Surescripts Deal Connects EMR Vendors And PBMs To Improve Price Transparency

I’m no expert on the pharmacy business, but from where I sit as a consumer it’s always looked to me as though pharmaceutical pricing is something of a shell game. It makes predicting what your airline ticket will cost seem like child’s play.

Yes, in theory, the airlines engage in demand-oriented pricing, while pharma pricing is based on negotiated prices spread among multiple contracted parties, but in either case end-users such as myself have very little visibility into where these numbers are coming from.  And in my opinion, at least, that’s not good for anyone involved. You can say “blah blah blah skin in the game” all you want, but co-pays are a poor proxy for making informed decisions as a patient as to what benefits you’ll accrue and problems you face when buying a drug.

Apparently, Surescripts hopes to change the rules to some degree. It just announced that it has come together with two other interest groups within the pharmacy supply chain to offer patient-specific benefit and price information to providers at the point of care.

Its partners in the venture include a group of EMR companies, including Cerner, Epic, Practice Fusion and Aprima Medical Software, which it says represent 53% of the U.S. physician base. It’s also working with two pharmacy benefit managers (CVS Health and Express Scripts) which embrace almost two-thirds of US patients.

The new Surescripts effort actually has two parts, a Real-Time Prescription Benefit tool and an expanded version of its Prior Authorization solution.  Used together, and integrated with an EHR, these tools will clarify whether the patient’s health insurance will cover the drug suggested by the provider and offer therapeutic alternatives that might come at a lower price.

If you ask me, this is clever but fails to put pressure on the right parties. You don’t have to be a pharmaceutical industry expert to know that middlemen like PBMs and pharmacies use a number of less-than-visible stratagems jack up drug prices. Patients are forced to just cope with whatever deal these parties strike among themselves.

If you really want to build a network which helps consumers keep prices down, go for some real disclosure. Create a network which gathers and shares price information every time the drug changes hands, up to and including when the patient pays for that drug. This could have a massive effect on drug pricing overall.

Hey, look at what Amazon did just by making costs of shipping low and relatively transparent to end-users. They sucked a lot of the transaction costs out of the process of shipping products, then gave consumers tools allowing them to watch that benefit in action.

Give consumers even one-tenth of that visibility into their pharmacy supply chain, and prices would fall like a hot rock. Gee, I wonder why nobody’s ever tried that. Could it be that pharmaceutical manufacturers don’t want us to know the real costs of making and shipping their product?

Posted in health information exchange, Healthcare Integration, Hospital EHR Vendor, Hospital Electronic Health Record, Hospital Electronic Medical Record, Hospital EMR, Hospital EMR Company, Hospital EMR Vendor, Hospital Healthcare IT | Tagged , , , , , , , , | Comments Off on Surescripts Deal Connects EMR Vendors And PBMs To Improve Price Transparency

Announcing the Inaugural Health IT Expo


Healthcare Scene is pleased to announce the inaugural Health IT Expo conference happening May 30 – June 1, 2018 in New Orleans, LA. HITExpo 2018 is going to be a one of a kind event that brings together the top hospital and health system IT professionals in one venue to experience a new level of collaboration, learning, and fun.

We’re committed to creating a new, unique, collaborative conference experience. Read more about our unique approach from our conference chairperson. If you’re tired of plastic conferences where every session says that everything is perfect and speaks in useless platitudes, then join us at Health IT Expo for an extremely different experience.

The super early bird registration for Health IT Expo is open through January 5, 2018. Register now and save $500 off the regular registration price. If you’re interested in bringing your whole hospital healthcare IT team, reach out to us on our contact us page about group discounts. We love to provide a tremendous team building opportunity together with an amazing conference.

The Health IT Expo Call for Speakers is also open. If you’ve used technology to improve your healthcare organization, we want to hear about your experience. For those not looking to be professional speakers, we have a 15 minute session option where you can share your experiences using IT to improve your hospital or health system without having to spend weeks preparing your presentation. Plus, some amazing ideas only need 10-15 minutes to explain, so why waste 45 minutes sharing something that could be shared in 15? Every session must have practical, implement now takeaways in their presentation.

A big thank you to all of the Health IT Expo sponsors who have signed up. We’re excited to create a uniquely collaborative environment where sponsors and attendees collaborate and work together at the conference. We still have a few sponsor slots available. If you’re interested, take a moment to look at our Health IT Expo sponsor prospectus. Be sure to take a look at our unique health IT user focus group or user group meetings available for sponsors as well.

We look forward to seeing many of you from the Healthcare Scene community at Health IT Expo in New Orleans! If you have any questions about this new conference, please let us know on our contact us page.

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UPMC Plans $2B Investment To Build “Digitally-Based” Specialty Hospitals

The University of Pittsburgh Medical Center has announced plans to spend $2 billion to build three new specialty hospitals with a digital focus. Its plans include building the UPMC Heart and Transplant Hospital, UPMC Hillman Cancer Hospital and UPMC Vision and Rehabilitation Hospital. UPMC already runs the existing specialty hospitals, Magee-Womens Hospital, Western in Psychiatric Institute and Clinic and Children’s Hospital of Pittsburgh.

UPMC is already one of the largest integrated health delivery networks in the United States. It’s $13 billion system includes more than 25 hospitals, a 3-million-member health plan and 3,600 physicians. If its new specialty centers actually represent a new breed of digital-first hospital, and help it further dominate its region, this could only add to its already-outsized clout.

So what is a “digitally-based” hospital, and what makes it different than, say, other hospitals well along the EMR adoption curve? After all, virtually every hospital today relies on a backbone of health IT applications, manages patient clinical data in an EMR and stores and stores and shares imagines in digital form.   Some are still struggling to integrate or replace legacy technologies, while others are adopting cutting-edge platforms, but going digital is mission-critical for everyone these days.

What’s interesting about UPMC’s plans, however, is that the new hospitals will be designed as digitally-based facilities from day one. UPMC is working with Microsoft to design these “digital hospitals of the future,” building on the two entities’ existing research collaboration with Microsoft and its Azure cloud platform.

The Azure relationship dates back to February of this year, when UPMC struck a deal with Microsoft to do some joint technology research. The agreement builds on both UPMC’s fairly impressive record of tech innovation and Microsoft’s healthcare AI capabilities, genomics and machine learning capabilities. For example, in working with Microsoft, UPMC gets access to Microsoft’s health chat bot technology, which is being deployed elsewhere to help patient self-triage before they interact with the doctor for a video visit.

I’d love to offer you specific information on how these new digitally-oriented will be designed, and more importantly how the functioning will differ from otherwise-wired hospitals that didn’t start out that way, but I don’t think the two partners are ready to spill the beans. Clearly, they’re going to tell you all of this is the new hotness, but nobody’s provided me with any examples of how this will truly improve on existing models of digital hospital technology. I just don’t think they’re that far along with the project yet.

Obviously, UPMC isn’t spending $2 billion lightly, so its leadership must believe the new digital model will offer a big payoff. I hope they know something we don’t about the ROI potential for this effort. It seems likely that if nothing else, that technology investment alone won’t drive that big a rate of return. Clearly, other major factors are in play here.

Posted in Cloud EHR, EMR ROI, Healthcare AI, Hospital EHR, Hospital Electronic Health Record, Hospital Electronic Medical Record, Hospital EMR, Hospital Healthcare IT | Tagged , , , , , , , , | Comments Off on UPMC Plans $2B Investment To Build “Digitally-Based” Specialty Hospitals

CHIME Suspends the $1 Million Dollar National Patient ID Challenge

CHIME just announced that they’ve suspended their National Patient ID Challenge. For those not familiar with the challenge, almost 2 years ago CHIME Announced a $1 million prize for companies to solve the patient identification and matching problem in healthcare. Here’s the description of the challenge from the HeroX website that hosted the challenge:

The CHIME National Patient ID Challenge is a global competition aimed at incentivizing new, early-stage, and experienced innovators to accelerate the creation and adoption of a solution for ensuring 100 percent accuracy in identifying patients in the U.S. Patients want the right treatment and providers want information about the right patient to provide the right treatment. Patients also want to protect their privacy and feel secure that their identity is safe.

And here’s the “Challenge Breakthrough” criteria:

CHIME Healthcare Innovation Trust is looking for the best plan, strategies and methodologies that will accomplish the following:

  • Easily and quickly identify patients
  • Achieve 100% accuracy in patient identification
  • Protect patient privacy
  • Protect patient identity
  • Achieve adoption by the vast majority of patients, providers, insurers, and other stakeholders
  • Scale to handle all patients in the U.S.

When you look at the fine print, it says CHIME (or the Healthcare Innovation Trust that they started to host the challenge) could cancel the challenge at any time without warning or explanation including removing the Prize completely:

5. Changes and Cancellation. Healthcare Innovation Trust reserves the right to make updates and/or make any changes to, or to modify the scope of the Challenge Guidelines and Challenge schedule at any time during the Challenge. Innovators are responsible for regularly reviewing the Challenge site to ensure they are meeting all rules and requirements of and schedule for the Challenge. Healthcare Innovation Trust has the right to cancel the Challenge at any time, without warning or explanation, and to subsequently remove the Prize completely.

It seems that CHIME’s legally allowed to suspend the challenge. However, that doesn’t mean that doesn’t burn the trust of the community that saw them put out the $1 million challenge. The challenge created a lot of fanfare including promotion by ONC on their website, which is a pretty amazing thing to even consider. CHIME invested a lot in this challenge, so it must hurt for them to suspend it.

To be fair, when the challenge was announced I hosted a discussion where I asked the question “Is this even solvable?” At 100% does that mean that no one could ever win the challenge? With that in mind, the challenge always felt a bit like Fool’s Gold to me and I’m sure many others. I thought, “CHIME could always come back and make the case that no one could ever reach 100% and so they’d never have to pay the money.” Those that participated had to feel this as well and they participated anyway.

The shameful part to me is how suspending the competition is leaving those who did participate high and dry. I asked CHIME about this and they said that the Healthcare Innovation Trust is still in touch with the finalists and that they’re encouraging them to participate in the newly created “Patient Identification Task Force.” Plus, the participants received an honorarium.

Participation in a CHIME Task Force and the honorarium seems like a pretty weak consolation prize. In fact, I can’t imagine any of the vendors that participated in the challenge would trust working with CHIME going forward. Maybe some of them will swallow hard and join the task force, but that would be a hard choice after getting burnt like this. It’s possible CHIME is offering them some other things in the background as well.

What’s surprising to me is why CHIME didn’t reach out to the challenge participants and say that none of them were going to win, but that CHIME still wanted to promote their efforts and offerings to provide a solid benefit to those that participated. CHIME could present the lessons learned from the challenge and share all the solutions that were submitted and the details of where they fell short and where they succeeded. At least this type of promotion and exposure would be a nice consolation prize for those who spent a lot of time and money participating in the challenge. Plus, the CIOs could still benefit from something that solved 95% of their problems.

Maybe the new Patient Identification Task Force will do this and I hope they do. CHIME did it for their new Opioid Task Force at the Fall Forum when they featured it on the main stage. How about doing the same for the Patient Identification Challenge participants? I think using the chance to share the lessons learned would be a huge win for CHIME and its members. I imagine it’s hard for CHIME to admit “failure” for something they worked on and promoted so much. However, admitting the failure and sharing what was learned from it would be valuable for everyone involved.

While I expect CHIME has burnt at least some of the challenge participants, the CHIME CIO members probably knew the challenge was unlikely to succeed and won’t be burnt by this decision. Plus, the challenge did help to call national attention to the issue which is a good thing and as they noted will help continue to push forward the national patient identifier efforts in Washington. Maybe now CHIME will do as Andy Aroditis, Founder and CEO of NextGate, suggested in this article where Shaun Sutner first reported on issues with the CHIME National Patient ID Challenge:

Aroditis complained that rather than plunging into a contest, CHIME should have convened existing patient matching vendors, like his company, to collaborate on a project to advance the technology.

“Instead they try to do these gimmicks,” Aroditis said.

I imagine that’s what CHIME would say the Patient Identification Task Force they created will now do. The question is whether CHIME burnt bridges they’ll need to cross to make that task force effective.

The reality is that Patient Identification and Patient Matching is a real problem that’s experienced by every healthcare organization. It’s one that CHIME members feel in their organizations and many of them need better solutions. As Beth Just from Just Associates noted in my discussion when the challenge was announced, $1 million is a drop in the bucket compared to what’s already been invested to solve the problem.

Plus, many healthcare organizations are in denial when it comes to this problem. They may say they have an accuracy of 98%, the reality is very different when a vendor goes in and wakes them up to what’s really happening in their organization. This is not an easy problem to solve and CHIME now understands this more fully. I hope their new task force is successful in addressing the problem since it is an important priority.

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Logicalis Global Survey: CIOs Worldwide Target Legacy IT in Push for Digital Transformation

Despite Slow Progress Over the Past 12 Months, IT Leaders Have Big Plans for Overcoming Barriers

NEW YORK, November 15, 2017 – According to the results of a new Logicalis global survey, CIOs around the globe are more determined than ever to achieve digital transformation within their organizations despite setbacks experienced over the past year. Logicalis, an international IT solutions and managed services provider (www.us.logicalis.com) is making the survey results available online at our website. Download a copy of the 2017/2018 Logicalis Global CIO Survey here: http://ow.ly/jVfZ30gzqws.

The survey, which polled 890 CIOs across 23 countries, unearthed surprising findings this year. Although CIOs are determined to achieve digital transformation, optimism about their strides toward success has waned over the last 12 months. While only 11 percent report their organizations have “no desire” for transformation, those that ideologically embrace digital transformation have made only minimal advancements to date:

* Just 5 percent classify their organizations as “digital innovators,” down from 6 percent in last year’s survey.
* Fewer CIOs (19 percent) see their organizations as early adopters today, a step back from last year’s 22 percent.
* However, the proportion of CIOs that characterize themselves as part of an early majority with digital transformation rose from 45 percent last year to 49 percent this year, illustrating that, despite difficulties, IT leaders are moving ahead with digital transformation plans.

Overcoming Difficulties
The main barriers to delivering digital transformation, CIOs say, include complexity, cost, culture, skills and security issues.  Notably, 44 percent of CIOs cite the complexity of legacy technology as their top obstacle, while 50 percent point to cost, 56 percent name organizational culture as their largest issue, 34 percent say it’s a lack of skills, and 32 percent identify security as their biggest hurdle.

Far from discouraged, CIOs around the world have big plans for overcoming these digital transformation barriers:
*51 percent say they plan to replace and/or adapt existing infrastructure.
*51 percent plan to attempt culture change within their organizations.
*38 percent will address skills shortages through increased training and development.
*31 percent expect to invest in extra security capabilities.

“The way businesses view technology is undergoing an exciting yet fundamental shift,” says Vince DeLuca, CEO of Logicalis US.  “The goal behind technology is no longer simply about implementing and managing tools that enable people to do their jobs.  In a digitally transformed enterprise, it’s about giving people access to the information they need to fuel business agility and growth and to empower collaboration that will create business models no one has yet imagined. Digital transformation is the foundation upon which this new way of doing business will be built, and as this year’s Global CIO Survey indicates, IT leaders around the world not only recognize this, but they are determined to provide the platform their organizations need to embrace the change that is to come.”

About the Research
All figures were drawn from a survey of 890 CIOs and IT directors from mid-market organizations in 23 countries spanning Europe, North America, Latin America and Asia-Pacific.

About Logicalis
Logicalis is an international multi-skilled solution provider providing digital enablement services to help customers harness digital technology and innovative services to deliver powerful business outcomes.

Our customers cross industries and geographical regions; our focus is to engage in the dynamics of our customers’ vertical markets including financial services, TMT (telecommunications, media and technology), education, healthcare, retail, government, manufacturing and professional services, and to apply the skills of our 4,000 employees in modernizing key digital pillars, data center and cloud services, security and network infrastructure, workspace communications and collaboration, data and information strategies, and IT operation modernization.

We are the advocates for our customers for some of the world’s leading technology companies including Cisco, HPE, IBM, NetApp, Microsoft, VMware and ServiceNow.

The Logicalis Group has annualized revenues of over $1.5 billion from operations in Europe, North America, Latin America, Asia Pacific and Africa. It is a division of Datatec Limited, listed on the Johannesburg Stock Exchange and the AIM market of the LSE, with revenues of over $4 billion.

For more information, visit www.us.logicalis.com.

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Industry Report Highlights Widespread Dissatisfaction with EHRs and PHMs for Quality Performance Management

97% of Surveyed Health Systems Relying on Solutions Considered Unsatisfactory

CHICAGO – November 15, 2017 – SA Ignite Inc., a leading provider of solutions that simplify and automate the management of complex value-based programs, today announced key findings from its recent industry study. The State of QPP Preparedness Industry Report, conducted in collaboration with Porter Research, analyzed feedback from nearly 120 health system executives regarding their organizations’ preparedness for CMS’s Quality Payment Program (QPP). Researchers found that while most health systems are relying solely on electronic health record (EHR) or population health management (PHM) solutions for quality reporting, the majority are unsatisfied with the performance of those systems, indicating that organizations are at risk of missing out on their goals of maximizing payment incentives.

The QPP is a CMS initiative created under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) to improve health outcomes and aid the transition to value-based care. Ninety-four percent of the study respondents are actively participating in the QPP, which is indicative of the rapid national adoption of value-based programs.

According to the study, 97% of respondents say their organizations are relying on their EHRs or PHMs for QPP reporting. However, they have very low confidence in these tools, especially when it comes to the most critical functions related to QPP performance, such as:

  • Identifying all eligible clinicians
  • Pinpointing focus areas to increase scores
  • Seeing overall MIPS score/estimated financial impact

Additional study findings include:

  • The majority (64%) of health systems are seeking to maximize their QPP payment incentives.
  • 73% of respondents reported that their system vendor does not offer a specific QPP management solution.
  • There is a lack of consistency across organizations as to which department manages the QPP. Respondents cited quality, clinical, administrative, IT, and population health departments as various managers of the program.

“EHR and PHM solutions were designed to manage patient care, not to optimize performance in value-based programs,” said Matt Fusan, Director of Customer Experience of SA Ignite. “It should come as no surprise that these solutions don’t have the necessary functionality to support quality performance management. Healthcare leaders hoping to maximize their incentives must look beyond the EHR to solutions that mitigate complexity and facilitate proactive program management.”

Click here to learn more about this study and its results, and to receive practical guidance on how to manage quality performance and maximize payment incentives.

About SA Ignite, Inc.

SA Ignite’s compliance management and predictive analytics platform simplifies the complexities of evolving value-based initiatives, including MIPS and Meaningful Use for Medicaid. Some of the nation’s largest healthcare organizations optimize their quality scores to reduce reputational and financial risk with the help of timely, actionable insights from SA Ignite. For more information, visit www.saignite.com.

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Opening the Door to Data Analytics in Medical Coding – HIM Scene

The following is a HIM Scene guest blog post by Julia Hammerman, RHIA, CPHQ, is Director of Education and Compliance, himagine solutions.

Data analytics has moved from IT and finance to the majority of business functions—including clinical coding. However, most healthcare organizations admit they could do more with analytics. This month’s HIM Scene blog explores the importance of analyzing clinical coding data to improve quality, productivity, and compliance.

Coding Data in ICD-10: Where We Are Today

HIM leaders are implementing coding data analytics to continually monitor their coding teams and cost-justify ongoing educational investments. Coding data analytics isn’t a once-and-done endeavor. It is a long-term commitment to improving coding performance in two key areas: productivity and accuracy.

A Look at Productivity Data

Elements that impact coding productivity data include: the type of electronic health record (EHR) used, the number of systems accessed during the coding process, clinical documentation improvement (CDI) initiatives, turnaround time for physician queries, and the volume of non-coding tasks assigned to coding teams.

Once any coding delays caused by these issues are corrected, coding productivity is best managed with the help of data analytics. For optimal productivity monitoring, the following data must be tracked, entered, and analyzed:

  • Begin and end times for each record—by coder and chart type
  • Average number of charts coded per hour by coder
  • Percentage of charts that take more than the standard minutes to code—typically charts with long lengths of stay (LOS), high dollar or high case mix index (CMI)
  • Types of cases each coder is processing every day

A Look at Accuracy Data

Accuracy should never be compromised for productivity. Otherwise, the results include denied claims, payer scrutiny, reimbursement issues, and other negative financial impacts.

Instead, a careful balance between coding productivity and accuracy is considered best practice.

Both data sets must be assessed simultaneously. The most common way to collect coding accuracy data is through coding audits and a thorough analysis of coding denials.

  • Conduct routine coding accuracy audits
  • Analyze audit data to target training, education and other corrective action
  • Record data so that back-end analysis is supported
  • Assess results for individual coders and the collective team

Using Your Results

Results of data analysis are important to drive improvements at the individual level and across entire coding teams. For individuals, look for specific errors and provide coaching based on the results of every audit. Include tips, recommendations, and resources to improve. If the coding professional’s accuracy continues to trend downward, targeted instruction and refresher coursework are warranted with focused re-audits to assure improvement over time.

HIM and coding managers can analyze coding audit data across an entire team to identify patterns and trends in miscoding. Team data pinpoints where multiple coders may be struggling. Coding hotlines or question queues are particularly helpful for large coding teams working remotely and from different geographic areas. Common questions can be aggregated for knowledge sharing across the team.

Analytics Technology and Support: What’s Needed

While spreadsheets are still used as the primary tool for much data analysis in healthcare, this option will not suffice in the expanded world of ICD-10. Greater technology investments are necessary to equip HIM and coding leaders with the coding data analytics technology they need.

The following technology guidelines can help evaluate new coding systems and level-up data analytics staff:

  • Data analytics programs with drill-down capabilities are imperative. These systems are used to effectively manage and prevent denials.
  • Customized workflow management software allows HIM and coding leaders to assign coding queues based on skillset.
  • Discharged not final coded and discharged not final billed analytics tools are important to manage each piece of accounts receivables daily and provide continual reporting.
  • Systems should have the ability to build rules to automatically send cases to an audit queue based on specific factors, such as diagnosis, trend, problematic DRGs.
  • Capabilities to export and manipulate the data within other systems, such as Excel, while also trending data are critical.
  • Staff will need training on advanced manipulation of data, such as pivot charts.
  • Every HIM department should have a copy of the newly revised AHIMA Health Data Analysis Toolkit, free of charge for AHIMA members.

HIM directors already collect much of the coding data required for improved performance and better decision-making. By adding data analytics software, organizations ensure information is available for bottom-line survival and future growth.

If you’d like to receive future HIM posts in your inbox, you can subscribe to future HIM Scene posts here.

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Insight Venture Partners Invests $26M Series B in LeanTaaS to Fuel Growth of Healthcare Operations Platform

Predictive Analytics and Machine Learning Technology Lowers Wait Times, Increases Patient Access and Improves Operational Performance

SANTA CLARA, Calif. — Nov. 14, 2017 — LeanTaaS, Inc., a Silicon Valley software innovator that increases patient access and transforms operational performance for healthcare providers, today announced that new investor Insight Venture Partners, a leading global venture capital and private equity firm, has invested $26 million in a Series B round of financing.

“Healthcare is a difficult space in which to bring about radical change,” said Jeff Horing, co-founder and managing director of Insight Venture Partners. “We are impressed by the quality of deep customer partnerships, the product portfolio and the team that LeanTaaS has assembled.”

The company’s solutions — relied upon by more than 40 of the nation’s leading hospitals and infusion centers — use lean principles, predictive analytics, machine learning and the cloud to dramatically improve the patient experience. LeanTaaS customers have reduced wait times for appointments and surgeries by up to 50 percent, increased patient access by as much as 30 percent and improved operational performance up to 20 percent through increased revenue and reduced costs.

The mathematical foundation on which patient appointments are scheduled is fundamentally flawed. As a result, expensive assets like infusion chairs, operating rooms, diagnostic imaging equipment and inpatient beds are commonly over- and underutilized, often on the same day.

LeanTaaS has quickly emerged as the leader in using advanced data science and mathematics to address this perplexing paradox. The company’s patent-pending algorithms help providers do more with existing assets and defer investments in additional staff, equipment and facilities. LeanTaaS solutions also improve surgeon access to valuable operating room time, lower wait times for patients and level-load the day for anesthesiologists, nurses and staff.

“We are privileged to work with many of the leading health systems in the country to demonstrate the impact of combining lean principles, predictive analytics and scalable software to drive significant improvements in operational performance and asset utilization,” said Mohan Giridharadas, founder and CEO of LeanTaaS. “This investment from Insight Venture Partners is a strong validation of our approach and will enable us to dramatically accelerate our growth over the coming years.”

The financing will fund continued investment in the LeanTaaS iQueue platform, which currently consists of two solutions: iQueue for Infusion Centers and iQueue for Operating Rooms. In May 2017, the company also established iQueue Labs, which explores answers to emerging, significant operational challenges in diagnostic imaging departments, emergency departments, pharmacies, labs and inpatient beds. The iQueue platform is a cloud service that works with any electronic health record and requires only minimal assistance by the provider’s internal IT staff to set up and use.

LeanTaaS joins an Insight Venture Partners portfolio that already boasts five companies on Inc.’s annual ranking of the fastest-growing private companies in America.

About LeanTaaS

LeanTaaS provides software solutions that combine lean principles, predictive analytics and machine learning to transform hospital and infusion center operations. More than 40 providers across the nation rely on the company’s iQueue cloud-based platform to increase patient access, decrease wait times, reduce healthcare delivery costs and improve revenues. LeanTaaS is based in Santa Clara, California.  For more information about LeanTaaS, please visit www.leantaas.com, and connect on Twitter/LeanTaaSFacebook/LeanTaaSand LinkedIn/LeanTaaS.

About Insight Venture Partners

Insight Venture Partners is a leading global venture capital and private equity firm investing in high-growth technology and software companies that are driving transformative change in their industries. Founded in 1995, Insight has raised more than $18 billion and invested in over 300 companies worldwide. Our mission is to find, fund and work successfully with visionary executives, providing them with practical, hands-on growth expertise to foster long-term success. For more information on Insight and all of its investments, visit www.insightpartners.com or follow us on Twitter @insightpartners.

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Collective Medical Secures $47.5 Million in Series A Funding

Kleiner Perkins-led investment to fuel enrichment and expansion of Collective Medical’s care team collaboration network

SALT LAKE CITY, UTAH —NOVEMBER 14, 2017Collective Medical, delivering the nation’s largest network for care collaboration, has secured $47.5 million in Series A funding. The investment, led by Kleiner Perkins, will be used to expand and advance the company’s care team collaboration network accelerating efforts to drive better patient outcomes nationwide.

Bessemer Venture PartnersMaverick VenturesKaiser Permanente Ventures, Providence VenturesPeterson Ventures, and Epic Ventures also participated in the round.

Utah-based Collective Medical, which has been bootstrapped for eight years, has quietly developed the nation’s largest network for real-time care collaboration. Collective Medical’s technology addresses the full continuum of care in support of many of the country’s most vulnerable individuals—patients with complex needs that are not met at any single point of care. By unifying providers and payers through real-time information alerts, patient context, and collaborative care planning, Collective Medical empowers care teams to identify patients with complex needs and help them get the care they need, when they need it, from those best positioned to deliver it. Collective Medical’s approach has been proven to reduce avoidable emergency department (ED) visits and hospital readmissions, ease transitions of care, and eliminate unnecessary risk and friction from care delivery.

“We’re putting collaboration at the heart of the solution to a fragmented healthcare system,” says Chris Klomp, CEO of Collective Medical. “Our job is to connect care teams. By arming providers and payers with real-time insights and a platform to seamlessly collaborate across organizations and care settings, we ensure patients don’t slip through the cracks.” Klomp adds that, “we are beyond excited and grateful to be joined by such an extraordinary group of investors who share our vision for further enriching and expanding our network to help care teams provide the most effective care possible.”

Collective Medical is engaged with every national health plan in the country, hundreds of hospitals and health systems, and tens of thousands of providers and care managers including those in emergency departments, primary care practices, skilled nursing facilities, home health agencies, emergency medical services, and mental and behavioral health organizations. Collective Medical’s network has visibility across 13 states, with an additional 10 states expected to go live in 2018.

“Event notification systems (ENS) and care coordination applications have historically struggled to provide actionable information to providers at the point-of-care” says Noah Knauf, partner at Kleiner Perkins. “Collective Medical is the first technology we’ve seen that allows the providers and payers in a local healthcare system to efficiently collaborate, delivering significantly better outcomes through risk analytics, real-time notifications, and shared care planning tools. Supporting this team is a rare opportunity to be a part of something that is meaningfully changing the way care is delivered in this country.”

Collective Medical improves outcomes and lowers costs on an impressive scale. In a Brookings Institution review of Medicaid patients who visited emergency rooms in Washington State, Collective Medical’s network and EDIE application—allowing actionable, real-time coordination across organizations—was one of the core strategies for lowering the number of ED visits by patients with patterns of high ED utilization. By partnering with Collective Medical to focus on these patients, Washington State reported $34 million in savings in emergency costs and a decline of 9.9 percent in emergency department visits in its first year of use in 2013.

Similar results have been experienced across the country. “Collective Medical has been an integral part of our hospital system’s efforts to coordinate care for patients with complex needs,” says Dr. Maria Raven, MPH, MSc, a practicing emergency medicine physician and health services researcher and an associate professor of emergency medicine at UCSF. “With our partnership, we’re collaborating on our at-risk patients’ social determinants as well as curbing the opioid epidemic.”

Mitigating the opioid epidemic is a single but timely demonstration of the power of the Collective Medical network. Using the company’s partnership with Washington State as an example, care team collaboration and coordination through Collective Medical has reduced opioid prescriptions coming out of the ED by 24 percent since the program’s inception.

A recent evaluation of Collective Medical’s impact throughout the state of Oregon, conducted by the Oregon Health Leadership Council, found a promising downward trend in ED visits by patients with history of high ED utilization during a three-year period. As a participant in this evaluation, Kaiser Permanente Northwest initially used Collective Medical’s EDIE application to identify and collaborate on care plans for a group of approximately 363 patients with complex clinical and social challenges who visited the ED more than six times in six months. Over the three years of this program Kaiser has seen a 42 percent reduction in ED visits and a 47 percent reduction in inpatient admissions for those individuals enrolled in this program.

Collective Medical will use the funding to expand and advance its network with the goal of empowering care teams across the country to provide patients with the most effective care. As a part of this effort, Collective Medical plans to expand its leadership team and scale its engineering, clinical support, sales and marketing organizations. The company anticipates hiring more than 100 additional team members in the next 12 – 18 months, with the majority based in its Salt Lake City headquarters.

Collective Medical is endorsed as a best practice for emergency medicine by the American College of Emergency Physicians. The company has been recognized by Inc. Magazine and by the MountainWest Capital Network as one of Utah’s fastest growing companies.

Learn more about Collective Medical’s impact at www.collectivemedical.com

ABOUT COLLECTIVE MEDICAL 

Collective Medical empowers care teams to improve patient outcomes by closing the communication gaps that undermine patient care through seamless collaboration. With a nationwide network engaged with every national health plan in the country, hundreds of hospitals and health systems and tens of thousands of providers—including hospitals, emergency departments, skilled nursing facilities, primary care providers, mental and behavioral health clinics, and others—Collective Medical’s system-agnostic platform is trusted by healthcare organizations and payers to identify at-risk and complex patients and facilitate actionable collaboration to make better care decisions and improve outcomes. Based in Salt Lake City, Collective Medical is proven to streamline transitions of care, improve coordination across diverse care teams, and reduce unnecessary hospital admissions. Learn more at www.collectivemedicaltech.com and follow us on TwitterFacebook, and LinkedIn.

ABOUT KLEINER PERKINS

Kleiner Perkins partners with the brightest entrepreneurs to turn disruptive ideas into world-changing businesses. With $10 billion raised through 20 venture funds and four growth funds, the firm has invested in over 850 companies including pioneers such as Google, App Dynamics, Amazon, Flexus Biosciences, Nest, Waze, Twitter, JD.com and Square. Kleiner Perkins offers entrepreneurs years of operating experience, puts them at the center of an influential network, and accelerates their companies from success to significance. For more information, visit http://www.kpcb.com and follow us @kpcb.

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AMIA17 – There’s Gold in Them EHRs!

If even 10% of the research presented at the 2017 American Medical Informatics Association conference (AMIA17) is adopted by mainstream healthcare, the impact on costs, quality and patient outcomes will be astounding. Real-time analysis of EHR data to determine the unique risk profile of each patient, customized remote monitoring based on patient + disease profiles, electronic progress notes using voice recognition and secondary uses of patient electronic records were all discussed at AMIA17.

Attending AMIA17 was an experience like no other. I understood less than half of the information being presented and I loved it. It felt like I was back in university – which is the only other time I have been around so many people with advanced degrees. By the time I left AMIA17, I found myself wishing I had paid more attention during my STATS302 classes.

It was especially interesting to be at AMIA17 right after attending the 3-day CHIME17 event for Hospital CIOs. CHIME17 was all about optimizing investments made in HealthIT over the past several years, especially EHRs (see this post for more details). AMIA17 was very much an expansion on the CHIME17 theme. AMIA17 was all about leveraging and getting value from the data collected by HealthIT systems over the past several years.

A prime example of this was the work presented by Michael Rothman, Ph.D of Pera Health. Rothman created a way to analyze key vital signs RELATIVE to a patient’s unique starting condition to determine whether they are in danger. Dubbed the Rothman Index, this algorithm presents clinicians and caregivers with more accurate alarms and notifications. With all the devices and systems in hospitals today, alarm fatigue is a very real and potentially deadly situation.

Missed ventilator alarms was #3 on ECRI Institute’s 2017 Top 10 Health Technology Hazards. It was #2 on the 2016 Top 10 list. According to ECRI: “Failure to recognize and respond to an actionable clinical alarm condition in a timely manner can result in serious patient injury or death”. The challenge is not the response but rather how to determine which alarms are informational and which are truly an indicator of a clinical condition that needs attention.

Comments from RNs in adverse-event reports shared in a 2016 presentation to the Association for the Advancement of Medical Instrumentation (AAMI) sums up this challenge nicely:

“Alarm fatigue is leading to significant incidents because there are so many nuisance alarms and no one even looks up when a high-priority alarm sounds. Failure to rescue should be a never event but it isn’t.”

“Too many nuisance alarms, too many patients inappropriately monitored. Continuous pulse oximetry is way overused and accounts for most of the alarms. Having everyone’s phone ring to one patient’s alarm makes you not respond to them most of the time.”

This is exactly what Rothman is trying to address with his work. Instead of using a traditional absolute-value approach to setting alarms – which are based on the mythical “average patient” – Rothman’s method uses the patient’s actual data to determine their unique baseline and sets alarms relative to that. According to Rothman, this could eliminate as much as 80% of the unnecessary alarms in hospitals.

Other notable presentations at AMIA17 included:

  • MedStartr Pitch IT winner, FHIR HIEDrant, on how to mine and aggregate clinically relevant data from HIEs and present it to clinicians within their EHRs
  • FHIR guru Joshua C Mandel’s presentation on the latest news regarding CDS Hooks and the amazing Sync-for-Science EHR data sharing for research initiative
  • Tianxi Cai of Harvard School of Public Health sharing her research on how EHR data can be used to determine the efficacy of treatments on an individual patient
  • Eric Dishman’s keynote about the open and collaborative approach to research he is championing within the NIH
  • Carol Friedman’s pioneering work in Natural Language Processing (NLP). Not only did she overcome being a woman scientist but also applying NLP to healthcare something her contemporaries viewed as a complete waste of time

The most impressive thing about AMIA17? The number of students attending the event – from high schoolers to undergraduates to PhD candidates. There were hundreds of them at the event. It was very encouraging to see so many young bright minds using their big brains to improve healthcare.

I left AMIA17 excited about the future of HealthIT.

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