CVS Health is identifying at-risk members of Aetna health plans of upcoming heat waves and connecting them with resources for care management.
CVS Health has launched a digital health program aimed at consumers affected by heat waves and other extreme weather events.
The company is using a data analytics platform to identify at-risk patients, such as those with chronic health conditions, when an excessive weather event is expected to occur in their area. The service is currently available to members of Aetna health plans, with plans to expand to CVS Pharmacy and Minute Clinic locations.
“Extreme heat kills more Americans each year than all other weather events combined,” Dan Knecht, vice president and chief clinical innovation officer for CVS Caremark, said in a press release. “In addition to fatalities driven by heat strokes, extreme heat can worsen chronic conditions such as cardiovascular disease, asthma and chronic obstructive pulmonary disease.”
With more health systems and hospitals using digital health tools to connect with patients outside the hospital or doctor’s office and boost engagement, strategies like this could become more popular. Healthcare organizations need these types of outreach to improve care management and coordination and address preventive health and public health issues.
Technology plays a key role in these programs. Data analytics and AI tools can help care providers quickly identify at-risk patients and even send tailored e-mail, text, or phone messages. They can also alert primary and emergency care providers, including hospital emergency departments and clinics, to prepare for increased traffic.
Looking even further, these platforms could be used to synch in police, fire, ambulance and EMS departments as well as telehealth programs.
Through the CVS Health program, Aetna care teams can identify and contact at-risk members as many as seven days ahead of an extreme weather event and connect them to the appropriate resources, such as Oak Street Health clinics and other urgent care clinics, cooling centers, and pharmacies.
The company is first focusing on heat waves, with excessive heat alerts and pargeted outreach for those affected by hot weather. It plans to expand the platform in the fall to patients susceptible to reduced lung function, asthma and cardiac problems caused by excessive exposure to air pollution.
This type of program could also be expanded to cover extreme cold weather, smog alerts (or other alerts tied to air quality), wildfires, floods, dangerous storms, even epidemics and other outbreaks.
The Bipartisan Policy Center is recommending that Congress extend the CMS model for five years and study whether the innovative program is cutting costs and improving care outcomes.
The Bipartisan Policy Center is recommending that the Centers for Medicare & Medicaid Services extend the Acute Hospital Care at Home (AHCaH) program for another five years while launching a study to determine whether the innovative program is reducing costs and improving care outcomes.
The Washington-based think tank’s report comes at a crucial time for supporters of the Hospital at Home strategy. The November 2020 waiver issued by CMS for its AHCaH model, which relaxes rules on providing home-based acute care and enables hospitals and health systems to seek Medicare reimbursement, is set to expire at the end of this year, a move that could threaten the sustainability of many programs.
Currently CMS has authorized 331 health systems and hospitals to operate an ACHaH program, though not all are doing so; others are running or developing variations of the acute care at home model.
“Research shows that hospital at home models yield positive health outcomes,” the BPC report states, citing a small study which found that the program led to shorter hospital stays, lower readmission rates, fewer diagnostic tests, and lower costs compared to patients admitted to the hospital for the same health concerns.
“Initial data show promise, including the potential for cost savings,” the report added. “But more research is needed on patient and caregiver experiences, access and patient selection, the cost impact on Medicare and Medicaid, hospital expenses, and service delivery across diverse populations. Research is also needed on whether the relatively small number of hospitals participating is nonrepresentative and unique. … Congress needs more clarity about the likely financial effects of the model if it were to move from a model with low uptake, which is the case today, to something that would be implemented on a larger scale.”
An Alternate Take on the Hospital at Home Model
While the model has drawn a lot of support, including a users group of healthcare organizations lobbying to make the model permanent, it has its detractors. Some have said the program is too complex and costly, drawing on too many resources for patients who should be hospitalized.
Jain argues that the model should be re-evaluated to filter out what he calls the “toxic positivity that has defined the hospital-at-home movement.” In certain cases the program will work, he adds, but there has to be “a definable cost advantage and sound, scalable, highly reliable underlying logistics.”
Immediate and Long-Term Recommendations
The BPC report offers several immediate policy recommendations, including:
Congress should extend the AHCaH model for five years to maintain participation, support investment from payers and providers and gather additional evidence on the program’s value. “A temporary reauthorization of five years would likely increase participation in AHCaH and incentivize state Medicaid investment, improving the diversity of participation,” the report said. “It would also allow policymakers to collect data on the model to guide future reauthorizations and make informed programmatic and financial decisions.”
Congress should provide funding for and direct CMS to provide technical support for health systems and states launching the ACHaH model, especially to improve access for Medicaid members.
Congress should also provide funding for a CMS-initiated study of the cost and quality of the ACHaH model, with a report submitted back to Congress by September 2028.
Congress should direct CMS to strengthen regulatory guidance for health systems and hospitals that include evidence-based protocols for the use of telehealth and remote patient monitoring (RPM), infectious prevention practices, fall prevention and escalation for clinical deterioration.
Congress should direct CMS to create quality measures for the ACHaH model, covering functions like tracking adverse events beyond mortality, a patient’s ability to connect with the care team after hours, and care team response times to escalations.
Congress should direct CMS to develop evidence-based, standardized language for health systems and hospitals to use when offering the program to patients.
The report also identifies key issues that federal policymakers will need to address when deciding the future of the program beyond five years. They include whether to make the program permanent, extend it further or end it; whether to modify the model to ensure sustainability; and how to ensure safety and program integrity as more health systems and hospitals adopt the model.
Supported by a CMS alternative payment program, Illinois-based Egyptian Health is actively addressing SDOH and other barriers and helping kids get the care they need.
Rural healthcare organizations are getting serious about identifying and addressing the barriers that are keeping children and young adults from accessing the care they need—especially behavioral healthcare.
Many organizations, from health systems and hospitals to local clinics and public health groups, are screening for social determinants of health the moment someone comes through their door, if not sooner. Through surveys, interviews and digital health tools that can sift through claims and EHR data, they’re spotting barriers early on, including issues with housing, families, food, schooling and transportation.
“When kids come in and they have all of these other needs, basic needs, that if those aren’t met first, it’s really hard [for them to] to receive the more specialized services that they need,” says Angie Hampton, CEO of the Egyptian Health Department. “We were seeing that across the board.”
Founded in 1951 as a public health department, Egyptian Health serves a wide swath of rural Illinois known as Little Egypt. Based in Fairfield, the organization added behavioral health services in 1972; it’s now their fastest growing service, as more and more kids show up with behavioral healthcare needs that aren’t being addressed.
Hampton estimates some 11,000 children and their families rely on Egyptian Health for care. Any child under the age of 21 who is enrolled in Medicare or CHIP is eligible for those services.
And many are having problems accessing those services.
Egyptian Health was one of eight healthcare organizations selected in 2020 to enroll in the Centers for Medicare & Medicaid Services’ Integrated Care for Kids (InCK) Model, an alternative payment model borne out of the CMS Innovation Center that aims to reduce healthcare expenses and boost quality of care for children. The seven-year project, for which CMS has set aside almost $126 million, will reward providers who develop programs that identify and address barriers to access for at-risk children, putting them in front of the right care teams and keeping them out of the Emergency Room.
Hampton says Egyptian Health, like so many other healthcare organizations, was often reacting to SDOH and other barriers before developing a strategy to proactively identify and address them. Without that strategy, she says, kids were falling through the cracks, either ending up in the local hospital or avoiding care altogether.
Working with Solventum, a health management company spun off earlier this year from 3M, Egyptian Health began combing through claims data and other information to get a better picture of the youth population in their coverage area. They then created a strategy for surveying these youths on SDOH and other barriers and creating connections with the right resources to address those barriers.
A key element to this program, Hampton says, is primary care. Alongside the partnership with the state’s Medicaid program, Egyptian Health is coordinating care with a network of local hospitals, federally qualified health centers (FQHCs) and clinics. Under the CMS InCK model, participating providers will receive inventive payments based on the success of the program in meeting performance metrics, such as reduced ED visits and admissions and increased well child visits and follow-ups.
“Honestly it allows us … many additional opportunities,” Hampton says of the program, now in its fifth year and ready to report on outcomes and issue its first payouts this fall. She says Egyptian Health is “really focusing on what those interventions can be” and moving toward a time when they can focus more on care and less on the obstacles.
She says the program should also help the region’s schools, where teachers and other staff are spending more time addressing healthcare concerns and less time teaching.
One barrier that Hampton is seeing among providers is a lack of experience with alternative payment models. That has slowed adoption as providers learn what they should be doing to qualify for reimbursements.
She also sees a need to emphasize whole-family care and care for adults, which spurred Egyptian Health to expand the program to address those populations as well. The idea, she says, is that by resolving the barriers to care that one person or one family experiences, the door may open to affect and improve care for others.
Hampton says she’s eager to see the first results come out in August, which will provide concrete examples of how the program is working and give providers the incentive to keep addressing SDOH. And she’s working on new partnerships and grant opportunities to keep that momentum going when the InCK program ends in two years.
“We’re here now and it will only get better,” she says.
During a recent HealthLeaders AI NOW panel, nursing leaders said the technology can help improve patient handoffs and scheduling.
Nurses face many headaches during their shift, including figuring out their schedules and making sure patient handoffs are done right. Could AI help them out?
Their bosses think so.
"We've been talking about nursing for a long time, about bringing back joy and practice," says Betty Jo Rocchio, Senior Vice President and Chief Nurse Executive at Mercy. "And I think done correctly, augmented intelligence … can really help us get there faster."
Rocchio participated in a panel at the recent HealthLeaders AI NOW summit that focused on how AI is figuring into a healthcare organization's nursing strategy. The panel, sponsored by Collette Health, included Jon McManus, Vice President and Chief Data, AI and Software Development Officer at Sharp HealthCare, and Nicholas Luthy, Collette Health's Chief Product Officer.
AI is the topic du jour in the healthcare space these days, and while a lot of the talk has centered on using the technology to improve back-office functions and give doctors more time in front of their patients, nursing leaders are eager to claim some of that spotlight.
The AI NOW discussion centered on how hospitals and health systems can use AI to improve nursing workflows and nurse well-being, critical factors at a time when many organizations are dealing with stress and burnout and a depleted nurse workforce.
McManus said San Diego-based Sharp HealthCare wants to "empower the nursing workforce with mobile-based technology so that they can document more at ease on the fly."
"The more that we can reduce some of the information worker burden that is attached to the modern nursing discipline is a key step toward coming back to top of licensure and why someone wanted to become a nurse in the first place," he noted.
"We've added the technology, we've added the electronic health record, we've added disparate technologies into the workflows of nurses, but what we haven't done is [understand] how we could literally integrate all of this to clean up the work environment and workflows," she said.
Nurses spend the most time in the EHR, she added, "and we're left at the bedside to have to go through all those amounts of information to get to what we need to make good decisions."
That includes patient handoffs. Rocchio said Mercy targeted that pain point with an AI tool, aiming to improve an often confusing process that accounts for roughly 80% of documentation errors. ED nurses often have to pull together disparate data, such as physician orders and EHR information, then pick up the phone and relay that information to the next member of the patient's care team.
Much like hospitals and health systems are using AI tools to summarize a physician's encounter with a patient, Rocchio said the technology can be used to help summarize a patient's ED stay. She said the tool has helped Mercy reduce charting errors by some 60%--and helped to identify breakdowns in care coordination.
"We didn't anticipate that unless the doctor signs their note in the emergency department, the items that we were pulling from that field weren't always coming across correctly," Rocchio said.
Aside from AI tools to improve interactions with the EHR and give nurses the patient data they need at the bedside, nursing leaders said they'd like to see the technology applied to the complex process of scheduling nurse shifts. A key factor in improving nurse workflows is giving them shifts that fit their work-life routine and aren't overwhelming. That includes factoring in vacations and time off requests and breaks.
"There's a lot of opportunity there to support improvements," McManus pointed out.
McManus, who's a member of the non-profit Coalition for Health AI (CHAI), which aims to establish standards for the safe and ethical use of AI in healthcare, said AI needs to be carefully planned and tested be health system leadership.
"You really need to practice micro to macro," he said. "You have to do pilot-based work. You have to do integrated feedback loops with your care teams. You have to kind of grow these disciplines."
He also said AI programs should be developed to improve existing workflows, not create new ones, and protocols should be based on facts.
"If you cannot ground in fact-based work, you're not going to be able to build any type of trust in those workflows," he said.
And as with any innovative idea, nurses should be included in planning and governance. Nurses need to be included in the deign of any new process or tool that they'll be using, and they need to understand how to spot problems and react quickly to correct them.
"I'm not sitting in a boardroom deciding what this looks like for our nurses," Rocchio noted. "I have an entire nursing informatics team that's on the ground, at the elbow, with our nurses, developing."
"Having our senior nurse leadership engaged in the topic, in the oversight, in the strategy development … is paramount," McManus added.
He added that AI literacy is taught throughout the health system.
"We're developing these foundational skills so that when we introduce specific features, we're supporting the readiness to use, the readiness to understand and the expectation of transparency and feedback loops," he said.
Addressing a common concern in healthcare that AI might replace jobs, both McManus and Rocchio pointed out that AI, to them, stands for augmented intelligence, and that the technology is a tool to be used by and for care providers, not instead of them.
"AI will never replace critical judgment," Rocchio noted.
A new survey from Carta Healthcare finds that almost half have found inaccuracies in their medical records, and more than half say AI can be used to improve accuracy.
Some 45% of consumers in a new survey say they’ve found inaccuracies in their medical records, and many feel that AI can be used to correct them.
The survey of more than 1,000 consumers, conducted by Propeller Insights for healthcare tech company Carta Healthcare earlier this month, finds an American public intrigued by the potential of AI, but also wary of its effects. For while 60% feel that the technology can improve the accuracy of medical records, more than half have concerns about security and more than 40% worry about accuracy.
“The integration of AI in healthcare record management shows promise, though trust issues need to be addressed,” company co-founder Matt Hollingsworth said in a press release. “As the healthcare industry continues to digitize, ensuring the accessibility and accuracy of medical records and addressing public concerns about AI integration will be paramount to improving patient care and trust in the system.”
Back-end functions like data entry and processing have been the low-hanging fruit for AI in healthcare, with numerous hospitals and health systems using the technology to relieve doctors and nurses of those administrative tasks. But a more savvy consumer population is keeping an eye on how that technology works.
That may be because younger generations, who are growing up with AI, are paying more attention to their medical records than their parents and grandparents.
Indeed, according to the survey, almost 61% of Gen Z and 52% of Millennials have had to correct a mistake in their records, compared to only 32.5% of older generations. All of the generations blame human error for those mistakes, with the Baby Boomers, at 60%, being the most critical. And at 84%, they also have the highest confidence that AI can help with the accuracy of healthcare data.
Accessibility, on the other hand, is not a big issue. Among those surveyed, 83% feel their medical records are accessible when needed, 74% know how to get to them, and 76% know how to request them from providers or payers.
And while they are finding errors, 86% believe their records are accurate and 67% say they don’t believe those errors have affected their current treatment. The errors, they report, are most often in personal information (33%), allergies or aversions (23%), and treatment history (22%).
According to the survey, 46% use e-mail to ask for their records, while 37% now do that through online portals. That said, only 28% of those surveyed have had to ask for their medical records.
Finally, 73% of those surveyed say the healthcare industry has the processes in place to ensure data accuracy, and 72% should play a part in ensuring the accuracy of their healthcare data through AI tools.
The survey should help healthcare executives to understand that while AI holds promise to address some of the industry’s biggest pain points, they should take care to ensure that the technology is monitored for accuracy. And because their patients and others are becoming increasingly knowledgeable around the use of AI, they can also use this as a marketing tool.
HHS Secretary Javier Becerra says the changes highlight federal efforts to take a more active role in defining AI and data policy and address cybersecurity concerns.
ONC Chief Micky Tripathi will be Washington’s current point man for AI governance under an ambitious reorganization unveiled this week by the U.S. Department of Health and Human Services.
The reshuffling sharpens federal leadership around data governance and policy as well as AI policy, which has been an ongoing concern in light of the rapid adoption of AI in healthcare and other industries. The changes also highlight federal leadership on cybersecurity, a key pain point at a time when ransomware attacks and cybersecurity outages are happening almost weekly.
Tripathi, formerly head of the Office of the National Coordinator for Health IT (ONC), will become the Assistant Secretary for Technology Policy/National Coordinator for Health Information Technology (ASTP/ONC), as well as the Acting Chief AI Officer.
Just a few weeks ago, Tripathi and Troy Tazbaz, director of the U.S. Food and Drug Administration's digital health center of excellence, ended their participation as non-votring members of the board of directors of the Coalition for Health AI (CHAI), an organization of more than 1,000 health systems, vendors and others working to develop AI standards and governance. That move, along with this reorganization, signals that the federal government may be distancing itself from collaborating with the healthcare industry.
Alongside AI policy, oversight over technology and data will also shift from the Assistant Secretary for Administration (ASA) to the ASTP/ONC, and the Chief Technology Officer and Chief Data Officer will join Tripathi in that department.
In addition, the Administration for Strategic Preparedness and Response (ASPR) will take over the so-called 405(d) Program, a public-private collaboration between the healthcare industry and the federal government addressing cybersecurity.
“Cybersecurity, data, and artificial intelligence are some of the most pressing issues facing the health care space today,” HHs Secretary Xavier Becerra said in a press release issued Thursday morning. “As a department, HHS must be agile, accountable, and strategic to meet the needs of this moment. For decades, HHS has worked across the organization to ensure appropriate and safe use of technology, data, and AI to advance the health and well-being of the American people. This reorganization builds on that success and prepares the department for the challenges that lie ahead.”
“Under the vision and leadership of Secretary Becerra and Deputy Secretary [Andrea} Palm, HHS is fully embracing the importance of information technology to the department’s mission, and consolidating organizational resources accordingly, to lead and shape technology policy across the department’s broad array of external and internal activities,” Tripathi said in a blog.
“For some time, and especially over the last few years, ONC has played an informal role shaping technology and data policy across HHS,” he continued. “This move formalizes this function, which will allow us to build synergies with the work that we’ll continue to do in health IT, and stand-up dedicated organizational capacity to ensure that HHS is making the best use of technology and data across all operating and staff divisions.”
According to HHS, the Chief AI Officer will:
Set AI policy and strategy for the department;
Establish internal governance, policies, and risk management approaches for uses of AI internal to HHS;
Coordinate HHS’ AI approach in the health and human services sectors;
Support the safe and appropriate use of AI technologies and tools across the department; and
Coordinate AI-related talent and training initiatives.
Tripathi will fill that role until the federal government concludes its search to fill that role as well as the roles of Chief Data Officer and Chief Technology Officer.
The Chief Data Officer, meanwhile, will:
Continue to oversee data governance and policy development;
Drive data literacy and data talent initiatives;
Manage HHS data strategy;
Support data collaboration and exchange; and
Manage HHS’ data as a strategic asset for the department.
The latest in digital therapeutics features a new device that uses Ai to scan a patient’s sinuses and create an acoustic vibration, delivered through a headband, to reduce nasal congestion.
AI is being touted as the biggest new thing since the printing press, a technology that can clear up healthcare’s administrative headaches and improve clinical outcomes. But can it also help cure a stuffy nose?
Digital health company SoundHealth has announced De Novo authorization from the U.S. Food and Drug Administration for SONU, a digital therapeutic device that uses AI-enhanced “acoustic vibrational energy” to relieve nasal pressure. The San Francisco-based company can now market the device to consumers aged 22 and older.
“Acoustic vibration associated with humming has been shown to decrease symptoms of nasal congestion, possibly through modulation of autonomic inputs to the nasal mucosa or through nitric oxide activity, which may in turn exert a decongestant and anti-inflammatory effect on the nasal passages,” the company said in its press release.
According to a 2021 Harris On Demand survey, roughly one of every four Americans suffers from nasal congestion on a daily basis, and 85% of those with chronic nasal congestion say it impacts their daily activities. Aside from the discomfort of a stuffy nose, nasal congestion can also lead to sleep problems, headaches, coughing, and a sore throat.
The device may interest healthcare providers who, wary of the addictive nature and side-effects of nasal sprays and drugs, have been looking for alternatives to traditional medication-based treatments, including digital therapeutics.
The SONU device combines innovative new technology with an ages-old therapy.
“It's based on the really old understanding that when we hum or sing or whistle, our sinuses open, and we also feel very relaxed,” Jacob Johnson, MD, president of San Francisco Audiology, an ENT specialist with the San Francisco Otolaryngology Medical Group, and an associate clinical professor at the University of California, San Francisco, said in the SoundHealth press release.
“The vibration relaxes the sympathetic and parasympathetic parts of our autonomic nervous system,” he continued. “It opens our sinuses with resonance [and] improves the flow of mucus in the nose and promotes ciliary action. …It's a very good alternative to the other options of medications, allergy management, surgery and office procedures.”
According to the company, the SONU device includes a headband and smartphone app that scans the user’s sinuses to create a digital map, then calculates the user’s “optimal resonant frequencies.” The user then puts on the headband, which “delivers frequencies tailored to the patient based on the app’s calculations.”
But don’t feel bad for nasal sprays. If they lose their appeal for defeating stuffy noses, they may find a new use, such as in treating Alzheimer’s.
The insurer plans to open 23 new senior primary care centers in Walmart Supercenters, and is partnering with Google Cloud to boost its AI capabilities
Amid pullbacks by several large disruptors, Humana is reinforcing its presence in the primary care landscape.
The insurer announced this week that it would open 23 new senior primary care centers at Walmart Supercenter retail stores in Florida, Texas, Georgia, and Missouri. The clinics, operating under the CenterWell Senior Primary Care and Conviva Care Centers brands, join roughly 300 other Humana-branded clinics in 15 states.
“Embracing technology solutions in healthcare can help lower costs and improve consumer experiences,” Humana CEO Jim Rechtin said in a press release. “At Humana, we plan to use the capabilities offered by Google Cloud to make it easier for our members and patients to have affordable access to the right care at the right time. Google Cloud’s technology platform can make our contact centers more responsive, our provider networks easier to navigate, healthcare coverage easier to understand and primary care better tailored to individual needs.”
The two announcements come at a time when retail giants Walmart, Walgreens, CVS Health, and Amazon are either shutting down or consolidating their primary care and virtual care plans, citing challenges to creating a sustainable (or profitable) business model.
Healthcare executives aren’t exactly surprised at those decisions.
"For primary care practices, when you buy them and then you think you can run them profitably by just being behind the scenes, having a standardized billing system, it's ludicrous," former Banner Health CEO Peter Fine said in a recent HealthLeaders interview. "We're going to see a lot more crashing and burning because they think this is just an easy business to get into and they're not always totally sure of how to handle insurance and not totally sure about really understanding the behaviors of the consumer."
Humana’s expansion aims to rebut that trend by focusing on population health—in particular, the senior care market, which is expected to grow significantly over the next six years. The insurer, which acquired locations in Texas and Nevada last year from Cano Health and announced plans this year to move into North Carolina and Louisiana, aims to give its members a branded primary care option.
“These nearly two dozen primary care centers are specifically designed for seniors, and each location’s design, including dedicated entrances and easy parking, offers patients the access that they have come to expect at our clinics across the nation,” CenterWell President Sanjay Shetty, MD, said in a press release. “We are eager to expand on our mission to help patients lead happier, healthier lives.”
In collaborating with Google Cloud, Humana is jumping on the fast-moving AI bandwagon, which promises to improve care through administrative efficiency and data analysis.
"By combining Humana's deep understanding of healthcare with Google Cloud's cutting-edge AI and cloud technologies, Humana can unlock new possibilities for operational efficiency, clinical insights, and personalized care,” Google Cloud CEO Thomas Kurian said in a press release.
Richardville was a CIO for more than 30 years at health systems including Intermountain, Atrium and ProMedica.
Craig Richardville, MBA, CHCIO, Intermountain Health’s award-winning Chief Information and Analytics Officer, has left the health system to pursure other opportunities in healthcare.
“These are exciting times for all of us in healthcare IT,” he wrote in his social media post. “I want to thank the many partners who work in this space that are so valuable to the successes we've had but mostly to the people, the caregivers who commit and contribute to the mission each and every day.”
Richardville was a familiar presence on social media and at innovation conferences and a strong supporter of digital health innovation.
Craig Richardville.
He joined Intermountain as its Chief Digital and Information Officer in 2022, after more than three years as SVP and Chief Digital and Information Officer at Denver-based SCL Health (which merged with Intermountain). Prior to that, he’d been CIO and chief analytics officer at Atrium Health in North Carolina for more than 20 years and vice president of information services at ProMedica for 11 years. His many honors include the 2015 John E. Gall Jr. National CIO of the Year Award, from HIMSS and CHIME; the 2021 National CIO of the Year Healthcare ORBIE Award, the 2020 Colorado CIO of the Year Award, and the 2017 Carolinas CIO of the Year Award.
Richardville had a busy tenure at Intermountain, and listed several accomplishments on his social media post, including consolidating nine EHR platforms across the enterprise into one Epic platform; helping the health system develop and launch several AI programs; developing digital health programs to improve patient care; transitioning the health system’s Microsoft and Google cloud environments into one Microsoft Azure platform; and transitioning multiple ETP systems into one with Workday.
"I've got 12 CIOs or CDOs in the industry that used to work for me, and I'm just privileged that those people have grown," he said. "It's really [about saying] 'I'll give you the challenge, I'll grow your résumé, I'll make you more valuable to the market, and if I'm able to keep you I'll just continue that. But if there are other opportunities somewhere else, I'm here to help you capture those as well so you can fulfill your life goals.'"
He was also a familiar presence at innovation events like ViVE. At last year’s conference in Nashville, he spoke of the collaborative nature of healthcare innovation at a time when health systems and hospitals were struggling to be competitive.
"I might see something really interesting and tell (another healthcare executive) about it, or someone will tell me, 'You should check this company out,'" he said. "It's the chance to meet up and talk with people."
He also signed on this past March to support the Match IT Act of 2024, a bill now before Congress that would create a federal definition of ‘patient match rate’ that providers would address as they would a clinical quality measurement.
“[T]his legislation will address our nation’s current inability to consistently and accurately identify patients to their health records,” he said in a press release. “Improved standardization of patient demographic data will lead to more accurate patient matching, which in turn will produce advances in patient safety, more complete information for clinical care, and cost savings from reducing the need for repeated medical care, among other benefits.”
An industry still smarting from the effects of the Change Healthcare cyberattack is reportedly bouncing back quickly from Friday’s global outage.
(Editor's Note: This article has been updated to include comments from First health Advisory)
Friday’s global software outage caused some headaches for hospitals and health systems across the world, a grim reminder that technical mishaps aren’t always the result of bad actors.
As of this morning, most of the affected systems are back up and running, and hospitals across the country are getting back to business as usual, with a few hiccups along the way. Experts say the global effect of the outage, which was still being felt in other industries, especially the airlines, could top $1 billion.
“All too often these days, a single glitch results in a system-wide outage,” Lina Khan, chair of the Federal Trade Commission, said in a tweet on Friday. “The incidents reveal how concentration can create fragile systems.”
“Random issues and outages persisted over the weekend for a number of healthcare providers and will continue into the early parts of this week," Toby Gouker, CSO of government and digital health at First Health Advisory, said in an e-mail to HealthLeaders this morning. "While the fix to the problem only takes a matter of minutes, each machine running an impacted windows operating system has to be physically touched by a qualified individual. There is no centralized patch/fix that can be pushed out on the network and reaching each endpoint in a healthcare system will take upwards of a week for some larger or understaffed facilities.”
The outage originated with the cybersecurity firm CrowdStrike, which reported problems tied to a routine software update to its Falcon Sensor product, which is designed to protect cloud-based data during cyberattacks. The outrage reportedly impacted about 8.5 million Microsoft devices, according to a company blog posted Saturday, more than a million of which are used in healthcare.
“We are working closely with impacted customers and partners to ensure that all systems are restored, so you can deliver the services your customers rely on,” CrowdStrike founder and CEO George Kurtz said in a company blog on Friday, adding that the incident was not a cyberattack but a “defect found in a single content update.”
But he also warned that bad actors could take advantage of the disruption.
“We know that adversaries and bad actors will try to exploit events like this,” Kurtz said. “I encourage everyone to remain vigilant and ensure that you’re engaging with official CrowdStrike representatives. Our blog and technical support will continue to be the official channels for the latest updates.”
David Chou, a healthcare security analyst and chief digital officer for Legacy Community Health, said the incident should give CIOs and CTOs cause to review their cybersecurity setup.
“CIOs typically only auto-update some technology packages but trust CrowdStrike,” he wrote in a Forbes opinion piece posted Sunday. “This scenario is alarming because CrowdStrike's last update involved a kernel-level change. The concern is that CrowdStrike and its agents have kernel access to nearly every major system and endpoint running Windows worldwide, particularly in healthcare, government, financial institutions, and critical infrastructure.”
“The CrowdStrike outage serves as a critical lesson in the importance of designing resilient systems, preparing for rapid response, maintaining clear communication, and continuously improving cybersecurity measures to manage the risks associated with interconnectivity,” added First Health Advisory's David Finn, EVP of governance, risk, and compliance
The outage affected health systems and hospitals using Microsoft products, as well as airlines, transportation services, banks, schools, and other businesses. A few states also reported that their 911 call centers had been affected.
Several health systems, including Mass General Brigham, Emory Healthcare, Norton Healthcare, RWJBarnabas Health, Penn Medicine, Memorial Sloan Kettering Cancer Center, Baptist Health, CommonSpirit Health, Cleveland Clinic, and Providence, to name a few, postponed some services on Friday.
“While we continue to monitor the situation closely, we are hearing from hospitals and health systems that the impact varies widely,” John Rigg, national advisor for cybersecurity and risk at the American Hospital Association, said in an AHA press release issued Friday afternoon. “Some have experienced little to no impact while others are dealing directly with some disruptions to medical technology, communications and third-party service providers. These disruptions are resulting in some clinical procedure delays, diversions or cancellations. Impact is also being felt indirectly as a result of local emergency call centers being down.”
“Impacted hospitals are working hard to implement manual restoration of systems and the CrowdStrike patch,” he added. “Affected hospitals have also implemented downtime procedures to ensure that disruptions to patient care are minimized or avoided to the extent possible.”
By Monday, not much remained of the uproar within the healthcare sector. Massachusetts General Hospital, which was among the first to postpone some services on Friday, posted a notice on social media on Saturday that “all scheduled appointments and procedures will happen as planned on Monday.”
“Our response teams are continuing to work diligently throughout the weekend to address the many additional downstream impacts across our system from the CrowdStrike failure,” the notice continued. “We are grateful for the patience and understanding of our patients and we extend our heartfelt gratitude to all our staff who have worked tirelessly to respond to this extremely challenging incident.”
Atlanta’s Emory Healthcare still had a notice posted on its website this morning warning that “patients may experience delays in our call center or other operations.” It asked them to use their MyChart portal to manage appointments and communicate with their care team.
By contrast, more than 700 U.S. flights were still being cancelled on Monday, many of them run by Delta Airlines, as the industry struggled to bounce back.
The outage affected healthcare organizations across the country in different ways. Some postponed all or most procedures, while others reported minor disruptions. There were news reports of clinicians going back to pan and paper because they couldn’t gain access to the EHRs.
Epic reportedly issued a statement saying the outage did not directly affect its software or services, but some services tied to its Nebula platform, which uses Microsoft Azure, were impacted. It also said the outage did cause some healthcare organizations to lose access to their Epic platforms.
In the UK, where the healthcare industry was still trying to bounce back on Monday, one Shropshire doctor called on the public to be “kind” to beleaguered doctors and nurses.
"This is beyond all of our control," Jess Harvey, who runs the Much Wenlock & Cressage Medical Practice, told the BBC. "Everyone is doing their best to try and make everything work the best they can."
"We're working really hard as a team to try and get through it,” she added, saying she and her staff were “getting to grips with our handwriting.”
