Monday Morning Update 5/20/24

Top News

The all-important KLAS report on the US acute care EHR market finds that Epic gained 153 hospitals in 2023 while losing none, while all other vendors showed a net loss of hospitals and beds. Epic now holds a 39% market share of US hospitals, representing 52% of beds.

Oracle Health finished last in losing a net 71 hospitals representing 15,000 beds.

Most of Oracle Health’s wins since 2016 have been in standalone hospitals of under 200 beds. Those hospitals aren’t buying due to economic pressures.

Meditech, which enjoyed an all-time high customer retention rate of 84% in 2022, saw that drop to the lowest-ever 30%, with 25% of that due to M&A.

Reader Comments

From Benny Jets: “Re: article naming the top 10 healthcare AI companies. Most of the list is obvious, but the interesting name is Merative. This is the IBM Watson Health spinout that is led by Gerry McCarthy. In two years, they have reversed the ridiculous IBM strategy and have led each of the core solutions back to the top of their respective markets. Big tech shouldn’t be allowed in healthcare. It is just a matter of time before Oracle drives Cerner into the ground and Francisco Partners buys and fixes that too.” IBM sold the business – which includes the former Truven, Merge Healthcare, and Curam — to Francisco Partners for a reported $1 billion in 2022, after which it hired Gerry – who has spent nearly 35 years in our industry — and renamed itself. I’m not linking to the article in the UK-based magazine because that publication reeks strongly of pay-for-play, it does not include the criteria of how it chooses its many click-baity Top 10 lists, and nobody involved seems to have any experience or knowledge about healthcare. I also don’t know how much AI is used in Merative’s offerings or why even cursory research should have caught the May 2024 list’s inclusion of Babylon Health, a pretty scammy company that filed bankruptcy and died an ugly death last summer. But I agree that Merative is flying under the radar and seemingly shedding the Watson Health baggage.

HIStalk Announcements and Requests

Most poll respondents support the idea of a mandatory, government-issued national patient identifier, although thoughtful comments address the realities of making that happen.

New poll to your right or here: does your business card or email signature list a certification or fellowship credential?

I’m watching more YouTube videos as their quality has improved – documentaries, concert videos, and travel recaps. My use and satisfaction has always been limited by intrusive ads (not Ryan Reynolds again), but I wasn’t willing to spend $18.99 per month to avoid them. I was happy to find that I don’t need to since YouTube Premium is only $13.99 per month or $11.67 if paid annually, provided that you buy it from the website and not the IOS app, where Apple’s 30% skim will cost you an extra $5 per month. There’s also a 90-day free trial. I’m enjoying the ad-free experience, the ability to download videos, playing videos in the background, and the surprisingly strong Apple Music, which I would use constantly if I didn’t already have Spotify Premium. Dig beyond the narcissistic, TikTok style dreck that is good only for wasting time while stunting your brain and you’ll find some solid content out there. Not only that, the experience is stupendously better when played on the big screen.

I’m finding that I use ChatGPT more for web searching. It’s like a pleasant vacation from Google’s ads, spam, and SEO-juiced junk content. I see why Google started holding emergency meetings basically the day that OpenAI released ChatGPT 3.5.

Readers funded the Donors Choose teacher grant request of Ms. I in New York, who asked for STEM manipulatives for her class of three year olds. She reports, “I hope this note finds you well and filled with the same warmth and gratitude with which our classroom overflows, thanks to your incredible generosity. As a teacher, witnessing the excitement and enthusiasm radiating from my students as they engage with the STEM supplies you’ve provided fills my heart with. Your generosity has transformed our classroom into a dynamic learning environment where curiosity thrives, creativity flourishes, and innovation knows no bounds.”

Webinars

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

Acquisitions, Funding, Business, and Stock

Waystar is reportedly considering a June IPO after tabling those plans last year due to market conditions.

Sales

• Sturdy Health will implement Notable’s healthcare operations platform, integrated with Oracle Health, for patient outreach and self-service.

People

Cleveland Clinic promotes Sarah Hatchett, MBA to SVP/CIO.

Announcements and Implementations

The Toronto newspaper covers the Meditech Expanse rollout in 23 hospitals in northeastern Ontario.

Epic issues a rare press release in recapping the 9,000-attendee XGM (Expert Group Meetings) that concluded on May 9. It seems like a university’s Alumni Weekend, where people flock back to campus to once again to reconnect with with the like-minded in the hallowed halls, sit around the campfire, and pose for treehouse pictures. All that’s missing is a football game.

HCA Healthcare runs a Q&A with Chief Nursing Informatics Officer Sherri Hess, RN, MS-IS.

Privacy and Security

Ascension has issued no ransomware attack updates since May 15.

Other

Therapists are making more money as influencers who crank out empathetic TikTok self-help videos than they made seeing patients, according to The Cut, which quoted the therapist above who is making $1 million per year via brand deals, selling merchandise, and charging for subscriptions. Still, that therapist still warns that he’s burned out from making videos, dealing with hate comments, and working under a system where “Daddy Algorithm is my boss and I get a performance review every single day based on an algorithm that’s mysterious and doesn’t make any sense.”

Sponsor Updates

• HCTec sponsors the AltaMed Foundation’s annual golf tournament, supporting patients of the AltaMed Medical and Dental Group (CA).
• QGenda announces new and add-on customers of its enterprise credentialing solution, including UT Health San Antonio, Crouse Health, OB Hospitalist Group, and Parkland Health.
• Availity wins two Bronze Stevie Awards for sales and customer service.
• Wolters Kluwer Health launches Ovid Nutrition and Health, an exclusive interdisciplinary health research database.
• Redox releases a new Diagnosing Healthtech Podcast, “Data interoperability now: Why healthcare can’t afford to wait.”
• Hospital Universidad del Norte in Colombia selects Sectra’s enterprise imaging technology.
• Spok publishes an e-book, “Six strategic advantages of consolidated contact centers.”

Blog Posts

• Building more effective health systems through social determinants and patient-centered approaches (Nordic)
• The Impact of AI Trust and Literacy in Your Health System (Optimum Healthcare IT)
• The Nurses of Note 2024: The Infusion Nurse and ‘Ambassador of Enjoyment’ (PerfectServe)
• Leverage Innovative Technology to Drive Pharmacy Growth and Enhance Patient Care (RxLightning)
• Real-Time Prescription Benefit Goes to Work for Health Systems (Surescripts)
• 4 Current Legal Issues in Healthcare (Symplr)
• How to Identify and Address Weak Points in Your Revenue Cycle (TruBridge)

Contacts

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

Morning Headlines 5/17/24

Lawmakers propose more scrutiny of VA’s new EHR, reauthorize VET-TEC program

The House and Senate Veterans’ Affairs committees introduce legislation related to the VA’s implementation of Oracle Health that calls for, among other things, the contract between the two organizations to be cancelled if the VA can’t provide metrics that show overall improvement.

Beth Israel Lahey scores $400M MassDevelopment bonds for real estate

MassDevelopment issues $400 million in tax-exempt bonds to fund Beth Israel Lahey Health’s real estate and upgrades to Epic.

Former executive for medical records firm gets probation for trying to obstruct opioid kickback probe

Three years after pleading guilty, former Practice Fusion Director of National Accounts Steven Mack is sentenced to one year of probation and 40 hours of community service, and ordered to pay a $20,000 fine for attempting to obstruct the federal investigation into the relationship between Practice Fusion and Purdue Pharma.

News 5/17/24

Top News

The House and Senate Veterans’ Affairs committees introduce legislation related to the VA’s implementation of Oracle Health:

• Rollouts will be paused until the facilities that are live on the system “have recovered to return to normal operational levels.”
• The project and the VA’s Oracle Health contract will be cancelled two years after the bill is passed unless the VA can show metrics that prove overall improvement.
• The metrics that the VA reports to Congress would be expanded to include user adoption, employee satisfaction, and employee retention.
• The VA will be required to provide an additional report to Congress that provides the cost and module-by-module status of its legacy VistA system.

Reader Comments

From Slow Green: “Re: Greenway Health. Tiffani Misencik, chief revenue officer, has departed.” I compared the company’s executive page to the year-ago version and note these changes:

• No longer listed: Tiffani Misencik, chief revenue officer; Terri Gonzalez, chief HR officer.
• Newly added: Frank Piraino, chief of staff; Mark Goodwin, SVP of Greenway Revenue Services; Brandi Kline, VP of marketing; Nallajerla Murthy. GM of Greenway Health India.

From Sprinter: “Re: Vince Ciotti’s HIS-tory series. Do you have a link to the file?” The 1,400-page file that the late Vince wrote for HIStalk over the years covering the industry from the 1960s to the 1990s is here. I ask him in a 2019 conversation what his epitaph would say, to which he replied, “If I could be remembered for anything, it would probably be my HIS-tory files, which I thank you for posting over such a long time, two and a half years. I hope some of the future CIOs read them and learn from them. I hope that’s what they remember me by, the guy that warned them about not repeating these mistakes of the past.”

Webinars

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

Acquisitions, Funding, Business, and Stock

The Wall Street Journal notes that hospitals raised prices 7.7% in April, the largest increase in 13 years.

Sales

• Group Health Cooperative of South Central Wisconsin will offer 24×7 virtual urgent care visits via MyChart from KeyCare.

Announcements and Implementations

Epic will roll out a “patients like this one” type tool to its users in Indiana this summer. It will compare the active patient’s chart to Epic’s Cosmos database to help doctors make decisions about treatment options.

Meditech reports that its clients took three of the top five top digital maturity scores among NHS trusts and Integrated Care Systems.

Get-to-Market Health announces Commercial Health Check, a fixed-price review of a client’s go-to-market efforts that details areas of strength and potential improvement. The company’s principals are Steve Shihadeh and MP Brock Zimmerman, who have spent their entire careers in digital health.

MassDevelopment issues $400 million in tax-exempt bonds to fund Beth Israel Lahey Health’s real estate needs and its upgrades to Epic.

Transcarent adds AI-powered patient navigation to its system, which provides a single app and log-in for members to access their benefits, obtain medical advice, and initiate virtual care.

Athenahealth announces GA of AthenaOne modules for women’s health and urgent care.

Epic announces that two of its hospitals in the Netherlands are the first to use its AI-powered patient summaries, presumably in the Dutch language.

Privacy and Security

Ascension has posted no news on its Cybersecurity Event Update. Regional updates indicate that pharmacies still can’t fill prescriptions, patient care may be delayed, and results from imaging and tests may take longer. From press reports:

• One patient whose doctor hadn’t seen her pulled out her own IV and left.
• Another said they can’t get their scheduled chemotherapy.
• A post-surgery patient couldn’t get pain meds because there’s no record of the procedure.
• Patient class action lawsuits have been filed.
• A family member of a patient who died at an Ascension hospitals says they can’t proceed with cremation because the hospital can’t access her cause of death.
• An ultrasound tech says that some areas have working fax machines, while others don’t, adding, “We don’t really have a lot of direction from anyone in upper admin or management.”
• A nurse at an Ascension hospital in Nashville describes the situation as “pure and utter chaos from the second you walk in the door.”
• Ascension Via Christi sent several ICU nurses home after they raised concerns about inadequate staffing.
• Some nurses worry that a mistake made due to the lack of electronic patient safety checks, such as those offered by drug dispensing cabinets and bedside barcoding, could jeopardize their licenses.
• The local paper reports that Ascension Seton medical offices in the Highland Lakes area of Texas have had their systems restored.

Australia’s federal government investigates a ransomware attack of Melbourne-based MediSecure, which offers an e-prescribing system. The company says that it has been affected by a cybersecurity incident. Its website and phone lines are down. It suspects that the incident originated at one of its vendors.

Sponsor Updates

• Five9 employees volunteer in their local communities as part of Five9 Day.
• First Databank expands its Meducation Solution medication instructions to include translations of Hindi and Punjabi.
• Health Data Movers publishes a new episode of its “QuickHITs” podcast titled “Advancing Health Equity through Technology: A Conversation with Dr. Julia Skapik.”
• FinThrive releases a new Health Rethink Podcast, “Health Equity is Earned, and Learned!”
• Healthcare IT Leaders releases a new Leader to Leader Podcast, “Building a Purpose-Driven IT Organization.”
• Inovalon publishes a new case study, “Guardian Angels Senior Services Sees Overtime Drop with Smart Scheduling.”
• The HITea with Grace Podcast features KeyCare Chief Medical Officer Carrie Nelson, MD, “Dr. Carrie Nelson Spills the Tea on Telehealth Patient Safety & Quality.” 

Blog Posts

• Transforming Health Plan Operations with Digitized Claim Appeals (Availity)
• Evidence-based information in the EHR supports teamwork and an improved clinician experience (Wolters Kluwer Health)
• 2024 Connect Summit Recap: Building a Better Social Safety Net (Findhelp)
• From Legacy Systems to Workday: Managing Scope, Integrations, and Team Dynamics (Health Data Movers)
• How to Protect Your Healthcare Organization Against Social Engineering (Fortified Health Security)
• Embracing the Digital Transformation: Navigating the Ethical Frontiers of AI in Healthcare (InterSystems)
• The Critical Role of Early Detection of Stroke Risk: A Guide (Lucem Health)
• Denial Management in Healthcare: Benefits, Strategies & Key Trends (Medhost)
• Spotting medical provider burnout: A call to action (Meditech)
• What is a SOAP Note? (Net Health)

Contacts

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

EPtalk by Dr. Jayne 5/16/24

I was back in the patient role this week, visiting a different hospital for my annual MRI. I was glad that the high-risk clinic at Big Academic Medical Center offered me the option to have it done at a branch hospital, which shaved 30 miles off my travel.

The hospital is relatively new. Each person coming in is greeted personally and their appointment is searched in the system to make sure that accurate wayfinding directions are provided. When I arrived at the radiology waiting room, there was a check-in line backed up due to a patient who was confused about whether he could go home or not.

Once the line cleared and I made it to the desk, I noticed that there was a sign inviting people to check in via the kiosk, but unfortunately the sign had been completely blocked by the long line of waiting patients. Additionally, looking at the situation with a process improvement eye, I noticed that the kiosks were on the back wall of the waiting room – functionally behind you as you came in – so you weren’t likely to see them.

Part of my check-in involved a paper MRI screening form on a clipboard, so I’m not sure the kiosk would have helped anyway. I haven’t gotten a pacemaker, deep brain stimulator, or other implants since yesterday when I completed my online check-in, so I’m not sure why those questions couldn’t have been formulated into a patient questionnaire that I could have completed while in my pajamas.

The study went smoothly and I slept through a big part of it, which is a plus considering how noisy an MRI can be. The noises were a little different than I’m used to because it’s a different machine, and the last sequence sounded a bit like the cicadas that have descended on my area.

When the technician returned to the room to free me from the scanner, she said she noticed on my chart that I’m a physician and asked where I practiced. I talked about my work in virtual healthcare, and that I work from home for the most part. She said she thought that was cool, but when I mentioned that it probably wasn’t applicable to working in radiology, she said I would be surprised.

She mentioned that since the scanner manufacturer is based in Germany. The process for scanning patients there has more physician involvement. They actually have protocols for remote scanning, where the physicians operating the machines work from either a control center or from their homes. This facility recently piloted it, and although results were good, it relied heavily on having a certain level of support staff at the bedside that doesn’t match up with how roles are defined in the US. Additionally, the hospital felt that there was too much liability for it to be successful in our current environment, so the pilot concluded with a determination that more investigation is needed.

I always enjoy having a serendipitous moment like this and learning something new. But as far as other opportunities discovered on this visit, if you’re a radiology director, you might want to visit your waiting rooms and assess the positioning of signage and kiosks. 

HIMSS has opened its call for proposals for the 2025 conference, encouraging potential presenters via email to “lead conversations and make waves.” One could have some marketing fun with the “make waves” idea if the conference were held somewhere near a large body of water, such as San Diego or New Orleans, which would be welcome additions to the venue rotation in my opinion. Instead, next year’s event is in the desert, which doesn’t really apply.

Regardless, the email prompted me to go ahead and make my hotel reservation since Las Vegas hotels are often disgustingly expensive. I usually stay at The Palazzo and was sad to discover that even 10 months in advance, not a single standard suite was available on the Wednesday of the conference. I tried different occupancy types to confirm and had no luck. It just seemed weird. Maybe they are saving all of those for exhibitors rather than attendees? Nonetheless, if you’d like to submit a presentation, you can do so through June 10 at 5 p.m. Central time. In the mean time, I’ll stick with the two queen beds and see if any of my friends want to cost share since the room wasn’t cheap.

I’m always on the lookout for practical applications of AI technology that cut through the hype that currently swirls everywhere. This write-up from Missouri S&T caught my attention, especially a photo caption that had an electrical engineering graduate student looking through a dermatoscope to learn more about skin cancer since his team was working on solutions to improve detection. Joe Stanley, PhD is a professor in computer engineering and recently received a $440,000 grant from the National Institutes of Health on a project that will tag existing skin photographs then employ machine learning to expand the usefulness of existing data.

Given the fact that the solution will be used by physicians, it’s critically important that those developing it understand what goes on in a medical office and how physicians use data and tools to care for patients. There are far too many solution development teams out there that don’t take this vital step, so kudos to this one for helping researchers better understand the field they’re trying to improve.

Another headline that caught my attention this week was about a hospital getting rid of passwords for nurses. Unfortunately, it was a mindless blurb about transitioning from passwords to a badge reader system on an innovation unit. I’m not sure how innovative or newsworthy that really was since we had that at my primary hospital sometime in the neighborhood of 2016 and I’m sure it was at other places before that. Must have been a slow news day at Becker’s, or maybe just a diligent placement effort by a solid marketing team.

I heard from a reader this week who has been forced to participate in his company’s Return to Office program despite the fact that none of his team works in the local office. Apparently the company is trying to promote “new, exciting offerings in the cafeteria” to reduce the sting of coming to the office three days each week. The day’s offering was heavy on salami, onions, and other aromatics that I’m sure would make people prefer to be on a video call afterwards than in an in-person meeting. The office also issued guidance on how employees should communicate with family when they’re stuck at work at the end of the day, encouraging them to just say that they are delayed without hinting that meetings are running late or that anything is less than perfect at the company. That’s just about the worst micromanagement I’ve seen, and I’ve seen a lot.

What’s the worst micromanaging tactic that you’ve experienced from an employer? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 5/16/24

New Orleans Startup Secures $13.6M for Patient Care Coordination

Care coordination software vendor Watershed Health announces $13.6 million in new funding.

Missouri Launches Pioneering Statewide Digital Health Initiative to Transform Crisis Response and Behavioral Health Care

The Missouri Department of Mental Health and Missouri Behavioral Health Council will use technology from Chorus Innovations to develop MOConnect, a digital tool that will help coordinate care between crisis lines, crisis centers, mobile teams, and referral networks.

SmarterDx Raises $50M to Bolster Hospital Revenue Integrity and Quality with Its Clinical AI Solution

SmarterDx, which uses AI to audit and review medical claims, raises $50 million in a Series B funding round.

Healthcare AI News 5/15/24

News

OpenAI releases GPT-4o (the “o” stands for “omni”):

• All users, including those who use the free plan, will have access to the new version.
• Users can carry on voice conversations with ChatGPT with faster responses and can interrupt it when it is talking.
• The system can perform real-time language translation.
• It can interpret photos, screen shots, and other documents in real time.
• It can return real-time information from the web.

Google announces enhancements related to Gemini AI:

• Addition of 1.5 Flash, which is optimized for speed and efficiency with a lighter weight than 1.5 Pro.
• Adding audio understanding to Gemini 1.5 Pro.
• Extending Project Astra, the next generation of AI assistants that can understand real-time video and conduct conversations about what it sees, which can be extended to phones or glasses.
• Adding Gemini-powered AI Overviews to results from Google Search.
• Enhancing Google Photos with Ask Photos, which can find photos in response to user queries.
• Enhancing Gmail with generation of summaries and replies, complex search and the ability to analyze attachments.

Google launches AlphaFold3, which offers a 50% improvement in analyzing and predicting molecules for biology-related research and drug discovery.

Business

CLEW Medical’s learning models for predicting patient deterioration receive FDA’s 510(k) clearance

An Amazon Web Services blog post describes how Japan’s Fujita Health University used Amazon Bedrock’s managed AI service to generate discharge summaries, which it says reduced time requirements by 90 minutes to about 1 minute per patient.

An interesting Forbes article features digital health Investor Glen Tullman:

• He says that telehealth is dead, declaring that “all of the virtual care we’re doing now is going to move to chat.”
• His latest venture Transcarent – which has reached a $2.2 billion valuation for its chat-based primary care services —  is creating an AI chatbot that can answer a patient’s questions about their health plan, such as those that are related to deductibles and in-network doctors.
• Tullman says that Transcarent’s $100 million acquisition of 98point6 in 2023 gave it 1 million doctor-patient chat conversations that it is using for AI validation and testing.
• He says that Teladoc Health – onto which he unloaded Livongo for $18.5 billion in 2020 – saw its market cap shrink to around $2 billion because of poor leadership and the high cost of conducting video visits.

Sift Healthcare raises a $20 million Series B funding round to expand its AI tools that tie clinical information to financial outcomes to predict “adverse payment outcomes” and calculate patient responsibility upfront.

SmarterDx, which uses AI to audit and review medical claims, raises $50 million in a Series B funding round.

Other

A Wall Street Journal report on how professionals are using AI profiles a Mass General primary care doctor who says that ambient documentation is “incredibly accurate,” never requires major editing of the notes it creates, and allows her to interact with patients rather than typing.

America in a nutshell: a researcher finds that ChatGPT creates more compelling GoFundMe pitches for donations from strangers to cover catastrophic medical expenses. He notes, however, that sometimes AI creates stories and images that are too polished, which turns off potential donors. A research team used ChatGPT to rewrite the stories of 900 medical crowd-funding projects, where it added emotion and direct calls-to-action to move people to open their wallets.

Contacts

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

Morning Headlines 5/15/24

Crosby Health Raises $2.2M in Pre-Seed Funding

Crosby Health will use $2.2 million in pre-seed funding to further develop its automated clinical appeals software.

CareCloud, Inc. (CCLD) Reports Q1 Loss, Misses Revenue Estimates

Ambulatory health IT vendor CareCloud reports Q1 results: revenue down 13%, EPS –$0.02 versus –$0.28, beating earnings expectations but falling short on revenue.

Augmedix Delivers 40% Revenue Growth for First Quarter of 2024

Augmedix, which specializes in AI medical documentation, reports Q1 results: revenue up 40%, EPS –$0.12 versus –$0.14, beating expectations for both.

News 5/15/24

Top News

Ascension’s most recent update from Monday evening reaffirms that it will take some time – no timelines were announced — for it to return to normal operation following its May 8 cyberattack.

The update confirms that the attack involved ransomware.

Ascension also added region-specific updates for its patients. It warns that it is unable to accept credit card payments, wait times will be extended, and that some of its retail pharmacies cannot fill prescriptions.

Webinars

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

Acquisitions, Funding, Business, and Stock

Specialty care coordination company Switchboard Health raises $6.5 million in seed funding. Health IT veteran Derek Baird co-founded the company in 2022.

A Black Book survey of 30,000 physician office leaders and practitioners about their response to the Change Healthcare outage finds that 92% of medical practices are navigating short-term fixes and long-term vendor solutions. Nearly all complained that they first heard about the cyberattack from sources other than Change Healthcare. Black Book also notes that healthcare organizations that are negotiating new clearinghouse contracts should consider the value of the data that is contained in their claims, rights to which may have been signed over to their vendor in their original contracts. The top-rated competitors to Change Healthcare are Veradigm Payerpath, Waystar, Experian, and Availity.

Sturdy Health (MA) implements Notable Health’s AI-powered patient engagement, intake, and payments software.

Adam Selipsky, MBA, CEO of Amazon Web Services, will leave the company after three years. He will be replaced by AWS sales and marketing SVP Matt Garman, MS, MBA.

CareCloud reports Q1 results: revenue down 13%, EPS –$0.02 versus –$0.28, beating earnings expectations but falling short on revenue, sending shares down sharply and valuing the company at $30 million.

Augmedix reports Q1 results: revenue up 40%, EPS –$0.12 versus –$0.14, beating expectations for both. Shares dropped 51% as the company announced lowered revenue expectations, which it attributed to providers pausing to evaluate competing AI offerings. The company’s market cap is $56 million.

Sales

• Elbert Memorial Hospital (GA) selects telehealth services from Equum Medical.
• Meditech chooses Ellkay to provide interface services, including supporting the technical infrastructure involved in implementing Expanse as Meditech-as-a-Service.

People

Alpha II promotes Ashley Womack to CEO.

Censinet names David Woska, PhD (PHD Consulting Services) CISO.

Justin Jacobson, MBA (Microsoft) joins Symplr as managing director/SVP of its contract and supplier management business.

Suzanne Delbanco, PhD, MPH, founding CEO of The Leapfrog Group and co-founder and executive director of Catalyst for Payment Reform, has died of cancer.

Announcements and Implementations

LG Electronics announces Primefocus Health, which offers digital health solutions for in-home care.

Nuffield Health, the UK’s largest healthcare charity, goes live on a new digital booking experience for health assessments with assistance from Lumeon.

Dandelion Health, which offers a real-world data and clinical AI platform, launches a clinical dataset of 200,000 patients who are taking GLP-1 drugs, as extracted from the systems of its non-academic health system partners.

Researchers that include Eric Topol, MD introduce medical image interpretation dataset MedInterp, which contains 13 million annotated instances across three modalities. It will support the development of the “learnable orchestrator” that they call MedVersa.

Meta will shut down its enterprise communication system Workplace and is recommending Zoom-owned Workvivo as its replacement.

Government and Politics

HHS offers new funding opportunities for projects related to accelerating the adoption of health IT in behavioral healthcare settings, and to developing novel ways to evaluate and improve the quality of health care data used by AI solutions.

The Idaho Department of Health and Welfare will likely end its contract with the bankrupt Idaho HIE unless the exchange improves transparency over security, financials, and employees. The HIE has spent $94 million of mostly federal tax funds, but a watchdog found that the 10-year-old organization has instituted few accountability measures.

Privacy and Security

Johnson Memorial Hospital (IN) President and CEO David Dunkle, MD says that the hospital is still feeling the effects of the ransomware attack that crippled its computer network in 2021: “We are forced to spend millions on cybersecurity, and we’re still suffering from higher insurance rates because of our attack, and we pay more than our peers, our same size peers do, because we had an attack. We see what Ascension is going through. My heart breaks for them because I’ve been there.”

Other

OpenAI’s newly announced GPT4o includes integration with the Be My Eyes app for the vision impaired. The ability for a blind person to hail a taxi as shown at the 0:35 mark is spectacular.

Sponsor Updates

• Availity and Waystar rank highest in physician customer satisfaction with clearinghouses during and after the Change Healthcare ransomware attack.
• CereCore releases a new podcast, “Cybersecurity Expert from Defense Weighs in on Healthcare’s Opportunities.”
• Consensus Cloud Solutions will sponsor the Colorado HIMSS Spring Conference May 15-16 in Denver.
• CloudWave will exhibit at the HIMSS New England Spring Conference May 16 in Norwood, MA.

Blog Posts

• Prior Authorizations as a Use Case for Solving Interoperability (Availity)
• KLAS Research Enterprise Imaging Summit 2024 – Insights from Kyle Souligne (Agfa HealthCare)
• Cutting Through Prior Authorization Headaches: Strategies for Providers (AGS Health)
• Celebrating nurses: The impact of digital nursing (Altera Digital Health)
• From data to decisions: Enhancing healthcare outcomes through strategic data use (Arcadia)
• Aridhia’s Role in Enabling New Alzheimer’s Research (Aridhia Informatics)
• How AI in healthcare could change patient care (AvaSure)
• Surveillance Watchlists: Proactively Monitoring Patients (CereCore)
• Ascension: What We Know & What You Can Do Now (Clearwater)
• AI-Powered Medical Scribe Integration within the EHR is Revolutionizing Clinical Documentation (EClinicalWorks)

Contacts

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

Morning Headlines 5/14/24

Switchboard Health Announces $6.5M Series Seed Funding

Specialty care coordination company Switchboard Health raises $6.5 million in seed funding.

HHS Announces LEAP in Health IT Special Emphasis Notice for AI and Behavioral Health Focused Projects in Fiscal Year 2024

HHS offers new funding opportunities for projects related to accelerating the adoption of health IT in behavioral healthcare settings, and to developing novel ways to evaluate and improve the quality of health care data used by AI solutions.

Avel eCare opens renovated headquarters with room to grow

Avel ECare, a telemedicine provider serving patients in 42 states, expands and renovates its headquarters in Sioux Falls, South Dakota.

Curbside Consult with Dr. Jayne 5/13/24

I have friends who work for Ascension. The concerns coming out of their facilities, which are offline due to a ransomware attack, are quite serious. It sounds like they haven’t done adequate downtime preparation, let alone preparation for a multi-day incident that has taken nearly all of its systems out of commission.

Mr. H reported in the Monday Morning Update about a patient who left one facility because it had been two days and he still hadn’t been seen by a physician. This is completely unconscionable. I hope regulators step in immediately.

Any hospital leaders in any organizations who are not aware of the current ransomware and cyberattack landscape should be removed from their positions of authority immediately. Hospitals need to be drilling for the eventuality on a regular basis. Not annually, but monthly.

I’ve written about this before, but one of the most serious near-misses of my career, which to me will always be a full miss, occurred during an EHR downtime, when the environment in my facility can only be described as chaos. No one knew where the downtime forms were. They were reluctant to engage downtime procedures due to a misplaced fear of “having to fill out a bunch of paperwork” that is required when they formally call a downtime.

I was working in what was essentially a freestanding emergency department at the time, although it was licensed as an urgent care. Due to that licensing, we could have easily stopped taking new patients while we got things sorted. However, the fear of repercussions from management was too great. They continued to bring patients into the exam rooms, leaving the clinical teams scrambling.

Once I found out what was going on and that we were still taking new patients, I called the downtime and demanded we stop bringing in new patients. There’s no need to worry about diversion, EMTALA violations, or turning people away when you’re not licensed as an emergency facility. I’ve been around long enough and practiced in enough challenging environments, including in a tent and out in the field with no support, to know that sometimes you just have to take charge.

Shame on these facilities that are putting patients at risk through lack of planning, lack of leadership, and focusing on the bottom line instead of focusing on the patients who are in front of them. I hope they’re providing counseling for the clinical team members who are experiencing profound moral injury as they are expected to continue to just do their jobs in an untenable situation. One person who reached out to me described it as a “battlefield” situation.

For those of you who are in administrative positions, I urge you to walk to the front lines in various clinical departments in your facility and start asking questions about downtime. It’s not enough to simply trust the reports that are coming out of planning committees and safety assessment committees. My free consulting advice: you need to put your proverbial boots on the ground to find out whether people know what to do or not. It’s not enough to perform phishing tests and to look at the reports that show that people are becoming less likely to click on sketchy links or to visit dodgy websites. People have gotten really good at watching those cybersecurity videos and picking the correct answer on a bland, five-question test.

What you need to know, though, is that when push comes to shove and someone has taken control of your infrastructure, do your employees know how to see patients? Kind of like when you’re drilling for an inspection by The Joint Commission and you expect everyone to be able to explain the PASS acronym for how to use a fire extinguisher (Pull, Aim, Squeeze, and Sweep for those of you who might not be in the know) you need to ensure that everyone knows how to successfully execute a downtime.

Back to PASS, though. Knowing the acronym isn’t enough. Does your team even know where the fire extinguishers are? If a random person came up to them during a time when there was no inspection, could they verbalize where to find them? A downtime is no different. All staff should be able to articulate what are the conditions that require that a downtime be called, how to initiate a downtime, the various roles of the team during downtime, how to find the “downtime box” or whatever supplies they need to use, what the downtime communication plan is, and how to manage critical patient care tasks in the near-term while the entire downtime procedure is put into place. 

Every single healthcare facility needs to know how it will handle a multi-week downtime. News flash: no one is immune to this, and anyone who thinks otherwise needs to seriously reevaluate their leadership readiness. Our facilities need staffing plans to help workers cope with prolonged downtime, including adequate double-checks and safety procedures to account for the loss of systems we’ve all grown to rely on, such as bar code medication administration (BCMA), allergy and interaction checking, and electronic time-out checklists.

At this point, and especially after the Change Healthcare debacle, no one has any excuse for keeping their heads in the sand and thinking, “It couldn’t happen to me.”

This weekend marked the opportunity to cross something off my bucket list without having to leave my home state to do it. The raging Level 5 geomagnetic storms are the first to hit Earth since October 2003, which was a time when I was knee-deep in building my practice and didn’t know a solar cycle from the citric acid cycle. Being involved in amateur radio for the last several years has taught me quite a bit about the former, and every day that I move farther from medical school has allowed me to forget more details about metabolic cycles than I care to admit.

As a “science person,” I’m happy to see this month’s expanded Northern Lights phenomenon capture the attention of so many people. I personally learned that the aurora comes in all different colors besides the most-often featured green. I hope there are children being inspired by it and considering future careers that involve exploring our universe and all the fantastic phenomena around us. Kudos to my favorite college student for capturing this amazing pic.

Were you able to see the aurora, or do you still have a trip to the northern latitudes on your bucket list? Leave a comment or email me.

Email Dr. Jayne.

Readers Write: Interoperability’s Last Mile – Universal Patient Consent and Access is Holding Us Back

Interoperability’s Last Mile – Universal Patient Consent and Access is Holding Us Back
By Lew Parker

Lew Parker, MSIS, MBA is chief technology officer of Arrive Health of Denver, CO.

As always, the latest round of health technology conferences has inspired us with new ideas for the application and value of interoperability in healthcare. The combination of existing and new technology offers tremendous potential to impact patient outcomes and provider experiences. There’s one last mile we’ve yet to cross, however – our business policies haven’t caught up to our technology, and we’ve fallen short on the key step for how true data sharing will work.

Healthcare interoperability is meant to create transparency, giving providers and patients the information that they need to make decisions about all types of things, including diagnoses, treatments, costs, and more. We’ve made great strides in developing technology to standardize how we share data, such as HL7 and FHIR, at a granular level. There are also shining examples of interoperability at work to tackle specific challenges, such as using real-time prescription benefit (RTPB) data to support patient affordability and adherence.

What’s needed to cover interoperability’s last mile is a federated, decentralized way to authenticate, access, and, most importantly, verify consent to that data.

This isn’t an impossible task or pie-in-the-sky recommendation. Think about when you register a website domain. You purchase the domain from a single registrar, point it to your server, and every DNS instantly knows where to route traffic. The registration isn’t centralized, but it is handled in a way that makes the ownership and access, managed by one registrar, available to all for verification and use.

For another example, look at how SSL certificates facilitate secure communications across the internet through a federated registry system, where trust is decentralized yet universally acknowledged. Over 100 trusted certificate authorities are providing this service. By applying a similar federated model to healthcare, we can enable seamless access to data while respecting the autonomy of individual entities within the network. Imagine what our world, and patient experience and outcomes, would look like if we achieved this same level of trust and access.

In a federated model, the focus shifts from establishing a single centralized governing body to an alliance of healthcare entities that agree on shared policies and standards for data use and access. Much work has been done to create these types of alliances, and we should leverage existing organizations if possible. This would:

• Create a single place for healthcare entities and partners to ping for information once patient consent is given.
• Streamline access to data, removing firewalls that we experience today because of contract or independent business policies.
• Foster innovation by providing an easy way to grant data access to trusted partners.
• Pave the way for patients to access, understand, and plan their healthcare in a single place.

In this future scenario, RTPB data has new potential. RTPB surfaces millions of real-time patient events a day, events like me getting a new prescription or having a prior authorization approved, that others could use to improve care delivery, lower costs, connect me to community resources, and a million things I have not thought of myself.

Without a unified way to provide access to this data, however, these opportunities to make my experience better cannot happen. Instead, to gain access to real-time information, each innovator and partner must establish 1-to-1 relationships and partnerships, each with their own policies, contracts, and requirements. Our systems become complicated and cumbersome as we must codify this variability into our interoperability applications. This ultimately slows down, and in many cases prevents, access to the very data that is needed to drive progress and health outcomes.

I am extremely proud of our industry for our interoperability achievements, and I remain positive about what’s to come. I also believe covering the last mile and achieving true interoperability in healthcare is going to require us to think more broadly and collaboratively about not only how we share data, but how we use it. It remains to be seen if TEFCA can provide the federated model that is required for success.

Readers Write: Unification of Content Will Unlock the Next Phase of Healthcare Innovation

Unification of Content Will Unlock the Next Phase of Healthcare Innovation
By Greg Samios

Greg Samios, MBA is president and CEO of clinical effectiveness of Wolters Kluwer Health. 

The pressures and challenges in the healthcare environment are numerous, from dealing with financial constraints to coping with severe staffing shortages. The situation is concerning and getting worse: 16.7% of healthcare facilities anticipate critical staffing shortages, one in four nurses plan to exit the profession because of overwork and understaffing, and disruption from cyberattacks has put many healthcare facilities on the brink of closure.

The stark reality is that 60% of physicians’ questions go unanswered daily and more than one in every 20 patients experiences preventable harm, incurring costs that are associated with medication errors of approximately $42 billion USD globally. 

Yet healthcare executives must strive to deliver the best possible patient care amidst continually evolving circumstances. The shape of healthcare has changed with new care delivery models for where and how healthcare is provided, from retail clinics to virtual health. Within this cyclone of change, healthcare enterprises are seeking scalable solutions that can not only improve patient outcomes, but also drive care team efficiencies and reduce care variability.  

Each day, healthcare providers turn to information and technologies to make care decisions and educate patients. Content and data underpin the continual information stream, but too often that content is based on disparate technologies that lack harmony, leading to inconsistent care decisions and inefficiencies that may exacerbate care variability.

In many cases, this disconnect is the result of solutions being added at different times to address different needs while forgetting to consider how they fit into the clinical workflow. For example, as COVID-19 arrived, many healthcare providers pivoted quickly to solutions to support remote and virtual care out of necessity. For many organizations, this resulted in relying on “best for need” vendor solutions to fill in immediate gaps, but not necessarily best address long-term, enterprise level goals. Today, however, like many industries, healthcare is looking for fewer vendors in seeking consistency, efficiency, and cost savings. 

Looking at this issue, the unification of content is a necessary next step for healthcare to facilitate seamless decision-making at the point of care and across the healthcare ecosystem. Harmonized content makes healthcare delivery easier for all members of the healthcare team, who can access the same information for treatment, drug dosing, and patient education to support better care.

Having consistent content also creates a vital underpinning to support and coordinate high quality patient care and eliminate care variability as healthcare adopts innovative technologies such as generative AI. In fact, both physicians and consumers have expressed concerns about the source of the content that is driving GenAI healthcare solutions, making it even more critical that there is a trusted and unified content solution for healthcare.

Unified content and solutions help align care teams and administrators to work together, rather than in disparate workflows, to deliver the best care for patients and position themselves for success in meeting current and emerging health challenges.

Morning Headlines 5/13/24

Cybersecurity Event Update

Ascension’s 140 hospitals in 19 states remain offline following a ransomware attack on Thursday.

#StopRansomware: Black Basta

The federal government issues a warning about the Ascension-linked Black Basta ransomware variant.

Senators call for VA to tighten performance standards in new health records contract

Three members of the Senate Veterans’ Affairs Committee call for the VA to take advantage of its recently renegotiated contract with Oracle Health to strengthen accountability and oversight terms.

Sift Healthcare Raises $20M Series B Funding Round to Enhance AI-Powered Payment Solutions

AI-enhanced RCM company Sift Healthcare raises $20 million in a Series B funding round led by B Capital.

Monday Morning Update 5/13/24

Top News

Ascension’s 140 hospitals in 19 states remain offline following a ransomware attack on Thursday. An unstated number of the facilities are diverting ambulances.

The health system says restoring the systems “will take some time to complete,” adding, “we will be utilizing downtime procedures for some time.”

Ascension advises patients to bring in their own appointment notes and prescription information. A hospital family nurse said, “Patients are getting harmed. No one can tell you otherwise.”

A patient who was hospitalized when the attacked started reports, “It was like 1980. Everyone’s running to get pieces of paper, charts, clipboards. They have no computers whatsoever. It was chaos.” The patient, a colon cancer survivor who was vomiting blood, left the hospital two days after admission because he still hadn’t been seen by a doctor.

CNN reports that the Russia-linked ransomware group Black Basta was responsible for the attack. The federal government issued a warning about its ransomware variant on Friday.

HIStalk Announcements and Requests

Here are the results from last week’s poll. For me, the convenience of co-locating a medical and dental practice with a big-box store doesn’t hold value since plenty of doctors and dentists have offices in easily accessible locations. Some respondent comments that I’m paraphrasing:

• Walmart shut it down because they can generate higher margins elsewhere. The company benefits only from bringing in more dollars per square foot, not from supporting “healthier communities.”
• Health systems know that primary care and pediatrics are loss leaders, but Walmart missed that fact. They can’t sell enough groceries and TV sets to make up the cost.
• Walmart didn’t differentiate its services. It was just a bigger box with more expensive executives who were disconnected from any kind of healthcare transformation. Still, the company probably isn’t done with healthcare and an acquisition is likely.

New poll to your right or here: Should the federal government issue a national patient identifier?

I was pondering another poll: which platform’s users have the apparent lowest IQ or technical capability, Facebook or Nextdoor?

I always offer a Summer Doldrums Sponsorship Special, which usually involves some free months for the first year. Contact Lorre. Former sponsors also get a deal for returning. All gain visibility with the most influential people in the industry, who read HIStalk quietly but religiously.

Webinars

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

Sales

• The Centers chooses Netsmart CareFabric, which includes the MyAvatar EHR.

People

Industry long-timer Dann Lemerand (Navv Systems) joins Otter Products as healthcare vertical lead. Dann created the 4,200-member HIStalk Fan Club on LinkedIn many years ago, of which I can’t cite any specific benefits except to my ego when it gets bruised.

Government and Politics

Three members of the Senate Veterans’ Affairs Committee call for the VA to take advantage of its recently renegotiated contract with Oracle Health – which changed the contract’s five-year term to five, one-year terms – to strengthen accountability and oversight terms. They note that poor service delivery in the previous five-year period resulted in just a few hundred thousands of dollars in credits being extended toward the $10 billion contract.

Sponsor Updates

• Wolters Kluwer Health publishes a new “UpToDate Point of Care Report: An enterprise approach to unify healthcare.”
• EVisit announces a business development partnership with digital consulting firm Monsterlab.
• TruBridge announces Multiview’s cloud-based enterprise resource planning software as its preferred financial management solution for its customers.
• Nordic releases a new Designing for Health Podcast, “Interview with Farhan Ahmad and Jon Keevil, MD.”
• PerfectServe honors 150 outstanding nurses in its fourth annual Nurses of Note Awards program.
• Sonifi Health will exhibit at the HIMSS Texas Regional Conference May 13-16 in Grapevine.
• Tegria publishes a new case study, “Custom Demo Environment Accelerates EHR Adoption.”

The following HIStalk Sponsors are named MedTech Breakthrough Award winners:

• Amenities – best online search and scheduling solution
• Nym – health administration innovation award
• Bamboo Health – best care orchestration platform
• Artera- best patient communication solution
• Elsevier – AI innovation award
• Symplr – best provider data management platform
• Inovalon – best data visualization solution
• Waystar – healthcare payments innovation award

Blog Posts

• Navigating Standards Upgrades Together (Surescripts)
• Supporting the human aspect of care in a world of increasing burnout (Wolters Kluwer Health)
• Protecting healthcare revenue flow: the power of a business continuity plan (Nordic)
• From Regulations to Reality: HIPAA Compliance and ServiceNow (Optimum Healthcare IT)
• Five Best Practices for Using Credentialing Workflows – Part Five: Track and Set Milestones (QGenda)
• Finding the future of interoperability with Redox – Part 3: How Carequality can solve disconnected data for digital health (Redox)
• What it Truly Means to Be Revuud (Revuud)
• 5 Ways Provider Credentialing Leaders Can Prepare for Big Spikes (Symplr)
• Negotiating Payer Contracts: Strategies for Favorable Terms (TruBridge)

Contacts

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

Morning Headlines 5/10/24

CareCloud Retains Citizens JMP as its Exclusive Capital Structure Advisor

CareCloud hires an investment bank to review its capital structure after it turns down an unsolicited acquisition offer.

DoorSpace secures $2M in seed round

Healthcare workforce management software startup DoorSpace raises $2 million in seed funding.

Guthrie Lourdes Hospital Experiences Communication System Issues

Guthrie Lourdes Hospital (NY) works to recover from a communications system outage that impacted phone lines.

Oracle’s $28 Billion Cerner Health Tech Bet Sputters With Lost Customers and Slipping Sales

Bloomberg reports that the former Cerner business lost at least 12 large clients in 2023.

News 5/10/24

Top News

Ascension’s 140 hospitals and 2,600 healthcare sites in 19 states divert patients and go back to paper documentation following an unspecified cybersecurity event that forced the health system to take down “select technology network systems” Wednesday morning.

Ascension has urged its business partners to disconnect from its systems, which would suggest a ransomware attack.

Hospital visitors say that they saw younger doctors struggling to use fax machines, pneumatic tube systems, and paper prescription pads for the first time.

Reader Comments

From Rashaverak: “Re Steward bankruptcy filing. Hoping that the Commonwealth of MA sues Cerberus Capital to recoup some of the nearly $1 billion profit via its fleecing of Steward’s MA hospitals. Steward spun off its MA real estate to a real estate holding company for $1.25 billion in 2016. It appears that none of those dollars went into improving Steward patient care, but more likely to Cerberus’ pockets.” Blame the game, not the player, for employing immoral but not illegal behavior to do what private equity (aka pirate equity) firms do best – buy a company, load it with debt, pay investors all their money back immediately, and then walk away with bro high-fiving when the business is financially starved because it can’t even pay the interest on the loans that were taken out in its behalf. I’m sure that Steward chairman and CEO Ralph de la Torre, MD is anguishing over the plight of patients and communities from his $40 million yacht that operates out of the Galapagos Islands (one of two that he owns). He awarded himself a $100 million bonus when Cerebrus quadrupled its investment by selling the land from under its hospitals, pocketing $800 million.

HIStalk Announcements and Requests

Last chance for HIStalk sponsors to get a free mention in my guide to the MUSE Inspire conference. I have just one response versus the several companies that are exhibiting, so my work will be minimal.

Webinars

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

Acquisitions, Funding, Business, and Stock

CareCloud hires an investment bank to review its capital structure after it turns down an unsolicited acquisition offer. CCLD shares have lost 64% of their value in the past 12 months and are 91% off their all-time high, valuing the company at $17 million.

A Bloomberg report that is based on interviews with former Cerner clients and employees concludes that the business lost at least 12 large clients in 2023. Bold product ideas have been placed on hold as Oracle’s engineers struggle with moving the Cerner product to the cloud. Internal documents predict that Oracle Health sales will decline 5% this fiscal year due to the VA project’s hold. Insiders say that Larry Ellison’s boasting that most Cerner clients have been moved to the cloud is accurate, but misleading – it’s a bunch of small medical practices, but no huge health systems that are likely to have customized the product.

People

NextGen Healthcare hires Jacob Sims (Gainwell Technologies) as CTO and Garo Doudian (Moody’s Analytics) as CIO/CISO.

Nisha Gandhi, RN, MBA (AbleLight) joins KeyCare as chief growth officer.

Nordic hires Stuart McLean, MBA (Alvarez and Marshal) as interim CEO following the retirement of Jim Costanzo. The company also lists Uyon Johnson, MBA (Bon Secours Mercy Health) as interim chief human resources officer.  

Announcements and Implementations

Valley Health System (NJ) opens a new “smart hospital” as its flagship in Paramus, which uses Meditech Expanse, in-room monitors to allow patients to review their medical information and manage room environment, RTLS-based display of the names of caregivers who enter the room, and AI-powered fall monitoring.

Customer experience app vendor Ushur releases a white labeled medication adherence solution for payers and pharmacy benefit managers.

Privacy and Security

Some systems at Palomar Health Medical Group (CA) remain down after the organization took them offline following suspicious computer activity on Sunday.

Sponsor Updates

• Symplr launches a new Symplr Workforce mobile app feature to enable healthcare professionals to nominate nurses for a DAISY Award.
• FinThrive publishes a new case study, “McCurtain Memorial Hospital Cuts Weekly Verification Time by 30 Hours with Real-Time Insurance Discovery.”
• Arcadia publishes a study that finds that nearly half of all healthcare data is not used in decision-making.
• HCTec will sponsor the Texas Regional HIMSS Spring Conference May 14-16 in Grapevine.
• The Medicomp Systems Tell Me Where IT Hurts Podcast earns an honorable mention in the PR News Digital Awards program.
• Mobile Heartbeat partners with technology consulting firm Signet.

Blog Posts

• Empowering Nurses for Effective Bedside Medication Counseling (First Databank)
• Solving the Top Challenges of Prior Authorizations in Healthcare (FinThrive)
• Is “Sorry” Good Enough? Insights from UHG’s Change Healthcare Testimony (Fortified Health Security)
• How Healthcare Risk Adjustment and Detailed Documentation Can Improve Member Care (Inovalon)
• Reveal: The Future of Lung-Cancer Detection (Lucem Health)
• How EHRs Help Nurses Balance Care Planning (Medhost)
• Using innovative technology to drive quality improvement efforts (Meditech)
• Choosing the Right QPP Reporting Method of MSSP ACOs in 2025 (MRO)

Contacts

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

EPtalk by Dr. Jayne 5/9/24

The American Medical Informatics Association is working with the Patient ID Now Coalition to persuade members of Congress to reject language in Section 510 of a 2025 appropriations bill that continues to ban the US Department of Health and Human Services from investing money towards a national unique patient identifier.

Organizations are still using a hodgepodge of matching algorithms that often work, but sometimes don’t. There are particular challenges with pediatric patients when organizations include phone numbers in the algorithm. Infants who might not yet have a Social Security number are also at risk. I’ve seen EHR conversions that inadvertently combined a pair of infant twins due to inadequate matching algorithms, so I would very much like to see a unique patient identifier even if it’s voluntary and patients have to opt in. The risks to patient safety remain great and I want my care teams to have access to all of my data.

Also in Congress, the House Ways and Means Committee is entertaining a two-year extension of Medicare telehealth rules that have improved reimbursement since the COVID-19 pandemic. There are multiple bills under consideration, including the CONNECT for Health Act and the Telehealth Modernization Act. Without an extension, the rules will expire at the end of this year. Primary care docs are leaving my state’s rural areas in droves, and increased coverage would allow patients to have visits with physicians in other areas of the state without driving for multiple hours.

I’m so used to working in high-reliability organizations that it shocks me when I encounter an organization that probably should be more high-reliability than it is. I was at a large regional post office this morning, and apparently they had experienced a power outage and the electricity had just come back on. There was one customer at the counter and two in line, so the postal employee announced what had happened and asked for our patience as they rebooted the systems. It took a few minutes for her station to come back up, and when the customer was ready to check out, apparently the credit card machine didn’t work. She was sending several registered mail items, so went out to her car to rummage for cash or a checkbook.

The employee suspended her transaction and called me to the window, making an announcement to the dozen or so people that had accumulated in line that the credit/debit machine was down and that they could only take cash or check. Everyone behind me turned and left, and I was grateful that I had my friend Andrew Jackson in my wallet, although I haven’t carried a checkbook in decades. One would think that the US Postal Service would be critical infrastructure and have at least some level of UPS backup (uninterruptible power supply of course, not the competition) with generator backup. They can deliver despite rain, heat, and gloom of night, but a power outage is going to put a dent in things.

I’ve been a panelist for several Women in STEM events and am always on the lookout for ways to increase the number of girls interested in healthcare and technology careers. During a recent talk, one of my co-panelists talked about “The Scully Effect,”  which shows that women who watched “The X-Files” were more likely to pursue careers in STEM-related fields. According to 2017 data, 63% of study respondents who were familiar with the Dana Scully character admitted an increased their beliefs in the importance of STEM.

Many of the young women I work with weren’t alive when Gillian Anderson began playing Dana Scully in 1993, so it will be interesting to see who will be STEM role models for newer generations. Media popularity now seems to be centered on TikTok and various social media influencers, many of whom share unscientific and downright dangerous content. I’d love to see a campaign to raise awareness about the roles available to women in healthcare IT, since I’ve run across multiple medical students who didn’t have a clue that it was a career path.

Federal regulators in the US are taking a greater interest in the issue of organizational consolidation in healthcare. They’ve opened comments looking to understand “the effects of transactions involving health care providers (including providers of home- and community-based services for people with disabilities), facilities, or ancillary products or services, conducted by private equity funds or alternative asset managers, health systems, or private payers.” You can browse the submitted comments (1,400 so far) and see how frustrated patients, physicians, and other providers are with our healthcare non-system. Hot topics in the comments I screened include lack of competition, greed, hospitals requiring pre-operative labs to be done in-house at a higher cost than competitive labs, the negative effects of companies like CVS expanding their scope of business, and compromised patient care. All the talking heads in healthcare should have to understand comments like this one from Lindy:

I am a retired home health caregiver, as well as an American citizen who lives below the poverty line financially. It has been a lifelong struggle for me to access good healthcare, and it is only getting worse. Corporations are by design intended to maximize profit, and in the health care field, this translates into sacrificing the good of a human being for the profits of a corporation. Every human being should be prioritized over profit, failing that is to put money over humanity which degrades us all. How can it be that dollars are more important than a mother, a father, a child who is suffering and in need? It is cruel, heartless, and inhumane on every level. It is time to put the genie back in the bottle, prioritize human beings over dollar signs, and prevent moneychangers from having the ability to dictate who lives or who dies because of money. America must be better than that, and corporations must be kept in line with humanitarian priorities.

It’s National Nurses Week, so here’s a shout-out to all the nurses out there who are caring for patients day in and day out. Special props to my nurse informaticist colleagues, who have taught me so much about thinking about systems from different points of view.

Of course, there are still hospital executives behaving badly as they attempt to show gratitude to the people that make their facilities run. One example of a tone deaf gift choice was sent to me by a nurse in the Midwest. The hospital gave nurses lunch boxes, which felt particularly insulting to night shift workers since the facility removed all hot food service for them. They also require workers to use self-checkout for prepackaged items on the night shift. The only overnight worker is a cook who is doing prep work for daytime workers, who still have full food service, including salad bar.

It sounds like managers suspected that the gift wasn’t going to be well received and provided these adorable badge reels plus breakfast out of their own pockets.

What’s the most irritating thank you gift you’ve received from leadership? Leave a comment or email me.

Email Dr. Jayne.