Recent Articles:

Morning Headlines 5/26/21

May 25, 2021 Headlines No Comments

Iodine Software acquires physician engagement platform Artifact Health

AI-powered revenue cycle company Iodine Software acquires Artifact Health, which offers a physician engagement and patient documentation query technology platform.

Weight-Loss App Noom Gets $540 Million in Silver Lake-Led Round

Weight loss coaching app vendor Noom raises $540 million in new funding, valuing the company at $3.7 billion as it expands into stress management, sleep, diabetes, and hypertension.

Scripps enters fourth week of ransomware attack

Scripps Health CEO Chris Van Gorder says the May 1 attack on the hospital’s computer systems was ransomware, and that its EHR and patient portal systems should be back up by the end of the week.

Bassett Healthcare Network and Optum Launch Strategic Relationship to Advance Quality Care and Improve Experiences for Patients in Central New York

Bassett Healthcare will give 500 employees the opportunity to transition to Optum as the vendor prepares to enhance the health system’s analytics, and IT and RCM systems.

News 5/26/21

May 25, 2021 News No Comments

Top News

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AI-powered revenue cycle company Iodine Software acquires Artifact Health, which offers a physician engagement and patient documentation query technology platform.

Artifact CEO Marisa MacClary, MBA will join Iodine as EVP of the Artifact team.


HIStalk Announcements and Requests

A generous donation from reader Deborah, with matching funds applied from my Anonymous Vendor Executive, allowed me to fully fund the Donors Choose teacher grant request of Ms. H in Los Angeles, who asked for 3D geometry kits for her middle school class.


Webinars

June 3 (Thursday) 2 ET: “Diagnosing the Cures Act – Practical Prescriptions for Your Success.” Sponsor: Secure Exchange Solutions. Presenters: William E. Golden, MD, MACP, medical director, Arkansas Medicaid; Anne Santifer, executive director, Arkansas Department of Health – Office of Health Information Technology; Kyle Meadors, principal, Chart Lux Consulting. A panel of leading experts will provide practical guidance on how to prepare for the Cures Act. Will it upend your business model? What is information blocking? How can standardized technologies be applied to meet Cures Act requirements? What must I do now as well as in the next five years?

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


Acquisitions, Funding, Business, and Stock

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Baptist Health South Florida severs ties with Health System Solutions, which had been handling the hospital’s revenue cycle management since 2018. BHSF created the RCM company as a joint venture with Navigant, transitioning nearly 600 hospital staff to the new business. The hospital will bring those employees back in-house.

The private equity arm of Adu Dhabi Investment Authority acquires a minority stake in health IT provider Dedalus Holding.

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Weight loss coaching app vendor Noom raises $540 million in new funding, valuing the company at $3.7 billion as it expands into stress management, sleep, diabetes, and hypertension. The company hopes to expand from individual subscribers, who pay $60 per month, to employers and insurers. 


Sales

  • MSU Health Care (MI) will implement Epion Health’s patient Check-In and Digital Screeners software.
  • McLaren Health Care contracts with India-based HCL Technologies to deliver IT services to its 15 hospitals in Michigan and Ohio and create a global EMR Center of Excellence.
  • Clinical management company SCP Health will expand its use of SOC Telemed’s Telemed IQ acute care telemedicine platform as it extends its telemedicine practice so it can offer both on-site and virtual care.
  • US Orthopedic Alliance selects 2bPrecise’s precision medicine platform to identify drug-gene interactions.
  • Colorado Center for Personalized Medicine will make the de-identified data of 7.3 million patients available to UK-based Sensyne Health, which will mine it and sell insights to drug companies, with revenue shared with CCPM. The company signed a similar deal with St. Luke’s University Health Network last week.

People

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Tidelands Health (SC) family physician and Air Force veteran Gerald Harmon, MD will become AMA president next month.

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Shelagh Fraser, MD (Priority Physicians) joins LifeOmic as its first CMO.

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Jackson Hospital (AL) names Mark Lauteren (El Centro Regional Medical Center) AVP/CIO.

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Tania Schade (Slalom Consulting) joins The Greeley Company, a division of The Chartis Group, as VP of business development.

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Connect America hires Rosemary Kennedy (ECare Informatics) as chief health informatics officer.

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Babylon names Darshak Sanghavi, MD (UnitedHealthcare) as global chief medical officer.

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NextGen Healthcare hires Srinivas Velamoor, MBA (McKinsey) as EVP / chief growth officer.


Announcements and Implementations

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Qardio implements Redox’s health data exchange API to enhance the interoperability of its remote patient monitoring solution.

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Geisinger Health System (PA) launches ConnectedCare365, a remote patient monitoring program for people with chronic conditions. The program’s technology comes from virtual care delivery startup Noteworth.

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CareAlign offers free access to its task management system through the rest of 2021 for clinicians who sign up as beta testers.

Queen Anne County, MD will equip paramedics and EMTs with DrFirst’s Backline for EMS, which will allow them to scan a driver license barcode to confirm identity and retrieve a six-month medication history. It also allows them to exchange messages with local hospitals.


Other

Appointment-booking website Zocdoc fixes a software glitch that improperly allowed current and former employees of doctor and dental offices to access the patient data of 7,600 people via its provider portal. The company revealed similar programming errors in 2016.

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St. Luke’s Health System in Idaho expands virtual emergency services to all nine of its EDs across the state. Patients will have access to virtual neurologists, behavioral health providers, pediatricians, social workers, critical care and nursing support specialists, plus emergency physicians and nursing teams through the system’s Virtual Care Center in Boise.

Cleveland Clinic seeks a digital health venture partner for its commercialization arm.

Scripps Health CEO Chris Van Gorder says the May 1 attack on the hospital’s computer systems was ransomware, and that its EHR and patient portal systems should be back up by the end of the week. He said the organization has kept quiet about the specifics of the attack to avoid copycat hackers: “Other attackers are already using what is being reported in the media to send scam communications to our organization.”


Sponsor Updates

  • SCP Health expands its use of SOC Telemed’s technologies to include its Telemed IQ software for acute care.
  • Ascom publishes a new whitepaper, “The high-reliability ICU.”
  • Cerner’s Charitable Foundation honors 39 employees with Volunteer Impact Awards.
  • The local paper profiles CoverMyMeds’ new $240 million headquarters, set to open in the coming weeks as the company begins bringing back its 1,500 workers.
  • Diameter Health Software Architect Sam Schifman will present at the 2021 HL7 FHIR DevDays on June 9.
  • Avtex publishes “Omnichannel Healthcare Experience Report 2021.”
  • Meditech will convene its virtual “2021 Nurse Forum: Setting the Pace” June 16-18.
  • KLAS recognizes Engage as a leader for its response to the COVID-19 crisis with a perfect score within the All Services Firms category.
  • Ellkay recognizes Nuance EVP and GM Diana Nole as part of its Women in Health IT program.
  • WHO Director-General Tedros Ghebreyesus will speak at the Everbridge COVID-19: Road to Recovery Executive Summit May 26-27.
  • First Databank is included on Modern Healthcare’s “Best Places to Work in Healthcare” list.
  • Glytec releases a new video, “An Update in Glycemic Management in the Hospital: Impact and Lessons from COVID-19.”
  • WebPT CEO Nancy Ham joins the HST Pathways Board of Directors.
  • Georgia Hospital Health Services, a subsidiary of the Georgia Hospital Association, will promote Jvion’s All-Cause Readmissions product to member hospitals across Georgia.

Blog Posts


Contacts

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

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Morning Headlines 5/25/21

May 24, 2021 Headlines No Comments

Zocdoc says ‘programming errors’ exposed access to patients’ data

Appointment-booking website Zocdoc fixes a software glitch that improperly allowed current and former employees of doctor and dental offices to access patient data.

Recuro Health Acquires SupDoc: Expands Digital Care Platform, Enhances Virtual Primary Care and Behavioral Health Solutions

Virtual care company Recuro Health acquires chat-based telemedicine startup SupDoc.

Clinigence Holdings Announces the Signing of a Binding Letter Of Intent to Acquire Procare Health

Population health analytics company Clinigence Health acquires ProCare Health, a managed services organization serving four IPAs in California.

CHS Makes Bold Move Acquiring Healthcare Division From Selent and Associates, Inc.

Complete HealthCare Solutions, a health IT developer, reseller, and services company, acquires the healthcare division of Selent and Associates, including Computerized Business Systems and medicalbillingsoftware.com.

Curbside Consult with Dr. Jayne 5/24/21

May 24, 2021 Dr. Jayne 6 Comments

I experienced firsthand the confusion caused by the Centers for Disease Control and Prevention’s abrupt change in masking recommendations. Although it essentially stated that fully vaccinated individuals can go about their activities maskless, it completely failed to understand the dynamics of multi-age gatherings.

I was at a local park in an area where masks are required for groups that are outdoors, and it’s fair to say that the 11-and-under crowd isn’t going to self-select to wear masks when they see their parents and other adults kicking back with a cold drink and being maskless. Kids also aren’t going to stay three feet apart, let alone six, without someone giving them reminders. What I observed was similar to a rugby scrum made of unmasked 8- to 10-year-olds, so we can only hope that none of them were carrying COVID. Being outdoors doesn’t eliminate the risk if people are on top of each other. For the sake of all the healthcare providers who are having post-traumatic stress disorder symptoms, I hope we don’t get ourselves in trouble before vaccines are available for younger age groups.

As a primary care physician at heart, I hope that this push to get back to normal also involves patients being able to schedule appointments for needed healthcare. In my area, some primary care physicians are still limiting their schedules due to COVID-19 concerns. I’m curious how long their employers are going to be on board with it before there are repercussions. I’m sure those providers with RVU-based compensation plans are feeling the impact of limited schedules on their paychecks, but others on guarantees might just be in for a surprise when their next contract period comes around.

Third-party telehealth companies are still seeing plenty of patients asking for medication refills, often saying they can’t get an appointment with their primary physician or can’t get the office staff to contact them back. If access issues are real, you would think that practices would be eager to bring in part-time or contract physicians to help fill the gap and work through the backlog. None of the health systems in my area want to hire part-time physicians, which I find shocking. I’d love to see acute urgent patients one day a week somewhere, even just on an hourly or temporary contract, but everyone I’ve talked to would rather be backlogged than have part-time physicians on the books. It seems penny-wise but pound-foolish, but nothing is surprising any more when it comes to the people managing medical practices.

From the payer viewpoint, however, patients are getting back into the swing of things with preventive care services. Cigna CEO David Cordani said that in the first quarter of 2021, his company saw levels of mammograms, colonoscopies, pap tests, and childhood vaccine visits at levels not seen since the COVID-19 pandemic started. In an analyst call earlier this month, Cordani stated that Cigna has been focused on steering patients toward preventive services especially for services like cancer screenings. Cigna is my health insurance provider and I haven’t seen any outreach regarding services, so I’m curious what kind of programs they have in place.

Despite significant spending on COVID-19, Cigna seems to be holding its own financially. It’s Evernorth division, which includes pharmacy benefits management services, is growing, with total pharmacy prescriptions increasing by nine percent. I wonder what portion of those medications are prescribed to treat anxiety, depression, insomnia, and other conditions related to the stresses of the pandemic, distance learning, and altered family dynamics? Even in my limited time as a telehealth provider, I’m still seeing a fair number of those diagnoses. Patients are much more eager to just take a pill than to want to accept my recommendations for counseling or therapy. Although many think the pandemic is behind us, healthcare providers in the trenches know that there will likely be complications for years to come.

Speaking of telehealth, I was glad to see Arizona move to the front of the class with HB 2454, which supports telehealth policy. It allows for audio-only telehealth visits in some circumstances and also allows providers from other states to treat Arizona residents without having an Arizona-issued medical license. Essentially it makes emergency pandemic-driven measures permanent, identifying Arizona as one of the more progressive states in its treatment of the issue. Everyone talks about access to medical services for rural residents or those who struggle to get to appointments, but the press release from Governor Doug Ducey’s office also made note that the bill “allows snowbirds visiting our state to receive telemedicine from their home state.”

For those hoping to press forward with asynchronous care options, the bill does exclude emails, voice mails, and instant messages from the definition of telehealth. There are also some hitches in the way it manages license portability. Those licensed in other states who want to care for Arizona residents must register with the state board, register with the controlled substances prescription monitoring program, pay a registration fee, and agree not to have a physical office in Arizona. How arduous that process truly is will define how many telehealth providers want to reach their practices into Arizona.

The one thing I was surprised by in the bill was that medical examinations for worker’s compensation matters can be conducted via telehealth if all the parties involved are in agreement. Dealing with worker’s comp cases is one thing I will not miss from my brick-and-mortar practice, and personally I’d be surprised if there’s much uptake on telehealth delivery of those services.

I’m continuing to play the back-and-forth phone call and email game with some of my state regulatory folks, who can’t quite understand the idea that a physician has a “telehealth only” practice and doesn’t have a physical space where she treats patients. I’ve had several people tell me “you can’t do that” and I try to better explain it to them by saying it’s like a house-call only practice, but they still don’t get it. I’m going to try to make additional phone calls this week to get it sorted out, but until then, I’m running slightly afoul of a couple of regulations, but it’s a risk I’m willing to take.

Are you willing to give up your in-person primary care physician in favor of virtual visits? Leave a comment or email me.

Email Dr. Jayne.

Readers Write: How the New ONC Cures Act Will Transform Patient Access to Healthcare Data

May 24, 2021 Readers Write No Comments

How the New ONC Cures Act Will Transform Patient Access to Healthcare Data
By Ariel Katz

Ariel Katz is founder and CEO of H1 of New York, NY.

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On April 5, the non-partisan federal rules mandating Open Notes for healthcare data took effect. Known as the Cures Act, the rules specify that clinical notes are among electronic information that must not be blocked and must be made available free of charge to patients.

This is a game changer for any patient who’s ever had trouble getting healthcare providers to share or exchange information on their care – i.e., nearly every US patient, ever.

Data exchange among healthcare providers has been a vexing problem for patients in the US for decades. Providers make patients pay for hard copies of their own files. They force patients to pick up CDs with copies of scans in order to get the data to another provider. They clearly aren’t up to speed on care that’s been provided elsewhere — even when it’s in the same health network — and repeat tests that have already been completed. Patients often get bounced from provider to provider, answering the same questions repeatedly before any care is even provided. The list goes on and on.

All of the problems people thought EHRs were supposed to fix are finally addressed in the Cures Act.

Here are several health initiatives that the Cures Act will catalyze:

Making apps like Apple Health a central place where a person’s complete health data is stored

Patients will be able to access their own health data at any time in one place. This is great for patients, and also really useful for providers in emergencies. For example, say a person from New York gets into a car accident while in Mexico. ER staff can access their health info easily to quickly learn about the patient’s health status and provide the best treatment. Apple Health appears to be emerging as the frontrunner for this, but there are other options. like Google Fit.

Better international data sharing

Right now, the Cures Act applies only to healthcare data in the US. But I believe other countries will quickly follow with their own legislation and standards that will ease secure international data sharing. Increasingly we’re seeing patients, especially those with rare diseases, seeking treatment in multiple countries. Global data sharing would save time and resources, enabling providers to quickly assess what has and hasn’t already been done, leading to quicker and more efficient healthcare.

Better contact tracing for future disease outbreaks

If the Cures Act had been passed earlier – say, in 2019 – it would have completely transformed contact tracing for COVID-19. If all this technology was in place at the start of COVID, contact tracing would have been incredibly simple, and COVID’s effect could have been far less severe in our country, and maybe in the world. If there is ever another pandemic, contact tracing under the Cures Act should be a much faster and simpler process.

The Cures Act seems to have gone into effect almost unnoticed, with very little fanfare. But healthcare pros who are paying attention will quickly realize the potential here for empowering patients with better access to their own health data. Look for a host of new technology solutions enabled by this capability in the coming months.

Readers Write: Alert: Three Keys to Navigating the Traffic Ahead on the Road to Healthcare Access

May 24, 2021 Readers Write No Comments

Alert: Three Keys to Navigating the Traffic Ahead on the Road to Healthcare Access
by Karly Rowe

Karly Rowe, MBA is VP of patient access, identity, and care management products at Experian Health of Franklin, TN.

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For any of us who use GPS when we drive, hearing the robot voice warn “alert, traffic ahead” is all too familiar, and usually followed by suggestions for alternate routes to our destinations. In our industry, however, there is only one road, and it’s about to get more crowded, complex, and nuanced. To help patients navigate their way through healthcare in the future, the industry is going to need to innovate.

As the economy emerges from the pandemic, there are dramatic changes in people’s lives and many industries are having to transform their operations in significant ways. For healthcare, we are going to see a changed landscape or, to put it more bluntly, there’s serious traffic ahead.

The impact on employment has been no less than stunning. Data earlier this year revealed that 78 million initial jobless claims had been filed with the Labor Department during the pandemic (that’s almost half of the country’s workforce), and that we had lost more than 10 million jobs. For those of us who remain employed, almost fourth-fifths are working differently, mostly notably through working from home.

These dramatic changes create new barriers impacting patients’ ability to access. Their coverages have changed or been lost entirely, as has their willingness to seek care in the face of their financial situations or other barriers, such as language, and their ability to do so is often impeded (this is especially true for underserved populations). Patient needs have and will also change as they contend with long-haul conditions and Americans in general learn to manage the mental health effects (about half of us have experienced such impacts already) of time in isolation and with limited human contact.

The volume of this transformation is itself a change, and a big one.

The impacts of technology on healthcare should no longer be called revolutionary, but rather the norm, as the pandemic has accelerated the transformation that was already underway. The market for wearables is expected to reach $81.5 billion this year, which is an 18% increase from a year ago. Individuals are using these technologies to manage their own health and the data are factored into a majority of wellness programs. The promise and peril of aggregating and applying these new sources of data aren’t news to you, whether in technical, administrative, or compliance terms. My point is that it’s an unavoidable component of that traffic we face going forward.

And the sheer volume of that component, to the tune of thousands of exabytes in growth annually, is a big one, too.

The road ahead is going to be tough since there are no alternate routes we can take. So, I say we embrace that clarity and apply it to three key areas of work that will help us navigate it:

Invest in tech

Challenging times challenge us to innovate, and it is clear that our systems (the “road” in my analogy) aren’t built to accommodate the changes I noted above. Telehealth is one area that shows immense promise, as patients have grown accustomed to remote interaction during the pandemic. Simply put, getting to a website can be far easier than making an office appointment, and relegating certain diagnostics to remote engagement can be more cost efficient. Integrating that data across touchpoints are important, as is exploring ways to make telemedicine available and attractive to vulnerable populations (the traffic is there, thanks to patients added due to COVID-19, so think about adding lights at entrance ramps to highways to ease traffic access and flow).

Use data to drive patient engagement

It might seem counterintuitive but the engagement and resulting data from interactions beyond the four walls of the clinic can be crucial to better health outcomes. To apply my traffic metaphor again, it’s not necessarily the volume of data, or traffic, that is the problem. Rather, it’s that the lines on the road need to be clearer. According to the Sequoia Project, about 12% of demographic data become outdated within a year due to such facts as 70% of married women change their names. Further, almost a third of that data are misspelled, incomplete, or incorrect. The challenges of consistent and reliable patient identifiers are nothing new, but they take on new currency when the challenges dependent on them increase and become more complex. Today’s solution helps preclude tomorrow’s “traffic” problems.

Don’t make the traffic worse

Patients’ healthcare journeys do not all travel the same road, but rather merge and exit at a number of points, many of which aren’t necessarily traditional sources of health services (and therefore new sources of health-related data). The technologies exist to connect patients to food banks, shelters, counseling services, and community programs, which may serve to lessen the overall impact on traffic. Then, by connecting those services, you can learn more about them and their needs. Insisting that there’s only one way to get to a desired destination – as if there were a single express lane – is old thinking, while considering the opportunities to provide patients with multiple routes while connecting the resulting data and insights into a single, overarching view (a GPS picture, if you will), may be the pathway forward.

We have a clear picture of what the road ahead looks like. While we can’t choose a different route, we can use technologies and tools to make the traffic flow better, faster, and more safely. Times of massive change are challenging, but they can also be inspiring.  We can embrace this opportunity to take our industry where it needs to go.

Morning Headlines 5/24/21

May 23, 2021 Headlines No Comments

Conti Ransomware Attacks Impact Healthcare and First Responder Networks

An FBI advisory says that at least 16 US healthcare and first responder networks were attacked by Conti ransomware in the past year.

Advocate Aurora Health will make remote work permanent for 12,000 employees

Advocate Aurora Health will change 12,000 non-clinical positions to remote-first, eliminating their physical offices in departments such as finance, accounting, administration, and consumer experience in allowing employees to work from wherever they want.

HSE making progress on restoring health systems, but disruption to continue next week

Irish health officials say services will remain disrupted as their cybersecurity teams work to bring IT systems back online after last week’s systemwide Conti ransomware attack.

Monday Morning Update 5/24/21

May 23, 2021 News 2 Comments

Top News

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An FBI advisory says that at least 16 US healthcare and first responder networks were attacked by Conti ransomware in the past year.


Reader Comments

From Pat Hand: “Re: CEO selling. Can you ask your readers at what stage of a company’s growth it become detrimental for the CEO to lead pitch meetings with the prospect hospital’s C-suite? My startup employer has hired tremendous HCIT leaders, but our CEO (who is also a co-founder) struggles to relinquish control of the initial discovery and pitch process. He isn’t great at reading a room, asking discovery questions, giving succinct answers, and simplifying the pitch based on need. When our sales execs ask him to let the salespeople do their jobs, he says that the first meeting should be C-suite to C-suite and they can take over afterward. Do prospects see this negatively and do they question a premium price tag when the CEO is the de facto sales rep?” I’ll invite readers to weigh in. My experience from being on the health system receiving end of pitches is that I would find it puzzling and perhaps a bit desperate to have a vendor CEO show up in the first meeting. I would rather meet with the sales folks, decide mutually what happens next, and hold back the CEO’s participation until either (a) the first meeting on the vendor’s campus, and even then just for a short meet and greet; or (b) as a final reassurance during contract negotiations. The company folks will defer silently when their CEO is in the room, which is the same reason that I as the health system person wouldn’t invite our high-ranking folks to those first meetings. I think the company should stop sending the CEO out on sales calls as soon as it can afford to hire experienced salespeople.


HIStalk Announcements and Requests

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Poll respondents are generally upbeat about the hiring practices of their employers through the end of the year.

New poll to your right or here: How does the HIMSS21 “vaccinated attendees only” policy change your plans to attend?

It’s a shorter post and no Weekender since Mrs. H and I took a great 12-hour drive in the splendor of late spring to a family event, a road trip that I enjoyed immensely. She probably needed some “Lonesome Dove” backstory to understand my enthusiastically blurted quote: “Ain’t nothing better than riding a fine horse in new territory.”


Webinars

June 3 (Thursday) 2 ET: “Diagnosing the Cures Act – Practical Prescriptions for Your Success.” Sponsor: Secure Exchange Solutions. Presenters: William E. Golden, MD, MACP, medical director, Arkansas Medicaid; Anne Santifer, executive director, Arkansas Department of Health – Office of Health Information Technology; Kyle Meadors, principal, Chart Lux Consulting. A panel of leading experts will provide practical guidance on how to prepare for the Cures Act. Will it upend your business model? What is information blocking? How can standardized technologies be applied to meet Cures Act requirements? What must I do now as well as in the next five years?

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


Sales

  • France’s Institut Curie will implement digital pathology from Sectra.

People

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Jeff Webber (Healthcare Triangle) joins Tegria-owned Navin Haffty as VP of operations.

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JoRel Nye (Aledade) is named chief product officer at Stellar Health.


Announcements and Implementations

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Change Healthcare launches a vaccination record solution that is based on the open standards of the  Vaccination Credential Initiative. Vaccination and testing providers, state registries, pharmacies, and labs can send their vaccination records at no cost, allowing pharmacies, testing labs, and government agencies to develop API-powered digital vaccine proof apps. The company notes that this approach puts consumers in control of how their vaccination information is selectively shared.

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Bose launches an $850, no-prescription hearing aid – the first that FDA has approved for direct-to-consumer sale — for people with mild to moderate hearing loss, which includes an app that wearers use to tune them to their preference or to their immediate surroundings.


Other

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This is an interesting concept: robotic process automation vendor UIPath offers StudioX, a no-code builder that allows employees to automate their own tasks that also includes corporate governance tools, such as permissions control and logging. I’ve used Macro Scheduler for many years to automate desktop and browser tasks and to tie applications together like the examples above.

Two ED doctors in Ireland, whose national health IT systems remain down from a ransomware attack, say that a big problem is that the country never developed a universal identifier that would allow accessing a patient’s records from multiple hospitals.

Advocate Aurora Health will change 12,000 non-clinical positions to remote-first, eliminating their physical offices in departments such as finance, accounting, administration, and consumer experience in allowing employees to work from wherever they want.


Sponsor Updates

  • LexisNexis Risk Solutions releases the “2021 COVID-19 Mental Health Impact Report,” validating that mental health telehealth claims have increased significantly during the pandemic.
  • Nordic, Pivot Point Consulting, Protenus, and Surescripts are included on Modern Healthcare’s “Best Places to Work in Healthcare” list.
  • The Business of Pharmacy Podcast features RxRevu CEO Carm Huntress in its episode on improving prescribing decisions.
  • Innovaccer will integrate the Healthwise Knowledgebase patient education solution into its Health Cloud
  • Spirion wins four Global InfoSec Awards from Cyber Defense Magazine, including for next-gen in privacy management software.
  • Visage Imaging will sponsor the virtual SiiM21 Annual Meeting May 24-27.

Blog Posts


Contacts

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

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Morning Headlines 5/21/21

May 20, 2021 Headlines 1 Comment

US Hospital Market Share 2021

A new KLAS report on EHR market share in US hospitals finds that Epic gained the most in 2020, while Cerner saw its second consecutive year of net market decrease.

JPMorgan Chase Launches Morgan Health

JPMorgan launches Morgan Health to improve the care of its US employees, and to develop care models for other employers.

Harris adds patient engagement solutions with the acquisition of ER Express

Harris acquires ER Express, which offers EDs and urgent care facilities software for online check-in, patient intake, and online referral.

Tegria Acquires Colburn Hill Group to Ease Revenue Cycle Management Challenges for Healthcare Providers

Providence-founded Tegria acquires RCM robotic process automation vendor Colburn Hill Group.

Scripps website back up, patient portal still down

Scripps Health (CA) announces its website is back up but its patient portal is still down nearly three weeks after a ransomware attack.

News 5/21/21

May 20, 2021 News 19 Comments

Top News

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A new KLAS report on EHR market share in US hospitals finds that Epic gained the most in 2020, adding 101 hospitals representing 19,000 beds.

Cerner saw its second consecutive year of net market decrease in losing 19 hospitals and 10,000 beds, which KLAS attributes to big-hospital concerns about its revenue cycle functionality.

Epic’s market share is 31% of all hospitals and 42% of all beds, while Cerner has 25% and 27%, respectively.

All the hospitals that Meditech added in 2020 were under 100 beds and 62% of its legacy customers that made EHR decisions in 2020 moved to other vendors, Epic in almost all cases.


Reader Comments

From HIPAA To Be Square: “Re: vaccination record for conference attendance. Isn’t this a HIPAA violation involving PHI?” Of course not. HIPAA does not prevent an individual from voluntarily disclosing their own information to whoever they want. PHI is a concept that applies only to covered entities and business associates, otherwise you couldn’t tell anyone your name or email address since they are among the 18 PHI identifiers. You aren’t required to disclose your vaccination status, but conferences are not legally required to let you in if you don’t. I trust the vaccine and don’t worry about what everybody else is doing, such as presenters wearing face shields and exhibitors wiping down booth surfaces, but I’m curious why HIMSS is insistent on distancing when CDC says it isn’t necessary (HIMSS hasn’t decided on masks yet, but there’s zero chance they will voluntarily enter that minefield). More interesting to me is how conferences will use mostly untested technology to efficiently check vaccination status at scale, HIMSS21 being particularly at risk given that we’re just 80 days out. My guess is that proof will involve waving dog-eared (and easily faked) paper vaccination cards, which is ironic for a healthcare technology conference. HIMSS hasn’t said if it will allow vaccination exceptions, but its virtual version of HIMSS21 should protect it from any legal challenge by prospective attendees who can’t or won’t be vaccinated since it will be offering “reasonable accommodation.” Companies should be careful about requiring employee attendance, however, since that means asking about vaccination status and deciding how to respond to those who refuse to be vaccinated.


Webinars

June 3 (Thursday) 2 ET: “Diagnosing the Cures Act – Practical Prescriptions for Your Success.” Sponsor: Secure Exchange Solutions. Presenters: William E. Golden, MD, MACP, medical director, Arkansas Medicaid; Anne Santifer, executive director, Arkansas Department of Health – Office of Health Information Technology; Kyle Meadors, principal, Chart Lux Consulting. A panel of leading experts will provide practical guidance on how to prepare for the Cures Act. Will it upend your business model? What is information blocking? How can standardized technologies be applied to meet Cures Act requirements? What must I do now as well as in the next five years?

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


Acquisitions, Funding, Business, and Stock

JPMorgan, fresh off its failed Haven healthcare joint venture with Amazon and Berkshire Hathaway, launches Morgan Health to improve the medical care of its 165,000 US employees and family members. The business will partner with leading healthcare organizations to develop models for other employers and will be given $250 million to invest in companies that offer promising healthcare solutions. Named as Morgan Health CEO is Dan Mendelson, MPP, who spent 21 years as CEO and founder of consulting firm Avalere Health, which was acquired by Inovalon for $140 million in 2015.

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UK-based chatbot and virtual visit vendor Babylon acquires 700-physician Meritage Medical Network (CA). The company has raised $631 million in funding through a Series C round and is considering whether to launch an IPO or merge with a SPAC at a valuation of over $4 billion. 

White-labeled virtual care technology and clinician network vendor Wheel raises $50 million in a Series B funding round.

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Harris acquires ER Express, which offers EDs and urgent care facilities software for online check-in, patient intake, and online referral. It will be placed within Harris’s PulseCheck business.

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Providence-founded Tegria acquires RCM robotic process automation vendor Colburn Hill Group.

Allscripts files a federal trade secrets and non-solicitation complaint against its former senior VP Raj Toleti, who was CEO of mobile patient engagement platform vendor Health Grid when Allscripts acquired that company in 2018. Allscripts made Toleti an executive and he stayed until March 2020. Allscripts claims that Toleti’s other companies, Andor and India-based Mahathi, offer staff augmentation for the implementation of Allscripts FollowMyHealth and used Allscripts intellectual property in their products.

Israel-based healthcare Internet of Things cybersecurity vendor Cynerio raises $30 million in Series B funding.

Money-losing Medicare Advantage insurer Bright Health, which offers plans in 13 states, files for an IPO, having raised $1.6 billion in funding and booked a five-fold revenue increase in 2020 from its several acquisitions. The company’s S-1 form says it has developed analytics to provide care advice and is “in the process of making it fully operational.” 


Sales

  • Banner Health will enable “digital health prescriptions” using the deployment platform of Xealth.
  • Geisinger Health Plan will use the cost and quality transparency platform of HealthSparq as integrated with the provider search and scheduling solutions of Kyruus, which acquired HealthSparq in April 2021.

People

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PeraHealth promotes Joe Beals, PhD, MBA to CEO.

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Edwin Miller, MBA joins telehealth vendor Sitka as chief product officer.

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ArborMetrix names Maria Siambekos, MBA (Champion Healthcare Technologies) as CEO.


Announcements and Implementations

Anthem signs an agreement with Epic to support bi-directional health information exchange between Anthem’s affiliated health plans and providers using Epic’s Payer Platform. Anthem says it will use patient information to identify care gaps, streamline prior authorization, and to notify providers when their patients are discharged.

Six hospitals in Ottawa, Canada develop a version of Meditech’s patient portal for French speakers.

KLAS looks at the telehealth ecosystem, concluding that Amwell and Teladoc offer feature-rich virtual care platforms, Health Recovery Solutions has broad capabilities in remote patient monitoring, Doxy.me stands out among videoconferencing platforms, Epic customers report deep adoption, and NextGen Healthcare’s EHR-agnostic product is strong in ambulatory practices and specialties.

Mitre publishes a draft national strategy for digital health that includes:

  • Universal broadband access.
  • A sustainable, tech-prepared workforce.
  • Digital technologies that empower people to manage their health.
  • Data exchange architectures, APIs, and standards.
  • A digital health ecosystem that provides information for public health decision-making.
  • Integrated governance.

TransformativeMed brings its Core Work Manager App to Epic as University of Washington / UW Medicine – which originally developed the specialty-specific workflow and handoff coordination tool as a Cerner-embedded MPages tool – migrates to Epic and continues its use of Core Work Manager. The original developers, trauma surgeon Erik Van Eaton, MD and lead EHR architect David Stone, founded TransformativeMed and have implemented the product in 130 hospitals.

Microsoft will retire Internet Explorer next year in favor of its Edge browser, which holds a 3% browser market share. IE is still present on Windows 10 PCs, accessible from the Search window for those looking to take a trip back in time with a browser that was slow and clunky even in its heyday.


Other

Ransomware hackers post sample information from Ireland’s health service online after the government declines to pay their demanded $20 million. The information includes patient medical files, meeting minutes, contracts, and correspondence with patients.

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New Zealand’s Waikato District Health Board is experiencing “absolute chaos” after a ransomware attack Tuesday, going back to paper records and trying to properly identify patients.

Wyoming’s health director and the state’s CIO resign after COVID-19 test results ended up on GitHub due to an apparent mistake by a health department employee. Scammers have used the exposed data to call people they hope will be convinced to disclose their financial and insurance information.

A Minnesota doctor is charged with sexual assault after a female patient complained that he performed a rectal exam on her during an unrelated visit, then afterward had one hand on the computer keyboard and the other down his pants.


Sponsor Updates

  • The Healthcare Technology Report includes Wolters Kluwer Health Business Unit GM Karen Kobelski and Central Logic CEO Angie Franks on its list of “The Top 25 Women Leaders in Healthcare Software of 2021.”
  • Carrot Health will add social determinants of health data from LexisNexis Risk Solutions to its SDOH data and analytics software for providers and payers.
  • Everbridge achieves its 16th Authority to Operate on the FedRAMP Marketplace.
  • Experity, formed in 2019 in the merger of DocuTAP and Practice Velocity, says its urgent care clinic customer base – 50% of the US total – experienced a 58% increase in visit volume in 2020.
  • Lumeon, Fortified Health Security, Impact Advisors, and First Databank are included on Modern Healthcare’s “Best Places to Work in Healthcare” list.
  • Jvion publishes the “AI Champions Connect Quarterly Report: Artificial Intelligence & Population Health.”
  • Meditech congratulates customers Avera Health and HCA Continental Division/HealthONE on being named among the Watson Health 15 Top Health Systems for 2021.
  • CHIME’s Opioid Action Center Podcast features Meditech Associate VP Janet Desroche.
  • NTT Data and its affiliates donate $10 million to help India through its COVID-19 surge.

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 5/20/21

May 20, 2021 Dr. Jayne No Comments

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Since I’m no longer providing in-person clinical care, my schedule has a different level of flexibility and I’m trying some new things both personally and professionally. Today I enjoyed attending a medical school’s Grand Rounds presentation from the comfort of my bed, which was much nicer than being in a subterranean auditorium. I’ll be doing some travel and sampling the digital nomad lifestyle a bit as well as trying my hand at Locum Tenens coverage.

For HIStalk, I’ll be adding some interviews with women leaders and entrepreneurs in health IT. I’ve already identified a couple of potential candidates but am looking for suggestions. Drop me a note with your nominee and why they would make an interesting interview. I’ll start running them in June, so stay tuned.

Lots of chatter around the virtual water cooler this week about a Kaiser Health News writeup addressing parking charges for cancer patients receiving care. The article references a research letter in JAMA Oncology last summer that looked at parking fees at National Cancer Institute-designated cancer treatment centers. Although the idea of charging cancer patients to park while they undergo treatment is particularly odious, we should be looking at the broader idea of charging patients to park, period.

I recently had care at a major institution that has billions in its endowment, but can’t afford to allow patients to park for free. Given the preponderance of organizations getting on the facility charge bandwagon as a way to increase their bottom lines, one would think that parking should be part of those facilities. As a healthcare insider, I know that many organizations run on razor thin margins, but I would argue that if you can still afford to build marble foyers with fountains and landscaping, you should take a serious look at whether charging patients to park is the right thing to do.

Kaiser Health news also ran a piece this week looking at patient reaction to having greater access to health data. Patient-side stories include patients who were anxious when seeing laboratory results without the benefit of a clinician’s explanation and those who felt offended or judged after reading physician notes. Another story mentioned a patient receiving biopsy results on the weekend, blindsiding both the patient and the physician with a cancer diagnosis. Organizations including the American Medical Association are encouraging adjustments to the rule, allowing delays for certain tests (such as biopsies) to allow physician annotation prior to release.

For some organizations, this change has not been an issue since they already provided access for more than 50 million patients. Others are creating reference guides for patients to better understand their results. My former employer is in violation, although most of the providers at the practice don’t realize that greater accessibility is now a requirement. It will be interesting to see what enforcement on this looks like.

The last water cooler conversation piece was the recent JAMA Viewpoint editorial that offered suggestions for designing successful capitated payment models for primary care physicians. I agree with the seven design elements proposed by the authors (my favorite healthcare IT crush, Farzad Mostashari, MD included). However, in order for capitated contracts to succeed, we need better support for interoperability around healthcare data in order to facilitate patient care through home health, remote monitoring, and better coordination of specialist care.

Despite what the integrated delivery networks think, there are still a good number of independent physicians out there. As a family physician, I need easy access to all the information my referral specialists hold on my patients, whether we’re part of the same network or not. Despite information blocking regulations, large health systems continue to not play nicely with anyone outside of their network and patients pay the price, not only financially through duplicated services, but medically through poor care coordination.

The Journal of the American Medical Association published a recent article that looked at whether COVID-19 vaccine registration websites were accessible to those with disabilities. The authors looked at 54 official websites in the US and compared them against the Web Content Accessibility Guidelines (WCAG) 2.0 and 2.1 guidelines. They found “suboptimal compliance” with the guidelines among the sites evaluated, with only two meeting the WCAG 2.1 standards. They call for greater availability of text-to-speech functionality to better meet user needs along with better use of color, contrast, spacing, and other presentation features to improve visual understanding.

Navigation challenges were also specifically called out in the analysis, with recommendations for improved titles, headers, labels, and links. They also recommended user testing that involves people with disabilities and ongoing evaluation as websites are updated. None of these findings are surprising to me, as I regularly have to call out technology developers for non-ideal use of color and contrast when they’re creating user-facing screens. Accessible UX design helps everyone, and I would encourage those companies that don’t have experts on staff to consider using consultants who can get the job done.

I had to break down and try to find a primary care doc recently and the whole process was only describable as a disaster. Most of the family physicians in my community aren’t accepting new patients and those that are taking new patients have a greater than six-month wait. I finally broke down and reached out to a colleague directly to see if he’d make an exception to the “no new patients” policy, which fortunately he did.

I had to play some phone tag with the office, and since this was an exception situation, the appointment line couldn’t book my appointment. Instead, they needed to me to speak directly with the physician’s medical assistant. However, they made me go through the full verbal COVID screening questionnaire before they would transfer my call, even though the appointment I was trying to book was for a month or two out. If they’re doing the verbal screening for every patient who calls regardless of what they are trying to book, it seems like a lot of wasted energy collecting screening information that will be long invalid by the time the patients arrive.

How is your institution managing COVID-19 screening in the new era of vaccines? Have things changed? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 5/20/21

May 19, 2021 Headlines No Comments

Wheel Raises $50 Million Series B to Build the Next Generation of Virtual Care

White-label telemedicine and staffing startup Wheel raises $50 million in a Series B round that brings its total funding to $66 million.

Glen Tullman raises $150 million health-tech fund

Former Livongo and Allscripts executives Glen Tullman and Lee Shapiro will use $150 million in venture funding to invest in early-stage healthcare startups focused on connected consumers.

DarioHealth Acquires Digital Behavioral Health Platform WayForward

Chronic condition-focused remote patient monitoring company DarioHealth acquires WayForward for $25 million.

Morning Headlines 5/19/21

May 18, 2021 Headlines No Comments

Baltimore-based digital health company to expand after securing more than $6 million in venture capital

Medication compliance and remote monitoring app developer Emocha raises $6.2 million in a funding round led by Claritas Health Ventures.

Taking a stand on vaccines at HLTH 2021

Alongside HIMSS, HLTH announces that attendees will need to present proof of COVID-19 vaccination to attend their respective events in 2021.

Scripps Health ransomware shutdown hits the two-week mark

Scripps Health in California remains offline more than two weeks after it was hit by a ransomware attack.

SymphonyRM Raises $25 Million In Series B Funding to Help Health Systems Transform Their Data Into Actionable Plans For Every Healthcare Consumer

SymphonyRM raises $25 million in a Series B funding round led by TT Capital Partners, bringing its total raised to $35 million.

News 5/19/21

May 18, 2021 News 16 Comments

Top News

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The 2021 HIMSS and HLTH conferences will require in-person attendees to show proof that they have been fully vaccinated for COVID-19.

HLTH attendees will need to present vaccination proof via Clear’s Health Pass app, which is not yet available for COVID-19. HIMSS hasn’t decided how attendees will prove their vaccination status, but suggests that it will choose a digital solution.

Other announced items related to HIMSS21:

  • Attendees, exhibitors, and HIMSS staff who have not received the full regimen of vaccines from Pfizer-BioNTech, Moderna, J&J, or AstraZeneca will not be allowed to enter conference areas.
  • Exhibit hall booths will be spaced, as will the layout within individual booths.
  • Presenters will be required to wear face shields.
  • HIMSS has not yet decided whether attendees will be required to wear masks.
  • Seating in educational sessions will be spaced with reduced capacity guidelines, with overflow seating and live stream simulcast offered for some sessions.
  • HIMSS is still reviewing rules for networking events, but may require them to be conducted outdoors, to serve only individually portioned food and beverage items, and to employ distancing.

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In other conference news, RSNA confirms that it will return to an in-person conference this year, starting on its usual Thanksgiving weekend at McCormick Place. RSNA  work with the convention center and the city to determine health and safety requirements.


Reader Comments

From Eadric: “Re: Meditech surgical case data. Do you know of any experts who can help point my company in the right direction to get it for our shared clients?” I don’t, but I will forward any contacts that readers suggest.

From Co-Vegas: “Re: HIMSS21. The HIMSS conference precautions won’t mean much in Las Vegas, which is anything-goes when it comes to coronavirus.” Read down the page for the just-announced HIMSS21 precautions. Las Vegas is the probably the worst US city for trying to seal off a conference to control viral spread given the mask-free intermingling of domestic and international tourists along with conference attendees in hotels, casinos, and restaurants. Convention centers are usually freestanding entities that control access to their entire footprint with their own security, but that’s not possible in Las Vegas, which intentionally makes it impossible to get from Point A to Point B without passing through crowded casinos, packed elevators, and throngs of sketchy Strip occupants.


Webinars

June 3 (Thursday) 2 ET: “Diagnosing the Cures Act – Practical Prescriptions for Your Success.” Sponsor: Secure Exchange Solutions. Presenters: William E. Golden, MD, MACP, medical director, Arkansas Medicaid; Anne Santifer, executive director, Arkansas Department of Health – Office of Health Information Technology; Kyle Meadors, principal, Chart Lux Consulting. A panel of leading experts will provide practical guidance on how to prepare for the Cures Act. Will it upend your business model? What is information blocking? How can standardized technologies be applied to meet Cures Act requirements? What must I do now as well as in the next five years?

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


Acquisitions, Funding, Business, and Stock

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Healthcare staffing, resource, and telemedicine company AMN Healthcare acquires virtual care startup Synzi from Kinderhook Industries for $42.5 million.

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Provider management and credentialing software vendor Symplr acquires HealthcareSource, which specializes in healthcare employee recruitment, retention, and development. Symplr acquired competitor Phynd Technologies in January.

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Employer-focused mental health tech company Lyra Health raises $200 million just four months after securing $187 million, bringing its estimated value to $4.6 billion.


Sales

  • National medical group Mednax selects R1 RCM.

People

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Darren Dworkin (Cedars-Sinai Health System) joins Press Ganey as chief strategy officer and managing partner of PG Ventures. He has been at Cedars for 16 years as SVP/CIO, managing director of its venture organization, and executive managing director of its accelerator.

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Culbert Healthcare Solutions names David Francis (Steward Medical Group) SVP of management consulting services and Charlie Brown (Tower Health) VP of Epic revenue cycle consulting services.

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Luyuan Fang (Change Healthcare) joins Prescryptive Health as chief AI and data officer.

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Advanced Medical Strategies names David Cardelle (Change Healthcare) chief strategy officer.

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Patient Discovery Solutions hires Theresa West (Signify Health) for the new role of chief commercial officer.

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Dina hires Bob Maluso, MBA (Woundtech) as chief growth officer.


Announcements and Implementations

The American Medical Association announces Return on Health, which will develop a framework for assessing the value of digitally enabled care, such as telehealth.

The Minnesota Board of Pharmacy will give prescribers access to the state’s prescription monitoring program data through Appriss Health’s PMP Gateway interface.

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Sutter Health (CA) implements Docent Health’s patient engagement technology as part of its new virtual mental healthcare program. GetWellNetwork acquired the company in January.

Blessing Health System (IL) deploys Allscripts Sunrise at Blessing Health Keokuk, Hannibal Clinic, and Scotland County Hospital. It has also signed on for the company’s managed services.

Medhost chairman and CEO Bill Anderson describes in an Amazon Web Services blog post how its multi-tenant, cloud-based EHR benefits customers and supports innovation such as machine learning, analytics, telehealth, ambient listening, mobile-friendly apps, and Alexa-based services.

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Cleveland Clinic expands its virtual second opinion program for employers and health plans, offered with Amwell, to brain and prostate cancer.


Other

Scripps Health remains offline more than two weeks after it was hit by a ransomware attack.

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A survey by mental health vendor Woebot Health finds that users of its therapy encounter app develop a bond — similar to that between human therapists and patients — within 3-5 days of use without diminishing over time. The “relational agent” app simulates a supportive conversation using AI and NLP that monitors and manages symptoms of stress, depression, and anxiety. I started a free trial to check it out and am not all that impressed so far – it led me through a heavily scripted “chat” that was mostly me clicking on canned responses, went through a “lesson,” insisted on a daily session (no more, no less), and then didn’t have anything useful to offer when I revisited for the second time today and said I was feeling anxious to see what would happen. Maybe it will perform better over time or as it learns.

Kaiser Health News calls out dentists who recommend unneeded or more-expensive procedures to boost their bottom lines, quoting an insurance fraud journal that concludes, “Medicaid fraud is the most lucrative business model in US dentistry today.” Corporations and private equity firms who acquire small practices sometimes order their employed dentists to push profitable procedures and fire them if they don’t. One dentist was charged with fraud after billing for $2 million in crown procedures in 18 months, which authorities say he made possible by intentionally breaking the teeth of patients with his drill while filling their cavities.


Sponsor Updates

  • Wolters Kluwer Health announces that the global customer support teams for Ovid, Lippincott, and Audio Digest have received the CRMI’s NorthFace ScoreBoard Award for the 10th consecutive year.
  • SOC Telemed will present during the virtual 2021 RBC Capital Markets Global Healthcare Conference May 18.
  • Athenahealth integrates Nuance’s Dragon Medical speech and virtual assistant technology into its AthenaOne EHR and mobile app.
  • Patient engagement vendor Sonifi Health announces a partnership with CipherHealth.
  • Capsule Technologies publishes a new white paper, “Remote Monitoring Assessment of COVID-19 Patients.”
  • Epocrates becomes the exclusive reseller of ConnectiveRx’s ScriptGuide patient savings messages.
  • Netsmart earns its seventh consecutive top post-acute technology solutions vendor ranking from Black Book Market Research.

Blog Posts


Contacts

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

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Morning Headlines 5/18/21

May 17, 2021 Headlines No Comments

St. Pete telehealth company Synzi acquired for $42 million

Healthcare staffing, resource, and telemedicine company AMN Healthcare acquires Synzi, a virtual care management vendor for home health and outpatient providers, for $42.5 million.

Amazon may launch healthcare business line with at-home COVID test and other diagnostic services

Sources say Amazon may launch a home diagnostics business and a third-party marketplace for related services.

Clearlake Capital-Backed Symplr To Acquire HealthcareSource From Francisco Partners

Provider management and credentialing software vendor Symplr acquires HealthcareSource, which specializes in healthcare employee recruitment, retention, and development, for an undisclosed amount.

Mental Health Startup Lyra Health Valued at $4.6 Billion in Coatue-Led Round

Employer-focused mental health tech company Lyra Health raises $200 million just four months after securing $187 million.

Curbside Consult with Dr. Jayne 5/17/21

May 17, 2021 Dr. Jayne 2 Comments

Last week, the US Centers for Disease Control and Prevention (CDC) dropped new recommendations covering the need for mask use for individuals who have received COVID-19 vaccinations. To be honest, Thursday was overly busy and I headed out of town on Friday, so I didn’t have time to read the primary source documents before my inbox started blowing up with questions from family and friends as well as updates from businesses I frequent.

As always with the CDC, the devil is in the details, and there were footnotes to the recommendations for educational institutions. Guidance for youth summer camps and activities is still forthcoming. Unfortunately, most people just latched onto the sound bites and it was off to the races.

I spent the weekend alternating sleeping on the ground with canoeing in the rain, which was actually a lot better than it sounds. Floating through the wilderness with one of my besties is always a good time. She’s a nurse who has been run into the ground during the pandemic and definitely needed a break. Even though things are easing, her hospital is chronically understaffed and nurses are being asked to continue to give more and more when their reserves are spent. COVID-19 cases in our area are at an all-time low and her unit is no longer a pandemic overflow unit, but case mix doesn’t really matter when you don’t have enough staff to properly care for patients.

The hospital is offering bonuses for people to pick up extra shifts, but I can’t help but wonder if increasing base pay and adding additional perks would keep people from calling in sick. Creating a dedicated float pool or paying people to be on call are also options, but those cost money up front, so I guess they would rather spend it on the back end and have burned-out staff instead.

It is in this context that most healthcare providers are listening to the CDC recommendations, which were dropped on states with little notice and effectively turned small businesses and community organizations into the vaccination police overnight. The way the recommendations were released stressed the system and did not give frontline providers enough time to digest the science behind them before being hit with loads of patient questions.

Anyone with any change leadership experience knows that consensus and communication are key to effectively managing change, and both were lacking. For healthcare providers who have been exhausted caring for COVID-19 patients over the last few months, an overwhelming sentiment involved the idea that maybe we could have just waited a little bit and given clinical caregivers a break. Would it have been so bad to allow six or eight weeks so that a good chunk of the 12- to 15-year-old crowd could become fully vaccinated? Could we have had just a little more time to recharge before throwing open the floodgates nationwide? Many of us have significant concerns about potential summer spikes and the growing body of information that shows that the long-term impact of COVID-19 is going to be more significant than initially thought.

The bottom line is that very few people seem to care what healthcare providers in the trenches actually think. Frontline clinical staff have become a commodity and there’s a sentiment that we can all be easily replaced even though in reality we can’t. You can’t just replace registered nurses with patient care technicians and expect things to turn out OK. Similarly, letting your seasoned physicians walk away and replacing them less experienced (and often cheaper) resources probably isn’t the best long-term play either. The idea that happy clinicians make for happy patients seems to be lost on most medical administrators these days.

The healthcare IT industry has significant focus on patient satisfaction and patient engagement, but there aren’t a lot of tools out there for care team satisfaction or engagement. There has been plenty of conversation about the usability of EHRs for years, but it’s not just that – it’s all the different systems that we have to engage with on a daily basis.

Take scheduling systems, for example. If it is difficult and annoying for employees to schedule their shifts, does that add to their satisfaction? If the learning management system doesn’t make it easy for you to complete required training, that certainly isn’t a win, either. At my last employed position, I had to use one system to submit my schedule requests and access another system to see how my schedule actually turned out. We had three different systems for employee education – one true learning management system, one intranet site, and then random text messages distributing critical information. It made it difficult to feel like you were in command of all the information.

Our EHR was a poorly configured version of a product that I know can do better, but that had been tweaked to support our particular (or peculiar, depending on how you look at it) workflows and policies. The CPOE for in-facility medications was beyond clicky and borderline unsafe, but we were expected to just deal with it. Our PACS went down on a daily basis because it wasn’t fit for purpose given the exponential growth of the organization, but no plans were made to replace it. When concerns were surfaced, we were essentially told to just deal with it, because replacing either would be too much of a hassle “and would distract us from our patient care mission.” We were also told that they couldn’t afford to upgrade the systems, but eventually organizations reach a point where they can’t afford not to upgrade the systems. I see these same concepts played out at organizations across the US, so I know it wasn’t unique to our situation.

Knowing how burned out everyone is from the pandemic, I can’t imagine what healthcare organization employees are going through when their employer is hit by a ransomware attack. It’s hard enough to care for patients today as it is without that added stressor. We’re all suffering from compassion fatigue and have little tolerance for things that make our lives harder. Many of us are also experiencing significant moral injury from having to make ridiculous decisions that shouldn’t happen in a large, industrialized nation in the 21st century. But that’s where things have landed, and at many organizations, we are told that we should be grateful to have a job.

I’m not sure what the answer is, but I think we need a greater dialogue around how healthcare organizations care for their employees. We need more exposure to the public about what the staffing pool looks like, and the potential negative impacts on care when the caregivers are still suffering. And maybe we need some fancy new technology to put the sexy back in employee satisfaction.

Got any ideas on how to rejuvenate the healthcare workforce? Leave a comment or email me.

Email Dr. Jayne.

HIStalk Interviews John Gannon, CEO, Blue Spark Technologies

May 17, 2021 Interviews No Comments

John Gannon, MBA is president and CEO of Blue Spark Technologies of Westlake, OH.

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Tell me about yourself and the company.

I’m CEO of Blue Spark. I have been here for about 10 years. I am an aerospace engineer by training and have spent time in banking and venture capital. 

Blue Spark is a medical device company. Our primary product is TempTraq, which is a wearable, continuous temperature monitor that is designed for patients in clinical settings or remote patient monitoring environments. It’s an FDA-cleared device that is used by pharmaceutical companies and hospitals for early detection of fever.

What is the clinical value of having a patient’s temperature continuously monitored?

Temperature is the only vital sign that is not continuously monitored outside the intensive care unit phase. Temperature taking has been done globally the same way for about 150 years. It is done intermittently, taking the temperature once every four hours. In a number of disease states, patients deteriorate more quickly than within that four-hour window. That is where TempTraq plays a role, such as in oncology, where you have immunocompromised patients, or post-surgery where you are looking for infection, sepsis, or infectious disease.

The American Society of Clinical Oncology’s guideline for the US is that neutropenic fever should be treated within one hour, but they still only take their temperature once every four hours. The benefit of doing something continuously, as is done with pulse oximetry and blood pressure, is that identifying that fever early allows you to intervene sooner.

How does integration with other systems work, such as turning the stream of temperature data into something actionable?

We have designed the system to feed data into an electronic health record. EHRs are records of truth, but that is “records” as opposed to “monitoring devices.” We have a HIPAA-compliant cloud architecture called TempTraq Connect. We provide the hospital with a dashboard for real-time monitoring that can monitor either inpatients or those in remote settings, or we can push that information to their own internal systems. For example, it can go into an EHR, but we’re bringing a process live now where we are pushing data to the Vocera badging system so that nurses who are specifically aligned to rooms are getting actionable data in real time. It’s a flexible system.

What is the task management that is involved in changing a patient’s disposable patch?

Doctors we talked to at the outset of the design cycle asked for two features. The patch needs to be uniquely identifiable so you can associate a dataset with a unique ID, and then further associate that with a patient. Second is disposability. We are measuring the axillary temperature of an infectious disease patient for up to 72 hours. They don’t want to sterilize that device.

We have two versions that we sell into the hospital setting. We have a one-time use, 24-hour device and a one-time use, 72-hour device. When it’s done, you dispose of the device. The system will give you an alert 30 minutes before the end of its run time that it’s time to change that patch.

Is battery life the life-limiting factor?

Interestingly, it is not. It was a surprise in the development cycle that one of the more difficult things to get right was the adhesive. We wanted FDA clearance for all ages, which we have. We use a very gentle adhesive that is silicone gel based. That allows us to use that patch on all ages. But at the same time, we found that, particularly in adult patients wearing the 72-hour patch, the very gentle adhesive drives the end of life at 72 hours from both a hygiene and adhesive perspective. We certainly could design a patch that would run longer based on that battery, but the adhesive and hygienics were the limiting factors we found in our clinical studies.

What does the connectivity to the patch look like?

We use Bluetooth Low Energy. We are sending that signal in a hospital setting to a Bluetooth gateway that we install. It is specifically listening for TempTraq devices. That data is sent back to TempTraq Connect, our HIPAA-compliant cloud. For patients in an outpatient setting, they download our patient application to their device or use a device that is provided by the hospital or the pharmaceutical company that is running that software. Then the same thing happens to data. Once it gets Bluetooth from the patch to the phone, it is transmitted to TempTraq Connect.

Some consumer wearables, such as the Oura Ring, can measure temperature. How good is the reliability and accuracy of those devices versus TempTraq, where you had to prove your capabilities to the FDA?

The FDA is very prescriptive in terms of what is required to use a device as a clinical thermometer, which is the category we are in. FDA requires being compliant with the ASTM E1112 standard, which is plus or minus 0.1 degree Celsius within body temperature range. Beyond that, we also did clinical studies to show accuracy. We did our gold standard test at the Cleveland Clinic, where they were comparing TempTraq to readings from a pulmonary artery catheter in the chamber of the heart. The concluding statement of that study was that TempTraq was in agreement with core. Beyond what the FDA requires in terms of testing for submission, we also did human testing to show that that validation occurred on patients.

We’re seen a wide pandemic rollout of thermometer guns and walk-through fever-detecting frames that seem to offer limited accuracy and usefulness. Does that make people wary that devices like yours can actually work?

I think we’ve all had the experience of somebody using a gun and measuring our temperature at 94 degrees or something like that, hoping that it is still consistent with life. We are conscious that they have been used widely and are fairly erratic. We don’t generally run into those types of devices in the clinical setting, which is our primary market, so we don’t really view those as competitive devices. We make sure that people are familiar with the clinical studies and the standardized testing that we’ve done.

The “normal” temperature of people isn’t always the same 37 degrees Celsius. Is the change in someone’s temperature as important as its value at any given snapshot of time?

Absolutely. It has been studied over time that fever profiles across disease states have a distinctive footprint. The point that you made is a really important one, which is that 37 degrees Celsius or 98.6 degrees Fahrenheit is widely considered normal. But long, large studies have found that someone’s normal can have a standard deviation of plus or minus one degree Fahrenheit. Having a baseline and being able to look at trend data can absolutely be valuable when you are working with patients.

Is the future of the company always going to be related to temperature monitoring, or does your experience with patch technology provide more opportunities?

We view TempTraq as a platform. We have developed an unique database of continuous temperature data. Given the fact that there isn’t a lot of continuous temperature monitoring done outside of an intensive care unit, that makes that data more interesting.

We are looking at two areas of expansion. One is work that we are doing relative to being predictive around early warning. We have engaged with Adam Perer, PhD at Carnegie Mellon University to help us work on doing some of the artificial intelligence work around our network.

The other is looking at moving from univariate to multivariate, taking additional sensors and sensor readings into our database to help with that early warning score concept. But the other is looking at additional devices. We have a unique form factor in the TempTraq device. We will be looking at adding additional sensors to it, likely with a different device because the placement in the axilla under the arm, for example, is not a location that you would typically monitor another vital sign. So to do it effectively, we are probably looking a second device where we could bring in data from another vital sign.

Do you have any final thoughts?

It has been a really interesting year. If you go back 15 months, remote patient monitoring and telehealth were on the horizon, but hadn’t taken a foothold in the healthcare industry. COVID certainly has accelerated that. We have seen a breakdown of regulation to allow telehealth acceptance. We have seen a greater healthcare provider acceptance of telehealth. With that acknowledgement, there is a need to do remote patient monitoring. Not just temperature, but across all the vital signs. A lot of hospitals that we are engaged with today have initiated remote patient monitoring strategies, and we are hoping to work with them as they think through what that will look like.

There is a whole continuum of possibilities across different patient populations. We are an element of that, but it is certainly a multifaceted array of sensors that are being looked at to see what particular patient populations are most effectively tracked in the home setting. If you think about remote patient monitoring, going back a year, it really was around population health and chronic care, and now it is accelerating into the acute care setting. That is important for patients and important for overall healthcare cost. It’s an interesting time to be part of it.

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