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Morning Headlines 2/16/22

February 15, 2022 Headlines Comments Off on Morning Headlines 2/16/22

Athenahealth Acquired by Hellman & Friedman and Bain Capital

Bain Capital and Hellman & Friedman finalize their $17 billion acquisition of Athenahealth.

Memora Health Announces $40M Financing To Scale Platform for Simplifying Complex Care Delivery

Automated care management company Memora Health raises $40 million, bringing its total funding to just over $50 million.

$1.13M settlement proposed in Inmediata Health in lawsuit over 2019 data breach

Puerto Rico-based claims clearinghouse Inmediata will pay $1.13 million to settle a class action lawsuit filed by patients who were affected by a 2019 data breach in which the company failed to secure patient data online, enabling search engines to serve up PHI in search results.

Comments Off on Morning Headlines 2/16/22

News 2/16/22

February 15, 2022 News 7 Comments

Top News

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The $17 billion sale of Athenahealth to a pair of private equity firms has been completed.


Reader Comments

From Elizabeth Holmes: “Re: Circadia Health. Touts how they do remote patient monitoring, but FDA’s clearance says specifically that ‘The Circadia C 100 System is not indicated for active patient monitoring.’” I emailed the company to clarify, but haven’t heard back. The website says that the touchless system issues a daily report of respiratory rate and time in bed, which seems to be in conformance with FDA’s requirement that its system not be used to monitor vital signs and is “for retrospective analysis only.” Still, the company’s website touts its capability to “prevent the 3rd leading cause of death” in managing acute respiratory distress syndrome, COPD, sepsis, and pneumonia while earning post-acute care facilities a 2% Medicare incentive payment.


HIStalk Announcements and Requests

HIStalk sponsors who are exhibiting at or attending ViVE and HIMSS22 – click the link, complete the short form, and I’ll include you in my online and downloadable guide. You may recall from last week that my poll respondents gave as their #2 reason for visiting a booth as simply knowing ahead of time the activities that will be presented there, so share your plans and maybe get more feet onto your expensively rented carpet.


Webinars

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


Acquisitions, Funding, Business, and Stock

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PriorAuthNow, which offers automated, real-time prior authorization software for providers and payers, raises $25 million in funding. The company says its technology has helped Cleveland Clinic staff reduce the prior authorization process from 45 minutes to four minutes.

Kidney care company DaVita acquires transplant software vendor MedSleuth for an undisclosed sum.

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Radial Analytics, a patient care transition software startup based in Concord, MA, raises $3 million in funding.

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Automated care management company Memora Health raises $40 million, bringing its total funding to just over $50 million.


Sales

  • Community Health Systems (TN) selects remote patient monitoring and virtual care technology from Cadence.
  • Davis Health System (WV) will implement Cerner across its three hospitals beginning this summer.

People

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Azara Healthcare hires Todd Schlesinger (Jvion) as VP of sales.

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Patti Baran (Teladoc Health) joins AliveCor as SVP, Healthcare Americas.


Announcements and Implementations

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Little Rock Air Force Base Clinic (AR) will transition to the DoD’s Cerner-powered MHS Genesis system next month. The department plans on rolling out MHS Genesis at 54 facilities this year, which would see the technology deployed at more than half of all military hospitals and clinics.

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Guthrie County Hospital & Clinics (IA) will go live on Epic this weekend.

A Tegria-commissioned Harris Poll survey finds that 69% of Americans would consider switching providers to gain access to same-day appointments, convenient locations, and self-scheduling. More than half would be willing to have their first visit with a new provider conducted virtually, although only 37% of those over 65 agree.


Government and Politics

VA Acting Deputy CIO Laura Prietula tells attendees at an AFCEA Bethesda health IT event that the department has made significant improvements to its EHR data transfer processes, adding that it has standardized the majority of the high-priority datasets that are being transferred from VistA to Cerner’s Millennium and HealtheIntent platforms.


Privacy and Security

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Puerto Rico-based claims clearinghouse Inmediata will pay $1.1 million to settle a class action lawsuit filed by patients who were affected by a 2019 data breach in which the company failed to secure patient data online, enabling search engines to serve up PHI in search results. I mentioned at the time that the majority of the 1.6 million patients alerted about the breach had never heard of the company. Many received multiple notification letters, with some of those being addressed to other patients.

Avita Health System (OH) notifies patients of a network security incident last week that forced it to revert to downtime procedures.


Other

I’m not sure I noticed until reading the CHIME update below that former HIMSS President and CEO Steve Lieber has been working for CHIME as chief analytics officer since October 2021.

Sachin Jain, MD, MBA says big tech firms have accomplished basically nothing in healthcare because scale is hard to achieve, fee-for-service hasn’t gone anywhere so improving health isn’t a priority, managing healthcare means managing risk, and margins are small. He says companies like Apple need to stop tinkering around healthcare’s edges and instead buy a big health system, where they can demonstrate the benefits of technology, make the argument for value-based care, and integrate payers and providers. He says Amazon’s dabbling in the grocery business didn’t amount to much until it bought Whole Foods.

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This is an interesting thought about primary care in considering non-healthcare markets, where generalists could be squeezed out by specialists on the upper end, and on the lower end, by less-expensive substitutes who follow protocols that those experts approve.


Sponsor Updates

  • CHIME launches new media resource Digital Health Insights as a digital destination for healthcare industry professionals.
  • Ellkay will exhibit at Greenway Health’s Engage conference February 18-23.
  • The Kansas Hospital Association’s Health Services subsidiary selects ChartSpan as its exclusive chronic care management partner.

Blog Posts


Contacts

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

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HIStalk Interviews Gidi Stein, MD, PhD, CEO, MedAware

February 15, 2022 Interviews 1 Comment

Gidi Stein, MD, PhD is co-founder and CEO of MedAware of Ra’anana, Israel.

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Tell me about yourself and the company.

I started my career as a software engineer many years ago. I was a VP of research and development and the CTO of several startups in the early 1990s. At some point, I vowed never to do startups again, changed my career course, and went to medical school. I was the oldest medical student in Tel Aviv University. I graduated, specializing in internal medicine, did a PhD in computational biology, and held executive roles in one of Israel’s leading hospitals. MedAware is a software company that uses artificial intelligence and smart algorithms to identify medication-related risks and save lives.

What points in the process of ordering and administering medications are most likely to introduce patient harm that existing systems won’t detect?

The flow that begins with the prescriber ordering the medication, the pharmacy approving it, and then administering it or having the patient visit an outpatient pharmacy — all of these situations are basically covered, in some way, by existing systems. But after the patient is already on the meds, after they are  home or are already admitted, things can go wrong. Laboratory abnormalities are found. Vital signs change. Patients can deteriorate into shock or have acute renal failure or anemia. These changes impact the risk that is inflicted on them by their meds, and some have drug events that are related to the medications that they are receiving. Current solutions are usually not good at tracking this, monitoring these patients, and picking up those risks in the post-prescribing, post-dispensing period. Most of the problems we find are there.

What are the alerting challenges that are unique to smart infusion pumps?

Smart infusion pumps are IV pumps that “know” the medications that are being provided to the patient by that pump. The nurses program these pumps in terms of the medication to be administered, the patient’s weight, the rate, the dose, how long the infusion should take, etc. In each of these steps, there can be a typo, a click of the wrong button, or mis-programming. The current systems are similar to the electronic medical record in being not very good at identifying these risks. The alerts that they generate are mostly false alarms, which drive alert fatigue. It’s similar to what we do with electronic medical records — we know how to identify pump programming errors and do this through our partnership with Baxter.

How do you identify an exception to normal practice to generate an alert?

We assume that nurses, physicians, and pharmacists know their jobs. They don’t need MedAware or any of us to teach them how to practice. But you can be the best poet in the world and still have typos that a spellchecker will find. You can be the best doctor in the world and still need that intelligent spellchecker to identify these typos in prescriptions or the programming of pumps. This is where the outlier piece is more relevant.

We published research two years ago with Sheba Medical Center, a large hospital here in Israel, in which we analyzed the errors that physicians make when they’re tired, overworked, or don’t have specific experience with the medications they are prescribing. Two times, three times, eight times as many errors are made when physicians are tired, overworked, working in an overcrowded ER, and especially when they are prescribing medications that they are not used to prescribing. We’ve seen that more and more with COVID in the last two years.

How does the technology coexist with an EHR to reduce alert burden?

What is unique about our system is that the alert burden is very, very low. Current systems can generate alerts in about 20% of medications or medical orders. We provide less than 2%, almost 1%, of the alert burden. The accuracy of the alerts we provide is very high, more than 85% as compared to less than 5% in the current solutions. In most of the cases, physicians — and we monitor this continuously — change their order following our intervention. Instead of applying rules like current systems, we do something more intelligent in applying more sophisticated algorithms to understand the prescription patterns in each hospital, in each care setting, and identify the outlier behavior as a potential error. These are usually consistent with the physician saying, “Oh, I didn’t mean to do that. I’m going to change that.” We see that every day

Are the EHR alerts suppressed by replacing them with yours?

It depends on the client. It depends on the workflow. In some cases, we completely replace the current systems and we are able to generate very few alerts and change the whole experience of providers. In other cases, we focus more on the pharmacy, where all the medical orders are funneled to, so we’re able to surface the catastrophic problems for the pharmacy to focus on. Our engine can be applied in different settings and in different workflows. It really depends on the client and the setting, even inside infusion pumps.

Does the alerting intelligence use the clinician’s individual patterns, or does it look only at their facility’s collective experience?

It’s more detailed than that. It’s at the level not only of the institution, but of the specific department and boiling down to specific prescribing patterns. It really depends on the amount of data that we have in each institution and our ability to model the “normal” behavior based on this data. The more data we have, the more accurate we can be. We can drill down to more refined accuracy and resolution.

How does an organization analyze their alerting patterns to determine that your system can help?

It’s common knowledge. We don’t have to persuade the customers that the current alert burden is too high and that they are ignoring most of the alerts. The challenge is to persuade them that it’s not necessary — they could do it differently and it could be a different experience for the provider. They find that hard to believe. One of the things that we do in most of our clients is take a little bit of historical data and show them what we find. This is the “aha” moment, because with most of the stuff that we find, they were not aware that it is happening in their own back yard. That easily triggers the “OK, I want this.”

How much of the capability that your system has was made possible by advances in AI, and where do you see AI finding a place in healthcare?

Our solution uses many type of algorithms, from the simplest statistical analysis to really robust AI with deep learning, neural networks, and all the buzzwords that come with it. We use the most sophisticated part of AI for specific use cases, one of them being to identify cases in which the patient receives the wrong meds. Either the physician clicked on the wrong patient or drug was given to the wrong patient.

Understanding the clinical context of the patient and the relevance of this specific medication to that patient’s profile is an extremely hard task to do. We’ve been able, for several years now, to identify and to classify the medication as, is this relevant for this patient, or is this not relevant for this patient? It doesn’t have to be even something dangerous. It could be a two-year-old male child who is ordered birth control pills. It wouldn’t kill him, but he definitely doesn’t need it and it’s a complete outlier for that child. This is an extreme case, but there are a lot of more simpler ones that are hard to detect by anything else than using sophisticated AI. Our point is that we would rather use the simplest methodology to fix the problem, but in some cases, you need something that is more complex.

The use of AI in healthcare will find its place. It’s still struggling. W see very nice solutions in the imaging world where companies identify risks in CTs or MRIs and surface them up to the clinicians that hey, you have pulmonary emboli, CVA, or a critical event that you have missed –put it on top of the file.

The fine line is understanding and comprehending that we are not here to replace the clinicians. We are here to help them make better decisions. We are not here to teach them medicine. We are not here to tell them what to do. Just being that safety net to make sure that they don’t type the wrong thing. This approach can grow into more helping with diagnosis and procedures and providing a better prescribing and platform for clinicians, as long as we don’t even think or say that we can replace them or do their job, because that just doesn’t make any sense,

Where do you see the company in the next few years and the use of technology like yours in healthcare?

We have developed a unique engine that can be applied in different places in the industry. Our strategy on the business front is to partner with larger companies that have embedded solutions — in medical devices, decision support, or anything in the medication delivery space — where we can make their data smarter. We can make their systems and devices perform better. This is the path of growth to the company going forward. Baxter is one example. We have more that are coming and the future is looking good.

Morning Headlines 2/15/22

February 14, 2022 Headlines 1 Comment

Nevada Tech Company Brisk Health Launches Mobile Urgent Care

Las Vegas-based Brisk Health launches app-based telemedicine and urgent care house call services.

PriorAuthNow Raises $25 Million to Expedite Healthcare Authorizations

PriorAuthNow, which offers automated prior authorization software for providers and payers, raises $25 million, bringing its total funding to $57 million.

DaVita Acquires MedSleuth, Deepens Efforts to Improve Transplant Experience

Kidney care company DaVita acquires transplant software vendor MedSleuth for an undisclosed sum.

Curbside Consult with Dr. Jayne 2/14/22

February 14, 2022 Dr. Jayne Comments Off on Curbside Consult with Dr. Jayne 2/14/22

I started the HIMSS22 vaccine verification process today, and we’ll have to see if it works this time. Last year, when I still planned to attend the event in person, I started the process and never received conformation that my vaccine submission had been validated. The current process includes uploads of both a government-issued ID and the vaccine card. I tried using my passport this time to see if it works any better than my driver’s license did last year.

The emails I’m receiving from HIMSS22 vendors have started to increase in frequency, but I have yet to see a marketing campaign that really stands out. I’m trying to do a little planning every day so I can stay ahead of the game and avoid a flurry of organizing at the end.

This weekend’s hot topic in the virtual clinical informatics physician lounge is a petition to extend the so-called “practice pathway” for board certification in clinical informatics. The practice pathway, which is scheduled to expire in 2022, allows a certification mechanism for those of us who didn’t complete formal fellowships in clinical informatics. To be eligible for certification, physicians must demonstrate three years of practice in the field, with at least 25% of professional time in informatics. Physicians can also be eligible if they complete a 24-month master’s or PhD program in biomedical informatics, health sciences informatics, clinical informatics, or a related subject.

A number of clinical informaticists are supportive of extending the practice pathway, particularly due to the disruption caused by the COVID-19 pandemic. They note issues with the availability of residency and fellowship rotations that disrupted the ability of participants to complete their programs. Proponents cite a shortage of certified informaticists and the expected need for roles in thousands of hospitals and clinics. They also note the large number of physicians who have been practicing clinical informatics but who might not have the time or financial resources to pursue a fellowship. Others are concerned about the ability of fellowship programs to ramp up enough to be able to train the numbers of informaticists required to staff the workforce.

Others are opposed to leaving the practice pathway open. Some feel that the option hurts fellowships, leading to decreased applications and filled positions. Personally, I think the low salaries paid to fellows are at least partially responsible for decreased applications, not to mention the disruption to your career if you’re already practicing in the field. There is also concern that the practice pathway creates a lower standard. In my experience employing clinical informaticists, I’m not sure the board certification really makes a difference. It’s more of a check-the-box formality for some, but I’m perfectly happy hiring a seasoned informaticist who can do the job that needs to be done regardless of their certification status.

I obtained my certification through the practice pathway, having practiced clinical informatics exclusively in the seven years prior to certification. At that point in my career, there was no chance that I would consider leaving an EHR implementation at a major health system to complete academic pursuits. I used the Board’s content outline to craft a study plan and spent nearly six months reading more than a dozen college-level textbooks to prepare for the exam. Other than some specific and highly technical questions, the majority of the board examination involved topics that I dealt with on a daily basis in my informatics practice. One physician commenting on the issue noted that as data experts, we should be looking for proof that there are differences in outcomes when clinical informaticists are certified through the practice pathway versus through the fellowship pathway.

Board certification is a hot topic for physicians in general. Most boards require physicians to participation in a process called Maintenance of Certification. Depending on the board, physicians have to participate in continuing medical education, complete performance improvement projects, document evidence of professionalism, and complete a demonstration of knowledge. Those knowledge demonstrations vary. Some still require the traditional high-stakes examinations, and others allow longitudinal assessments. Most physicians aren’t interested in cramming for a high-stakes exam, especially when we’re tested over content that is no longer part of our daily practice. There is no immediate feedback on questions that are missed and it’s a generally miserable experience.

The last time I took one of those exams, I had a pat-down by the testing center employees and was treated like a criminal before even entering the testing room. There have been recent reports of physicians who were treated poorly at testing centers, including one lactating physician who was offered “accommodations” for pumping that failed to include a private area, a table or counter, or even an electrical outlet for the pump. She was forced to pump in a bathroom stall and the time spent counted against her limited exam breaks. I can’t imagine the mount of stress that added to the situation.

Specialty boards are trying to update their Maintenance of Certification processes to make them less onerous for physicians. However, there isn’t evidence that participating in the process makes physicians better at their jobs. I agree that for those of us participating in the longitudinal assessments, the process helps physicians become more proficient at finding information they don’t know.

Since I’ve been in urgent care for the last decade, I can handle most of the board questions that cover the musculoskeletal, digestive, and respiratory systems without blinking. Trauma is also a slam dunk and I’m solid with dermatology, infectious disease, and psychiatry. For maternity care, which I haven’t practiced in a very long time, I end up resorting to reference materials to handle those questions, just like I consult with practicing maternal care physicians in real life. Hopefully, the process is teaching physicians how to find information when they don’t know it off the tops of their heads, and to do so efficiently. However, it sometimes just feels like a game that we have to play.

Has there been any chatter about clinical informatics board certification in your organization? Are you for or against extending the practice pathway? Leave a comment or email me.

Email Dr. Jayne.

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Morning Headlines 2/14/22

February 13, 2022 News Comments Off on Morning Headlines 2/14/22

Doximity Announces Fiscal 2022 Third Quarter Financial Results

Medical social network operator Doximity announces Q3 results and that it will acquire physician on-call scheduling app vendor Amion for up to $83 million.

Announcing Radial Analytics’ $3M Round led by Initialized Capital

Radial Analytics, a patient care transition software startup based in Concord, MA, raises $3 million in a funding round led by Initialized Capital.

Vocera Announces Fourth Quarter 2021 Financial Results

Vocera announces Q4 results: revenue up 16%, adjusted EPS $0.29 versus $0.28, beating analyst expectations for both.

LifeOmic Acquires Bavard, an Enterprise-grade Conversational AI Platform

Precision digital healthcare company LifeOmic acquires Bavard, which offers AI-powered digital assistant technology.

Comments Off on Morning Headlines 2/14/22

Monday Morning Update 2/14/22

February 13, 2022 News Comments Off on Monday Morning Update 2/14/22

Top News

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Medical social network operator Doximity announces Q3 results: revenue up 67%, adjusted EPS $0.29 versus $0.07, beating Wall Street expectations for both. Shares jumped up sharply on the news, up 14% in the past 12 months versus the Dow’s 2% increase. The company’s valuation is at $16 billion, with co-founder and CEO Jeff Tangney holding 33% of shares. From the earnings call:

  • Doximity is acquiring physician on-call scheduling app vendor Amion for up to $83 million and will integrate its offering with Doximity’s secure messaging, CV, referral, and telehealth tools.
  • Chief Commercial Officer Joe Kleine will retire this fall, to be replaced with Paul Jorgensen.
  • Continuing medical education credits issued are up 25% quarter over quarter as in-person education is being increasingly replaced with online programs.
  • Job postings quadrupled year on year as physicians sought new opportunities.
  • The company’s video telehealth platform earned Best in KLAS over Microsoft Teams, Zoom, and other services.
  • Drug companies whose sales reps can’t visit doctors in person are moving to digital marketing programs and eliminating sales positions. The company says that the count of drug reps has doubled since the mid-1990s to 81,000, but it expects 10% of those reps to lose their jobs in the next couple of years.
  • CEO Jeff Tangney says that Fortune 500 companies spend 70% of their marketing budget on digital channels, while healthcare is at 23%.

HIStalk Announcements and Requests

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The fortunes that conference exhibitors spend on fancy booths, catering, glossy presentations, and tchotchkes generate a lower return than the free options – choosing and coaching your booth reps carefully and letting people know ahead of time what you’ll be doing in your expensive patch of carpet. My #1 recommendation is, as always, to confiscate the phones of those who are working the booth – humans seeking information are an irritating intrusion into their cyber-bliss.

New poll to your right or here: Does your business card or email signature list a certification or fellowship credential? I’ve stopped listing both since in my case, their value seems to accrue more to issuers who are looking for recurring revenue than for holders to prove their competence or ethics. Some are still hard to earn and maintain (CPA or PMP, for example) and I would use those if directly relevant to a current or desired job. I also don’t understand listing questionably rigorous, non-selective “executive education” on LinkedIn, especially in lieu of having earned an actual degree from an accredited school. Business card alphabet soup and sitting in front of “I love me” walls plastered with framed, yellowing certificates is a fascinating study in occupational vanity. I’m always intrigued that sales executives, CEOs, and startup founders are often light on formal education, having set a path while young in which formal education would have been a multi-year distraction from their destined accomplishments. I should run a poll asking respondents if they report to someone with less-impressive education credentials.


If your HIStalk sponsor company is spending money to participate in ViVE and HIMSS22, why not boost attention to your involvement with a free entry in my conference guides? Those links lead to forms where you tell me about what you’re doing, which I need to know in the next couple of weeks since said conferencing is imminent.


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Welcome to new HIStalk Gold Sponsor Biofourmis. The fast-growing, Boston-based global health technology company is focused on leveraging software and data science to deliver virtual care and develop novel digital therapies. Its robust care management platform, Care@Home, enables remote disease management across a range of medical conditions for acute, post-acute, and chronic care. The solution utilizes medical-grade wearables to continuously collect patient data, which is analyzed by Biovitals, Biofourmis’ highly sophisticated, clinically validated AI-powered predictive analytics engine. With support from Biofourmis’ in-house clinical care team, payers and providers can leverage the solution to predict clinical deterioration in advance of a critical event, which enables earlier interventions for better outcomes and cost savings. Likewise, the company discovers, develops, and delivers clinically validated digital therapeutics. These monotherapies or “pill plus” prescription therapeutics support payers and providers in improving patients’ lives while reducing healthcare utilization and associated costs. Thanks to Biofourmis for supporting HIStalk.


Webinars

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


Acquisitions, Funding, Business, and Stock

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Vocera announces Q4 results: revenue up 16%, adjusted EPS $0.29 versus $0.28, beating analyst expectations for both. Stryker’s $3 billion acquisition of the company remains on track.


Sales

  • Northwest Primary Care (OR) implements Deviceless Remote Patient Monitoring from CareSignal, a Lightbeam Health Solutions Company.

People

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Salesforce promotes David Cousins, MS to SVP of healthcare and life sciences.

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ReMedi Health Solutions hires Scott Collins (Futura Mobility) as chief revenue officer.


Announcements and Implementations

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Virtual care and digital therapeutics company Biofourmis launches Biofourmis Care, a chronic condition management system and virtual care team for heart failure, hypertension, diabetes, lipid management, and atrial fibrillation. The service includes automated medication management for optimizing therapy.

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HIMSS22 in-person attendees who plan to voluntarily provide proof of COVID vaccination have until March 11 to use the pre-show online process of Safe Expo, which will send confirmation that allows picking up a conference badge. Attendees who used Safe Expo for HIMSS21 can use last year’s verification based on their email address, which took me a grand total of perhaps 10 seconds today (good job on that, HIMSS). The alternative is to show vaccination proof or a negative result no older than from the previous day at the onsite verification desk, which is ideal for folks who want to kick off their HIMSS22 experience by waiting in line (or “on line” for you New Yorkers).

For those who were annoyed by the HIMSS21 virtual program ambassadors (Dr. Jayne was, emphatically) they will be back for HIMSS22, adding nearly zero value with their chirpy omnipresence.


Other

In Netherlands, the government’s National Coordination Center for Patient Spreading – which hoped to address COVID-19 admission surges by distributing patients across multiple hospitals – paid $1.4 million for a real-time hospital capacity tracking system that was developed by two of the organization’s advisors. The manually updated system proved to be unreliable, to the point that seriously ill patients were being taken to hospitals that showed available beds even though they were full. The government eventually bought the software company itself in a no-bid deal.


Sponsor Updates

  • The local paper profiles Cooper University Health Care’s implementation of Nuance’s Dax ambient clinical intelligence solution.
  • EClinicalWorks releases a new podcast, “Handling Hospital Notifications with Direct Messaging.”
  • AGS Health will exhibit at the ACDIS Virtual Summit February 16-17.
  • OptimizeRx CEO William Febbo will speak at the Bank of America Annual HCIT and Digital Health Conference February 23.
  • Nordic releases a new podcast, “How interoperability and cloud transformations can support healthcare organizations.”
  • Commitment to customer success drives growth at RCxRules in 2021.
  • Surescripts congratulates DAW Systems, winner of the 2021 Surescripts White Coat Award for highest e-prescribing accuracy.
  • SyTrue caps off a year of tremendous growth in its client base, number of employees, and transaction volume.
  • Verato publishes a new report, “Achieving a 360 Degree View of the Patient: Why Accurate Patient Identity is Critical to Health System Success.”

Blog Posts


Contacts

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

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Comments Off on Monday Morning Update 2/14/22

Weekender 2/11/22

February 11, 2022 Weekender Comments Off on Weekender 2/11/22

weekender 


Weekly News Recap

  • AndHealth, founded by CoverMyMeds co-founder Matt Scantland, exists stealth mode and raises $57 million in funding.
  • Germany-based Ada expands its Series B round to $120 million and plans aggressive expansion to the US.
  • Senators form a commission to consider updating HIPAA.
  • Best in KLAS named.
  • NThrive will acquire Pelitas.
  • Premier reports Q2 results.

Best Reader Comments

I have been interviewed by the CEO of a company once, and I walked away from it thinking “what do you actually *do* that this is how you spend your time?” To me it indicates poor leadership and an inability or unwillingness to build a team that can do the job independently. (HIT Girl)

I sometimes wonder if the unspoken role of the EMR is to remind and support the clinicians. What did they do, when did they do it, and why? As long as your capability includes interviewing the clinicians, maybe an incomplete EMR/EHR isn’t the worst thing. POC activities can continue. However the higher level goals we set, including Population Health surveys? Those typically mean that interviews of the onsite clinicians are too slow and introduce unwanted errors into the process. (Brian Too)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. M in Phoenix, who asked for headphones for her second grade class. She reports, “These headphones have made a huge difference for learning and our classroom environment. Students now have access to accommodations and differentiation when utilizing our online programs. As well, it helps keep our classroom environment quieter and peaceful when using our technology. We are so thankful for these! We use them every day! Thank you for supporting our classroom!”

A Florida doctor claims that he was duped by the owner of a sober living facility who is accused of insurance fraud in having the doctor order 30,000 urine tests as the facility’s medical director – the owner called them “liquid gold”– that netted the owner $31 million.

Doctors and advanced practice registered nurses in Tennessee argue over a pending state bill that would eliminate the existing requirement that doctors sign off on 20% of the charts of APRNs every 30 days. Nurses say the requirement means patients are paying for the time of a doctor they didn’t see and nurses are restricted from opening independent practices in rural areas, while the Tennessee Medical Association says nurses would rather live in cities just like doctors anyway. Tennessee is one of 26 states that require chart review.

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The state of Oklahoma is paying an unnamed doctor$15,000 for each prisoner who is executed under the state’s death penalty. The doctor doesn’t actually administer the drugs used – they start the IV and verify that the correct drugs have been prepared. The doctor also earns $1,000 per day for attending weekly training.

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Alamance Regional Hospital (NC) welcomes 25 National Guard troops who will help the hospital deal with staffing shortages.

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Epic employee volunteers create handmade Valentine’s Day cards for the 300 people who are serviced by SSM Health’s Meals on Wheels program.


In Case You Missed It


Get Involved

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Morning Headlines 2/11/22

February 10, 2022 Headlines Comments Off on Morning Headlines 2/11/22

Ideawake Closes Investment with HealthX Ventures to Democratize Innovation on the Frontlines in Healthcare

HealthX Ventures invests in Ideawake, which offers a platform for healthcare leaders to engage employees and their ideas for saving money and improving care via time-based challenges that are transparently tracked.

AndHealth, the Digital Health Company for Reversing Migraine and Autoimmune Diseases Raises $57 Million in Financing for Growth

AndHealth — which offers app-based, employer-sponsored treatment, coaching, and medication management for migraine – comes out of stealth mode and raises $57 million in funding.

Signify Health to acquire Caravan Health, accelerating the movement to value-based healthcare

Signify Health, which offers technology, analytics, and provider networks geared towards value-based payment programs, will acquire ACO enablement company Caravan Health for $250 million.

2nd Watch Expands Data & Analytics Capabilities with Acquisition

Cloud services company 2nd Watch acquires cloud data and analytics consultancy Aptitive.

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News 2/11/22

February 10, 2022 News 1 Comment

Top News

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AndHealth — which offers app-based, employer-sponsored treatment, coaching, and medication management for migraine – comes out of stealth mode and raises $57 million in funding.

Investors include Francisco Partners and the AMA’s venture capital arm.

The company will launch a second service line for autoimmune diseases.

AndHealth’s founder and CEO is Matt Scantland, who co-founded and led CoverMyMeds through its $1.4 billion acquisition by McKesson in 2017.


Reader Comments

From Orion Pictures: “Re: HIMSS22. An internal document I saw lists just [unverified number omitted] people attending, which also includes at least some vendors.” I’m hesitant to publish the number that was cited because (a) it’s super low; and (b) my only HIMSS contact who would have verified its accuracy no longer works there. HIMSS claims that nearly 19,000 people – including exhibitor staff – attended HIMSS21 in person, although it sure didn’t look like that many. We’re just a month away and COVID-19 is waning a bit, so I would say everybody has already decided if they are going or not. I’ll be doing my usual daily write-ups, although I expect to be COVID-robbed of my beloved MedData scones.


HIStalk Announcements and Requests

HIStalk sponsors – submit your participation information in the ViVE and HIMSS conferences and I’ll include your company in my guide to each.


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Welcome to new HIStalk Platinum Sponsor Owl. Owl gives behavioral health organizations better data, better insights, and better outcomes with its data-driven, evidence-based solutions. Leading organizations — including Main Line Health, Amita Health, Inova Health, Polara Health, and Aurora Mental Health Center — rely on Owl to expand access to care, improve clinical outcomes, and prepare for value-based care. Owl makes measurement-based care easy to engage patients, optimize treatment, improve care, reduce clinician burden, and capture data to optimize business performance. Thanks to Owl for supporting HIStalk.


Webinars

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


Acquisitions, Funding, Business, and Stock

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HealthX Ventures invests in Ideawake, which offers a platform for healthcare leaders to engage employees and their ideas for saving money and improving care via time-based challenges that are transparently tracked. I interviewed CEO Coby Skonord last fall, who summarized, “It empowers anyone at the front lines of the organization, regardless of role or title, to make their voice heard based upon the quality of their idea versus their job title.”

Nuance announces Q1 results: revenue down 7%, adjusted EPS $0.08 versus $0.20. The company’s acquisition by Microsoft remains on track for the end of the first calendar quarter.

Ascension will turn over operation of its hospital-based laboratories in 10 states to Labcorp, which will also buy the health system’s outreach lab business. Ascension will also offer patients services of pharma contract research organization Labcorp Drug Development, which the company created in 2014 with its acquisition of Covance for nearly $6 billion.

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Cloud services company 2nd Watch acquires cloud data and analytics consultancy Aptitive.

Thirty Madison, which runs online businesses for hair loss, migraines, GI problems, and allergies, will acquire Nurx, which offers female-focused online services for contraception, STI testing, HIV prevention, and dermatology. Thirty Madison says its combined businesses will bring in $300 million in revenue in 2022.

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Germany-based Ada, which offers AI-based health assessments and care, extends its Series B funding round to $120 million. The company plans to expand aggressively into the US market.

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Israel-based Scopio, which offers slide-scanning and AI analysis technology to allow peripheral blood smears to be analyzed by pathologists remotely, raises $50 million.


Sales

  • Jupiter Medical Center (FL) will deploy Vocera’s Smartbadge wearable and Edge smartphone app for team communication and collaboration. It will also implement Vocera Ease application to allow care team members to communicate with patient-designated friends and family members.

People

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Healthwise names Andy Binder, MS, MBA (HP) as COO.

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Pharmacy solutions vendor Transaction Data Systems hires Robert Ven (Intrado) as CTO.

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Socially Determined hires Paul Matsui (The Antigrav Group) as chief strategy officer and Mike Considine (TransUnion) as chief product officer.

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Sandeep Sabharwal, MBA (Accenture) joins Impact Advisors a managing partner and board member.


Announcements and Implementations

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CoverMyMeds publishes its annual Medication Access Report, with these findings:

  • 84% of patients had to delay or skip in-person healthcare visits in 2021, with primary care being the most-missed visits.
  • The percentage of patients who skipped medications because of cost rose from 36% in 2020 to 51% in 2021.
  • 84% of patients had a telehealth visit in 2021, about equally split between PCPs and specialists. Their most commonly stated reasons for choosing telehealth were COVID-19, convenience, and reduced wait time.
  • Nearly all respondents say they have electronic access to their medical records and can share it with providers.
  • Three-fourths of providers can’t see plan-specific prescription costs, deductibles, and pharmacy-specific pricing  in their EHR. Nearly all can’t see social determinants of health information.
  • Pharmacists say that the highest-value task they can’t perform on their computer system is checking prior authorization status. They also note that providers don’t usually submit prior authorization requests until the pharmacy contacts them, which delays treatment.

Ascom forms new professional services and customer success organizations to support its healthcare collaboration and communication solutions business.


Government and Politics

US Senators Bill Cassidy, MD (R-LA) and Tammy Baldwin (D-WI) form a commission that will make recommendations to Congress about updating HIPAA.

NBC News covers ONC’s December 31 deadline for certified EHR developers to provide FHIR APIs, also noting the progress that has been made in the industry’s implementation of EHRs. .

A GAO report reviews the military’s expansion of telehealth for mental health services during the pandemic, with these lessons learned:

  • March 2020 guidance allowed providers to use consumer videoconferencing technologies such as FaceTime and to offer services using their personal devices.
  • Use of telehealth reduced the stigma of seeking mental health care since in-person services required sitting in a clinic waiting room in full uniform that includes service member name.
  • Group sessions were problematic because of confidentiality concerns, the need to train providers on how to lock the virtual room to uninvited participants, and the level of computer equipment and web camera required.
  • Providers need to obtain the location and contact information of patients at high risk or with suicidal thoughts so that local authorities can be contacted to perform a wellness check if contact is lost.
  • Providers were given training on the technology, the administrative process, and the privacy requirements of conducting virtual visits.

A new report finds that 14% of 1,000 randomly selected hospitals are complying with the HHS requirement that they post their real prices online. HCA Healthcare, Ascension, and CommonSpirit Health – whose combined revenue is $120 billion — had just two compliant hospitals of their 361.


Other

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KLAS reports that some Cerner customers are forming contingency plans in reacting to company changes that include hiring a new CEO, a revenue cycle management pivot, executive turnover, and an announced acquisition by Oracle. Notes:

  • Cerner’s overall KLAS performance scores haven’t changed over five years and under three CEOs, while confidence in the company’s ability to deliver has declined.
  • Some customers attribute their success to their own efforts rather than those of Cerner.
  • CEO David Feinberg will need to improve overall customer success, break the company’s history of broken promises and nickel-and-diming, and establish its new revenue cycle product.
  • Many customers question Cerner’s choice of the old Soarian platform to develop RevElate, noting that the product is rated only in the 60s and sometimes takes customers years to use effectively. They also question how the lack of native integration will work in an industry that has mostly moved away from standalone applications.
  • Company acquisitions tend to work out well about half the time, and when they don’t, customers are twice as likely to abandon the vendor.

The Wall Street Journal notes the sudden proliferation of mashed-up CIO titles to reflect wider responsibilities beyond infrastructure and experience that becomes more customer-focused and operational. Examples: chief technology, operations, and transformation officer (CTOTO) and chief information, data, and digital officer.


Sponsor Updates

  • Healthcare Growth Partners advises NThrive in its acquisition of Pelitas.
  • Impact Advisors celebrates its 15th anniversary.
  • Symplr completes its acquisition of Midas Health Analytics solutions from Conduent.
  • Lumeon names Brittany Jones (Memora Health) senior director of business development.
  • NTT has been selected by the Arizona Health Care Cost Containment System to provide Medicaid Enterprise Systems Roadmap consulting services for Arizona and Hawaii.

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 2/10/22

February 10, 2022 Dr. Jayne 1 Comment

The Centers for Medicare & Medicaid Services released details on the status of Accountable Care Organizations. CMS promotes the fact that 66 new ACOs joined the program and 140 renewed their agreements, bringing the total number of programs to 483. Looking at historical data, however, that’s small growth (six programs) since last year, but an overall decrease since 2020’s count of 517 programs. Doing the math, that means 60 organizations left the program.

In speaking with colleagues who are closer to the ACO world, even when ACOs don’t renew, it is likely that upwards of 50% of clinicians will move into a different ACO. That’s good news for patients who value continuity. The overall ACO initiative has a long way to go to meet its goals of providing coverage for the majority of Medicare beneficiaries in the US. It will be interesting to see how the program continues to evolve and how quickly it can build that kind of coverage.

Telehealth is hot in the news this week. The first story involves telehealth gone bad, with a Georgia nurse practitioner being found guilty of $3 million in fraudulent activities. Charges include healthcare fraud, identity theft, illegal kickbacks, and false statements. The Operation Brace Yourself sting operation targeted providers who were unnecessarily ordering durable medical equipment for patients they had never evaluated. The criminal conspiracy involved targeting senior citizens through telemarketing, then using their personal information to submit claims for orthotic braces. The convicted nurse practitioner signed over 3,000 orders related to falsified medical records in exchange for money. Despite what was said in the 1990s, greed is NOT good.

Amazon’s telehealth efforts were also in the news as it announced plans to expand Amazon Care’s in-person services to more than 20 new cities this year. Its virtual services are already available across the country. Amazon’s blurb says, “Care Medical doctors and nurses across the country are dedicated to treating Amazon Care customers, so patients are able to build lasting relationships with their health care providers over time.” Hopefully, Amazon’s model for employing physicians and nurses is more flexible and rewarding than some of the employment practices we hear about at Amazon’s warehouse and delivery operations. Keeping patients happy over time involves keeping their care teams happy over time, which is a difficult nut that healthcare organizations have struggled to crack for decades.

Anthem also announced its plans for virtual primary care services for its members in 11 states. The virtual offering includes an initial health check with creation of a personalized care plan and is being offered at little or no cost to members. Anthem talks about delivering services through its Sydney health app, which can handle secure chat for urgent care as well as support for scheduling. However, it’s unclear how its offering will integrate with patients’ existing medical records or care providers such as subspecialists. Both Anthem and Amazon seem to be targeting employer-sponsored plans. Since employers have a vested interest in trying to reduce healthcare spending, it will be interesting to see what adoption of these programs looks like.

I serve on the health advisory committee for my local school board. We had an interesting conversation this week about the role of testing in the current phase of the COVID-19 pandemic. With the explosion in at-home testing and the fact that those tests are generally not reported to public health authorities, overall testing numbers and positivity rates are becoming skewed. My colleagues in public health informatics have already struggled with the knowledge that we’ve been underreporting cases throughout the pandemic, and the boom in home-based testing isn’t helping. Local schools have been looking at positivity rates to determine whether to hold classes in-person and whether to require masks and those decisions have become more complicated. We’re starting to talk about using percentage of vaccination as another indicator, but it’s difficult to get people to self-report their vaccination status. The last couple of years have been agonizing for educators and I don’t envy the decisions they have to make on a daily basis.

We’re also seeing a boom in patients who think they might have COVID but don’t want to be tested because they can’t afford to be off of work. This also applies to people who don’t want their children tested because they don’t have backup childcare options if the students have to be kept out of school. This also creates decision-making challenges and was on my mind when I read a recent JAMA article looking at the number of adults who thought they had COVID-19 but actually didn’t. About half of unvaccinated adults who thought they had been infected were found not to have antibodies, which are expected to be present at least at some level for about nine months after an infection. Conversely, 99% of people who had a test-confirmed infection had antibodies. Of note, 11% of people who thought they had never been infected had antibodies. The data is from pre-Omicron days, so I will be interested to see what it looks like after the current wave.

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Working from home has certainly given me more time for pastry therapy. Now that many of us have been fully remote workers for a couple of years, it’s interesting to think back about how things used to be. We’ve all become used to some of the quirks of this new normal, from sharing broader views of our colleagues’ home lives to joining them in the carpool line as they pick up children from school. It’s been interesting to see how some organizations have evolved to new ways of working, with guidelines around whether meetings have to be video or whether they can be audio only, etc. Some have policies about how/when to use phone versus collaboration solutions versus email. Some organizations have become casual and free form with meetings, where others observe more formal meeting disciplines.

I ran across a situation the other day that I hadn’t encountered. I was on a client call with my normal working group and we were just doing our thing. Out of nowhere, someone joined the meeting, and although initially I thought they were a Zoom-bomber, I noticed they had a company logo on their pullover. Since I wasn’t the facilitator or the host, merely a member of the working group, I didn’t say anything. I figured I would wait to see how long it took for them to introduce themselves or for someone else on the call to say something. We weren’t discussing anything sensitive or proprietary, so I felt comfortable waiting. A full 38 minutes later, the meeting ended, and I never did figure out the identity of the mystery person other than their name caption. I’m still surprised that no one said anything, but that kind of thing is what makes being a consultant interesting.

What do you do when random people show up in your meetings? Leave a comment or email me.

Email Dr. Jayne.

HIStalk Interviews Clay Ritchey, CEO, Verato

February 10, 2022 Interviews Comments Off on HIStalk Interviews Clay Ritchey, CEO, Verato

Clay Ritchey, MBA is CEO of Verato of McLean, VA.

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Tell me about yourself and the company.

At Verato, we are identity experts that enable better care everywhere by solving the problem that we believe drives everything else, which is knowing who is who. Our mission is to be the single source of truth for identity that provides healthcare a complete and trusted 360-degree, longitudinal view of the people that they serve. I’ve spent the last 20 years in healthcare technology, with a passion for helping people leverage technology to deliver better care, better outcomes, and better patient experiences. I’m excited about Verato’s ability to do just that with identity resolution.

What is the extent of mismatched patient records in an average health system?

It is not atypical to have 8% to 10% of medical records be mismatched, either as  duplicate medical records or overlays. That’s very common. That problem has been exacerbated as we move into digital health. The ecosystem is more complex and the information is even more inaccurate as you try to aggregate that data and those identities across not just one or more EHRs, but over 20 to 30 different inputs or data sources that are collecting data on patients.

Is patient identity harder to manage with hospital acquisitions and increased interoperability?

Yes. Unfortunately, we’re still in a world where most health systems are thinking about how to drive interoperability inside their own physical enterprise and virtual enterprise. Even in that scenario, mergers and acquisitions create a challenge with how you take a patient census that is sitting in different EHRs and combine them into one so that the patient experience isn’t harmed or important information is missing so that I can’t treat the whole patient. That’s a key driver as health systems think about expanding and need to welcome these new patients and deliver the service they expect.

How well do EHRs detect patient matching problems, especially now that using Social Security number as an identifier has been eliminated?

There’s two significant challenges with the EHR’s ability to prevent identity mismatching. One is the fact that most EHRs only have visibility into the data that they house themselves. As you start thinking about all these additional channels of data and data sources outside of the EHR, they don’t have the ability to reconcile those data sets from an enterprise perspective.

The second challenge is that the typical EHR identity matching technology is driven by probabilistic matching or algorithms, looking at information that you have physically about the patient. We think a better approach is using referential matching, where we have data that might not be sitting in the EHR about that person and we can connect the data points and fill in the gaps with that information to provide better matching.

Have you seen interest in uniquely identifying people who aren’t necessarily patients, such as public health organizations that try to match vaccination data to their medical records?

The pandemic drove a lot of wonderful things for the future of healthcare. One of the most important is that it created a reimbursement model for telehealth. We are seeing 38 times as many telehealth visits as we had before, and it is stabilizing at around 17% to 20% of all outpatients. With that is a change in the mindset around how consumers want to be treated. Consumers who plan to make an important purchase go online 85% of the time to find information first. In a post-pandemic world, healthcare is seeing that number upwards of 90%, where people consult online resources about their symptoms before they talk to their doctor.

Because of all these different channels and digital engagement around the consumer, health systems have to understand who is who. How can I create a 360-degree view of all those interactions to create an experience for that patient, showing them that I know who they are, I have empathy for them, and I can solve their problem holistically?

What are the competitive advantages of accurate patient identification?

Forward-looking health systems are committed to offering a patient experience that is based on a simple premise – you have to show them that you know them. They are using an identity management platform to create and curate an experience for the consumer who is thinking about consuming a service from them. It might be somebody doing research about a knee or hip knee replacement. You need to understand who they are and be able to tailor your communications with them, so that as they continue to interact with the health system, that health system already knows that they have been on the website, downloaded a white paper on hip replacement, and are now calling in. Can I help you find a doctor who can help you answer questions around those types of things? Accelerating the acquisition of patients requires understanding the identity of the patient and then being able to deliver better care.

Finally, as health systems are moving from fee-for-service to fee-for-value, population health, and social determinants of health — and being able to manage both in-hospital and out-of-hospital concerns — it becomes critical to understand the patient identity, to proactively identify them as having risk factors, and to proactively give them a care plan to prevent a chronic condition or to better manage their chronic condition. All of those things contribute to happier customers, happier patients, lower cost of treatment, and overall better outcomes.

Outside of healthcare, customers uniquely identify themselves via a loyalty card or a website login that allows a business to then understand their behaviors. Can we learn from those industries?

Yes. Healthcare doesn’t have to look far at all to figure out how to delight the patient and deliver an exceptional patient experience. Loyalty programs, being able to know who you are as you’ve logged into their website, and from there to present them with information that is relevant to what we know about them. If we know that you are a cancer survivor, we should be delivering content to you that can help with your journey.

There are many examples across other industries that you can draw from. One of my favorite airlines is Delta Airlines. They seem to be able to anticipate my needs as a traveler even before I have them. If there’s a delayed flight, they are already thinking ahead about giving me options for rescheduling. We are starting to see forward-looking healthcare systems think about embracing consumerism and applying these types of technologies. Over 50% of millennials today don’t have a primary care provider, so they will be looking for experiences similar to how they buy something from Walmart or Amazon. To do that, we have to transform the way that we engage them.

Health systems experimented years ago with patient loyalty cards that also allowed medical records lookup. Why hasn’t that been adopted more widely?

The reporting from a year go on Ascension and Google Health showed a lot of privacy concerns that exist in America with respect to healthcare, our privacy rights, and protecting information about our health. I believe those basic concerns around privacy are pervasive. There’s a lot of conversations going on about universal patient identifier. That would be helpful and necessary, but we don’t believe that it alone will ever be sufficient. There’s just so many ways for patients to engage with the health system and so many front doors they come in, whether physical or digital. The idea that that patient will always have that identifier with them and present it in a confirmed way is challenging.

That’s where you’re seeing this pervasive, long-term need for additional technologies on the back end that continue to piece together these stories and be able to help us identify them. That being said, I do believe that we’re going to see the industry move towards a more trusted identifier. That may be through a trusted private sector opportunity versus the government. We have to work through how to get something that is safe, secure, and trusted before we can break those barriers.

What problems would arise or remain unsolved with the implementation of a universal patient identifier?

You mentioned Social Security number. Isn’t it already a universal patient identifier? Why hasn’t that been sufficient? The idea of using a universal identifier as a key into a lock that it gets you access to a health system, your health records, and information about yourself has a lot of goodness, but you’ll still find that it’s not practical to have a key that can be trusted and validated everywhere it would be used. Our own experience on the consumer side is that we have to find ways to create that experience that don’t rely on that type of unique key. I believe that a universal patient identifier will move forward, but while it is necessary, it won’t be sufficient for delivering the value proposition that we all hope for.

Where do you see the company in three to five years?

We see Verato continuing to enable this idea of better care everywhere by focusing on enabling the interoperability of digital health and the digital health transformation that is happening across the health system. Today, it’s health systems themselves. Tomorrow, it’s going to be across the care continuum. Being able to make that information portable, so that a patient can visit a health system in Pennsylvania and then while traveling on vacation to Florida and being able to visit the health system there, having that type of interoperability across health systems. I believe that Verato will be a part of that transformation as we move from interoperability within a health system to interoperability across the care continuum.

We’re also working on partnerships. We believe that having a common view across the care continuum — pharmacy, pharmaceuticals and biotech, medical devices, HIEs, providers, and payers – that trusted, protected, secure common view will help us eventually get to liquidity of data so that it gets to the right place at the right time to deliver a better outcome.

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Morning Headlines 2/10/22

February 9, 2022 Headlines, News Comments Off on Morning Headlines 2/10/22

Thirty Madison and Nurx to merge, creating the leading virtual specialty care platform

Thirty Madison, a direct-to-consumer telemedicine company focused on chronic conditions, acquires Nurx, which offers women virtual care for dermatology and reproductive and sexual health.

Compliancy Group Announces Aldrich Capital Partners has committed to invest $75 million

Compliancy Group, a New York-based HIPAA compliance software and training business, secures a $75 million investment from Aldrich Capital Partners.

Tabula Rasa Healthcare to Sell DoseMeRx

Medication risk management vendor Tabula Rasa Healthcare decides to put its DoseMeRx precision dosing software, acquired in 2018, up for sale.

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HIStalk Interviews Kyle Silvestro, CEO, SyTrue

February 9, 2022 Interviews 1 Comment

Kyle Silvestro is founder, president, and CEO of SyTrue of Stateline, NV.

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Tell me about yourself and the company.

I’ve been in the world of clinical natural language processing for almost the last 17 years. I started SyTrue a little over nine years ago, thinking about how to solve challenges around archaic workflows where we still require humans to read medical documents, especially from the perspective of CMS. And, how we automate a number of processes by eliminating inefficiencies within the system.

How has the need and the ability to automatically extract information from medical records changed over the years?

The need has been there for more than a decade. The awareness is coming to the forefront. We are truly understanding the value in information. The advances in AI and ML have highlighted that. Most of those advancements have been more around structured data and what is possible. Looking forward, organizations are understanding the value of the unstructured clinical note that still comprises the majority of information created in healthcare today. We process more than a billion pages of these notes annually, and that’s just scratching the surface. That would be on data created within the last 12 months. The majority of information is still in this format.

It depends on where you are in the process from the point of care to the point of need. At the point of care, maybe you can get high quality data quickly, but most organizations are not. They are downstream of that information, and it’s packaged up more often than not in a PDF. It’s not even unstructured data — it’s an image. That image is shared with organizations and data is often needed 20 ways downstream. If you don’t have a way to create this exponential uplift, then you can’t start addressing the challenges we see in the system. This problem has been here for a while and there are truly no good solutions addressing it that have a critical level of adoption.

Do PDFs usually come from outside facilities, meaning that it’s an interoperability problem, or are they self-generated because the source system doesn’t capture the data discretely?

It’s a combination. More often not, this is a byproduct of a record release process. Thousands of people go on site to facilities every day to get data from hospitals or provider offices. There are some electronic exchanges now, with CCDAs being sent across the wire, but that’s really the two ways that they are getting this data. It’s definitely an interoperability issue, but it’s more of a misalignment of incentives that is potentially preventing wider adoption.

What are payers and CMS doing with the data?

We have a unique challenge within the payer market. So much of what they get is an image, a PDF that can be thousands or tens of thousands of pages long. The only answer before SyTrue was to assign a nurse to read the document, go through the 4,000 pages, and find the eight or 10 pieces of information that answer the question. But more often than not, the 5,000 other data points that are in that PDF document that could be driving exponential uplift within an enterprise are left behind. They’re saved as an image, so they are being lost. The knowledge that is in front of them is gone. Our solution addresses the efficiency challenge, but we can also liberate all of that information to drive exponential downstream value on an enterprise level, to be able to create standardization and interoperability that can drive change.

What is involved with taking a PDF document and turning it into useful information?

This is a differentiator between SyTrue and everybody else. I had the privilege, or the advantage, of failing more than most people in pushing an early technology into the marketplace. Before I started SyTrue, I implemented NLP across life sciences, payers, and providers across a number of use cases, but had also seen challenges at failure points. As somebody who doesn’t like to lose, I remember those failures. 

When we architected SyTrue, we knew that it’s not just about NLP. If healthcare data is clean, NLP is easy. It can read the document, parse it, and extract it. But the problem is that we are dealing with inconsistency from organization to organization, physician to physician, EMR to EMR. How do you account for all this dirty data that was created by a million physicians that generate billions and billions of notes annually? And if those notes are needed 20 or 30 ways downstream, you’re creating a exponential data problem that you can never throw enough humans at to solve.

That’s what we thought about. We thought about that document life cycle. We thought about the creation sources. We thought about who needs it along the way. The question that we asked ourselves is, how can we make people money along the way? How can we add value? That approach allowed us to look at it from a longitudinal perspective, because we thought that if you can get to a longitudinal data and you can do it accurately, everything else downstream becomes easy. You have all the Legos, you just have to actually assemble the house or build the car. The structural components of the information are in that longitudinal record. It’s a matter of how you are combining them. 

With HEDIS, you need problems, procedures, and HCPCS codes. Risk adjustment. You’re looking at problems and supporting conditions and payment integrity. You’re looking at elements that would roll up to make a determination — is this truly an acute kidney injury, or is this sepsis? If you have that baseline data, the downstream questions that you’re asking or the objectives that you’re looking to get out of that information become a lot easier. You can do it across many domains, as represented by our client base and use cases that they leverage.

How will the healthcare entry of big tech firms affect your business, such as Google’s work with EHR search?

How soon before they call it quits again? They’ve all taken bites of this apple, only to fail miserably. I honestly think that’s the trajectory they are on. They do the market a bigger disservice than they do a service. They push early-stage technology that’s not prime time into our marketplace. They suck the oxygen out of that marketplace, and organizations that are small and may not have the $100 million marketing budget get squeezed out. True innovation never gets bubbled up to the top because you have these massive enterprises send 14 sales reps into a client to push a product that’s half baked.

You see that in Amazon Comprehend. They just reduced their price by 95% and now it’s this big announcement around SNOMED. Great, right? If it wasn’t good to begin with, it’s not going to be better when it’s 95% discounted. We’ve had SNOMED for nine years. It’s not new. It’s not really an announcement. Talk about how you’re making people money, talk about how you’re changing the system, and don’t just make noise. That’s what a lot of these organizations do. They truly don’t understand the problem and they truly don’t understand the solution that they need to create to solve it.

IBM Watson Health had some pretty grand ambitions and failed miserably.

MD Anderson Cancer Center. The trail of tears goes on. The billions of dollars that were invested into a technology that played “Jeopardy!” and then thought it could solve healthcare was amazing. They had 5,000 people at one point. It had a lot of data. But they couldn’t roll out anything that was meaningful, except for marketing hype. That is true of many of these big tech players getting into healthcare. They don’t understand the problem that they are trying to solve. They see dollars, they think they can throw enough money to grab market share. Unfortunately, I think they do the overall marketplace a humongous disservice. I haven’t seen truly significant impact from companies that took something that was playing a video game and thought it could solve healthcare.

How do you see the investment buzz over AI playing out?

There’s real opportunity in the technology. But I think you apply technology where it makes sense. You just don’t try to brute force everything, and because there’s a new technology out, think you can solve all the problems. We take a pragmatic approach. Use technology where it makes sense to apply it. As we get downstream, AI is going to be really, really meaningful. It’s going to be important in healthcare. But we have a foundational problem today in healthcare that is going to prevent that from becoming a reality for a little while, unless organizations start to realize it. If you’re not creating an interoperable base of accurate information that you are basing your models on, you are building a house of cards. I wonder how many of those actually exist today versus true value.

There’s a lot of hype, but when you actually get into the information, what impact is it actually making? Marketing has latched onto it. Not a lot of people understand it. Everything is a supervised model. Unless you get to accurate datasets at high volume, you’re somewhat playing with fire. But we have clients that actually do this and they see significant improvements in accuracy, sensitivity, and the impact it has on an organizational level, because they are working from an accurate, interoperable piece of base-level data that’s a solid foundation.

Where will the company focus on the next few years?

SyTrue is positioned to be a dominant player across many different solutions — HEDIS, payment integrity, fraud risk and abuse, risk adjustment, social determinants, expansion of radiology, expansion in oncology — all with a single platform and with the focus of making organizations money quickly and being able to get them live fast to enable that ROI. I see great things for SyTrue. I see us going from just shy of 40 employees now to a significant number in that period of time.

Morning Headlines 2/9/22

February 8, 2022 News Comments Off on Morning Headlines 2/9/22

Curve Health Raises $12M in Oversubscribed Series A

Curve Health, which helps hospitals and nursing homes coordinate and manage patient care, raises $12 million in a Series A funding round.

VisuWell raises $10.1 million, plans to nearly double workforce

Telemedicine company VisuWell raises $10.1 million in a funding round that could grow to over $12 million.

Fivos Health Announces the Spin-off of Its Cardiovascular Imaging Business into Astute Imaging

Data solutions vendor Fivos, formerly known as Medstreaming/M2S, will spin off its imaging services business as Astute Imaging, which offers pre- and post-surgery planning and follow-up tools.

Clearlake Capital-backed NThrive to acquire Pelitas

Revenue cycle management company NThrive will acquire Pelitas, which offers solutions for patient access, digital intake, and front-end RCM.

Comments Off on Morning Headlines 2/9/22

News 2/9/22

February 8, 2022 News Comments Off on News 2/9/22

Top News

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Highlights from the just-announced Best in KLAS awards:

  • Epic, Nordic, Galen Healthcare, and The Chartis Group were named as overall best.
  • Epic won Best in KLAS awards in 11 market segments.
  • Most-improved products include Infor ERP and Greenway Intergy Practice Management.
  • Epic was the top-rated physician practice vendor by far, followed by Athenahealth, NextGen Healthcare, Greenway Health Intergy, Allscripts, and EClinicalWorks.
  • Topping the overall software suite rankings was Epic, followed by Meditech Expanse, Cerner, CPSI Evident Thrive, and Allscripts.
  • Nordic led overall IT services firms, followed by Pivot Point Consulting, Bluetree Network, Experis Health, Impact Advisors, Engage, and Cerner.

KLAS also announced the global software (non-US) winners. Some highlights:

  • Nearly all respondents have adopted virtual visit technology.
  • Digital pathology is growing rapidly in Europe.
  • Top acute care EMR winners are InterSystems TrakCare EPR (Asia/Oceania), Epic (Canada and Europe), Philips (Latin America), and Cerner (Middle East/Africa).

HIStalk Announcements and Requests

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Welcome to new HIStalk Platinum Sponsor Volpara Health. The company has acquired CRA Health, LLC and Volpara Risk Pathways is its new solution. It is a complete program for identifying and managing patients who are at high risk for breast cancer. The company applies world-class knowledge and over 15 years of experience in risk and genetics to help prevent advanced-stage cancer. Volpara Risk Pathways can identify lifetime and hereditary high-risk patients in any setting, including primary care, OB-GYN, and imaging. This solution interfaces or integrates with EHRs and genetic testing labs without compromising time or workflow. Volpara Risk Pathways is more than just a score, offering guidelines, recommendations, and tools to help coordinate care for patients at elevated risk. Let Volpara Health leverage its vast experience, including performing over 2 million assessments annually, to help build or improve your high-risk program with both product and consulting expertise. Thanks to Volpara Health for supporting HIStalk.

I found this YouTube video describing Volpara Health’s intelligent cancer screening workflow.


HIStalk sponsors, your company can be listed in my conference guides simply by sending me contact and participation information, even if you are attending but not exhibiting. Fill out the forms for ViVE and/or HIMSS22


Webinars

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


Acquisitions, Funding, Business, and Stock

Revenue cycle management company NThrive will acquire Pelitas, which offers solutions for patient access, digital intake, and front-end RCM. Pelitas won Best in KLAS for patient access in 2019, 2020, and 2022.

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Data solutions vendor Fivos, formerly known as Medstreaming/M2S, will spin off its imaging services business as Astute Imaging, which offers pre- and post-surgery planning and follow-up tools. Medstreaming founders Elseaidy and Ewald de Vries will run the business.

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E-consult company AristaMD acquires Preferral, which offers referral management, analytics, and document routing software. Preferral founder and CTO Jon Gautsch will become SVP at AristaMD.

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Telemedicine company VisuWell raises $10.1 million. President and COO Gerry Andrady took on the CEO role last April after predecessor Sam Johnson was fired after being caught on video in an altercation with 18-year-old Dalton Stevens, who was was wearing a dress on their way to the high school prom.

Healthcare advisory and analytics firm Press Ganey will acquire Forsta, a customer experience and market research technology business. Press Ganey Chief Strategy Officer Darren Dworkin is a health IT industry veteran, having worked in executive roles at Cedars-Sinai, Boston Medical Center, Stanson Health, and Summation Health Ventures.

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Neura Health, a membership-based virtual clinic specializing in headache and migraine treatments, raises $2.2 million in seed funding. The company plans on collecting a massive, anonymized data set of neurological conditions and outcomes to share with researchers and pharmaceutical companies.

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Curve Health raises $12 million in a Series A funding round. The startup helps hospitals and nursing homes coordinate and manage patient care.

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I missed this during the holiday break: RWJBarnabas Health Children’s Specialized Hospital (NJ) and Pinnacle Solutions have launched Predictive Health Solutions. The new business will offer technology focused on improving patient outcomes, initially focusing on reducing appointment no-shows.


Sales

  • King’s College Hospital NHS Foundation Trust in England will go live on Epic next year.
  • Nebraska-based HIE CyncHealth selects HealthEC’s population health technology and services.
  • Community Care of North Carolina selects Bamboo Health’s Pings care coordination and notification software.

People

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Healthcare workforce optimization company Prolucent Health names Dan Owens (PatientPoint) CTO.

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Greg Miller (Talkdesk) joins Lumeon as chief growth officer.


Announcements and Implementations

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NorthBay Healthcare (CA) implements Oracle Cloud ERP and human capital management software with assistance from Alithya Group.

In Australia, cancer center Chris O’Brien Lifehouse goes live on Meditech Expanse.

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Amazon Care will expand its employer-contracted urgent and primary care services, which are offered both virtually and in-person, to 20 new cities this year.


Government and Politics

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Training issues still plague the DoD’s Cerner-powered MHS Genesis system, according to an annual oversight report from the DoD’s Office of the Director, Operational Test, and Evaluation. Nearly 75% of the report’s survey respondents consider the program’s computer-based training to be “poor,” though a new initiative to give users hands-on practice in a mock environment did see improvement. The report ultimately concludes that the system “is not yet survivable in a cyber-contested environment.”


Other

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JAMA publishes guidelines on how hospitals can meet the CMS requirement that they assess their EHR safety using the SAFER Guides, which is provided by SAFER Guides developers Dean Sittig, PhD; Patricia Sengstack, DNP; and Hardeep Singh, MD, MPH.

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Athenahealth clarifies its COVID-19 vaccination policy, telling a local paper that the vaccine will no longer be mandated for employees who don’t directly interact with customers. Unvaccinated employees, presumably those who work in the office, must provide a weekly negative test result. All employees have the option to work from home until June.


Sponsor Updates

  • Ascom signs an agreement with Champs Group Purchasing, giving its members access to Ascom’s communications workflow technology.
  • Clearwater promotes Chris Dowhan to principal consultant and Leeanne Lane to director of contracting.
  • Divurgent releases a new episode of its podcast, The Vurge, focusing on women in technology.
  • Surescripts recaps its 2021 accomplishments, including enhancements to and expanded use of its Medication History services.

Blog Posts


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These HIStalk sponsors were named as Best in KLAS. If I missed your company or if you are signing up as a new sponsor, let me know and I’ll do an addendum.

  • Arcadia.io (value-based care management services).
  • Change Healthcare (payer IT consulting services).
  • Fortified Health Security (security and privacy managed services).
  • HCTec/Talon Healthy IT Services (partial IT outsourcing).
  • Health Data Movers (HIT implementation leadership, small).
  • Impact Advisors (security and privacy consulting services).
  • Imprivata (access management).
  • InterSystems (interoperability platforms).
  • Lyniate (integration engines).
  • Meditech (acute care EMR, community hospital; home health, small; patient accounting and patient management, community hospital).
  • Nordic (overall IT services firm; HIT implementation leadership, large; revenue cycle optimization; technical services).
  • Nuance (speech recognition, front-end EMR).
  • Premier (value-based care consulting).
  • Sectra (PACS, large; PACS, small).
  • Symplr (time and attendance; clinical communications).
  • Well Health (patient outreach).
  • Wolters Kluwer (infection control and monitoring).
  • Zynx Health (clinical decision support – care plans and order sets).

Contacts

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

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Comments Off on News 2/9/22

HIStalk Interviews Russell Branzell, CEO, CHIME

February 8, 2022 Interviews Comments Off on HIStalk Interviews Russell Branzell, CEO, CHIME

Russell Branzell, MS is president and CEO of the College of Healthcare Information Management Executives of Ann Arbor, MI.

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Tell me about yourself and the organization.

I have been president and CEO of CHIME since 2013. I have held chief executive positions at UC Health and Poudre Valley Health System and some CIO positions  before that, including at one of my favorite places I started after I got out of the military, which was Mercy Health System in St. Louis. Before that, I was in the military and did medical administration and some other stuff that, like everybody in the military, you don’t talk about.

CHIME is a great organization. It has been around since 1992. I joined as a member in 1997 or 1998. It serves the purpose of supporting CIOs, digital health leaders, and the new titles in this space. We have over 5,000 members across the globe. We have members in 58 countries and chapters in 11. We have other associations that are part of our organization to include security and application technology officers. But in the end, we focus on one thing. One member at a time, we want to make sure they are exceptional leaders positioned to transform health and care. That’s what we do every single day. Everything we do revolves around our members and our industry, and we try to make it a little bit better every day.

How do those new titles and new roles such as chief digital officer fit into what has traditionally been a CIO world, and how does CHIME meet their needs?

I experienced some of that in my professional career, as the role of CIO changed fairly dramatically from the tech purveyor to a leader in the C-suite and transformation.This is just the next level of maturation.

It takes a lot of people to manage a digital enterprise. Eventually, you’re going to start hearing about the digital skills that are necessary for chief executive officers, chief financial officers, and so many others. Some CIOs, as they progress up the ranks, are positioned and ready to help lead an organization to that digital challenge and the digital journey they are going on. Some aren’t. People come and go depending on how their skills progress in the industry. The most important part for us is that we will do everything we can to help people move through that.

Our industry is in massive disruption. You’re also going to see that reflected in titles, skill requirements, and positions. Not just in the C-suite, but across the entire healthcare enterprise and ecosystem. We’re going to feel that every single day. We do everything we can, through a vetting process through membership, to identify those people that fit in that digital health ecosystem bubble. That’s who we want to serve.

What education and support does CHIME offer to technology leaders who are coming into healthcare from other industries?

It’s great that we are seeing more of them entering in the industry, mainly because more opportunities are available than ever for those leaders to transition into healthcare. It is a steep learning curve, although not insurmountable. We’ve always had some of them attending our CHIME Healthcare IT Leadership Academy, our ViVE event that is coming up soon in Miami Beach, and our Fall Forum. We’ve always tried to focus on building everyone’s skills up, and they plug right in.

The primary one for experienced people transitioning into healthcare, even though they may have 20 years of IT leadership or digital leadership in another industry, is our Healthcare CIO Boot Camp program, where we spend a lot of time working on and understanding the role of leadership inside healthcare. Part of that is digital health. Part of that is IT applications. But the primary thing is that you need to be a healthcare leader first to be able to apply those.

Then we help along with other things like mentorship programs, connecting them with a friend or a buddy along the way and trying to get them involved in the community. CHIME is a relational organization. We want to plug them into a support group and an environment where they feel like they can lean on people when they have those questions that maybe are a little bit too difficult to answer right there in a boardroom some days.

Has connecting people with peer support or networking changed now that in-person conferences aren’t the only option, or maybe at times aren’t an option at all?

COVID is a horrific thing that has been tragic and difficult for so many people, but it accelerated things that we thought would take five and 10 years, which is the acceleration of digital connections and digital thought. Part of that is exactly what you described. People have come to rely on feeds of information from a digital format. Your site is one of those.

But we sometimes live in a world of isolation, because so many people work in a remote environment. We count on those connections digitally to accelerate as a relationship. That’s the part that is still a little bit hard. We are human beings. We are relational beings who still need to see and talk to each other. Sometimes Zoom and our cell phones don’t meet that need. There still is a need to come back together, and we are experiencing that across the entire human race as we speak. We’ve seen that isolation maybe is not a great thing.

Healthcare is also different in that even multi-billion dollar organizations often compete only locally or regionally, which allows people to share information freely with people outside that area.

Most healthcare is still local. That has been a cliché for so long, but it’s true. You get most of your healthcare locally, where you live. With healthcare at a macro level, it has been — maybe “inspiring” is too strong of a word — at least motivating that I’ve never met any of our peers or any CHIME members who said, “I’m never going to talk to my peers about IT. It’s my true competitive advantage.“ It’s an enabler, and people are always willing to openly and freely share that. Even those who are on the cutting and bleeding edge are more than willing to share their lessons learned. That’s what’s great about our industry — people will tell you everything they’re doing just because they want to share and improve healthcare.

What led to CHIME launching a graduate degree program under CHIME University?

This has been a journey. We launched CHIME University initially as the umbrella for all of our education and development programs, which includes certification and long-time programs. We started getting feedback from people that there were no programs that met their needs on a realistic basis of “this is the way I work, this is where I think my career is going.” We got that feedback in multiple forums.

We started the journey of considering it, going out and asking questions. Some of the questions we asked were simple, such as, “What did you really love about the graduate programs you were in, whether that was a master’s or doctorate?” We were amazed that there was almost nothing they really enjoyed about their graduate and doctoral process, with a couple of exceptions. One was engaging with professors and lecturers from the real world who had been there, done this, lived this, or are living it currently as part of the curriculum. The other was that it’s real-world applicable and current, not a textbook from five years ago. It was applicable to me now and in my near future.

When we asked them what they didn’t like, the list was long. They hated synchronous learning, that they had to be there at a specific time. I’m a professional — who knows what my life is going to be like tomorrow? They hated the fact that it was almost always a structured environment that had to start and stop on a specific date. They said, that’s not how we work, it’s not how you work, and it’s not how our digital lives are.

Just as importantly, they wanted something that was going to be tailored towards their life, not towards a purely academic mindset, even though this will be extremely academic as we go through this. We boiled it down to a simple program that was a true, self-paced, convenient way to operate. If you need to take a month off, take a month off. If you want to go really fast in some part of the program, go really fast. We made sure this was applicable to our industry’s digital leaders.

But most importantly, the thing we heard the most was, why the heck is education so expensive? I’ve got a dear friend who is six years and $200,000 into a doctorate program. We said, we’re going to offer this at a reasonable cost. We’re going to use our leaders and real experts. We can offer this at an affordable cost so participants can keep their career going and and truly advance their education.

What led to developing the ViVE conference with HLTH?

We’re in a disruptive period of time. We are in a place where we need to do things differently and bring the right thought leaders in. What CHIME has always done really well is bring serious thought leaders together who want to collaborate and find ways to do things differently, to create something in a unique way.

We’ve been working with HLTH for a few years. We worked around innovation and collaboration skills and did some different things with them at their events. It was a symbiotic relationship, one of those rarities in life where one plus one equals a much higher number than two. We really felt good about that, but what we still felt was truly missing was a place where executives, leaders, innovators, disruptors, investors, and startups can come together and work an environment that tries to advance the industry at a much faster pace, questions the status quo, and finds something that we can all agree upon in different little increments all over the place to work in a different way.

HLTH has done an amazing job at reinventing what an event looks like. CHIME has done a good job of focusing on what leaders need to improve their skills. This isn’t intended to be a giant trade show floor. It will bring digital health leaders together who want to work collaboratively, exchange thought leadership, and do things in a meaningful way. We feel good about where we are with that.

How do you walk the line between wanting to grow as an organization but making sure that vendors aren’t driving the agenda or that membership becomes so diverse that people don’t have much in common?

The great part about this, and the direction of our board with our strategies and direction of CHIME, is that CHIME will still be CHIME. CHIME is still the entity for the senior digital health leaders. We will still have our CHIME Spring Forum, which is exclusive for those members and our small number of vendor or foundation partners. There will be a larger conference called the ViVE conference that wraps around that, which will have a lot of speakers and a lot of other opportunities. That’s for those leaders who need that level.

But the CHIME part stays CHIME. For lack of better term or analogy here, it’s the nucleus that sits in the middle that we will always hold sacred and always make sure we’re supporting. We can get bigger. We can support the industry. We can look at the whole ecosystem. But we also need to be true to our roots and true to what we do well for our CHIME membership. We think we can balance both well and in a meaningful way, and at the same time, look at a larger ecosystem that needs support and leadership, because there’s a lot of people out there who need to continue to advance, improve their skills, come together, and collaborate.

How did the ViVE conference end up being so close to the HIMSS conference in both timing and geography?

I’s always been a hallmark that we think we’re doing the right thing for our members, the right thing for our leaders in the industry. This was the right location, the right timing.

If you put it in perspective, the last two major events in the industry since the easing of COVID — I don’t in any way want to suggest that it’s over — was our Fall Forum last fall and now this event in collaboration with HLTH, ViVE. We want to continue to make sure we’re supporting the industry, and this was the right location and the right timing for us. There are places for everybody in the industry who wants to make sure they are doing the right thing and supporting the industry as a whole, but this is what we are going to focus on. We are really, truly not going to worry about other people.

Are you seeing increased membership from those folks with those new digital health job titles or those who work outside of provider organizations, say for health plans or drug chains?

We’ve always had some members who work in non-traditional roles outside of acute care, ambulatory care, and large medical groups. Our primary membership for years has been the provider sector, which was mostly the acute and the ambulatory environment. But we’ve always had some members in things like long-term care, nursing facilities, rehab facilities, and payers. As we see that ecosystem continuum come together and there’s so many pieces — some through acquisitions, some through relationships and partnerships — we see more and more of those come in.

Now we have not gone out and said, “we’re going to go out and try to get every payer into CHIME.” No. What we say is, we have programs and activities for leaders regardless of where they are and where they want to fit in. But even today, we have members such as the CIO of Walgreens Boots clinic structure, payers, and long-term care. It really comes down to whether it’s a vendor foundation partner and they fit in our foundation model, or they are a deliverer of care of some type and they fit in our CHIME model.

What developments will most affect CHIME and its members over the next few years?

Our board spent a majority of the 2019 strategic retreat discussing this for multiple days. No offense to any of our previous retreats, but it was by far the most productive, forward-looking retreat we’ve ever seen, where we talked about where the industry is going. They shaped a model of our 3.0 strategy, some parts of which you’ve already addressed, such as absolutely doing everything we can to help people advance in their skills, whether that’s small training and certifications and support, or if they need an advanced degree to move forward and continue to advance their whole educational aptitude. That was part of that strategy.

The other is that we have a higher responsibility to more than just the CHIME membership. Absolutely, we’ll never take our eye off our CHIME membership and do everything we can, but there’s a lot of up-and-coming digital leaders, a lot of people who will need support and need that vision that CHIME provides to them. We will look to the larger digital health ecosystem to make sure we’re doing that along the way.

The third leg of that stool is that not everybody’s going to connect in an in-person event. As a matter of fact, a vast majority will not connect in an in-person event. We need to provide everything from a digital connection engagement perspective, where they can do those things just as much as in-person in a digital format around the globe.That’s one of the things we can do in an easy way. We can leverage all the things that we’re doing to connect the entire ecosystem to raise all the boats while actually putting the same effort toward those.

We feel good about addressing the large ecosystem, staying true to what we are, but also advancing the whole industry to a place that will look dramatically different in five years. Healthcare will be almost unrecognizable, with the amount of technology and opportunities to improve care in the next three to five years, and then the next three to five years after that. We are in the revolutionary stage of healthcare delivery.

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