News 11/12/21

Top News

LifeScience Technologies sues Mercy, which it claims disclosed trade secrets about LST’s M.Care virtual care platform to telehealth competitor Myia Health.

The lawsuit claims that LST customer Mercy shared its system log-in credentials to Myia Health’s developers, allowing the company to develop a “derivative product” that Mercy then implemented to replace LST.

LST also says that Mercy invested $5 million in Myia Health. 

HIStalk Announcements and Requests

Welcome to new HIStalk Platinum Sponsor Current Health. The Boston-based company, which was acquired by Best Buy in November 2021, offers an enterprise care-at-home platform that enables healthcare organizations to deliver high-quality, patient-centric care at a lower cost. It integrates patient-reported data with data from biosensors – including its own continuous monitoring wearable device – to provide healthcare organizations with actionable, real-time insights into the patient’s condition. Leveraging clinical algorithms that can be tailored to the individual patient, it identifies when a patient needs clinical attention, allowing organizations to manage patient care remotely or to coordinate in-home care via the company’s integrated service partners. Its platform brings together telehealth capabilities, patient engagement tools, and cellular connectivity to provide a single solution to manage all care in the home. It has designed evidence-based care pathways that can be tailored to the needs of the individual patient, supporting a wide range of clinical conditions and acuity levels. To help its partners scale their care-at-home delivery, it also provides comprehensive logistics management, a Clinical Command Center, and integrations with in-home ancillary service providers, all serving as an extension of your team to help transform how healthcare is delivered at home. Thanks to Current Health 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

Definitive Healthcare, which went public in mid-September and finished its first week of trading with shares up 81%, announces Q3 results: revenue up 43%, adjusted EBITDA flat. The company’s market value is just under $4 billion. Founder and CEO Jason Krantz described the company’s business in the earnings call: “I founded Definitive Healthcare to help companies analyze, navigate, and sell into the complex healthcare ecosystem. We bring clarity and in-depth knowledge of the entire market that we have a deep understanding of the interconnected relationships between physicians, hospitals, providers, insurance companies, government regulators, and the patients themselves.”

Remote patient monitoring startup HealthSnap raises $5 million.

Sales

• SoftWriters will integrate First Databank’s Meducation medication adherence solution with its FrameworkLTC pharmacy management platform.
• Flagler Health+ (FL) will implement Halo Health’s clinical collaboration technology.

People

Surescripts CEO Tom Skelton will leave his role at the end of 2022 in a planned transition.

Former National Coordinator Don Rucker, MD joins interoperability startup 1upHealth as chief strategy officer.

Virtual nurse assistant software vendor Care Angel names Nick Martin (DuPage Medical Group) CIO.

Brad Rennick (Modernizing Medicine) joins NThrive as chief client officer.

Wolters Kluwer Health promotes Gregory Samios to president and CEO of Clinical Effectiveness and Peter Bonis, MD to chief medical officer of Clinical Effectiveness.

Announcements and Implementations

PeriGen announces GA of Vigilance Mobile, giving end users remote access to its AI-based early warning system and clinical decision support tools.

Government and Politics

Representative Kim Schrier, MD (D-WA), a former pediatrician and Cerner end user, shares her concerns with VA Secretary Denis McDonough about EHR usability and its impact on patient care after she toured a clinic that is connected to the VA’s first live Cerner site of Mann-Grandstaff VA Medical Center (WA). She notes that employees have told her the system frequently crashes, forcing them to re-type lost notes; and that its self-scheduling and prescription management features are so buggy that patients have resorted to calling the clinic, resulting in overwhelmed phone lines. “If they have to scrap this version of Cerner,” she says, “it’s probably better to do that and use something that’s tried and true than to try to fix a system that is just broken from within.”

A VA OIG review of its implementation of Cerner’s patient scheduling system finds that while many schedulers prefer the more user-friendly Cerner system over that of the replaced Vista system, they didn’t receive adequate training on complex scheduling scenarios and weren’t given enough time for practice. The VA also went live without resolving significant lapses in functionality, such as Cerner’s inability to automatically mail appointment reminder letters and to switch a scheduled visit between telehealth and in-person. Scheduling supervisors also reported confusion over measuring wait times, a nationally critical problem that the Cerner scheduling system was supposed to help resolve. After going live, care was delayed as permissions issues limited the ability of schedulers to book certain types of appointments, data migration problems required some information to be manually deleted, and reminder calls had to be turned off because patients were being told to check in at the front desk for visits in which on-site care was not available.

Privacy & Security

Southern Ohio Medical Center reverts to downtime procedures and diverts ambulances as it deals with a cyberattack that occurred early Thursday morning.

Sponsor Updates

• DirectTrust recognizes Cerner Director Greg Meyer as an Interoperability Hero during the third quarter.
• Vocera Communications signs a reseller agreement with MDI Medical in Ireland.
• Vyne Medical releases a new podcast, “How Patient Experience is Leading Hospitals Toward Digital Transformation.”
• Olive adds ClosedLoop to its marketplace for healthcare solutions.
• Fortified Health Security hires Joe Anderson (Geodis) as solutions architect.
• Goliath Technologies rolls out enhancements to Goliath Performance Monitor.
• For World Diabetes Day, Meditech shares stories of access to care.

Blog Posts

• Halo Health acquisition highlights benefits for customers (Halo Health)
• Get Your Head in the Cloud: Managed Cloud Services Help Healthcare Organizations Attain Digital Transformation (Healthcare Triangle)
• The Healthcare Research Network: 5 Modernizing Features (Health Catalyst)
• Engaging Our Community with Event-Based Vaccine Information and Advocacy (Healthwise)
• Why You Should Plan Your EHR Post Go Live Support Before You Go Live (Impact Advisors)
• Talent & the IT Skills Gap – Opportunities to Change the Way we Hire (Optimum Healthcare IT)
• Clinicians on the move: Is there more to the healthcare exodus than COVID-19? (Imprivata)
• Infor Cloverleaf continues to outperform the competition in the latest Black Book survey (Infor)
• The Right Tools for the Job: Here’s What Health IT Developers are Telling Us (InterSystems)
• Meds 101: Challenges for interoperability in healthcare (Intelligent Medical Objects)
• The Evolution of SDOH and Health Data Exchange (LexisNexis Health)
• Autonomous Care Journeys – Who Is Driving Your Care? (Lumeon)
• Best Practices for Reducing Supply and Inventory Waste in Your OR (Medhost)
• Anderson Hospital’s strategy to remain independent affords better community care (Meditech)
• What Could the SMART Act Mean for PT Practices? (MWTherapy)
• From Fragmented to Frictionless: The Next Stage of the Health Tech Revolution (NextGate)

Contacts

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

EPtalk by Dr. Jayne 11/11/21

I had dinner with one of my friends from residency tonight. She’s considering leaving practice even though she’s not even 50. She had two unvaccinated patients die from COVID this week, one of whom was only 46 years old and who died after being in the intensive care unit and on a ventilator for over two months. Her late patient left behind several children, and apparently their father spent the last several days harassing my colleague because she had refused to treat the patient with ivermectin. The harassment included threatening comments and a visit to my friend’s house, resulting in a call to the police and my friend bundling her own children off to their grandparents’ just in case. Physicians have been fighting this pandemic for more than a year and a half and they certainly didn’t sign up for what she experienced.

On top of that, her partner quit and the health system she works for has been unable to hire a replacement who is willing to join a rural practice, leaving her to care for more than 6,000 patients on her own. She has also developed a severe skin reaction from the soap and sanitizer used in the office, resulting in a worker’s compensation claim after multiple product changes failed to yield results. She’s had to miss work due to numerous physician visits, including second and third opinions from dermatologists at the local medical schools. Every time she takes off for a physician visit, it negatively impacts her office productivity, and the medical group’s newly appointed administrator asked her why she can’t schedule her visits after hours. As she was telling me the story, I wondered if the administrator had ever been a patient or caregiver, because that’s just an asinine suggestion.

She had a lot of questions about telehealth and whether that might be an option for her if she isn’t able to find a solution to her allergic skin reactions. Her only experience with telehealth was during the height of the pandemic, when the health system encouraged physicians to embrace virtual visits because patients didn’t want to come in. However, in her particular community, many patients didn’t think COVID-19 was a big deal and thought that dealing with a computer was a bigger nuisance than risking infection, so telehealth never really took off. From a technology standpoint, they were using a solution that was completely cobbled together and had no integration with their EHR, so I encouraged her not to judge her options based on that experience.

We talked about some trends in telehealth, including insurance plans that have a virtual-first focus. I would propose that such plans would be most effective if continuity could be preserved, either with the same care team providing both in-person and virtual care, or if dedicated virtualists had full access to the patient’s medical records. There are concerns about physicians providing virtual-only care as far as not being able to perform a physical exam. The new plans are designed to have networks of in-person physicians that can perform hands-on services when required, and who can coordinate with the virtual physicians. Although payer-sponsored plans might have their own patient records, they might have difficulty coordinating when patients receive services from non-network physicians or other care providers. Some of the plans have high deductibles for in-person care, which may serve as a deterrent. Additionally, they may not be compliant with the Affordable Care Act.

We also talked about the challenges of practicing telehealth, including technology issues. A recent piece in JAMA Network Open looked at factors influencing whether patients and physicians were able to successfully complete telehealth visits. The authors looked at over 137,000 video visits and found an overall success rate of 90%. Patient factors were “more systematically associated with successful completion of video visits” where “clinician comfort with technology was associated with successful video visits or conversion to telephone visits.” Certain factors were associated with conversion to telephone visits, including lower clinician comfort with technology, greater patient age, lower patient socioeconomic status (including low availability of high-speed internet), and racial/ethnic minority status.

The study has some limitations, including having been conducted at the height of the COVID-19 pandemic when most of us were still getting used to the idea of video visits and many providers were using substandard technology platforms to try to connect with patients. Visits at that time were often sporadic and urgent, and there was little lead time to help patients with technology or their comfort level with video encounters. The study also was conducted in the Midwest and at a single healthcare organization. Longer duration studies with a broader cross section of patients would be beneficial.

Our conversation crossed into a lot of different elements of practice, and she was interested to hear about my recent experiences in EHR training. We’re both veterans of multiple EHR conversions and implementations, and she asked if I had seen the story about the US Department of Veterans Affairs being ordered to pay $160 million to clinicians for extra work hours spent updating EHR data. I hadn’t seen it until she mentioned it, but the short version is that 3,200 nurse practitioners and physician assistants who were employed by the VA at the time worked overtime doing various EHR functions and weren’t compensated appropriately. The court ruled that employees should have had received overtime pay any time they worked more than eight hours in a day. In the class action suit, each member will receive about $50,000 in compensation.

The last thing we talked about as our bottle of pinot noir became depleted was an article that looked at whether physicians could accurately predict the out-of-pocket costs for medications they were prescribing. The authors found that only 21% of physicians could do so, which sounds like what I might expect given the craziness of medication pricing and the challenges in figuring out various formulary coverage, deductibles, co-pays, and annual caps. We’ve both used EHRs that were supposed to display formulary and eligibility data in a way that should help physicians figure this out, but have found that none of them were particularly effective, especially since different payers use different formulary levels that resulted in confusing EHR displays and data that just didn’t make sense.

The evening ended with a discussion of her children and their career plans and the fact that she’s completely baffled her children want to pursue careers in medicine despite her obvious dissatisfaction with it and eagerness to leave it. They’re still relatively young, in middle and early high school, so of course things can change. Given the way things are now, I know quite a few physicians who wouldn’t choose the career again, or if they did, would choose a different specialty. It’s a sad commentary on what healthcare has become for a lot of physicians.

If you had it to do over again, would you still choose healthcare? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 11/11/21

Health Catalyst (HCAT) Reports Q3 Loss, Tops Revenue Estimates

Health Catalyst reports Q3 revenue of $61.74 million, with a quarterly loss of $0.18 per share.

Surescripts Announces Planned CEO Transition

Surescripts CEO Tom Skelton will formally step down from his role at the end of the year, but will remain with the company while his successor is found.

Oneview Healthcare raising $23 million via Canaccord

Patient engagement technology vendor Oneview Healthcare seeks to raise $23 million to expand its sales, marketing, and product development efforts.

CPSI Announces Third Quarter 2021 Results

CPSI’s Q3 revenue increases to $70.1 million, with total revenues at the nine-month mark also experiencing a bump up to $206.6 million.

Morning Headlines 11/10/21

GE Plans to Form Three Public Companies Focused on Growth Sectors of Aviation, Healthcare, and Energy

General Electric will spin off GE Healthcare, GE Aviation, and several other segments into public companies within the next two years.

Sirona Medical Secures $40M in Series B Funding to Accelerate Adoption of its Cloud-Native Radiology Operating System

Sirona Medical, a vendor of cloud-based radiology operating system software, raises $40 million in a Series B funding round.

Introducing the Truveta Platform: Unprecedented De-Identified Health Data Refreshed Daily with New COVID-19 Insights

Hospital network-owned Truveta launches its flagship clinical insights platform, giving researchers access to real-time, de-identified clinical data from care sites across the country.

News 11/10/21

Top News

General Electric shares jump on the news that the company will spin off GE Healthcare, GE Aviation, and several other segments into public companies within the next two years.

Former GE Healthcare manager Peter Arduini (Integra LifeSciences) will become president and CEO of GE Healthcare in January. The business is expected to become independent in 2023, focusing on equipment, diagnostics, imaging, therapy planning, life care, and digital.

Readers may remember that Veritas Capital acquired GE Healthcare’s software (financial, ambulatory, and workforce management) business in 2018 for $1 billion, rebranding those assets to Virence Health several months later.

Veritas acquired Athenahealth around that same time for $5.7 billion with help from Evergreen Coast Capital, the private equity subsidiary of Elliott Management Corporation, which was the activist investor that targeted Athenahealth and forced out its co-founder and CEO Jonathan Bush earlier that year.

Virence Health wound up merging the former GE Healthcare’s Centricity business with Athenahealth. Veritas dropped the little-known Virence Health brand in favor of Athenahealth’s branding shortly thereafter.

Webinars

November 10 (Wednesday) 1 ET. “Too Important to Fail: How to Bring Better AI to Healthcare.” Sponsor: Intelligent Medical Objects. Presenters: Dale Sanders, chief strategy officer, IMO; Marc d. Paradis, VP of data strategy, Northwell Health. It’s relatively easy to obtain healthcare data and build an AI demo, but getting AI to perform reliably and with meaningful impact is much harder. However, strategies exist for delivering AI products to commercial markets. This fireside chat will review the status of AI in healthcare; discuss the vital importance of data quality, methodological rigor, and product focus; and explore what this means to the startup and investor world.

November 11 (Thursday) 1 ET. “Increasing OR Profitability: It May Be Easier than you Think.” Sponsor: Copient Health. Presenters: Michael Burke, co-founder and CEO, Copient Health; David Berger, MD, MHCM, CEO, University Hospital of Brooklyn at State University of New York Downstate Health Sciences University. The OR is a hospital’s biggest source of revenue and its costliest resource, yet it often sits idle because of unfilled block time even as providers with cases ready to book lack access. AI-powered emerging technologies can help fill unused OR time and provide decision support to structure workflows and optimize block allocation. This webinar explores the biggest challenges to profitability faced in the OR and the fastest, most impactful changes a hospital can make to address them.

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

Acquisitions, Funding, Business, and Stock

Sirona Medical, a cloud-based radiology operating system software vendor, raises $40 million in a Series B funding round.

Ambulatory health IT vendor CareCloud reports record Q3 revenue of $38.3 million, a 21% increase over Q3 2020. The company attributes the numbers to organic growth and the June acquisitions of Santa Rosa Staffing and MedMatica Consulting – now known as MedSR. MTBC acquired CareCloud in January 2020 for $17 million in cash and $41 million in total consideration.

Sales

• Family Health Centers will transition to EClinicalWorks at its eight facilities in Louisville, KY.
• NorthShore University HealthSystem (IL) selects Carevive’s Patient Reported Outcomes Mobile Platform.
• Baptist Health South Florida will implement Rx Capture software from Loopback Analytics.

People

Protenus names Michelle Del Guercio (Sunquest Information Systems) chief marketing officer.

Doug Duskin (Equality Health) joins Avel ECare as CEO.

Announcements and Implementations

GenieMD announces GA of Continuum, a virtual care platform encompassing telemedicine, remote patient monitoring, and chronic care management capabilities; as well as consumer and medical device integration.

Rochelle Community Hospital (IL) will go live on Epic next May.

LexisNexis Risk Solutions develops a Patient Centric Token to more effectively match de-identified patient records used for clinical research and patient care.

Truveta launches its flagship clinical insights platform, giving researchers access to real-time, de-identified clinical data from care sites across 42 states. The Seattle-based startup was launched in February by numerous health systems to provide its hospital owners, drug companies, and researchers with anonymized patient data for approved research projects.

Privacy and Security

Philips alerts end users to two vulnerabilities within its Tasy EHR that could allow hackers to extract data and potentially launch denial-of-service attacks. Upgrading the EHR software, according to the company, will remove the vulnerabilities.

Health officials in the Canadian province of Newfoundland and Labrador say health IT systems, including its Meditech EHR, are slowly being brought back online after last week’s cyberattack.

Other

This is interesting: Bluestream Health co-founder and CEO Matthew Davidge sells Med School Tutors to Blueprint Test Prep for an undisclosed amount. Davidge and business partner Joe Covey purchased the company in 2019. It is one of six they’ve acquired since 2008, including patient instructions and teaching systems vendor Logicare and several in-hospital television channels.

Sponsor Updates

• Bamboo Health applauds its ACO partners for generating over $1 billion in the Medicare Shared Savings Program.
• Cerner shares a new client achievement, “Children’s Mercy Kansas City Project HOPE training helps streamline provider documentation efficiency.”
• Divurgent celebrates its membership with the KLAS Arch Collaborative with a newly released badge.
• EVisit will exhibit and present at the virtual HealthImpact Live Fall Forum November 10-12.

HIStalk Sponsors exhibiting at HFMA include Ability Network, AGS Health, Cerner, Change Healthcare, Experian Health, Health Catalyst, Intrado, InterSystems, Nuance, Olive, and Waystar.

Blog Posts

• Understanding Business Processes and Critical Capabilities: A Closer Look at Business Impact Analysis with US Anesthesia Partners (Clearwater)
• Open enrollment and beyond – how to keep revenue on track all year (Ability Network)
• How to Optimize Texting with Your Patients (AdvancedMD)
• #IDoR2021 (Agfa HealthCare)
• Talent and the IT Skill Gap: Opportunities to Change the Way We Hire (Optimum Healthcare IT)
• CPaaS brings healthcare continuity to the Cantabrian region (Alcatel-Lucent Enterprise)
• What payers and providers need to know about the No Surprises Act (Availity)
• Azara Patient Outreach – Messaging, Metrics, and Milestones (Azara Healthcare)
• Increase Productivity and Improve Outcomes with Adaptive Learning (Bluetree)
• IT Leadership: The Human Side of Disruption (CereCore)
• An Inspiring Leader of Healthcare: Chasm Talks with Angie Franks, CEO of About (About)
• Streamline Acute Transitions of Care: 3 Strategies for Success (Collective Medical)
• Navigating Changes Along the Patient Journey (ConnectiveRx)
• What Providers Want from Biopharma Field Reps Amid COVID-19 Pandemic (CoverMyMeds)
• Why Improving the Quality of Clinical Data is Imperative to Avoid Public Health Reporting Breakdowns (Diameter Health)
• What We can Learn from Healthcare Collaboration During the COVID-19 Pandemic (Dimensional Insight)
• Evolve At-Home Services to Maximize Value-Based Care (Dina)
• Innova Primary Care: The Upside to Downside Risk (EClinicalWorks)
• 3 data-driven denial management strategies for faster claims processing (Experian Health)

Contacts

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

Morning Headlines 11/9/21

CareCloud Reports Record Third Quarter Revenue and Net Income

MTBC subsidiary CareCloud reports record Q3 revenue of $38.3 million, a 21% increase over Q3 2020.

Cyberattack on health tech vendor QRS leads to data theft tied to 320K patients

EHR and practice management vendor QRS Healthcare Solutions announces it was the victim of a cyberattack in August that compromised a server dedicated to the patient portal of several customers.

Philips discloses TASY EMR vulnerabilities pose risk to patient data

Philips alerts end users to two vulnerabilities within its Tasy EHR that could allow hackers to extract data and potentially launch denial-of-service attacks.

Curbside Consult with Dr. Jayne 11/8/21

The highlight of my weekend was attending a graduation party for one of my favorite former co-workers. I worked with her in the urgent care trenches for half a decade, through Flumageddon, COVID-19, the deaths of three co-workers, and a host of other calamities.

Of all the people I’ve worked with clinically, she’s one of the handful I would walk through fire for. Three years ago, she decided to go to nursing school and completed her bachelor of science in nursing degree while continuing to work part time. She’s one of the hardest working people I know. I had the privilege of working my last urgent care shift with her, so I was glad she invited me to come celebrate her achievement.

It was a mini reunion of former colleagues, 80% of whom have left our former urgent care employer. It seems like everyone is thriving since they left. Since I was kind of the “mom” of the practice sometimes, hearing their stories brought me joy. Several are in graduate school and others have moved to other healthcare settings, but all of them are still involved helping patients.

It was also fun meeting the graduate’s parents and brothers, and now I understand where she gets her sassiness. Sometimes we don’t get to see people bring their dreams to life, but I’m excited for her in her new role as a nurse in the emergency department of the city’s premier Level One trauma facility. Hopefully we’ll be able to catch up again down the road. It will be interesting to hear stories from a new graduate’s point of view.

The rest of the weekend was spent playing catchup – working on some personal projects and catching up on work I needed to finish after being out for a training class most of the week. For one of my new projects, I need to have a particular EHR certification that I’ve never done before, and it was quite the adventure. Since most vendors are still offering remote training, I decided to take advantage of that option. Not that I mind traveling, but it’s always better to be able to sleep in your own bed. I was pleased that the training had been adapted to remote learners, including having multiple trainers available to cover real-time questions while the main presenter continued presenting the content. That let people catch up while the rest of the class moved ahead. As someone who has taken countless in-person classes, I enjoyed that approach much better than when a single class member holds everyone up with questions since it’s much harder to hand someone off to a co-trainer in a live environment.

Of course, there were some technical glitches for attendees, with people intermittently losing audio or having glitchy video, but that’s to be expected even at this point where most of us have adapted to nearly 100% remote work and virtual meetings. There were also some people with multiple monitors who were having issues with popups they couldn’t see because they would open on a different monitor, and that seemed to be a little trickier for the remote training team to try to troubleshoot. Overall, I thought they did a nice job with plenty of breaks for people stretch and just get away from their desks, and also a full hour for lunch which I haven’t had before even in an in-person class. It was nice to be able to grab something to eat, check email, and walk around a little bit before settling in for another half day of classes.

Fortunately, I’ve worked with this part of the EHR before,so while I’ve never been certified, so the content wasn’t overwhelming. I imagine that if you were new to EHRs in general, such as an IT person who hadn’t done much clinical work but was diving in, the pace might have been a bit brisk. There are plenty of new terms to learn in healthcare (particularly in the wild and wacky world of US healthcare) so the learning curve on those items would have been steep. Most of the attendees were able to get through some clinical workflows though and had a good understanding of how their end users will be using the system. It’s always a good thing when clinical people can see what IT folks have to work with, and vice versa, in order to have a high functioning team.

I’m taking another class this week and it’s a much deeper dive into the underpinnings of the EHR, which I’m very excited about. I never met a database table I didn’t like and am looking forwarding to learning things I may not have known about the underlying structure. As a CMIO, I’m often at the 10,000-foot level, but it’s always good to understand the complexities of the system when I’m asking my team to consider using new features or attempting to customize around a native workflow. I’ve got a topnotch team of seasoned veterans, so I’m not worried about their skills, although I’ve had people working for me on previous engagements who tried to snow me on how hard it would be to do customizations or to modify workflows. I remember one upgrade when my team was acting like they’d have to do hundreds of hours of work to make changes to provider workflow templates, and when we did a work breakdown and estimation exercise, it turned out to be less than one person-week of work.

I also spent some time doing my quarterly Maintenance of Certification questions for both my primary and secondary board certifications. They use completely different methodologies and delivery systems for their questions, and I’m wondering why the different boards can’t get together and come up with a best-of-the-breed solution. One board allows five minutes per question, and you have to do 25 questions per quarter, where the other allows 10 minutes per question with 12 questions per quarter. Fortunately, they’re both open-book and open-internet, with the main limitation being that you can’t engage other people to help you or share the questions with others. I’m not close enough to retirement to consider dropping either certification, so I get to stay on the certification hamster wheel for many years to come.

Did you have a productive weekend, or were you just able to enjoy some down time? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 11/8/21

Spok Reports 2021 Third Quarter Results

Spok reports Q3 results: revenue down 5%, EPS –$0.13 versus $0.16.

Biden nominates Kurt DelBene as chief information officer at VA

The White House nominates Kurt DelBene, MS, MBA (Microsoft) as VA assistant secretary and CIO.

It will take time to restore healthcare IT system, say Newfoundland officials

Health officials in the Canadian province of Newfoundland and Labrador say health IT systems, including its Meditech EHR, are slowly being brought back online after last weekend’s cyberattack.

Monday Morning Update 11/8/21

Top News

From the Allscripts earnings call, following the announcement of quarterly results that beat earnings expectations but fell short on revenue:

• CEO Paul Black says that NIH has extended its contract for Sunrise for another five years.
• Veradigm revenue grew 10% year over year.
• The company admits being frustrated that Allscripts “stock is cheap” compared to companies that enjoy high multiples while operating businesses similar to Veradigm.
• The core clinical and financial solutions business has seen some shrinking, part of that intentional in focusing on higher-quality clients, but also because of the tail end of a bolus of larger academic medical centers and clients going in a different direction.
• Allscripts believes that non-US opportunities are “a more level playing field” even though those wins are hard to predict because they are mostly public sector clients with inconsistent deal times.
• The company sold 2bPrecise at a small gain in August, taking a non-controlling stake in the combined entity instead of cash.
• Allscripts expects to see managed services opportunities as clients deal with wage inflation and sending teams such as revenue cycle management to work from home, where they could just as easily be someone else’s employee.

HIStalk Announcements and Requests

An overall 85% of poll respondents seek ongoing engagement with a PCP, with a slightly higher percentage of over-35s looking for that kind of relationship. David says he wants ongoing engagement, but not ongoing disengagement where he sees the same doctor who never remembers much about him, while Kathy fears the “too many cooks” problem because whatever doctor was available to see her changed her treatment plan.

New poll to your right or here: How do you most often communicate in one-to-one work-related meetings? I’m curious because I do interviews via a conference line where I can record the call, and sometimes surprises people who have learned to spend their entire workday on video calls with cameras on. I say use video for one-on-one calls only if the value it adds exceeds the mental strain of being on camera, and I don’t know of many examples where that’s the case unless documents are being reviewed.

Webinars

November 9 (Tuesday) noon ET. “The Next Generation of Identity Resolution in Healthcare.” Sponsor: Verato. Presenters: J.P. Lugo, solution architect, Verato; Nick Orser, solution architect, Verato. This webinar will provide an overview of person-matching in healthcare, how challenges can be overcome with Verato Referential Matching, and how person-matching technology can support Customer 360, marketing, analytics, IT, and more.

November 10 (Wednesday) 1 ET. “Too Important to Fail: How to Bring Better AI to Healthcare.” Sponsor: Intelligent Medical Objects. Presenters: Dale Sanders, chief strategy officer, IMO; Marc d. Paradis, VP of data strategy, Northwell Health. It’s relatively easy to obtain healthcare data and build an AI demo, but getting AI to perform reliably and with meaningful impact is much harder. However, strategies exist for delivering AI products to commercial markets. This fireside chat will review the status of AI in healthcare; discuss the vital importance of data quality, methodological rigor, and product focus; and explore what this means to the startup and investor world.

November 11 (Thursday) 1 ET. “Increasing OR Profitability: It May Be Easier than you Think.” Sponsor: Copient Health. Presenters: Michael Burke, co-founder and CEO, Copient Health; David Berger, MD, MHCM, CEO, University Hospital of Brooklyn at State University of New York Downstate Health Sciences University. The OR is a hospital’s biggest source of revenue and its costliest resource, yet it often sits idle because of unfilled block time even as providers with cases ready to book lack access. AI-powered emerging technologies can help fill unused OR time and provide decision support to structure workflows and optimize block allocation. This webinar explores the biggest challenges to profitability faced in the OR and the fastest, most impactful changes a hospital can make to address them.

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

Acquisitions, Funding, Business, and Stock

Spok reports Q3 results: revenue down 5%, EPS –$0.13 versus $0.16

Early-stage investor Colin Keeley provides a fascinating analysis of Canada-based software giant Constellation Software and its reclusive billionaire founder Mark Leonard. The company’s Harris unit contains a long list of acquired health IT vendors, such as Amazing Charts, QuadraMed, IMDSoft, Iatric Systems, Obix Perinatal Data System, and Picis. Interesting observations:

• The company has acquired more than 500 vertical market software companies and has sold only one of those (in the early days, which Leonard regrets).
• The company was launched in 1995 with the equivalent of $33 million 2021 US dollars. Its has grown at 30% per year to a publicly traded market cap of $31 billion.
• Leonard started the company as a former venture capital operator who was frustrated that VCs were interested only in companies that have a large addressable market. He saw many businesses that were in niche spaces that generated high margins from recurring sales of mission-critical software. Constellation bought many of its companies directly from their founders.
• Acquisition criteria include a mid- to large-sized vertical market software company with consistent earnings and growth, committed management, and an offering price that has already been determined. The average acquisition price ranges from $2 to $5 million, although the company has done bigger deals and says it will continue to do so. They also prefer companies that have low capital investment requirements just in case they need to weather a business downturn.
• The company reportedly made 90 small acquisitions in 2020 alone.
• One analyst estimates that Constellation acquires at a price of just 0.8 times annual sales, which is far below market.
• Constellation leaves the management team of its acquisitions in place, supporting them with best practices and company-wide performance data.
• The company says it offers its business unit managers autonomy, the ability to scale, and an environment in which rules are few and the focus is making the pie bigger, not fighting over how to divide it.
• Constellation believes that growing companies create inefficiency by adding layers of management. They prefer that the original manager keep most of the business but then spin off a new business unit under a groomed protégé who can start with a blank slate and focus on customers.
• All employees are given an explicit career path in which they first learn their particular vertical market, then transition into a leader of people who can run their own business unit. Leonard says, “Become a master Craftsman in the art of managing your VMS business. It is the most satisfying job in Constellation and will generate more than enough wealth for you to live very comfortably and provide for your family. For those whose ambition exceeds their good sense, we have a role that we call a Player/Coach. A Player/Coach continues to run their BU, but ambition drives them to acquire a sizable business, usually in another geography or another vertical “
• The company’s bonus plan requires long-term investment in its shares, which has created several hundred employee millionaires.

Sales

• CyncHealth selects Nuance PowerShare for accessing and sharing diagnostic imaging and reports and to alert ED physicians of prior studies.
• Advanced Pain Care (TX) chooses Athenahealth.

People

The White House nominates Kurt DelBene, MS, MBA (Microsoft) as VA assistant secretary and CIO.

Jeffrey Brown, PhD (Harvard Medical School) joins TriNetX as chief science officer.

Walmart reportedly hires David Carmouche, MD (Ochsner Health) as SVP of its Omnichannel Care Solutions business that includes services that range from primary care to digital medicine and telehealth.

Announcements and Implementations

Nuance collaborates with Collective Medical to launch Nuance PowerShare Image Aware, which alerts ED physicians of prior radiology studies.

Redox announces a solution that enables payers to meet the CMS Interoperability and Patient Access final rule requirements.

Other

The Physician Network Advantage files a lawsuit against Santé Health Systems (CA) and related entities, which the EHR support company says failed to pay $1.5 million for Epic support. Santé says its agreement with PNA called for payment only as funded by grant funding and it notified PNA in September 2020 that the funding would be ending.

The National Nurses Union says its members are “horrified” at Kaiser Permanente’s pilot project for remote patient monitoring, saying it undermines the role of nurses, places the burden of work on family members, leaves patients far away from other services they usually need, and is intended to boost Kaiser’s profits by lowering costs while being paid by CMS at in-hospital rates under COVID-19 waivers for telemedicine.

Sponsor Updates

• The highest-rated HIStalk Sponsor vendors according to the FeaturedCustomers Fall 2021 Hospital Communications Software Customer Success Report include Market Leaders Change Healthcare, Imprivata, Spok, and Vocera; and Top Performers Halo Health and PerfectServe.
• Wolters Kluwer Health VP & GM Vikram Savkar joins The International Association for Scientific, Technical, and Medical Publishers’ Board of Directors.
• HCI Group publishes a new remote patient monitoring case study featuring Integris Health.
• RCxRules partners with AAPC to deliver an end-to-end physician risk adjustment coding managed service.
• OptimizeRx publishes a new report, “Multiple Sclerosis: Understanding Treatment Barriers and Market Fragmentation.”
• PerfectServe publishes a new customer success story, “Ridgeview Rehab Specialties department reduces no-show rate by 12.6% with automated text messages to patients.”
• Surescripts announces that its Real-Time Prescription Benefit has 550,000 prescriber users and processed 300 million real-time prescription benefit checks in the first nine months of 2021.
• Premier wins an NC Tech Awards winner for the innovative use of technology in the Analytics and Big Data category.
• The Outcomes Rocket Podcast features RxRevu CEO Kyle Kiser, “Enabling Lower-Cost Prescribing at the Point-of-Care.”
• TransformativeMed names Jason Larson (Care.ai) VP of sales.

Blog Posts

• Integris Health’s Rapid Response Remote Patient Monitoring (RPM) Program Built on ‘HealthNxt’ Recognized at CHIME21 (HCI Group)
• ICYMI: Elements of Effective Crisis Management (Netsmart)
• Unpopular opinion: Social distancing is the best thing to happen to EHR training (Nordic)
• Can AI Improve Patient Safety? (Symplr)
• How Providers Are Using Data to Determine Drugs’ Appropriate Use (Premier)
• Celebrating 10k PowerShare sites: 10 ways patients and providers are sharing without boundaries (Nuance)
• Fifteen Years: Guarding Data then, now, always (Spirion)
• Healthcare organizations must reimagine the patient experience to thrive (Talkdesk)
• System Change is at the Heart of Well-Being (Vocera)
• Post-Discharge Programs Vital to Good Patient Outcomes (Well Health)
• How to Overcome the Challenges of Integrating EMS Systems (Zen Healthcare IT)

Contacts

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

Weekender 11/5/21

Weekly News Recap

• Allscripts and Change Healthcare report quarterly results that beat earnings expectations but fall short on revenue.
• EverCommerce announces that it will acquire DrChrono.
• Worklfow automation vendor Notable raises $100 million in a Series B funding round.
• CMS will increase the minimum penalty for hospitals that don’t comply with pricing transparency requirements to $10 per bed, per day starting on January 1, 2022.
• 23andMe says it hasn’t decided how to integrate its recent acquisition of telehealth provider Lemonaid Health, but expects to incorporate genetic risk factors into its primary care prescribing.
• A VA survey of employees at its initial Cerner implementation site find widespread worsening of morale, burnout, and lack of confidence in performing their jobs using Cerner, leading to the VA’s pledge to add executive oversight to the project.
• Kareo and PatientPop merge to form Tebra.
• Cerner and NextGen report quarterly results that beat expectations for revenue and earnings.
• Cerner CEO David Feinberg addresses EHR usability and a tightening of less-profitable company products and partnerships in its quarterly earnings call.

Best Reader Comments

ECW is done, no group of size will consider them given their history with the ONC and DOJ. Ambulatory is a three headed race: NextGen, Allscripts, and Athena. And if you don’t want to outsource your billing and/or you want complete control over your data then Athena is out and it’s a two-headed race: Allscripts and NextGen. Yes, smaller market has a lot more competitors. Yes, when part of a hospital those deals automatically go to Epic / Cerner / Meditech / Allscripts. NextGen and Allscripts sitting pretty with cash, decades of data, and way less comp then three years ago. (Allscripts OUTSIDER)

Not sure why the Jonathan Bush post created that much “wake” this week (pardon the boat terminology). HIMSS isn’t any different from any large industry conference gathering including RSNA. Both are still dwarfed by the Consumer Electronics Show, too. HLTH is very well funded, run by experienced conference organizers, and benefited from a market right now (digital health) that is dealing with record inflows of funding. It isn’t some guerilla or boot-strapped effort run by industry outsiders. Probably rivals J.P. Morgan Healthcare Conference in SF right now for industry buzz and appeal to healthcare insiders. Just adding dental benefits to Medicare though would have a much more substantial and immediate impact than anything that comes out of the HLTH conference the next few years. (Lazlo Hollyfeld)

Telehealth is most likely to benefit patients by allowing patients to sidestep their local large medical groups and health systems. That really gets the hairs up on the medical establishment. The telehealth convenience aspects you discussed are very similar to how retail clinics shook out in the 2010s; consumer perceive retail clinics and telehealth to be strictly lower quality but the lower cost and convenience sometimes win out, especially within certain populations / conditions. There is only room for a couple players in this space who will have to have comparatively large scale and potentially with operations subsidized by another line of business. I don’t think any of the pandemic era entrants will survive long enough to challenge the existing participants.
I think what the money people are really interested in now is whether they can shake another business model innovation out of this tree. One model could be your insurance company employs your primary care provider who is readily available remotely. You trust this provider and they direct you to lower waste, lower cost, higher quality care. (IANAL)

Upcoding will always be a problem in the current payment model. Whatever is in the contract between the healthcare facility and the insurer will always trump short lived media attention. Whether it be state-owned hospitals sicking collections agents on their patients, massive hospital groups gobbling up competitors and driving prices up, or ruthlessly upcoding to extract as much revenue from the patient encounter as possible, the system financially rewards all of these behaviors. The hospitals give some discounts to patients exposed in the media, then quietly go about continuing mostly the same practices. (Elizabeth H. H. Holmes)

Watercooler Talk Tidbits

Readers funded the Donors Choose teacher grant request of Ms. S in New York, who asked for supplies to allow her first grade class to write letters and journal to offset all the time in front of Zoom and staying at home without siblings. She reports, “Thank you for the boost in letter writing! The children have been talking about their feelings, how they can be a good friend (while in COVID and at home), and have been excited by these extra materials that they have received. As you can see by their letters, they have been writing about how they can be kind, brave, responsible, honest, just to name a few. They are learning about making good choices and how to be great brothers, sisters, nieces, nephews, friends, and children. I have been teaching remotely to students via Zoom and I have to share with you how rewarding it is. They have been reading, writing, and wearing their capes to show their superpower! All of these activities are helping with expressing themselves. The families are so appreciative of all that we do and that YOU do! Thank you for your generosity and for enriching the lives of my children.”

A 65-year-old Utah man faces charges of posing as a doctor in selling medications and surgical procedures out of the basement of his house, which he limited to people who are in the US illegally. He diagnosed an undercover agent with multiple sclerosis, then offered to cure the condition for thousands of dollars in cash.

A New York Times article describes how tribe-operated Alaska Native Medical Center (AK) offers patients native fare items such as moose, herring roe, and seal, all donated and prepared as an exception to USDA guidelines since commercial sale is not allowed. Natives weren’t raised on chicken noodle soup and sandwiches, so the hospital added dishes made with traditional ingredient as a connection to the patients it serves. Food Services Manager Cynthia Davis says, “I do not believe that people go into a hospital for a gastronomic experience. I believe that they’re in a hospital because they’re sick or in pain, and they need care. They want comfort foods, foods that someone made for them when they were younger,  someone who loved them and made it with love. And that is our role.”

In Case You Missed It

• News 11/5/21
• EPtalk by Dr. Jayne 11/4/21
• Readers Write: Creating a More Equitable Health System
• News 11/3/21
• Curbside Consult with Dr. Jayne 11/1/21
• Readers Write: The Rise in Health IT Valuations and Deal Flow
• HIStalk Interviews Stephan Landsman, JD, Emeritus Professor of Law, DePaul University College of Law
• Monday Morning Update 11/1/21

Get Involved

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Contact Mr. H

Morning Headlines 11/5/21

Allscripts Announces Third Quarter 2021 Results

Allscripts announces Q3 results: revenue up 1%, adjusted EPS $0.27 versus $0.11.

Aver Raises $58 Million Investment led by Cox Enterprises and Introduces New Name, Enlace Health

Claims-based analytics vendor Aver raises $58 million and rebrands to Enlace Health to better reflect its focus on solving “the infrastructure challenges driving today’s unsustainable healthcare system.”

Change Healthcare Inc. Reports Second Quarter Fiscal 2022 Financial Results

Change Healthcare reports Q2 results: revenue up 9%, EPS –$0.11 versus –$0.13, beating earnings expectations but falling short on revenue.

News 11/5/21

Top News

Business management software vendor EverCommerce will acquire EHR/PM vendor DrChrono.

The company previously acquired MDTech, ISalus Healthcare, Updox, My PT Hub, EMHware, Collaborate MD, and AlertMD.

Webinars

November 10 (Wednesday) 1 ET. “Too Important to Fail: How to Bring Better AI to Healthcare.” Sponsor: Intelligent Medical Objects. Presenters: Dale Sanders, chief strategy officer, IMO; Marc d. Paradis, VP of data strategy, Northwell Health. It’s relatively easy to obtain healthcare data and build an AI demo, but getting AI to perform reliably and with meaningful impact is much harder. However, strategies exist for delivering AI products to commercial markets. This fireside chat will review the status of AI in healthcare; discuss the vital importance of data quality, methodological rigor, and product focus; and explore what this means to the startup and investor world.

November 11 (Thursday) 1 ET. “Increasing OR Profitability: It May Be Easier than you Think.” Sponsor: Copient Health. Presenters: Michael Burke, co-founder and CEO, Copient Health; David Berger, MD, MHCM, CEO, University Hospital of Brooklyn at State University of New York Downstate Health Sciences University. The OR is a hospital’s biggest source of revenue and its costliest resource, yet it often sits idle because of unfilled block time even as providers with cases ready to book lack access. AI-powered emerging technologies can help fill unused OR time and provide decision support to structure workflows and optimize block allocation. This webinar explores the biggest challenges to profitability faced in the OR and the fastest, most impactful changes a hospital can make to address them.

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

Acquisitions, Funding, Business, and Stock

Allscripts announces Q3 results: revenue up 1%, adjusted EPS $0.27 versus $0.11.

Notable, whose technology scans data from EHRs and other applications to trigger task automation workflows, raises $100 million in a Series B funding round. The three founders came from loan processing software vendor Blend.

Cohort Intelligence, whose technology allows doctors to find patients who are candidates for being billed for Medicare’s Chronic Care Management services, changes its name to Engooden. 

Aver raises a $58 million investment and renames itself to Enlace Health. The company’s website is dense with buzzword bingo-speak that leaves me clueless about what they’re selling, so I’ll let them describe: “Enlace Health delivers the only end-to-end solution that solves the infrastructure challenges driving today’s unsustainable healthcare system. Connecting payers, providers, and patients, Enlace empowers any type of healthcare delivery model, from facilitating retrospective programs to enabling risk for prospective programs. Combining executive-level healthcare DNA with an extensible technology platform, Enlace is the bridge from chaotic healthcare to the healthcare world when Triple Aim optimization is truly realized.”

Change Healthcare reports Q2 results: revenue up 9%, EPS –$0.11 versus –$0.13, beating earnings expectations but falling short on revenue. The company’s planned acquisition by OptumInsight is being reviewed by the Department of Justice and won’t be completed earlier than February 22, 2022.

Papa, which offers health plans a “family on demand” service to match older adults with non-medical helpers, raises $150 million in Series D funding, valuing the company at $1.4 billion. The company cites studies that found that its use reduces member loneliness by 68%, which then reduces hospital use. The father of 33-year-old co-founder Andrew Parker founded MDLive, where the younger Parker served in sales and VP roles for five years before Papa was launched in 2017. The company’s Uber-like model involves having “Papa Pals” accept task assignments from the company’s app in being paid as independent contractors.

Sales

• Gundersen Health System will implement Kyruus One and ProviderMatch for Consumers for finding providers and eventually booking appointments.
• Parkland Health & Hospital System chooses Current Health for remote patient monitoring for hypertension.

People

Well Health hires Sean Kelly, MD (Imprivata) as chief medical officer.

Healthcare Triangle names Manish Hindupur (XCM Solutions) as VP of cloud service delivery for life sciences and healthcare providers.

Nuance promotes Vito Augusta to regional VP.

The Providence Digital Innovation Group hires Andy Chu (Bold) as SVP of product and technology incubation.

Announcements and Implementations

In England, Verizon Business and telehealth platform vendor Visionable announce Care Everywhere, while will be sold in the APAC and EMEA regions.

Hospital for Special Surgery (NY) becomes the first US hospital to offer Clear’s Health Pass to expedite the entry of vaccinated patients for visits. Visitors who don’t use the technology will continue with in-person screening and check-in.

Mazda will add in-car cameras that will detect when drivers are having a stroke or heart attack and then guide their vehicle to a safe spot with flashing lights on, starting with next year’s models that are sold in Japan. By 2025, Co-Pilot Concept will also diagnose impending driver health problems and provide advance warning. The carmaker is working with medical experts to allow its cameras to recognize driver positions that indicate problems.

Government and Politics

The federal government will require facilities that are paid by Medicare or Medicaid to fully vaccinate all of their employees against COVID-19  by January 4, 2022. Enforcement will be via CMS surveyors.

CMS increases the minimum penalty for hospitals that fail to comply with the Hospital Price Transparency final rule to $10 per bed per day starting January 1, 2022. The final CMS rule also prohibits hospitals from hiding their machine-readable price files from search engines.

A VA-conducted anonymous survey of employees of Mann-Grandstaff VA Medical Center finds that 83% say their morale is worse since Cerner went live last fall, 81% report increased burnout, 62% aren’t confident about using Cerner to perform their jobs, and 63% question whether they should continue working for the VA. A Congressional committee questioned whether the VA has moved on prematurely from its first implementation to focus on the upcoming one in Columbus. VA Deputy Secretary Donald Remy says he will visit Mann-Grandstaff, the VA will create a new position for someone with large-scale EHR implementation to oversee daily decisions, and the VA may create a deputy CIO position to oversee the Cerner implementation directly.

Other

Bloomberg Businessweek says that 23andMe has stuck to its business plan from 15 years ago – first to convince consumers to send in their DNA samples to gain trivial insight about ancestral origins, then to use their sequencing data to profitably develop drugs — in creating a new IPO’d business that is “sitting somewhere between a Big Pharma lab, a Big Tech company, and a trusted neighborhood doctor.” The article says that co-founder and CEO Ann Wojcicki, who was formerly married to Google co-founder Sergey Brin, was influenced by Google’s strategy to “collect all the data, derive whatever insights you can, and find an adjacent line of business with the potential to yield much bigger profits.” The article notes that consumers who have sent samples might feel baited-and-switched by having the company use the data they paid to contribute used to generate drug profits. Wojcicki says she hasn’t decided how the company will manage its just-announced acquisition of virtual visit company Lemonaid Health, but Lemonaid’s doctors will use genetic information for prescribing drugs once the company has determined the usefulness of genetic risk factors in primary care. She responded to a question about patient privacy by saying that patient data is being widely sold by the medical establishment without the patient’s knowledge anyway, although experts note that 23andMe’s process bypasses a third-party data broker and doesn’t involve paying consumers for using their data to generate profits.

The Onion weighs in on a woman who was charged a $700 ED facility fee by Emory Decatur Hospital even though she left without being seen after seven hours of waiting with a head injury. Emory Healthcare told her that patients are charged before being seen, not for actually being seen.

Sponsor Updates

• Medicomp Systems releases a new Tell Me Where It Hurts Podcast featuring Phoenix Children’s Hospital EVP and Chief Innovation Officer David Higginson.
• Cerner and transplant software vendor Transplant Connect integrate their systems to automate donor referrals.
• CHIME honors Nordic Consulting Board Chair and former CEO Bruce Cerullo with its Foundation Industry Leader Award.
• Empowered Patient Radio features First Databank Nicole Wulf, “Debunking the Myth of Iodine Allergy Related to Contrast Agents Used in Imaging Procedures with Dr. Nicole Wulf FDB.”
• Fortified Health Security hires Jessica Marshall (ChanceLight Behavioral Health) as VP of human resources.
• Goliath Technologies has achieved record revenue and customer growth during the first half of 2021.
• Health Data Movers publishes a new client story, “EHR Integration Makes Providers’ Jobs Easier.”
• Vanguard Law Mag features Lyniate Chief Legal Officer Merritt McGowan, “Taking a personal approach to health care law.”
• Vyne Medical publishes a podcast titled “How Patient Experience is Leading Hospitals Towards Digital Transformation.”

Blog Posts

• Digital Health Technology as a Key Player in Nursing Efficiency (Get Well)
• Uncovering Obstacles to Healthcare Technology Adoption (Halo Health)
• Managed Services for the Ambulatory Setting (HCTec)
• HAS 21 Virtual in Review: Soaring Satisfaction Rates, Attendee Profiles, and More (Health Catalyst)
• Evolve At-Home Services to Maximize Value-Based Care (Dina)
• Partnering with the AAWP to Bring Health Education to the African American Community (Healthwise)
• Unpopular opinion: Social distancing is the best thing to happen to EHR training (Nordic)
• From ransomware to killware: Is the future of cyberattacks turning more sinister? (Imprivata)
• What’s in a variant? Part IV – Making variant sequencing data useful for patient care (Intelligent Medical Objects)
• How to Address SDOH When Caring for Patients at Home (Jvion)
• Digital Transformation: Just Hype, or Vital to Your Hospital’s Success? (Lumeon)
• 10 Disaster Recovery Capabilities All Hospitals Need (Medhost)
• How jump-starting quality improvement efforts can lead to transformational change (Meditech)
• 7 Ways to Streamline Documentation in Your PT Practice (MWTherapy)
• Early detection and real-time medical image-sharing save lives (Nuance)

Contacts

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

EPtalk by Dr. Jayne 11/4/21

I was at my local academic medical center for a meeting a couple of weeks ago and noticed that they have new policies in place regarding wearing scrubs outside the hospital. Apparently they’ve selected a new and distinctive color for the scrubs that are worn to the operating rooms, and if you’re caught trying to wear them out of the building, you’re subject to disciplinary action and possible termination. They already have scrub “vending machines” that prohibit you from taking scrubs home since they’re linked to your ID badge and you’re limited on how many sets can be issued to you. Wearing scrubs from the outside world into the operating suite isn’t ideal, so it makes sense not to let them go to the outside world in the first place.

Still, they don’t have any restrictions on what shoes can be worn in or out of the hospital, which given some recent news, might be a good idea. Shoe soles were swabbed for the presence of C. difficile bacteria, which is the most common healthcare-associated infection in the US. The results were presented at the Infectious Disease Week 2021 annual meeting and showed that shoe soles had a high rate of contamination and were similar to floor samples taken in either private homes or healthcare facilities. The researchers propose that when patients who are at risk for getting C. difficile infection are placed on high-risk antibiotics, that they may need additional education about cleaning floors and removing shoes before entering the home. Sometimes public health informatics isn’t considered sexy, but if you’ve ever encountered a patient with C. difficile diarrhea, you would likely support any research that would help reduce its presence in the world.

The AHIMA Foundation recently released a study on the “Understanding, Access and Use of Health Information in America.” In short, more than three-quarters of patients in the US don’t leave their physician’s office on a positive note. The study notes disconnects between the information that physicians think they are sharing and what patients understand. The findings are similar among caregivers who share concerns about their loved ones’ ability to process information they’ve been presented.

One of the data points I found most interesting was that more than 20% of patients don’t feel comfortable asking their physician certain questions. That points to the difficulty in building patient-physician trust and open communication. I was reading this in the context of a recent conversation with a medical school professor, who noted that at times his trainees were so uncomfortable with certain topics in class forums where patients were present that they asked if they could present their questions to the patients anonymously.

Other interesting tidbits:

• Seventeen percent of patients report not having an opportunity to ask questions at all during a visit.
• Ninety percent of patients search for health information on the internet, and 80% are confident that information is credible.
• More than half of patients report that they rarely access their medical records to review health information.

The latter bullet point indicates that we have a long way to go as far as the patient side of the information blocking equation is concerned. I certainly don’t see any public health organizations that have the resources to educate patients on the benefits of interacting with their own records, and although hospitals and health systems are promoting the use of patient portals as a convenience, I don’t see a lot of campaigns around how important it is to actually review your records. I’ve found multiple errors in my own charts (one of which was potentially life-altering), so I always review my after-visit summaries, but then again, I’m a physician who is also a data junkie which is a status shared by a relatively small number of patients.

Administrative simplification is a hot topic among my friends who are part of the revenue cycle side of healthcare informatics. The US spends a ridiculous amount of money on healthcare administration and a recent editorial in the Journal of the American Medical Association notes that administrative simplification has the potential to remove a quarter-trillion dollars from our healthcare expenditures in the near future. In 2019, $950 billion was spent on administrative functions within the US healthcare system, despite efforts to introduce technology as a way to streamline functions. In our non-system system, administrative staff outnumber physicians and nurses 2:1 with more than a million administrative roles being added in the last two decades.

The authors propose that 28% of annual administrative spending could be cut without impacts to quality or access. Many of the targeted areas are not healthcare related: general administration, human resources, non-clinical TI, sales, marketing, and finance. The second largest group of targets is financial, including revenue cycle management, prior authorization, and claims processing. Further down the list are the actual healthcare interventions, such as convincing payers they should standardize processes and clinical requirements for prior authorization. The authors propose that for many of the changes, financial incentives would be needed to overcome organizational inertia.

I’ve been in some recent training classes with international physicians, and it’s been interesting to hear their questions about phenomena that are particular to the US health system. In many countries, there’s no concept of different billing codes for different types of visits. In some countries, primary care physicians are mandatory, and in others, the concept doesn’t exist. I’ve enjoyed learning first-hand what things might look like in another part of the world and I hope that some day we could reach the levels of commitment to public health and universal coverage that I’ve been hearing about. In the mean time, we’ll have to keep playing Whac-A-Mole with crisis after crisis in the US healthcare system and see if it can recover before it breaks.

If you’re part of a payer/provider organization, I’d be interested to hear what administrative simplification looks like from your perspective. Is the grass already greener on your side of the street, or are you smiling like the Mona Lisa because there are secrets you can’t talk about? Let’s hear some ideas for how to solve these issues and free up money for other worthy projects. Have ideas? Leave a comment or email me.

Email Dr. Jayne.

Readers Write: Creating a More Equitable Health System

Creating a More Equitable Health System
By Wylecia Wiggs Harris, PhD

Wylecia Wiggs Harris, PhD is CEO of AHIMA of Chicago, IL.

As a Black woman, I have been aware of the negative impact of health inequities my entire life, long before becoming the leader of the American Health Information Management Association (AHIMA). In the past year and a half, the pandemic has put a spotlight on the inequities of our healthcare system.

AHIMA and our members stand in a unique position to improve health equity. Health information professionals possess the data skills and expertise to make a positive impact, and we often have a bird’s-eye view of our respective healthcare organizations, allowing us to see the big picture and the ripple effects of any decision.

There are tangible actions we can take to improve health equity. It’s vital that we continue to collect patient demographic and social determinants of health (SDOH) data. We must encourage health systems to prioritize the collection of accurate and complete patient demographic and SDOH data. This data will shed light on the socioeconomic factors that impact the health of both individuals and larger populations. Health information professionals treat this data with the respect it deserves.

I’m proud that AHIMA’s advocacy team encourages policies that improve access to care. We believe it’s important for policymakers to guarantee the right for all people to have access to affordable, high-quality health coverage. We must continue to advocate for policies that help our country reach this important milestone.

We’re fortunate that improvements in technology are making it more efficient to address health disparities. Health information professionals promote the use of technology to analyze and improve quality of care and patient outcomes. We encourage the development, piloting, and testing of machine learning and artificial intelligence technologies that identify and address biases in health data; this can help avoid exacerbating existing health disparities and inequities. We are excited and optimistic about how technology can improve health equities in the years to come.

None of this can be done without a capable team of professionals. Investing in and training a diverse, culturally competent workforce is vital to foster an inclusive approach to addressing health disparities and inequities. It’s critical that patients’ demographic data and SDOH data is managed in ways that are culturally sensitive and having a properly trained workforce is critical.

These teams are needed so that we can continue to support efforts to overcome historical mistrust in healthcare institutions. Many communities of color have an understandable mistrust of healthcare institutions, and to counter this we must identify and dismantle policies that support structural racism and discrimination. At a local level, we must also foster positive patient-provider relationships and engage community leaders in decision-making processes.

I thank all the health information professionals who are helping to create a more equitable and just healthcare system and world. Together, we are making a difference.

Morning Headlines 11/4/21

Notable Raises $100M Series B to Expand Intelligent Automation in Healthcare

Healthcare workflow automation company Notable raises $100 million in a Series B round led by Iconiq Growth.

Wellinks Announces $25M in New Funding to Expand First Integrated Virtual COPD Management Solution to More Patients

COPD-focused digital health vendor Wellinks raises $25 million in a Series A funding round led by Morningside Ventures.

Congress fears VA is ‘moving on’ amid persistent EHR challenges, low employee morale at initial go-live site

The VA plans to begin the testing and training phase of its new Cerner EHR deployment at a second site in February, despite concerns that issues at the first site still haven’t been resolved and governance leadership has yet to be put in place.

Morning Headlines 11/3/21

Kareo and PatientPop Merge to Form Tebra, A Digital Healthcare Technology Company Dedicated to Modernizing Healthcare Practices

Medical practice software vendor Kareo merges with PatientPop, which offers practice growth technology.

EverCommerce to Acquire DrChrono, a Leading Cloud-based SaaS Practice Management and EHR Solution

EverCommerce will add DrChrono’s EHR, practice management, and RCM software and services to its EverHealth line of solutions.

WhiteSpace Health Announces $18 Million in New Funding to Build Out AI-driven Revenue Intelligence Platform

Revenue-focused analytics vendor WhiteSpace Health secures an $18 million investment from parent company Omega Healthcare.

News 11/3/21

Top News

Medical practice software vendor Kareo merges with PatientPop, which offers practice growth technology. The combined companies will operate under the name Tebra.

Reader Comments

From Pipette: “Re: Jonathan Bush. He scorns the HIMSS conference ‘boat show’ in an article, but I seem to recall that Athenahealth docked its own figurative craft out there on the show floor with all those other vendors.” JB has always expressed amusing scorn for the show that his then-company supported as a sponsor and exhibitor. His latest piece from his new seat at Zus Health compares the HIMSS conference to HLTH, observing that while HIMSS feels outdated, mainstream companies are required to attend because 95% of doctor visits are still powered by code written by HIMSS members (he misspells Neal Patterson’s name as “Neil,” but so do a lot of people who probably confuse it with Neil Pappalardo). He says HLTH is like a prom of on-the-rise attendees that is more focused on care than technology, with few geeks in attendance and a lot of premature pomp from companies that will probably fail and “provide critical compost for the winners’ crops.” Here’s his introductory paragraph:

​I think I’ve been to HIMSS roughly a thousand times. It was almost comical to walk into that giant convention center and see the booths two and three stories tall, like giant ships at a boats how. Esteemed patrons would climb up gilded, spiraling stairwells for bottled water and espresso shots, while down on the floor, consultants and competitor employees were shooed away by stiff-smiled booth attendants. These booths, massive and imposing, increasingly looked like something a defense contractor might make, until they literally were made by defense contractors. It was a world where technology was starkly separate from care, where vendors would hawk their wares, distanced from the reality of the very institutions they were selling to. Sure, there were some doctors at HIMSS — the “CMIOs” and whatnot — but they were akin to Afghan translators embedded with our troops — good people, feeling a little bit out of place and a little bit worried that they may be viewed negatively by their people.

HIStalk Announcements and Requests

Question: does it bug you when someone writes “y’all” in an email or social media update? I’ve always liked hearing it said by actual Southerners — kind of like “holler, “howdy,” or “reckon” – but not as much in writing. Blame the English language for not offering a separate plural form of “you”  — other than the outdated “ye” as a plural or “thou” as the singular with “you” as its plural — and thus spawning the workarounds “yinz,” “youse,” and the grating server salutation “you guys.”

Webinars

November 10 (Wednesday) 1 ET. “Too Important to Fail: How to Bring Better AI to Healthcare.” Sponsor: Intelligent Medical Objects. Presenters: Dale Sanders, chief strategy officer, IMO; Marc d. Paradis, VP of data strategy, Northwell Health. It’s relatively easy to obtain healthcare data and build an AI demo, but getting AI to perform reliably and with meaningful impact is much harder. However, strategies exist for delivering AI products to commercial markets. This fireside chat will review the status of AI in healthcare; discuss the vital importance of data quality, methodological rigor, and product focus; and explore what this means to the startup and investor world.

November 11 (Thursday) 1 ET. “Increasing OR Profitability: It May Be Easier than you Think.” Sponsor: Copient Health. Presenters: Michael Burke, co-founder and CEO, Copient Health; David Berger, MD, MHCM, CEO, University Hospital of Brooklyn at State University of New York Downstate Health Sciences University. The OR is a hospital’s biggest source of revenue and its costliest resource, yet it often sits idle because of unfilled block time even as providers with cases ready to book lack access. AI-powered emerging technologies can help fill unused OR time and provide decision support to structure workflows and optimize block allocation. This webinar explores the biggest challenges to profitability faced in the OR and the fastest, most impactful changes a hospital can make to address them.

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

Acquisitions, Funding, Business, and Stock

Digital social services referral company Aunt Bertha rebrands to Findhelp.

Sales

• Christus Santa Rosa Hospital – New Braunfels (TX) selects Care Continuity’s care logistics software to facilitate patient transitions from its ED to primary care physicians and specialists.
• Pipeline Health System selects Premier’s supply chain technology and services.

People

WebPT hires Ashley Glover, MBA (RealPage) as CEO. She replaces the retiring Nancy Ham, who will move to board chair.

Hinge Health names Lalith Vadlamannati, PhD (Amazon) as CTO.

HIPAAtrek promotes Amy Coulter to CEO. She co-founded Ability Network, which was sold to Inovalon in 2018 for $1.2 billion.

Southwestern Health Resources (TX) names Mac Marlow, MBA (Lehigh Valley Health Network) CIO and Shashi Vangala, MS (Baylor Scott & White Health) chief data and value creation officer.

Medication management technology vendor Arine hires Todd Christiansen, RPh, MBA (Leidos Health) as chief growth officer, Thomas Cooke (Leidos) (not pictured) as VP of business development, and Amy Mosher-Garvey, MSSW, MBA (Leidos) as VP of client success.

Avia names Anjani Shah, MBA (McKinsey & Co.) SVP of transformation and Dhiraj Patkar, MS (HRGi Holdings) SVP of product for Avia Connect.

Agathos, which sends hospital physicians action-level insights on their practice patterns, hires John Pollard (Nordic) as head of marketing,

Announcements and Implementations

Soma Medical Center has deployed EHR and health information search engine technologies from EClinicalWorks across its 25 facilities in Florida.

A new KLAS report reviews risk adjustment solutions.

Privacy and Security

In Canada, Newfoundland and Labrador struggles to recover from a weekend ransomware attack on its health IT systems that has forced its facilities to revert to downtime procedures and cancel appointments.

Other

Seattle Children’s Hospital electronically replaces allergy reaction descriptions in Epic that contain the the formerly common term “red man syndrome” – which it says is racist language — with “vancomycin flushing syndrome.” The hospital also implemented autocorrect functionality to prevent use of the term. The phenomenon in which IV vancomycin causes a red rash was first documented in 1959 as “Red Man’s Syndrome,” which was the subject of a 1985 proposal to instead call it “Red-neck Syndrome” to recognize that it occurs equally in men and women.

Sponsor Updates

• The Health Innovation Matters Podcast features AdvancedMD Chief Marketing Officer Jim Elliott.
• A newly published peer-reviewed study concludes that Bamboo Health’s NarxCare solution is effective as an “initial universal prescription opioid-risk screener.”
• Philips Capsule Medical Device Information Platform has exceeded the milestone of integrating with more than 1,000 unique medical device models.
• Cerner publishes a white paper, “Unlocking the power of data with the Cerner Learning Health Network.”
• Dina will exhibit at the FirstLight Home Care conference November 4-5 in Salt Lake City.
• Engage, a Tegria company, maintains its position as one of the top firms in a new KLAS Research Performance Insights report, “Meditech Implementations Services 2021: Which Firms are Driving Successful Implementations?”
• Emerge publishes a case study, “Emerge Improved Revenue and Quality for Multi-Specialty Group Using Natural Language Processing.”

Blog Posts

• COVID-19 vaccine requirements: 4 facts SNFs need to know (Ability Network)
• Join Us at RSNA 2021 (Agfa HealthCare)
• Three Key Takeaways from HLTH 2021: Driving Change through Care Coordination to Transform Whole Person Care (Bamboo Health)
• Virtual Telemedicine: Innovative Care Delivery Models (Bluestream)
• The Information Advantage: How Esse Health Reduced High-Risk ED Visits and Drove $3.6M in Savings (CareSignal)
• MEDITECH Customers Named to CHIME’s Most Wired 2021 (Meditech)
• Power in the Portals: How to Get Patients at the Center of Care (CereCore)
• Wrap up on CBI’s Coupon and Copay Conference: TL;DR Takeaways (ConnectiveRx)
• The Power of Teamwork, Training, and Trust (Diameter Health)
• 2021 National Conference: Opening a New Chapter in Healthcare IT (EClinicalWorks)
• Single-Path Coding: Doing Away with Disparate Coding Practices (EZDI)

Contacts

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