Morning Headlines 9/10/24

EQT to acquire GeBBS Healthcare Solutions, a leading healthcare technology solutions provider

Global investment firm EQT will acquire revenue cycle and health information management company Gebbs Healthcare Solutions from ChrysCapital.

Aledade Launches Recruiting Service to Connect Primary Care Practices to Talent

Primary care network management company Aledade launches a physician recruiting service.

Cyberattack recovery costs hit $8.9M for SW Ontario hospitals — so far

Five hospitals in Ontario and Transform Shared Service Organization, their shared services provider, are on track to spend $6.6 million on recovery efforts stemming from a ransomware attack in October 2023.

Curbside Consult with Dr. Jayne 9/9/24

As I work on optimization projects with different care delivery organizations, I’m shocked by how much waste I see within the system. Many large health systems spent a significant amount of time and money over the last two decades investigating in process improvement initiatives. However, it seems like once focus is lost, waste creeps back into the system and becomes an impediment to efficient patient care.

End users such as physicians and nurses are often experiencing some degree of burnout and may not want to spend the effort pushing back against processes that they know aren’t serving patient care. Others may experience learned helplessness, where repeated stressors cause them to feel that they have no ability to change the situation, so they don’t even try.

Some of the inefficiencies I see are caused by people over-interpreting regulations. For example, two-factor authentication for electronic controlled substances is required. However, it is not required for electronic prescriptions for drugs that are not controlled substances. Organizations that don’t understand the ability of EHRs to have different settings for different types of medications may require two-factor authentication or a password input for all medication, resulting in millions of wasted clicks each year and countless hours of frustration among clinicians.

Other inefficiencies are caused by outdated attitudes towards patient management. In past decades, some institutions taught policies that hinted at the idea that patients can’t be trusted. For example, if a patient was due to have a follow-up visit in 90 days, one shouldn’t write them a prescription with more than 90 days’ worth of refills because then the patient would be forced to come for an appointment or at least to call the office. In contrast, practice management journals have advocating for years that this approach isn’t supported in the medical literature and just creates additional risk of patients running out of their medications as well as extra work for ambulatory practices as they field refill requests.

Practice management journals have also advocated having patients schedule their follow-up appointments before they leave the office, yet many do not. My own primary care practice refused to schedule my annual appointment before I left last year, citing the fact that physician schedules weren’t open yet. They said that normally they have patients fill out a postcard that they mail when the schedules open, but that they were out of postcards and would fill one out on my behalf when they were restocked and schedules were open.

It’s been a full three months, and I have zero confidence that this multi-step process is happening in the office. Given the lag time on getting an appointment in this particular practice, I should probably call this week to set myself up for nine months from now. Of course they don’t have online scheduling open either, so it’s lots of wasted effort when you add up how many patients are impacted by this lack of process.

I also see physicians who continue to retake blood pressures on every patient, regardless of whether values are in or out of range. I would propose that if you don’t trust the blood pressure readings that your staff members are doing, you have two options. One, you could teach them to take readings exactly the way you want them to so they can perform proficiently moving forward. Or, you could have them stop altogether, freeing up their time to do other support tasks. But continuing to repeat on every single patient is just wasteful. I also see the documentation of irrelevant vital signs just for the sake of documenting vital signs. Temperature is generally irrelevant for well visits and most chronic disease follow-up visits, so why does everyone end up with a thermometer under their tongue?

On the positive side, many organizations have taken the advice of their EHR vendor to filter the number of “thank you” messages that make it to physician EHR inboxes. Although this can decrease inbox burden, some of my colleagues report that they miss those expressions of gratitude and that it feels like their inbox is now only full of demand messages. Some ambulatory organizations are focusing on routing messages to ancillary staff, such as medical assistants, before escalating to nurses and to physicians only if needed. I’m seeing a few places adopt delegated refill policies, although there is still much more hand-wringing about these types of protocols than there ought to be.

I’m also seeing more organizations configure EHR message routing so that ambulatory physicians aren’t inundated with inpatient test and diagnostic results. Some are also stopping the practice of automatically copying the primary care physician on tests that are ordered by other ambulatory physicians. This is a plus in two ways – not only does it cut down on inbox volume, but it also prevents confusion as to who is responsible for managing the test results. This creates extra work for consulting physicians, though, who may need to send a specific communication back to the primary care physician to let them know what is going on with the patient. This shouldn’t be too much of a shock to them as they theoretically should be sending a consultation letter already, especially if the primary care physician referred the patient for evaluation.

The most widespread optimization efforts that I’m seeing are in the implementation of ambient documentation solutions. Adoption was slow at first, but is really taking off. At some point, it’s going to become a requirement for facilities that want to attract top physicians. If I was a graduating resident at an institution that had implemented it and I was used to using it every day, you can bet that it would be a must-have criterion for a future workplace. Organizations that aren’t ready to go all-in on the technology should consider other bridge solutions, such as virtual scribes, or at a minimum, human scribes.

In other technology news, I was able to catch a glimpse of NASA’s Advanced Composite Solar Sail System, also known as ACS3, flying through the sky at an altitude of 600 miles on Sunday night. Temperatures have dropped into the 50s overnight here, so it was a perfect excuse to pull out the fire pit, pour an adult beverage, and chill out in a lawn chair as I prepare for the coming week. I’ll have another prime viewing opportunity Monday night, so here’s to crossing my fingers and hoping for a crisp and cloudless night. If you’re interested in trying to spot it yourself, more information can be found here.

What activities help you recharge and get ready for the busy work week? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 9/9/24

EQT Is Said to Consider Sale of US-Headquartered AGS Health

Global investment firm EQT reportedly considers strategic alternatives for RCM vendor AGS Health that include a possible sale.

Zelis Owners in Talks to Sell Stake at $17 Billion Value

The private equity owners of Zelis consider selling their minority stake in the healthcare payments company in a potentially $17 billion deal.

Kipu Health Acquires Hatch Compliance to Strengthen Behavioral Health Technology Portfolio

Behavioral health technology vendor Kipu Health acquires Hatch Compliance, which specializes in compliance and risk management software for behavioral health providers.

Monday Morning Update 9/9/24

Top News

A cybersecurity researcher finds an unsecured web database that contains the information of patients of the ironically named Confidant Health, an AI-powered mental health and addiction treatment provider.

The database contained 120,000 files and included lengthy psychiatry patient intake notes. It also included audio and video recordings of sessions. Information in the files suggests that some of it was collected by Confidant’s conversational chatbot called Alfie.

The company says that less than 1% of those files could be accessed openly.

Confidant says that it fixed the problem within an hour of being notified. It objects that the findings were publicized in a “sensational” way.

Reader Comments

From Enlighted Analyst: “Re: CVS Health. Has announced that it will sunsetting its HDMS business as of the end of 2025. HDMS provides data warehousing and analytic services to health plans and large employers and was acquired by CVS Health as part of its acquisition of Aetna.” Reported in a CVS announcement. Health Data and Management Solutions offers the Enlight data solutions and visualization platform. It describes its business as “build[ing] connected health views for employers, health plans, providers, and brokers. We transform unrefined data, often disparate and difficult-to-access, into integrated insights.”

HIStalk Announcements and Requests

You are (sadly) beating poll respondent averages if you spend six or more hours dealing with work-related messages after hours. I have to commend employers who have somehow convinced their workers that spending their free (literally) time doing company work is OK.

New poll to your right or here: How much impact has the information technology that is used by your providers and insurers had on your overall health and happiness?

Webinars

September 10 (Tuesday) noon ET. “Overcoming Hurdles in Specialty Med Access Under Medical Benefits.” Sponsor: DrFirst. Presenters: Drew Hunsinger, VP of corporate business development, DrFirst; Tyler Wince, MEd, VP of product and technology specialty solutions, DrFirst. More specialty medications, which made up 80% of FDA’s new drug approvals last year, are falling under medical benefits, which challenges the patient care processes and efficiency of providers. Medication access experts will discuss how automation and unified medication management solutions can ensure better outcomes for patients and providers by addressing patient access hurdles and enhancing the ‘stickiness’ of EHRs. They will also provide insights into how regulatory changes such as interoperability and prior authorization mandates will affect healthcare stakeholders.

September 17 (Thursday) noon ET. “Level Up Your Stars – Innovative Approaches to Boosting Quality Performance.” Sponsor: Navina. Presenters: Dana McCalley, MBA, VP of value-based care, Navina; Michael S. Barr, MD, MBA, chief medical officer, PreferCare; Yair Lewis, MD, PhD, chief medical officer, Navina. The presenters will explore strategies to boost quality performance and close care gaps effectively. Topics include enhancing quality metrics, developing strategies for care gap closure, leveraging AI for enhanced performance, and optimizing workflows.

September 19 (Thursday) 1 ET. “Cuttng-Edge Conversations: A Fireside Chat With Top CMIOs.” Sponsor: DrFirst. Presenters: Drex DeFord, MSHI, MPA, This Week Health; Lacy Knight, MD, MSMI, Piedmont Health; Jake Lancaster, MD, MSHA, MS, Baptist Memorial Health Care; Colin Banas, MD, MSHA, chief medical officer DrFirst. This fireside chat will distill key points from 15 CMIO participants of the 229 Executive Summit. Topics include the impact of AI on clinical workflows, strategies for optimizing healthcare operations, addressing physician burnout and patient safety, and advances in population health management.

October 3 (Thursday) 1 ET. “Navigating AI-Powered Medical Interpretation: Insights for Health Leaders.” Sponsor: Globo. Presenter: Dipak Patel, CEO, Globo. AI is redefining how providers can communicate with patients who speak limited English. However, not all LLMs are created equal, and their potential and limitations need to be examined further. Globo has published its results from testing several LLMs. This webinar will address the promises and perils of AI-enabled medical interpretation in summarizing that research in four key domains: the process of AI interpretation, how to measure it, the state of AI tools today, and the areas where AI falls short with interpretation.

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

Acquisitions, Funding, Business, and Stock

Oracle acquires the former Cerner demonstration center on the vacant campus at 2800 Rockcreek Parkway. Oracle exercised the purchase option for the 125,000 square foot building that Cerner moved into in early 2019 in a sales-leaseback contract with North Kansas City.

Announcements and Implementations

Palantir launches HealthStart, a program for startup developers that focuses on three layers: streamlining compliance approvals, a starter kit for builders, and ontology as a service.

Government and Politics

Texas sues the federal government for implementing a HIPAA medical privacy rule that prohibits state investigators from obtaining the medical records of women who cross state lines to obtain abortion services. The lawsuit questions HHS’s ability to determine the scope of federal privacy and says that such action unlawfully limits state investigative authority, which is guaranteed by HIPAA.  

Two independent reviews find that VA hospitals outperformed non-VA hospitals in patient satisfaction (79% four or five stars versus 40%) and hospital quality ratings (58% four or five stars versus 40%).

Sponsor Updates

• NeuroFlow staff volunteer with Cradles to Crayons to help pack bookbags for local students.
• EClinicalWorks releases a new podcast, “Cutting Costs and Improving Care Seamlessly.”
• Netsmart recaps its 17th annual Connections2024 conference in Dallas, which showcased customer achievements and AI innovations of its CareFabric platform.
• Wolters Kluwer Health offers free, online access to evidence-based information about mpox in a dedicated mpox resource center.
• RLDatix will host a lunch and learn session featuring customers Bozeman Health and St. Francis Hospital at NAMSS 2024 September 30 in Denver.
• Laudio publishes a new report, “Frontline Leaders in Focus: Executive Strategies for Top Workforce Trends.”
• Medicomp Systems releases a new episode of its Tell Me Where IT Hurts Podcast featuring ASTP/ONC Deputy Director, Certification & Testing Division, Jeffery Smith.
• Med Tech Solutions expands its capabilities into the acute care market by enhancing its Epic, Oracle Health, and Meditech expertise.
• Inovalon, Arcadia, Wolters Kluwer, and MRO will sponsor Rise West 2024 September 11-13 in Colorado Springs.
• Nordic releases a new episode of its “Designing for Health: podcast, “Interview with Steve Muething, MD.”
• Pivot Point Consulting Physician Executive Partner Nick Patel, MD joins the HIMSS 2025 Americas Board of Advisors.
• Rhapsody Health publishes a new case study, “Qventus achieves 10X performance and reduces customer onboarding time by 50%.”
• Sectra releases a new podcast, “From co-development to go-live: Inside Penn Medicine and Sectra’s genomics journey.”
• SmartSense by Digi will exhibit at the Health Connect Partners Hospital Pharmacy Fall Conference September 30-October 2 in Columbus, OH.
• SnapCare will exhibit at the Colorado Healthcare 2024 Fall Convention September 10-12 in Loveland.
• Gartner names Verato a Sample Vendor in its latest Hype Cycle for Real-Time Health System Technologies report.

Blog Posts

• Empower pharmacists and streamline processes with advanced data visualization (Meditech)
• CPT vs. ICD-10 Codes: Mapping the ‘Why’ and ‘What’ of Rehab Therapy Patient Journeys (Net Health)
• 3 Health Checks to Know a Workday and ServiceNow Integration is Right for Your Organization (Optimum Healthcare IT)

Contacts

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

Morning Headlines 9/6/24

The Rawlings Group, Apixio Payment Integrity, and VARIS Merge to Form Next-Generation Payment Accuracy and Integrity Platform

New Mountain Capital will combine three of its healthcare billing portfolio businesses into a new company valued at $3 billion.

WindRose Health Investors Makes Strategic Investment in MyndYou

MyndYou, a virtual care assistant software developer, secures funding from WindRose Health Investors.

Kain Capital Launches Kain Analytics

Kain Capital’s new subsidiary, Kain Analytics, will offer healthcare companies value-based care data automation capabilities and intelligent dashboards that deliver real-time analytics.

News 9/6/24

Top News

Private equity firm New Mountain Capital will combine three of its healthcare billing portfolio businesses into a new company that is valued at $3 billion.

The companies are Rawlings Group, Apixio’s payment integrity business, and Varis.

Datavant has acquired Apixio’s Connected Care platform and value-based care solutions as part of the transaction.

The CEO of the unnamed company will be David Pierre, formerly COO of CVS Health-acquired Signify Health.

Reader Comments

From ID Protector: “Re: Optery. The CEO mentioned on their website is me, and the friend that introduced me to Optery was you, from an HIStalk post.” Pretty cool. Optery is a service that gets your name and personal information (address, phone number, age, family members, etc.) removed from websites that are easily found by Googling. Sign up for a free Optery account to see where your information is available for the world to see. I mentioned my personal experience with it in October 2021. I’ve been paying $3.99 per month for basic removal, but because of this CEO’s memory jog, I just now upgraded to Optery Extended for $120 paid annually after applying a promo code that I found online. His example was shocking – someone used his online information to obtain a fake driver license and apply for $50 million in PPP loans, not to mention that the personal information of employees makes it easier for hackers to breach a company. I just now chose a high-profile, Optery-free executive, and within 60 seconds, had photos of their house, what they paid for it, the names and ages of their family members, and details about their spouse’s employer.

Webinars

September 10 (Tuesday) noon ET. “Overcoming Hurdles in Specialty Med Access Under Medical Benefits.” Sponsor: DrFirst. Presenters: Drew Hunsinger, VP of corporate business development, DrFirst; Tyler Wince, MEd, VP of product and technology specialty solutions, DrFirst. More specialty medications, which made up 80% of FDA’s new drug approvals last year, are falling under medical benefits, which challenges the patient care processes and efficiency of providers. Medication access experts will discuss how automation and unified medication management solutions can ensure better outcomes for patients and providers by addressing patient access hurdles and enhancing the ‘stickiness’ of EHRs. They will also provide insights into how regulatory changes such as interoperability and prior authorization mandates will affect healthcare stakeholders.

September 17 (Thursday) noon ET. “Level Up Your Stars – Innovative Approaches to Boosting Quality Performance.” Sponsor: Navina. Presenters: Dana McCalley, MBA, VP of value-based care, Navina; Michael S. Barr, MD, MBA, chief medical officer, PreferCare; Yair Lewis, MD, PhD, chief medical officer, Navina. The presenters will explore strategies to boost quality performance and close care gaps effectively. Topics include enhancing quality metrics, developing strategies for care gap closure, leveraging AI for enhanced performance, and optimizing workflows.

September 19 (Thursday) 1 ET. “Cuttng-Edge Conversations: A Fireside Chat With Top CMIOs.” Sponsor: DrFirst. Presenters: Drex DeFord, MSHI, MPA, This Week Health; Lacy Knight, MD, MSMI, Piedmont Health; Jake Lancaster, MD, MSHA, MS, Baptist Memorial Health Care; Colin Banas, MD, MSHA, chief medical officer DrFirst. This fireside chat will distill key points from 15 CMIO participants of the 229 Executive Summit. Topics include the impact of AI on clinical workflows, strategies for optimizing healthcare operations, addressing physician burnout and patient safety, and advances in population health management.

October 3 (Thursday) 1 ET. “Navigating AI-Powered Medical Interpretation: Insights for Health Leaders.” Sponsor: Globo. Presenter: Dipak Patel, CEO, Globo. AI is redefining how providers can communicate with patients who speak limited English. However, not all LLMs are created equal, and their potential and limitations need to be examined further. Globo has published its results from testing several LLMs. This webinar will address the promises and perils of AI-enabled medical interpretation in summarizing that research in four key domains: the process of AI interpretation, how to measure it, the state of AI tools today, and the areas where AI falls short with interpretation.

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

Acquisitions, Funding, Business, and Stock

Netsmart acquires post-acute market intelligence firm HealthPivots, which it will integrate with CareFabric to support the transition to value-based care.

National oncology practice operator OneOncology acquires Navigating Cancer, which offers a patient engagement and care management platform.

Business Insider profiles Commure as “the weirdest startup in healthcare,” having raised $1 billion at a $6 billion valuation but then walking away from its original mission of developing a healthcare data integration platform to instead offer efficiency-boosting automation for healthcare administrative tasks. The company’s acquisitions include Augmedix, PatientKeeper, Strongline, and Rx.Health. Insiders say that the October 2023 “merger” of Commure and Athelas was actually a Commure acquisition, with products from Athelas becoming Commure’s primary growth engine. Athelas CEO Tanay Tandon took over as Commure’s fourth CEO in October 2023.

Sales

• In Canada, Nova Scotia Health will implement conversational web visitor search tools, EHR search, and radiology workflow from Google Cloud in a five-year, $31 million project.
• Sentara Home Care Services goes live on WellSky CareInsights and Value-Based Insights, integrated with their EHR. 

People

City of Hope hires Simon Nazarian, MBA (Optum) as EVP/chief digital and technology officer.

Michael Justice, MBA (Medical Advantage) joins Mind 24-7 as SVP of technology.

University of Chicago Medicine promotes Karen Habercross, MBA, MSW to VP/chief information security and privacy officer.

Industry long-timer Laura Anderson (Elsevier) joins IKS Health as chief product officer.

EHR vendor Canvas Medical promotes Adam Farren, MBA to CEO. He replaces founder Andrew Hines, who will transition to CTO.

Erik Johnson (BioMérieux) joins Harmony Healthcare IT as VP of marketing.

NVoq hires Dawn Iddings (Netsmart) as chief revenue officer.

Hugh Brennnan (11TEN Innovation Partners) joins Cordea Consulting as EVP of sales.

Greenway Health hires Geordie Sanborn (Arvest Bank) and Chuck Rackley (Infinx) as sales VPs.

Announcements and Implementations

University of Iowa Health Care rolls out Nabla’s ambient technology to all of its clinical workforce, including faculty, advanced practice providers, allied health professionals, trainees, and students. UI Health Care will work with Nabla to develop new use cases and improve its Epic integration.

IRhythm, which offers an ambulatory cardiac monitoring system, signs an exclusive license to incorporate BioIntelliSense’s technologies that measure pulse oximetry, accelerometry, and trending non-invasive blood pressure.

A new KLAS report on patient education solutions notes that 2024 Best in KLAS winner Healthwise, which was acquired by WebMD this year, is used by the widest variety of organizations. Wolters Kluwer is strong in EHR and portal integration, while Elsevier shines with its patient-friendly content. New vendor Mytonomy publishes short-form videos.

Government and Politics

The Republican National Committee alleges to election officials in six states that Vot-ER may be violating election laws, stating that the organization’s goal is to turn “every check-up and doctor’s visit into a political lecture” by pressuring patients to vote in a certain way as a condition of receiving medical care. Rep. Chip Roy (R-TX) previously asked Epic to respond to his concerns that its users could be registering non-citizen voters in Vot-ER. Vot-ER Executive Director Aliya Bhatia, MPP provided this response:

Vot-ER is proud of empowering health professionals and patients to vote, many of whom face significant barriers to civic participation. It’s unfortunate and frankly a shame that our nonpartisan efforts to promote civic engagement are coming under unwarranted scrutiny. Vot-ER has always been clear in its mission to remain nonpartisan, and we are guided by a bipartisan advisory board, including Republican and Democratic former elections officials, to ensure that our work reflects the needs and concerns of all voters, regardless of political affiliation. Vot-ER does not promote or endorse any political party or candidate, participation is entirely voluntary, and nothing in our programming remotely suggests that patients are pressured or coerced to register to vote. Moreover, we have protocols and technology in place to prevent ineligible individuals from registering, and any suggestion otherwise is simply false.

I mentioned the Epic app name post from interoperability guy Brendan Keeler earlier this week, so here’s another fun thread in which he looks at some of the interesting comments that ASTP received about HTI-2. He cites an anonymous commenter who was “coming out guns blazing” with these points (not Brendan’s):

• Questionable applications have already joined the network by exploiting its lenient onboarding process, which could include using fake NPIs and websites.
• Ineffective monitoring allows organizations to siphon off data without sharing data of their own.
• ASTP should follow Carequality’s focus on thorough vetting and continuous monitoring, which could include real-time participant monitoring and removal and notifying practices when their credentials are used.

Other

Kaiser Permanente hematologist / oncologist Faisal Cheema, MD says that he’s happy that they are using Abridge for ambient documentation after piloting Nabla Copilot. He says that Copilot was effective but not integrated with Epic (he didn’t say whether it was an app problem or KP decision) and Abridge’s integration with Epic Haiku was a game-changer. Next, he would like to see transcription of virtual visits directly from the smartphone app. 

Hamilton Health Sciences profiles cardiologist Darryl Leong, MBBS, MPH, MBiostat, PhD, who is also associate CMIO for research, and his involvement with the organization’s use of Epic in research.

Sponsor Updates

• Middletown Medical (NY) sees reduced claim rejections, decreased claims submission lag, and ROI savings after adding RCM capabilities to its EClinicalWorks EHR.
• Black Book’s latest survey of VC and PE healthcare leaders reveals priorities for healthcare IT investments in 2025.
• CereCore will present at Meditech Live September 27 in Foxborough, MA.
• Arcadia publishes a new report, “The healthcare CIO’s role in the age of AI.”
• Artera publishes a new customer snapshot featuring Newton Clinic.
• Availity partners with Iodine Software to bring advanced mid-revenue cycle solutions to its Availity Essentials Pro customers.
• AvaSure will host the 2024 AvaSure Symposium October 2-4 in Grand Rapids, MI.
• Capital Rx releases a new episode of The Astonishing Healthcare Podcast, “Never Move Again, a Paradigm Shift in Pharmacy Benefits, with AJ Loiacono.”
• The American Health Law Association features Clearwater Chief Risk Officer and Head of Consulting Services and Client Success Jon Moore on its latest podcast.
• Memphis VA Medical Center (TN) expands its use of CliniComp solutions.
• CloudWave publishes a new case study, “Safeguarding Patient Care: Emanate Health Adopts OpSus Live for Enhanced EHR Security.”
• Crossings Healthcare Solutions, FinThrive, and Nordic will sponsor Oracle CloudWorld 2024 September 9-12 in Las Vegas.
• Ellkay will exhibit at Mayo Clinic’s Leveraging the Laboratory Conference September 17-18 in Rochester, MN.
• Elsevier offers free access to research and clinical resources via its Mpox Information Center to accelerate the fight against viral disease.
• FinThrive releases a new episode of its Healthcare Rethink Podcast, “Is the Boom of Digital Health Really Booming?”
• Five9 will present at SaaStr Annual 2024 September 10 in San Francisco.

Blog Posts

• Epic’s UGM 2024: Innovations, insights, and the future of healthcare (Nordic)
• 5 Fundamentals to Master Healthcare Delivery at Scale (AGS Health)
• Specialty practices and the need for a mold-breaking EHR (Altera Digital Health)
• Elevating Patient Registration: Improving the First Step in Accessing Care (Amenities Health)
• Ascom Asks the Experts: The Future of Nursing – Embracing Virtual Care (Ascom)
• A Candid Conversation with the FDA: Medical Device Cybersecurity (CloudWave)
• Enhancing Diversity and Inclusion in Hiring (Direct Recruiters)
• The Emerging Role of AI Medical Scribes in Patient Engagement (EClinicalWorks)
• Pharmacists Serve as Last Line of Defense Against Drug Overdoses (First Databank)
• Streamline for Success: Top 3 Signs It’s Time to Consolidate Your Healthcare RCM Vendors (FinThrive)
• Healthcare Cybersecurity Threats: August 2024 (Fortified Health Security)
• Infrastructure Management Services (HCTec)
• Integrating Workday with Scheduling Applications (Impact Advisors)

Contacts

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

EPtalk by Dr. Jayne 9/5/24

I enjoyed reading the results of Mr. H’s poll on company culture, where a full one-third of respondents said their company’s culture was worse today compared to a year ago. There’s always a disconnect between what employers think of their culture and what employees experience.

A recent story of culture gone wrong details a company retreat involving some hiking in Colorado. One member of the group became separated and was ultimately stranded overnight on the mountain in dangerous conditions that included freezing rain and high winds. Contributing factors included co-workers who retrieved pieces of gear that had been used to mark the way through a scree field, as well as delayed notification to search and rescue personnel.

Search efforts were pended overnight due to conditions, but the hiker was eventually found after a coordinated search effort that included nine agencies. The man sustained multiple injuries in falls as he tried to descend, and had to be carried to a point where an all-terrain vehicle could assist. I’ve done a fair amount of hiking in my time and would highly recommend always carrying the 10 essentials even if you’re in a large group.

HIMSS is starting to hype its 2025 conference, sending emails to alert members that registration opens next week. The conference is once again in Las Vegas, which I’m not thrilled about since HLTH is there also. I’d really like a break from conferences in Las Vegas and Orlando, but the lack of growth in conference facilities elsewhere makes those venues seem like a lock. Conference passes start at $995 this year with an Executive Summit pass starting at $1,445 that promises access to additional events including a reception and an evening special event.

When I first started working in healthcare IT, there was no such thing as social media, let alone the idea of digital influencers. Things have certainly changed and our industry is bursting with influencers, leading to changes in how business in certain segments is conducted. The University of Texas at San Antonio has added a major in Digital Media Influence to its lineup of degrees. Under the leadership of the Communications program, students will take production classes as well as courses that are focused on digital communication and digital audiences. They will learn technical skills as well as strategies to build and retain followers.

It will be interesting to see how many graduates complete the program and where their career paths lead. I hope they include such topics as “buy a real microphone, no one wants to watch you talking into a wadded up set of wired earbuds” and “how to film without giving your audience vertigo.”

There’s no denying that social media has changed healthcare, however. East Idaho News reports that a local hospital will convene focus groups following a complaint about delays in its emergency department that was posted on Facebook. The post received 190 replies, eventually leading the hospital to contact the author and invite her to participate in a focus group. The organization plans multiple sessions over the net few weeks and hopefully they’ll not only receive constructive feedback but will take action on it.

From The Name Game: “Re: here we go again. Did you see the reports of Jefferson Health buying its way onto the Philadelphia Eagles practice jerseys? They’ll also have their logo featured on the backdrop at press conferences.” Terms of the deal were not made public, but I suspect that they paid a pretty penny for the privilege. The article mentions that the practice jersey logo replaces that of an orthopedic group, but I wonder how many fans will actually notice, let alone care.

Bring on the creepy images and supernumerary digits: The Verge reports that Google Gemini will once again allow users to create AI-generated people, following a hiatus after the tool produced “historically inaccurate images, like racially diverse Nazis.” The tool should be available to Gemini Advanced, Business and Enterprise users quickly and is powered by Imagen 3. Guardrails will be in place to prevent users from creating realistic images of public figures, content involving minors, or sexual scenes. I recently tried Meta’s “imagine yourself” and was impressed by its ability to interpret requests for 18th century fashion, although it did give me mismatched earrings in three of three generated images.

No wonder primary care physicians are tired. A recent research letter in JAMA Health Forum looks at the impact of value-based contracting on primary care. Researchers identified 57 distinct quality measures that one health system’s physicians were expected to track based on value-based contracts with multiple payers. Medicare contracts averaged 13 measures for contract, followed by 10 for commercial payer contracts and five for Medicaid agreements. The authors’ discussion highlighted the disparities in different quality metrics, noting that not only were they addressing different conditions, but that some differed in the outcomes that physicians were expected to meet.

In other study-based news, it’s no surprise that patients report higher satisfaction levels when clinicians are seated when meeting with them. The authors specifically looked at “the effect of chair placement on length of time physicians sit during a bedside consultation and patients’ satisfaction.” Over 100 physician encounters with hospitalized patients were observed, and chairs were placed either within three feet of the patient’s bedside or at a “usual” chair location.

Outcomes included whether the physician sat or not at any time during the visit, along with patient satisfaction. The difference in physician behavior was notable, with 38 of 60 physicians in the “chair placement group” sitting during the visit but only five of 65 physicians in the “usual” chair location group sitting. During college, a friend of mine who was studying architecture used to regale me with the things that he was learning while I was suffering my way through organic chemistry. The idea that “people will sit where they are places for people to sit” appears to be as true in the healthcare setting as it is in theory.

Are your clinicians encouraged to sit at the bedside, or are they just standing at the wheeled workstation or a wall unit? Do they ask for something different? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 9/5/24

Netsmart Announces Acquisition of HealthPivots to Support Value-Based Care Transition for Healthcare Providers

Netsmart acquires HealthPivots, a post-acute care market intelligence firm based in Oregon.

Revelstoke Capital Partners Announces Significant Growth Investment in MediQuant

Healthcare data management company MediQuant secures an undisclosed amount of funding from Revelstoke Capital Partners.

Navigating Cancer Accelerates Investments to Enhance Care Management Platform for Providers and Patients

OneOncology acquires digital oncology care software vendor Navigating Cancer.

Healthcare AI News 9/4/24

News

A legal advisor recommends that doctors not use AI to respond to patient complaints. She says that AI’s responses may use country-specific laws (most likely from the US), generate misleading statements, and ask for confidential information that could breach privacy laws. She also notes that patients may find AI’s wording to be insincere or indicative that their complaint didn’t warrant a human response.

Business

Aidoc adds seven AI solutions for the European health market. Four of them address notification and triage of vessel occlusion, aortic dissection, vertebral compression fractures, and malpositioned endotracheal tube. The others involve quantitative assessments for midline shift, coronary artery calcification, and abdominal aortic measurement.

Imaging-based real world evidence vendor Segmed raises $10.4 million in a Series A funding round, with Advocate Health being among the investors. The company will use the proceeds to expand its use of AI.

Samsung acquires France-based fetal ultrasound AI software vendor Sonio, whose product is FDA 510(k) cleared in the US, for $92 million.

Research

A study finds that AI models can guess a patient’s self-reported race based on technical aspects of radiology images, which could perpetuate diagnosis bias. The authors note that setting a score threshold for the relevant factors can mitigate some of the bias.

Other

Digital transformation leader David Bray, PhD, MSPH says that it’s imperative that AI-generated outputs be labeled consistently to avoid “AI self-cannibalization,” which occurs when AI models are recursively trained on data that was created by previous AI work. He believes that HL-7 standards could be expanded to provide healthcare data provenance to create a traceable, transparent AI ecosystem and to support interoperability.

Actor Tom Hanks warns fans that online ads for “miracle cures and wonder drugs” are using AI-generate images of him, for which he didn’t consent.

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
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Contact us.

Readers Write: Leveraging the Power of Technology to Improve Behavioral Health

Leveraging the Power of Technology to Improve Behavioral Health
By Shana Hoffman

Shana Hoffman, MBA is CEO of Lucet.

We are living in an age of anxiety. Americans of all ages are increasingly struggling with their mental health. Half of young adults and one-third of all adults reported feeling anxious, either always or often in the past year, according to a 2022 survey. In 2023, 60 million Americans, roughly 23% of all adults, reported experiencing mental illness in the previous year.

Despite the growing need for care, millions of people are finding themselves without access to mental health treatment. The barriers they face in accessing behavioral health services are numerous and complex. Long wait times, a shortage of providers, geographical barriers, stigma, and cost all contribute to a system that is unable to meet the demand.

The shortage of mental health providers is a particularly acute problem. According to the American Psychology Association’s 2022 COVID-19 Practitioner Impact Survey, 60% of psychologists reported no openings for new patients. Nearly half of the US population in 2022 lived in a mental health workforce shortage area, with some states needing up to 700 more practitioners to close the gap.

The consequences of this inadequate access to care affect more than just individuals. On a micro level, insufficient healthcare access can impair a person’s ability to proactively manage their mental health challenges, leading to a worsening condition and potentially negative long-term health outcomes. On a macro level, unaddressed mental health issues can contribute to a range of problems, including homelessness, poverty, unemployment, and safety concerns. These have a cascading effect on the local,  and ultimately national, economies.

But there is hope. We may be living in an age of anxiety, but we are also living in an age of technology. Technology can help bridge the gap and improve access to behavioral healthcare. By using today’s advanced tools, we can address many of the barriers that have historically limited access to mental health services.

One of the most significant advantages of using technology in behavioral healthcare is its ability to improve access in areas where mental health resources are limited. Rural areas in particular have long struggled with a lack of mental health services. Tele-mental health services offer a solution for these patients, connecting them to the care they need regardless of their geographical location. Mental Health America reports that rural areas have 20% fewer primary care providers than urban areas, with 65% of rural counties lacking a psychiatrist and 81% without a psychiatric nurse practitioner. Technology can help close these gaps, ensuring that these rural patients are not left behind.

Technology offers flexibility, enabling patients to access care at times that fit their schedules to make it easier for them to commit to treatment. Technology also helps expedite the process of connecting individuals to care. Current average time between booking an appointment and a claims-confirmed connection is over 45 days, with some psychologists reporting wait times of three months or longer. Technology tools that quickly identify active, in-network providers who are accepting new patients can significantly reduce these wait times, ensuring that patients receive the care they need when they need it.

Providers benefit from technology-enabled care access as well. By giving patients more flexibility in how they access care, technology makes it easier for them to stick to their treatment plans over time, helping providers achieve better long-term results.

Most critically, technology can help address the issue of provider shortages by offering advanced and accurate insights into available care resources, minimizing the time it takes for providers and patients to connect, allowing for more efficient scheduling of treatment. By streamlining administrative tasks such as patient intake, documentation, and screening, technology can also help free up clinicians to spend more time on delivering care.

Use of technology can improve treatment adherence and expand access to care in underserved areas, leading to healthier populations and lower long-term costs for payers. Additionally, by improving the accuracy of provider directory management systems, technology can help eliminate “ghost networks” in which healthcare providers who are listed in a health plan’s network are not actually available to provide care. This not only enhances regulatory compliance, but also boosts member satisfaction.

Mental health technology solutions have enormous potential to increase access to care, enhance efficiency, and improve outcomes. To fully realize this potential, stakeholders must continue to invest in and support technological advancements in behavioral healthcare, because only then can we create a more equitable and effective behavioral healthcare system.

Readers Write: Virtual Care Isn’t What It Used to Be – It’s Getting Better

Virtual Care Isn’t What It Used to Be – It’s Getting Better
By Derek Streat

Derek Streat is CEO of DexCare.

Virtual emerged as a vital access bridge during the pandemic, ensuring that patients received on-demand care while living in lockdown. As society transitioned back to normal, public use of virtual care inevitably declined. Today, as we watch market shakeups as companies shutter and shrink, critics are quick to point out that virtual fell short and will never replicate in-person care. That’s a shortsighted outlook, because like any technology, virtual is undergoing a natural pivot.

The industry grew too fast, but disruption drives progress, creates new applications, and forges pathways for value creation. The technology that is powering virtual care has matured from simple, one-off video consultations into an adaptive strategy that complements in-person care to balance a health system’s limited capacity.

Virtual care 2.0 is underway, and at just the right time. With 11,000 Americans aging into Medicare each day and not enough primary care doctors, a new model for how care is accessed and delivered is required. Virtual is a critical backstop to meet the rising demand for care while reducing the pressures on clinicians.

The reality is that not everyone needs to see a doctor in person. It’s the type of appointment and routing to appropriate venues of care that counts. Instead of follow-ups, consultations, and common conditions clogging up urgent care clinics, emergency rooms, or taking away from a doctor’s finite time, health systems can redirect patients to a virtual appointment, a clinic, or a nurse practitioner. Modern care orchestration is multi-modal, predictive, and powered by real-time intelligence to ensure that patients receive the right care, at the right time, in the right setting.

But how can a health system guide a patient to the right modality on the fly? By operating in real time and having the digital flexibility to coordinate how, when, and where patients select care. It’s about having dynamic controls to precisely administer system-wide resources to match demand against capacity. Virtual is part of a broad portfolio of care that underpins convenience for patients while managing workforce resources by the hour, day, month, or quarter.

Consider Kaiser Permanente’s multi-modal approach. By integrating virtual consultations, online check-ins, and secure messaging, the health system enhances patient access while optimizing resources before and after in-person visits or by reducing the need for patients to physically see doctors altogether. The net result is more time for clinicians, greater choice for patients, and the delivery of quality, clinically appropriate care.

Virtual is no longer a button for patients to push, but rather a technology to promote flexibility and growth. For many health systems, virtual is being applied in innovative ways to address more complex patients’ needs.

Health systems can extend the reach of care by offloading routine visits to virtual. These can include check-ups, preventive, and chronic-condition management. The impact is time saved at multiple touch points throughout the delivery pipeline, allowing for a responsive patient experience while liberating resources to focus on acute care and higher complexity cases.

Disruption isn’t failure. It is fuel for innovation. Virtual care is evolving, not fading, and is a cornerstone to a growing mix of care venues, including services, locations, and providers. It’s not about replacing doctors, but rethinking how and where care is accessed to extend workforce resources. This isn’t the slow, phase out of virtual care. It’s just the beginning of a smarter, more agile health system.

Readers Write: Don’t Skip the Digital Wash: 3 Cyber Hygiene Tips for Healthcare Security

Don’t Skip the Digital Wash: 3 Cyber Hygiene Tips for Healthcare Security
By Greg Surla

Greg Surla is SVP/CISO of FinThrive. 

In 2023, healthcare systems faced an alarming surge in cyberattacks, impacting over 100 million people across the US, according to The HIPAA Journal. This troubling trend continued into 2024, emphasizing the urgent need for advanced cybersecurity measures in healthcare.

With the rise of sophisticated ransomware attacks, such as those from BlackCat, and the increasing availability of ransomware-as-a-service, healthcare organizations must remain focused on cyber hygiene practices.

Cyber hygiene refers to the routine practices that are necessary to protect information systems and sensitive data. For healthcare organizations, effective cyber hygiene is particularly challenging due to factors such as outdated technology, stringent HIPAA regulations, and rapidly evolving cyber threats. Key cyber hygiene practices — regular credential rotation, MFA, and effective vulnerability management — are essential for mitigating the risk of breaches and ensuring regulatory compliance.

This article explores three essential cyber hygiene procedures for shielding healthcare data: credential rotation, multi-factor authentication (MFA), and vulnerability management.

Regular Credential Rotation

Regular credential rotation is a fundamental security practice that involves frequently updating passwords and access credentials. This process helps minimize the risk of unauthorized access, especially if credentials are compromised.

In healthcare settings, where multiple users with varying access levels are common, managing credential updates is a complex, but necessary, best practice.

• Develop a clear policy. Establish guidelines for how often credentials should be updated and assign responsibilities for managing this process.
• Use automation. Apply identity and access management (IAM) solutions to automate the credential rotation process and reduce manual effort.
• Educate and incentivize staff. Provide training on best practices for creating and managing secure credentials. Consider offering incentives for adherence to credential policies.
• Conduct regular audits. Regularly review and audit credential management practices to ensure compliance and identify areas for improvement.

Multi-Factor Authentication

MFA is a critical security measure that enhances protection by requiring multiple forms of verification beyond just a password. This additional layer of security is especially important in environments where unauthorized access to sensitive data has severe consequences.

• Select an integrated solution. Choose an MFA system that integrates well with existing infrastructure and is user-friendly.
• Deploy in phases. Start by deploying MFA in high-risk areas and gradually extend it across the organization.
• Train staff. Educate employees on the importance of MFA and provide thorough training on its use.
• Review practices. Periodically assess and update MFA practices to adapt to new security challenges.

Vulnerability Management

Vulnerability management involves identifying, assessing, and addressing security weaknesses within systems. Regular vulnerability management is crucial in healthcare.

This practice includes routine scanning, risk assessment, and timely patching to protect systems from potential breaches. Automated tools are available to frequently scan systems for vulnerabilities and rank risks based on their potential impact and the likelihood of exploitation. Look for emerging vulnerabilities and train staff to identify potential risks and deliver prompt resolution.

The most common attacks in healthcare attempt to exploit user accounts through social engineering methods such as phishing as well as brute-force types of attacks such as password spraying and credential stuffing.

By adopting the cyber hygiene practices list above, healthcare organizations can enhance their defenses against cyber threats, ensure compliance with regulatory requirements, and maintain the security of their systems. And as cyber threats continue to intensify, staying proactive and vigilant safeguards your organization’s sensitive healthcare information, preserving trust in the healthcare system.

Morning Headlines 9/4/24

‘Hospital at home’ startup Doccla raises $46 million for its European expansion

UK-based virtual hospital and remote patient monitoring technology vendor Doccla raises $46 million in a Series B funding round.

Rejoy Health Secures $125 Million Valuation, Plans AI Expansion in Healthcare

New funding for Rejoy Health, developer of large language models for healthcare applications, puts its valuation at $125 million.

Radiology data sharing vendor Enlitic to acquire rival for $5M

Medical imaging data company Enlitic will acquire competitor Laitek for $5 million.

News 9/4/24

Top News

UK-based virtual hospital and remote patient monitoring technology vendor Doccla raises $46 million in a Series B funding round.

The company will use the funds to expand in Europe beyond UK and Ireland.

Reader Comments

From Don O: “Re: Epic’s hiring practices. During my 17-year stint (now retired), I never met another vendor ex-employee. I’d be hard pressed to remember if Epic ever brought someone on from a customer, with possibly a couple of MDs who could not be part of the site’s installation team. Excludes the Emeritus program of experts that have retired from their organization primarily functioning in consulting roles.”

From Samsara Psychiatrist: “Re: mental health professional shortages. This is both in overall numbers as well as in-network psychiatrists, many of whom have full practices or are hospital based and don’t see outpatients at all. This is never reflected in the provider listings. Insurers want patients to make a bunch of unsuccessful phone calls before giving up and either paying cash or not obtaining care at all. Even those who are wiling to pay cash can wait six months for an appointment. Most problematically, patients with the most severe mental illnesses have the most difficulty in getting outpatient treatment since they are more likely to have Medicare or Medicaid and need complex, coordinated services that the average mental health professional is not equipped to give. On the health IT front, initiatives such as meaningful use, MIPS, and MACRA have made it increasingly less likely that mental health professionals will want to participate in these programs. Significant numbers of psychiatrists are retiring or cutting back their hours. The availability of telehealth has increased interest in psychiatry as a specialty, but there are still a limited number of residency training positions, and CMS rules — such as not allowing virtual supervision for in-person resident patients — should be more flexible. Insurers are certainly a big piece of the problem, but not the only one. Big changes are needed.”

From Danny DeVino: “Re: Epic trademarks. Industry interoperability guy Brendan Keeler had fun trying to figure out which of Epic’s trademarks involve products that either didn’t came to fruition or have been retired.” It’s a fun list.

HIStalk Announcements and Requests

About half of poll respondents say that their company culture has changed in the past year, and two-thirds of those say it got worse.

New poll to your right or here: How much time do you spend each week managing work-related messages after normal working hours?

Readers sent me questions last week about Epic related to Vot-ER and how Epic finances startup participation in its Workshop program. My experience is that the PR contacts of most companies don’t respond at all, and if they do, not quickly enough for that same day’s HIStalk news post. Epic always gets back to me quickly with an acknowledgment and then provides a company statement shortly after, which I appreciate since I can give my readers a timely response. It’s also good for companies to address rumors that are likely being discussed more widely than by the one person who asks me.

Webinars

September 10 (Tuesday) noon ET. “Overcoming Hurdles in Specialty Med Access Under Medical Benefits.” Sponsor: DrFirst. Presenters: Drew Hunsinger, VP of corporate business development, DrFirst; Tyler Wince, MEd, VP of product and technology specialty solutions, DrFirst. More specialty medications, which made up 80% of FDA’s new drug approvals last year, are falling under medical benefits, which challenges the patient care processes and efficiency of providers. Medication access experts will discuss how automation and unified medication management solutions can ensure better outcomes for patients and providers by addressing patient access hurdles and enhancing the ‘stickiness’ of EHRs. They will also provide insights into how regulatory changes such as interoperability and prior authorization mandates will affect healthcare stakeholders.

October 3 (Thursday) 1 ET. “Navigating AI-Powered Medical Interpretation: Insights for Health Leaders.” Sponsor: Globo. Presenter: Dipak Patel, CEO, Globo. AI is redefining how providers can communicate with patients who speak limited English. However, not all LLMs are created equal, and their potential and limitations need to be examined further. Globo has published its results from testing several LLMs. This webinar will address the promises and perils of AI-enabled medical interpretation in summarizing that research in four key domains: the process of AI interpretation, how to measure it, the state of AI tools today, and the areas where AI falls short with interpretation.

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

People

RxLightning names Peter Simmons, RPh as COO.

Nathan Gnanasambandam, PhD (HealthPointe Solutions) joins RhythmX AI as VP of AI.

Flatiron Health promotes Quincy Weatherspoon, MBA to VP/GM of Flatiron Point of Care Solutions.

Announcements and Implementations

Niagara Health in Ontario prepares to launch Oracle Health in November. Six hundred clinicians have signed up for extra training during the “Operation Monarch” implementation project, which was first announced in 2022.

Salem Township Hospital (IL) will go live on Epic next month.

The Ohio State University Wexner Medical Center goes live on Epic-integrated Cloud Payments from TrustCommerce, a Sphere company.

A new KLAS report on data archiving finds that the systems that are most commonly involved are EHRs from Altera Digital Health, Oracle Health, and Athenahealth. Top performance scores for complex archiving projects were earned by Galen Healthcare Solutions, an RLDatix Company; and Harmony Healthcare IT, while Triyam performed well in lower-complexity work.

Government and Politics

Clinicians at Lovell Federal Health Care Center (IL) continue to focus on improving the Oracle Health-based EHR that was implemented five months ago at the facility, which is jointly run by the VA and DoD. Areas of focus, dubbed “big rock” projects, include fine-tuning referral management, standardizing and consolidating user roles, improving training, and improving coordination between prescribers and pharmacists.

Other

Michigan researchers find that EHRs are not consistent in documenting the racial and ethnic designations of pediatric patients. They recommending implementing some form of gold standard that is appropriate for children who may not be able to self-report.

Sponsor Updates

• EClinicalWorks releases a new podcast, “Know Your No-Shows and Optimize Your Schedule.”
• Meditech releases a new podcast, “Zack Kass on seizing the healthcare AI advantage.”
• The Surescripts Role and Value of the Pharmacist Founder’s Donor Fund contributes $75,000 towards a grant that the National Council for Prescription Drug Programs Foundation will use to study the current pharmacy technology landscape.
• The Kansas City Business Journal honors Netsmart Chief People Officer Wendy Hill with its Women Who Mean Business Award.
• Revuud names Mark McDowell, Brian Litten, and Scott Schubert to its Board of Directors.
• A 2024 Forrester Consulting Total Economic Impact study reveals a 193% return on investment over three years for interviewed health technology teams using Rhapsody healthcare data integration solutions.
• RLDatix supports healthcare organizations in assessing their readiness for the new CMS Patient Safety Structural Measure, which takes effect next year.
• Waystar will exhibit at the WellSky Care Forum September 8-11 in Denver.
• Wolters Kluwer Health CMO Peter Bonis, MD will present at the HIMSS AI in Healthcare Forum September 5 in Boston.
• CereCore releases a new podcast, “Breaking Down Barriers: Fostering A True IT and Business Partnership.”

Blog Posts

• Carequality and Epic Make TEFCA Transition Announcements. How Does this Impact Nationwide Data Exchange? (Zen Healthcare IT)
• Navigating the new Epic Gold Star criteria with strategic approaches (Nordic)
• Summer Rewind: Top Healthy as Tech Hits (Optimum Healthcare IT)
• How Redox + Snowflake have teamed up to unlock AI and ML use cases for providers (Redox)
• Do You Need a Nurse Mentor? (SnapCare)
• 3 Ways Providers Can Add Digital Wallets to the Patient Payments Mix (TrustCommerce, a Sphere Company)
• Predictive Healthcare Staffing: Generating More Value Through AI Innovation (Symplr)
• Your Guide to Improving Payer-Provider Collaboration (Tegria)
• Outsourcing RCM: Why Choosing the Right Partner Matters (TruBridge)
• Healthcare leaders share how Verato improves the Epic experience (Verato)
• Five IT Infrastructure Points CIOs Should Discuss with Their Leadership (CereCore)

Contacts

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

Morning Headlines 8/30/24

MedHQ Expands Footprint with Acquisition of Trajectory Revenue Cycle Services

Healthcare advisory and administrative services company MedHQ acquires Trajectory Revenue Cycle Services.

CommonWell Health Alliance Announces Members, Platform Enhancements to Advance Interoperability with TEFCA-Ready Platform

CommonWell Health Alliance announces that Athenahealth, ModuleMD, and Solace Health are live on its new TEFCA-ready platform and QHIN that was developed with Ellkay.

Judge Ponders House Arrest for Indicted ADHD Telemedicine CEO

After considering her propensity to delete digital evidence and deeming her a flight risk, a federal judge considers placing Done Global founder and CEO Ruthia He under house arrest while she awaits trial on federal drug, fraud, and obstruction of justice charges.

News 8/30/24

Top News

PatientPay completes its acquisition of billing, statement, and payment technology vendor ClearGage.

The combined companies will have 1,600 healthcare organization clients and 1.2 million patient digital wallets.

Reader Comments

From Not So Vendor Neutral: “Re: Epic. I’ve heard from multiple sources that Epic is making deals for cash and equity as part of its Workshop program, where they give access to Epic resources while promoting those vendors to their customer base.” An Epic spokesperson provided this response to my inquiry:

We undertake a significant amount of R&D to co-develop products with Workshop vendors for the benefit of our provider community. Rather than front-loading this expense on start-ups, we’ve entered into novel financial arrangements, including warrants in rare cases. This way, the start-ups can delay the bulk of their payment until they are successful and we can share in that success. We have no intention of company ownership.

From ExMeditech: “Re: Epic hiring only entry level people. See this from Meditech’s Neil Pappalardo from a 1991 book.” Neil said this in the book “Entrepreneurs in High Technology: Lessons from MIT and Beyond,” which was written by the late MIT professor and Meditech co-founder Ed Roberts. It’s a reminder that Epic and Meditech shared some DNA and management philosophies in the early days:

We view ourselves as a family. We always hire entry level people, whether in software or sales. We don’t hire new people into managerial slots. All of our managers have been promoted from within. We want our people to join us when they’re still young and get their training here in our culture. They don’t have much experience when they start but at least they’re malleable at that age. And they learn quickly.

From Band Saw: “Re: Oracle CloudWorld. The band Journey is playing. Does the conference draw enough old dudes who care?” “Don’t Stop Believin” is my most-detested song, and I wouldn’t expect it to sound better played by the sole remaining original member in a million-dollar corporate jukebox show for IT geeks. The band’s most recent album is from 2022, but its later works are superfluous since — like skimpily talented insects trapped in musical amber – their music is indistinguishable from the 40-year-old stuff that includes that shriek-along favorite of tipsy karaoke moms. Don’t expect comradely glances between the keyboardist and guitarist, each of whom is a 50% band owner and opposing litigant in a money dispute that caused their upcoming European nostalgia-milking tour to be cancelled, and don’t expect to hear their singer – a non-English speaker from a Philippines tribute band who they saw on YouTube and hired purely because he sounds like Steve Perry despite looking as unlike him as is possible — since the audience will insist on singing along badly. The only deceased founding member is rhythm guitarist George Tickner, who according to his 2023 obituary was a registered nurse who left the band in 1975 to “pursue his PhD at Stanford University Medical School on a full scholarship.”

Webinars

September 10 (Tuesday) noon ET. “Overcoming Hurdles in Specialty Med Access Under Medical Benefits.” Sponsor: DrFirst. Presenters: Drew Hunsinger, VP of corporate business development, DrFirst; Tyler Wince, MEd, VP of product and technology specialty solutions, DrFirst. More specialty medications, which made up 80% of FDA’s new drug approvals last year, are falling under medical benefits, which challenges the patient care processes and efficiency of providers. Medication access experts will discuss how automation and unified medication management solutions can ensure better outcomes for patients and providers by addressing patient access hurdles and enhancing the ‘stickiness’ of EHRs. They will also provide insights into how regul

Sales

• Chicago-based Collaborative Bridges chooses HealthEC’s data and analytics solution.

People

EvidenceCare promotes Amy Deaton to president / COO.

Care2U promotes Lon Hecht to CEO.

Altais hires Kumar Murukurthy, MBBS (Walmart Health and Wellness) as chief information and digital officer.

Announcements and Implementations

CommonWell Health Alliance announces that Athenahealth, ModuleMD, and Solace Health are live on its new TEFCA-ready platform and QHIN that was developed with Ellkay.

University of Iowa Health Care CHIO James Blum, MD posted on LinkedIn that they have deployed Evidently’s EHR-embedded clinical decision support to all of their caregivers, of which 2,000 launched it on the first day.

Sponsor Updates

• FinThrive staff pack 576 “food paks” for Children’s Hunger Fund in Frisco, TX.
• EClinicalWorks releases a new podcast, “Say Hello to Easy Joint Documentation with EClinicalWorks.”
• Wolters Kluwer Health announces that 15 of its Lippincott healthcare journals received 37 Awards for Publication Excellence during the most recent APEX competition.
• Tegria, CloudWave, Nuance, and DrFirst will sponsor Meditech Live September 24-27 in Foxborough, MA.
• Fortified Health Security names Keenen Garnett (Deaconess Health System) penetration tester.
• Avoyelles Hospital (LA) adds Medhost’s Clinician Experience, Pharmacy Experience, and PDMP capabilities to its Medhost EHR.
• Meditech customer Ozarks Healthcare earns two EHR Experience Breakthrough Awards at the KLAS Arch Collaborative Summit.
• CliniComp earns “Great Place to Work” certification for the second year in a row.
• Revuud announces new board members Mark McDowell; Brian Litten, JD; and Scott Schubert, CPA.
• Surescripts CEO and pharmacist Frank Harvey recaps the company’s hosting of the Care Team Evolution Summit, in partnership with AHIP and the American Pharmacists Association, in Washington, DC last month.

Blog Posts

• Customer Obsession & Epic UGM Highlights (Health Data Movers)
• Steering Your Practice Towards Success (EClinicalWorks)
• 4 Key Customer Insights on AI Adoption (Five9)
• Irreverent, enlightening, and interesting: My experience on the OverReaction Podcast (Get-to-Market Health)
• EHR Consulting 101: Enhancing Patient Care Through Technology (HCTec)
• Leveraging Social Drivers of Health Data and Analytics for Enhanced Patient Access, Adherence, and Health Equity (Inovalon)
• The Evolution Of Telehealth: Time To Bust Some Old Myths (KeyCare)
• Achieving cost savings and elevated care with the Expanse MaaS model (Meditech)
• Wound Care Documentation: The New Rules (Net Health)
• How NeuroFlow’s Maternal Mental Health Care Pathways Support Parents at Every Stage of Pregnancy (NeuroFlow)

Contacts

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

EPtalk by Dr. Jayne 8/29/24

I’ve written previously about telehealth and the math that is needed to try to prove that it will result in overall savings to the healthcare economy. A recent JAMA viewpoint article further dissects the impact of telehealth on care delivery spending, calling out the “iron triangle” of tradeoffs where a service may improve only two of the three elements of quality, cost, and access.

The authors point out that telehealth may lead to more care, especially if preventive procedures are recommended as part of encounters. This will inherently increase spending, making suspect the claims that telehealth will reduce healthcare costs. On the other hand, that increased spending should drive value, but that value is often realized well down the line.

The authors propose that reframing the discussion around value might lead to different choices, such as only expanding telehealth services that address the areas of highest value. An example given is funding telehealth visits for federally qualified health centers in the hopes of improving quality and equity. Only time will tell, and we’ll have to wait to see what happens with federal telehealth funding in the US.

From Podcast Schmodcast: “Re: your pet peeve of being forced to use your phone for webinar links. I totally agree. Maybe I’m just a grumpy old man, but I prefer to do most of my work on a 24-inch monitor or larger but will use a laptop in a pinch. My pet peeve is written ’articles’ that are little more than redirects to podcasts, which I can’t stand. I can read much faster than many of the podcasters speak and am very much a visual learner. Podcast creators need to include a transcript so that they aren’t discriminating against what I suspect is a large part of the population that feels similarly.” I’m one of those people, so I agree. For the love of all things, please include a transcript. I’ve found that when I try to listen to recordings, I get too tempted to multitask, which results in my absorbing very little of the spoken content. When I’m consuming written documents, it’s much less likely that I’ll try to surf the internet or do any number of things that will cause me to have to skip back and listen again.

Members of the American Medical Informatics Association (AMIA) received an email this week addressing concerns about the organization’s Annual Symposium that is being hosted at the Hilton San Francisco Union Square. The hotel is apparently subject to a labor dispute and union leaders are discouraging organizations from doing business at the property. Since negotiations are ongoing, AMIA is following closely and hoping for a resolution that doesn’t impact the meeting. The hotel claims to have contingency plans to ensure service delivery in the event of a strike, but having stayed at hotels in several adverse but less-contentious circumstances (including boil orders and weather emergencies), I’m not hopeful for their ability to host the conference during a strike without some level of disruption. I’ll be following this one closely.

Speaking of meetings, Oracle has announced that its CloudWorld headliner will be legendary rock band Journey. I’ve seen them perform and it was a great show, but I’d imagine that a half century on the road might be starting to take its toll on some of the performers. Attendees can purchase a guest ticket for the show for a mere $350 while supplies last. Admission to the Oracle client conference is $2,300 with the price dropping to $1,700 for groups of five or more. The registration site includes a “Convince your boss” section complete with an email template to help workers summarize the costs and benefits of attendance.

I was back flying the friendly skies this week, enjoying some West Coast sunshine before starting a big project. Unfortunately, my seatmate made it a less than fun experience, as she constantly talked to herself, made tsk-tsk sounds when reading her emails, and laughed hysterically while marking up a PowerPoint presentation. I could see everything she was doing since she didn’t have a privacy filter. I could also see her email address and her passwords that were on a sticky note that was covered in tape applied to her laptop. I had half a mind to log in to her Concur account and enter a bunch of bogus expenses, just to prove a point.

The flight attendants had to scold her for failing to put her laptop away as instructed, after which she slammed things around trying to stuff them into her enormous bag. I normally travel with noise canceling earbuds, but somehow they got left at home, which is a mistake I won’t be making again. In fact, I might throw a pair of foam earplugs in my bag as a precaution since they weigh nothing and would have been very welcome in this situation. They say travel is broadening, but I would argue that it’s not always in the way we might want.

I’m as much at risk of being drawn in my clickbait headlines as the next girl, so I admit I was taken in by a discussion of “Death Bots.” I wasn’t even sure what the term referred, to so of course I had to follow along. The article is a transcript (yay!) of a discussion by medical ethicist Art Caplan. The concept is this: patients who know that they will be dying soon might be able to record their voices so that after they pass, family members can converse with a virtual entity that is representative of their loved one. This AI-driven entity would become part of the grief process and might also draw from other materials that are left by the deceased individual such as diaries, writings, videos, and more.

It’s very “Star Trek” to be able to have a conversation with your departed ancestors, but as a physician who has worked with patients and their families through various levels of grieving, it would need to be clear that anyone participating in this is part of an unregulated experiment that deviates from our current scientific understanding of grief. I’d feel a lot better if participants went through some kind of informed consent process, but given the fact that this is already being commercialized, that would be unlikely.

Caplan points out the risks of having an AI version of a departed person “create information that sounds like you, but really isn’t what you have said, despite the effort to glean it from recordings and past information about you. He illustrates the other ways to leave memories for loved ones, including audio / video recordings, diaries, and the like.

Caplan agrees with the need for a consent process as well as safeguards for control of the information and cessation of the service if survivors desire it to end. The comments on the piece are interesting and bring up topics including regulations and their enforcement, the impact of such a service on survivor mental health, and more. Another notes, “Hopefully I have a way to go before I am gone, which gives me a lot of time to try this out and see whether I can even tolerate my own company after I am gone, much less inflict myself on posterity.” There are numerous comments on how this might go awry. My favorite comment is this: “One character in Futurama was Nixon’s head in a bottle of preservative. It spoke, and had opinions. But of course, AI is more sophisticated now.”

What are your thoughts on so-called Death Bots? Would you make one yourself, or want to have one representing a loved one? Leave a comment or email me.

Email Dr. Jayne.