuro and pulmonary units ahead of a systemwide rollout.

The Sequoia Project publishes a draft of its Data Usability Workgroup Implementation Guide and invites public comment.

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USPTO awards pharmacy benefit manager / pharmacy benefit administrator Capital Rx a patent for the data tagging system that it developed for its JUDI enterprise health platform.

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A new KLAS report on go-live support places Optimum Healthcare IT in the #1 spot for overall performance, while emerging firms Ellit Groups and Healthrise earned high client satisfaction from the limited number of their clients who were interviewed.


Government and Politics

The VA will require veterans who use its website, apps, and My HealtheVet to enroll in Login.gov or ID.me starting next year.


Privacy and Security

Schneider Regional Medical Center (USVI) reverts to downtime procedures after discovering a ransomware attack on its systems over the weekend.

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Michigan Medicine notifies 57,000 patients of a data breach in late May that was caused by hackers infiltrating employee email accounts. The health system began sending out notifications last Friday, the same day that the global CrowdStrike/Microsoft update flaw temporarily crippled global IT systems across several sectors, including healthcare.


Sponsor Updates

  • Black Book survey-takers rank Symplr as the top end-to-end provider data management and credentialing platform for payers.
  • The Government of Greece will implement Agfa HealthCare’s Enterprise Imaging platform across its public hospitals.
  • Arcadia publishes a new guide, “Quality management tools to balance care and rising costs.”
  • Capital Rx becomes one of the Lehigh Valley Business Coalition on Healthcare’s pharmacy benefit management partners.
  • Clearwater integrates the Payment Card Industry Data Security Standard and NIST Cybersecurity Framework 2.0 into its IRM/Performance SaaS solution.
  • The “Powered by Authenticity” podcast features Cordea Consulting founder and CEO Jen Jones, “Coaching and Mentoring Along the Way.”
  • Health Data Movers posts a new episode of its “QuickHITs” podcast titled “Breaking Down Barriers in Healthcare IT: Insights from Stephanie Davis.”
  • Direct Recruiters releases a new e-book, “The Power of People: Why AI Alone Isn’t Enough in Modern Recruitment.”
  • CareCloud expands its partnership with DrFirst to include integrated RxInform functionality.
  • Crossings Healthcare Solutions now offers Oracle customers customized EHR content and functionality.
  • Inovalon offers Provider Market Insights to help life sciences organizations optimize investments based on market intelligence and accelerate the launch of innovative therapies.
  • Surescripts releases a new report, “Clinician Perspectives & Prescribing Patterns Reveal Opportunities for Care Team Evolution.”
  • CloudWave joins The Iroquois Healthcare Association as an enhanced business associate member.

Blog Posts


Contacts

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

Morning Headlines 7/23/24

July 22, 2024 Headlines Comments Off on Morning Headlines 7/23/24

Palomar Health restores some systems two months after cybersecurity breach

Palomar Health Medical Group (CA) restores its phone, EHR, appointment scheduling, e-prescribing, and patient portal systems after a cyberattack in early May forced its computer systems offline.

Norfolk and Waveney Collaborative approves £88m Meditech EPR

NHS Norfolk and Waveney Acute Hospital Collaborative in England will implement Meditech across three trusts in 2026.

Michigan Medicine latest health care system to be hit by cyberattack

Michigan Medicine begins notifying patients of a data breach in late May caused by hackers infiltrating employee email accounts.

Comments Off on Morning Headlines 7/23/24

Curbside Consult with Dr. Jayne 7/22/24

July 22, 2024 Dr. Jayne 4 Comments

The big news of the weekend was hearing about the response of organizations to the CrowdStrike debacle on Friday. Despite official statements that everything was fine and patient care was proceeding as usual, comments from worker bees at several local hospitals revealed significant issues that did impact patient care.

At one facility, patients who had mammograms performed on Wednesday and Thursday and were told to expect results by end of day Friday were left in the lurch, since the hospital’s cloud-based dictation service was down. Apparently there was confusion about whether there was a backup plan and what it might be, so radiologists stopped reading studies, bringing everything to a halt. There was no proactive communication to impacted patients letting them know that results would be delayed, causing a great deal of anxiety.

One physician friend who was impacted as a patient reached out on a local physician forum to find out whether her study was being delayed because it was abnormal, which is a common thought among patients. She had no idea about the CrowdStrike situation, but a number of hospital-based physicians chimed in about the patient care nightmare that was unfolding across the region. Several affiliated hospitals canceled elective imaging, including screening mammograms, on Friday. Other physicians reported delays in getting operating room systems started and an inability to get through to internal help desks due to a high volume of calls.

Since I work with various organizations and have company-issued laptops for each of them, I was able to experience firsthand how different places handled the problem. One organization was extremely hands on, sending messages via text starting in the wee hours of the morning. They’re not on my overnight priority list, so the text thread was muted, but I was impressed because they sent hourly updates. Fortunately, my laptop wasn’t impacted and I wasn’t scheduled to do work for them that day, but I followed along because that’s what a good healthcare IT reporter does. By around 7 p.m. in the company’s primary time zone, they sent another text indicating that mitigation efforts had concluded. I checked that company’s email over the weekend to see what other communications they might have sent and was pleased to see an overall summary and debrief communication.

Another company was radio silent, acting like nothing was happening. I guess it’s good that none of their systems or hardware were impacted, but it would have been nice to receive some kind of communication letting employees and contractors know that there was a worldwide issue and that vendors, external systems, or patient pharmacies might be impacted. Since they’re a virtual care company, I would be interested to see whether there was any increase in the number of failed prescription transmissions or patient callbacks asking for medications to be prescribed to a different pharmacy because of the outage.

My laptop for another health system was impacted by the outage and they didn’t send out any communications until two hours after I discovered the issue. I had reported it to the help desk via email by using my phone, so I knew I was in the hopper. Since everyone’s accounts are on Office 365, I was able to do the small amount of work I had for them by using my personal computer, which I’m not sure is entirely permitted based on the vague wording of their privacy and security policies. No one blinked when I said I was using my own device, though, so I’m assuming that I’ll ask for forgiveness if it becomes an issue later since I didn’t ask for permission. I was ultimately able to perform the fix on my laptop myself, which was good because the help desk didn’t get back to me until Saturday afternoon when I was nowhere near my laptop.

Mr. H reported a list of impacts in this week’s Monday Morning Update and they included surgery and procedure cancellations, appointment cancellations, closure of diagnostic facilities, and holds on shipping laboratory specimens due to delays with FedEx. Mr. H noted that Michigan Medicine reported a “major incident.” I’m not sure what that means at the institution, and whether something truly serious happened or whether it was classified as major due to the number of impacted systems, or something else. I’d be interested to hear from anyone at that organization as to what exactly that report means.

Since one of the more serious impacts occurred with 911 emergency call centers, it will be difficult to quantify the full effect on patients. Several state systems were down and analog backups were pulled into service in multiple places. It’s difficult to perform reporting and analysis on events that didn’t happen, but one could extrapolate from the historical call history as to how many calls weren’t received compared to a typical summer Friday. Given the typical percentages of different types of critical calls – cardiac arrests, penetrating trauma, motor vehicle accidents – one can start to do the math to understand how many lives might have been either seriously impacted or lost due to what others minimize as a “computer glitch.” I’m sure the loved ones of those individuals who were frantically trying to call 911 for help might have other words for it.

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I spent a fair amount of time this weekend following the Relive Apollo 11 thread (@ReliveApollo11) on the service formerly known as Twitter. I’ve always been a space junkie and being able to share the experience in a reenacted real time way was kind of thrilling. Through one of the links, I found the Apollo 11 Flight Journal, which is a fascinating read of the transcripts from mission communications. Other cool resources I found during my trip down the rabbit hole included a guide for using Google Earth to explore the moon, and in particular, the landing sites.

It’s hard to believe the level of accomplishment that took us to the moon, with human computers and slide rule-wielding engineers leading the way. The technologies are considered much less powerful than what most of us hold in our hands on a daily basis, but people achieved great things. It should be inspirational, especially on those days when we feel that we are making little progress.

I also learned a piece of information I didn’t previously know. The Apollo 11 mission patch doesn’t include the names of the crew members because those three astronauts wanted the patch to represent all of those who were involved in the mission. It’s a refreshing departure from the “me” culture with which we’re all too familiar.

For those of you who experienced Apollo 11 or other moon landings at the time they occurred, what are your significant memories? Leave a comment or email me.

Email Dr. Jayne.

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RECENT COMMENTS

  1. The poem: Well, it's not it's not the usual doggerel you see with this sort of thing. It's a quatrain…

  2. It is contained in the same Forbes article. Google “paywall remover” to find the same webpage I used to read…

  3. The link in the Seema Verma story (paragraph?) goes to the Forbes article about Judy Faulkner. Since it is behind…

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