There will be a plethora of firms diving into the AI ocean of ‘solutions’ over the next three years. But…
Monday Morning Update 3/25/24
Top News
UnitedHealth Group posts target dates for restoring Change Healthcare’s systems following its February 21 cyberattack.
UHG says that it restored its electronic payments platform on March 15 and is proceeding with payer implementations, noting that “the actual cash flow timing is dependent on payers.”
The company says that its medical claims backlog is $14 billion. It has advanced $2.5 billion to affected providers.
Reader Comments
From Aging Out: “Re: Epic. What happens when Judy is replaced?” Judy Faulkner turns 81 this year and will have served 45 years as Epic’s only CEO. The company has always assured that it has a solid succession plan, and more recently, has allowed some of its executives to get more visibility. Epic says it won’t sell out or change its ways, but her Giving Pledge says that she will donate 99% of her assets, including all of the proceeds of her Epic shares that will go to a foundation. Meanwhile, Oracle’s Larry Ellison turns 80 this year, so should he exit the company vertically or otherwise, the former Cerner business will lose its only cheerleader, and Oracle’s lackluster loyalty could take a big hit. I commend Meditech for turning the reins over to a younger and more diverse executive team years ago, to which I attribute the remarkable move from the archaic Magic to today’s state-of-the-art Expanse in making the company relevant again.
From Buoyancy: “Re: fixing healthcare. I always like to push people to name the single best first step.” I would say decouple insurance from employment. Give every American at least basic coverage and limit patient-insurer churn as people change plans every year or two based on decisions by themselves, their employer, or their insurer in the antithesis of medical continuity and health maintenance. We all want health for a lifetime, not just for the next year, and everybody’s incentive needs to be longer term.
From Badman: “Re: Healthbox. It seems to have died in the HIMSS portfolio, as did Health 2.0.” I don’t recall HIMSS saying that they shut the Healthbox innovation consulting firm and accelerator down, but its online presence is outdated, and CEO Neil Patel – a former Chartis Group employee, like Hal Wolf — moved on in May 2021. I assume it was abandoned quietly like HIMSS Accelerate, which is an online ghost town. We can’t see much detail on any of this since HIMSS still hasn’t published an IRS 990 form since the end of 2020.
HIStalk Announcements and Requests
Thanks to readers who provided feedback on HIMSS24, which I have posted.
Longtime HIMSS executive Elli Riley, who was moved to Informa Markets with the conference’s acquisition, says that HIMSS25 will be more of a “conference within a conference” that will be personalized to attendee focus. An executive of conference logistics operator Freeman says that HIMSS24 measured attendee sentiment using technology from Zenus, which uses anonymized “ethical facial analysis” and badge reading data from discreetly installed cameras to analyze attendee reaction for exhibitors and conference organizers. Other Informa-driven changes include greater use of digital signage, creating a new conference website, changing email marketing automation, and running new conference social media accounts. The article in Trade Show Executive also notes that while HIMSS creates the member-driven content part of the conference, “Informa is responsible for overseeing all content and programming development,” which makes it sound like Informa has more control over the entire conference than the initial HIMSS “partnership” announcements suggested.
Speaking of HIMSS, I noticed in Informa’s annual report that it paid $106 million in cash to acquire the HIMSS conference outright.
Most of us haven’t had a provider visit in which conversational audio was used to create documentation.
New poll to your right or here: Have you recently asked an AI tool a question about your health or medical care? Going beyond the scope of a poll question, I would appreciate hearing anonymously from anyone who has asked AI health and medical questions and received answers that changed their life significantly – maybe a new or corrected diagnosis, medication use or side effects, advisability of surgery, or a suggestion to seek medical attention that turned out to be fortunate.
Digital health vendors must be sweating that their sectors might be next up for a deep dive by the non-profit Peterson Health Technology Institute, which just concluded what we all suspected — that lifestyle-modification diabetes apps don’t deliver enough benefits to cover their cost. The organization noted in its year-ago report that digital health investments were ballooning with little proof that they improved outcomes or cost, calling for an independent authority to evaluate the value of digital health tools (note: PHTI reviews available public and private data and evidence, so it’s up to vendors to conduct studies). I checked the backgrounds of the PHTI’s key people and found little to criticize:
- Executive Director Caroline Pearson came from a research background at NORC at the University of Chicago and spent 13 years with Avalere Health in health policy consulting.
- Managing Director of Strategic Operations David Silk, MBA held marketing executive roles with two health tech companies and at Google Cloud’s healthcare and life sciences group.
- Senior Advisor for Strategic Initiatives Prabhjot Singh, MD, PhD held executive roles in provider groups and was a medical school and public affairs professor.
- Managing Director of Engagement and Outreach Meg Barron, MBA was a digital health VP for the American Medical Association.
- Assessment principal Vanessa Juth, PhD, MPH, MA was a digital strategy executive for two drug companies and was chair of CHOC’s biobehavioral oncology program.
- Senior policy advisor Mairin Mancino worked in innovation at NORC at the University of Chicago and VP of Avalere Health, with provider-side experience at Summa Health.
Listening: Boygenius, which I Shazam’ed in a store thinking sure the song I was hearing was new, hook-heavy Nada Surf. I liked it so much that I was sorry to learn that they’re hugely popular since I was hoping it was an obscure find on my part, but now I know it’s a supergroup of Phoebe Bridgers, Julien Baker, and Lucy Dacus, all in their late 20s, playing guitar-heavy, emotional indie.
Pondering: is anyone buying Apple Vision Pros? The photos that have been posted on X of people at conferences and on streets waving their arms like Bradley Cooper in “Maestro” makes me think it’s just a more expensive way to be a Glasshole, especially given the level of social anxiety among its target audience of trend-chasing nerds. Business and private use is the sweet spot, I assume.
Webinars
March 27 (Wednesday) 3 ET. “Houston Methodist: Deploying clinical AI at scale for improved outcomes.” Sponsor: Health Data Analytics Institute. Presenters: Khurram Nasir, MD, MPH, chief of cardiovascular disease prevention and wellness, Houston Methodist DeBakey Heart & Vascular Center; Brenda Campbell, RN, senior consultant, HM Health System Innovations; Nassib Chamoun, MS, founder and CEO, HDAI. The presenters will share how an interdisciplinary team collaborated to successfully use predictive models and a novel AI-driven approach to address post-discharge mortality. They will also describe how they expanded use of the platform to reduce clinician time spent digging through the EHR with a one-page risk profile, including codes extracted from notes using generative AI, and targeting their highest risk patients for extra attention. They will speak to how they overcame barriers to bringing AI at scale to support clinicians across the care continuum.
Previous webinars are on our YouTube channel. Contact Lorre to present or promote your own.
Acquisitions, Funding, Business, and Stock
Fortune reports that payment processor Global Payments is seeking a buyer for its AdvancedMD business at a reported asking price of $3 billion. Global Payments acquired the company in 2018 for $700 million.
People
Industry long-timer Kevin Soltysiak, whose career included roles at Shared Medical Systems, Healthtek Solutions, and Alora Home Health Software, died March 15. He was 62.
Announcements and Implementations
Montana HHS goes live on Netsmart’s electronic visit verification.
DrFirst launches TrueRx for pharmacies, which uses AI-enabled fingerprint technology and behavior outlier detection to protect against prescriber identity and prescription fraud.
Government and Politics
VA OIG issues three reports related to the VA’s implementation of Oracle Health:
- A patient died from an overdose seven weeks after missing an appointment at the Columbus facility because of EHR scheduling errors. The report notes that a nurse practitioner did not evaluate the patient’s medication refill request and the psychologist failed to thoroughly evaluate their depression and to consider related critical clinical information. The facility did not send “patient caring communications” because a high-risk flag had been inactivated.
- The Columbus facility went live on Oracle Health despite known pharmacy-related patient safety and usability issues, such as problems with sending newly entered allergy and medication information to VA facilities that are still running VistA. The investigators note that pharmacist burnout increased due to the EHR’s operational inefficiencies.
- OIG warns that the smaller VA facilities that have gone live had problems with patient scheduling that will probably be worse in larger centers, which will require higher staffing levels and overtime pay.
Sponsor Updates
- Experity migrates 300 urgent care practice customers to RCM vendor Waystar in the wake of the Change Healthcare cyberattack.
- Wolters Kluwer Health publishes a new book, “A Practical Guide for Nurse Practitioner Faculty Using Simulation in Competency-based Education.”
- AdvancedMD renews its partnership with data automation platform vendor FrontRunnerHC.
- Availity partners with Zelis to streamline the end-to-end process between providers and payers, from administrative workflows through payments.
- Nordic releases a new Designing for Health Podcast, “Interview with Joyce Lee, MD.”
- Consulting Magazine awards Pivot Point Consulting founder and President Rachel Marano its Leaders in Technology award in the Excellence in Leadership category.
- RxLightning now enables prescribers and their care teams the ability to enroll patients in Free-Drug and Patient Assistance Programs managed by KnippeRx.
- Sectra publishes a new whitepaper, “True SaaS or a cloudy promise?”
Blog Posts
- Social Work Month 2024: How AI-powered speech recognition can boost social worker productivity (Nuance)
- AI in Revenue Cycle Management: Three Key Areas Where Healthcare Organizations are Prioritizing AI Integration (Nym)
- How Technology Supports Value-Based Care in Home and Community-based Services (Netsmart)
- Beyond medicine: Envisioning healthcare’s role in fostering community and connection (Nordic)
- Finding Value and AI at HIMSS 2024 (Optimum Healthcare IT)
- 10 must-know perspectives on digital transformation for healthcare IT leaders (Redox)
- Interoperability insights from Digital Health Rewired 2024 (Rhapsody)
- Achieving the right balance of human interaction and technology at your hospital contact center (Spok)
- ViVE 2024: Navigating Healthcare’s Complexities through Collaboration & Innovation (Symplr)
Contacts
Mr. H, Lorre, Jenn, Dr. Jayne.
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Contact us.
I don’t know how easy it would be to create a poll based on Buoyancy’s question about ‘fixing healthcare and asking people to name the single best first step’. Hmmmm. Could be some interesting answers! I’d love to read them!
The hardest part of any change will be dealing with the huge unemployment surge due to the decrease in revenue. There is so much waste and overhead. What would the country do if 30% of the largest part of the economy was suddenly unemployed?
I 100% agree with the decoupling of insurance from employment. It would also reduce friction in the labor market and allow employees to swtich jobs that they are more suited for or interested in. I believe it would have a large positive effect on the economy.
The Netherlands has a mandatory insurance market where every person must have insurance, insurers must offer a basic plan that covers the standard across the board. If you’re poor, you get subsidies (not unlike ACA). If you think you can beat the system, you can increase your deductible from 385 up to 885 a year for a (small) decrease in monthly premiums. You can also add things like physio, massage, dental (the Dutch also exclude dental and vision from healthcare), vision, etc, etc. for varying additional monthly costs. I personally have worldwide health coverage for an extra 6.50/month which will cover any costs I end up with when I’m in the US. For the base plan with 385, it’s about 120/mo. There’s an employer portion healthcare tax (6.57%) and an employee portion (5.32%) up to a max salary of 71,628. The Dutch labor market has high levels of friction but it’s not due to helathcare.
This history of employer-provided healthcare is interesting: https://www.griffinbenefits.com/blog/history-of-employer-sponsored-healthcare
Yes, Meditech will talk your ears off about Expanse.
There are multiple factors at play here which undercut both Meditech and Expanse.
1). Meditech’s story was that Client/Server was “going to solve all the problems of Magic”. Not only did it not do that, C/S was at best a modest improvement. We’ve seen these messages before and they are designed to stop the customers from looking at the competition;
2). Meditech has no requirements for customers to stay current. On anything! They encourage, yes, but even that is remarkably muted. The upgrade dynamics include a tiny carrot and no stick at all.
The result? As of 2016 (the last time I have hard data), the customer-product breakdown was:
Magic: 33%
C/S: 42%
V6 (now Expanse): 25%
I can hear the objections now. “Oh, that’s so out of date, there’s no need to even talk about that.” Eh, no. Everything in Meditech world moves at a glacial pace. And V6 had been out a long, LONG time by 2016. Meditech did nothing but talk about V6.
Yet behind the scenes? Meditech had a long-standing policy of functional parity between Magic and C/S. Meaning, for customers disinclined to move up to C/S? They had even fewer reasons to tackle that.
Why would a customer be disinclined to upgrade to a newer lineage? Among other things, every time you make this move? Your entire inventory of reports gets left behind. There’s no compatibility at all, so you are starting over.
I see no evidence that Expanse changes any of this, at all.
Meditech certainly benefited from Cerner and Allscripts stumbles and before that the failures of ECW and Athena’s inpatient expansions. I agree that Expanse has a higher profile than it should right now. Meditech loses maybe a third of customers at upgrade time and new Expanse customers are all under 100 beds. To me, that’s a recipe for persistent decline. If Epic is willing to dilute their brand or Cerner gets their act together, those new installs will dry up too.
What do you see as the outcome for Meditech and Expanse?
Well, this is predicting the future, and my crystal ball is cloudy and cracked.
But my basic thesis about Meditech? They have a crushing burden of tech debt and cannot get out from under that. It’s too late and their moves are insufficient. And their company culture does nothing but reinforce the message that “the old ways got us here and guarantee success”.
Thus, my It’s Worth What You Paid For It prediction. Any of these are possible:
1). Meditech slowly runs into the ground, reminiscent of Research in Motion (later, BlackBerry);
2). Meditech gets acquired by a specialty company, someone like Harris or a cash cow operator (there’s an infamous computing example who’s name presently escapes me);
3). Oracle acquires them, as a way to somehow boost their Cerner acquisition.
The external evidence all supports this. According to KLAS data, only Epic is growing, while Cerner and Meditech are at best stuck in neutral.