EHR giant Cerner loses major health system client AdventHealth to Epic

https://www.fiercehealthcare.com/tech/large-ehr-client-adventhealth-plans-to-replace-cerner-epic?mkt_tok=eyJpIjoiT1dWa1lqWTRZalUxTkRNNCIsInQiOiJvajlDUUZMVVFZK3pwcThnQnhrbVZJRkc5Vm4wT2doXC9hOG5zN25VcDl0Z2Y5eFYwcFpMRTg2eEZjU3NSMlQ0Q3Q0Wm9sVTNIdWlzRlU2dlVhMFFNV3JkYTh1VU5vUkRTNnBXXC9NaFIrbnQyc0J1ZTV2Z0IwTXhua2FXWGtnUVdlIn0%3D&mrkid=959610

Cerner's headquarters are in Kansas City, Missouri

Florida-based AdventHealth plans to replace its Cerner electronic health record (EHR) system with rival Epic’s.

One of the largest faith-based health systems in the country, AdventHealth operates 50 hospital campuses across a dozen states. The health system employs more than 80,000 people who serve more than 5 million patients annually and reports nearly $20 billion in annual revenue.

The health system first signed a deal with Cerner in 2002 when it was known as Adventist Health System.

AdventHealth will begin the transition in March and will eventually roll Epic’s EHR out to 1,200 care sites. The work is expected to be completed in about three years, the health system said.

In a press release issued Tuesday, AdventHealth said it plans to install a single, integrated Epic EHR and revenue cycle management system across all of its acute care, physician practice, ambulatory, urgent care, home health and hospice facilities.

Epic’s Community Connect program will also allow AdventHealth to extend its EHR system to affiliated providers as part of the integrated platform, according to AdventHealth.

“Our journey to become a consumer-focused clinical company requires a fully connected network throughout our entire enterprise,” Terry Shaw, president and CEO for AdventHealth, said in a statement. “Connecting our network with a robust, integrated health record platform will give our caregivers access to the clinical information they need at the point of care and ultimately advance our consumer promises through a more seamless experience for those we serve.”

In an emailed statement, Cerner confirmed the changeover. “AdventHealth has made the business decision to transition over the next few years management of its EHR and revenue cycle management system to another supplier. The shift is expected to take up to five years and Cerner is committed to working closely with AdventHealth to continue delivering superior health care technology solutions throughout the transition,” the company said.

Anonymous Reddit posters predicted the change months ago, saying that the health system was frustrated with integration issues with Cerner’s ambulatory solution and revenue cycle functionalities. HIStalk first reported the Reddit posts regarding Cerner and AdventHealth.

One Reddit user said AdventHealth staff felt the health system was on the “back burner” since Cerner signed massive projects with the departments of Defense and Veterans Affairs.

It’s unclear what the loss of a big EHR client will mean for health IT company Cerner’s annual revenue or earnings.

The company continues efforts to turn its financial picture around and improve its operating performance.

Almost a year ago, activist investor Starboard Value stepped in, and Cerner reached a settlement with the hedge fund to add new directors to its board and buy back more of its shares. Cerner also agreed to take steps to improve operations and committed to hitting certain operating targets.

The new agreement between Cerner and Starboard Value, which has a 1.2% stake in the company, was seen as welcome news by many financial analysts as a plan to increase the company’s profitability.

Cerner’s full-year 2019 bookings were down 11% compared to 2018 bookings, from $6.72 billion to $5.99 billion. Company executives said during their full-year and fourth-quarter earnings call that the decline in bookings was primarily driven by the company being more selective in the types of contracts it pursues, which led to fewer large, long-term outsourcing contracts.

 

 

 

 

10 Health Care Trends To Watch In 2020

https://blog.providence.org/news/10-health-care-trends-to-watch-in-2020?_ga=2.242868994.1447754200.1576610293-1113187070.1573499391

Image result for 10 Health Care Trends To Watch In 2020

With 2020 shaping up to be another big year for health care, executives at Providence, one of the largest health systems in the country, today released their annual New Year’s predictions.

External forces will continue to bear down on health care, Providence leaders said. Politics, technology, social issues, labor shortages and heightened consumer expectations will all play a role. As a result, providers will feel more intense pressure to accelerate the transformation of health care.

“The question is whether providers can pivot fast enough,” said Rod Hochman, M.D., president and CEO of Providence. “In 2020, health systems that can get ahead of the major trends will be best positioned to meet the future needs of their communities.”

What can you expect next year? Here are Providence’s top 10 predictions.

  1. The value of health system consolidation will come to fruition in the form of large scale improvements in clinical quality and outcomes.

One of the most important reasons health systems have consolidated in recent years is to improve clinical quality and spread best practice across scale. Because clinical integration takes time, this will be the year that significant results begin coming to fruition. For example, Providence has leveraged its seven-state system to reverse the alarming national rise in U.S. mothers dying in childbirth. Thanks to collaboration among its clinical teams, Providence is one of the safest places for moms to give birth, having nearly eliminated preventable maternal deaths over the last three years. At the same time, Providence has reduced the cost of caring for moms covered by Medicaid, as well as the cost of NICU care. Expect more examples of improved outcomes and costs to emerge in 2020 as proven practices in other clinical areas begin bearing fruit on a large scale.

  1. Corporate social responsibility will take on a bigger role in tackling homelessness, suicide, the opioid crisis and other social issues that affect health.  

More companies will partner with health systems, government agencies, social services and other nonprofits to take action on the social determinants of health. Be Well OC is one example of the type of coalition that will make a significant impact in 2020. The public-private partnership in Orange County, Calif., brings diverse organizations together to meet the urgent need for mental health and addiction services in the community. Meanwhile, in cities like Seattle, Wash., health systems like Providence are partnering with the business community and other not-for-profits to address the growing homelessness epidemic.

  1. Personalized medicine and population health, two seemingly opposite approaches to health care, will begin working hand in hand to improve outcomes in the U.S.

The path to a healthier nation will be accelerated by treating both the unique needs of the individual down to the DNA level, as well as common issues shared by people in similar demographics. Health systems like Providence, for example, are using genomics to pinpoint a person’s biologic age, as well as tailor medical interventions to the individual. At the same time, Providence is coordinating care and resources across broad segments of people through steps such as cancer screenings and improving access to housing and nutrition. Combining the power of these two disciplines will help catapult the health of the nation.

  1. Health systems will prioritize digital access to care, convenience and personalization to compete with disruptors and collaborate with big tech.

Delivering same-day access to care – how, when and where people want it – will be a burning priority for health systems in 2020. New entrants will continue to disrupt the space and raise consumer expectations. Leading health systems like Providence will stay ahead of the curve with digital platforms that integrate telehealth, its in-store clinics at Walgreens and its vast network of specialty, primary care and urgent care clinics across the Western U.S. To help patients navigate these care options, Providence will also continue to develop its artificial intelligence capability, making its AI bot, “Grace,” more pervasive, helpful and capable. Providence will also continue to engage patients between episodes of care by providing personalized content and services to keep them healthy while developing a long-term, digitally engaged relationship with patients.

  1. As more health systems partner with tech companies to bring health care into the digital age, patients will count on providers to serve as the guardians of their personal health information. 

Machine learning and artificial intelligence will raise the potential for new breakthroughs in medicine and care delivery, and data will be key to this level of innovation. But whether tech companies are prioritizing the best interest of patients will remain a lingering question for the American public. Patients will look to providers to be their voice and advocates when it comes to protecting their health information. Expect providers to stand up for data privacy and security and take the lead in ensuring data is used responsibly for the common good.

  1. The race to bring voice-activated technology to health care will heat up and will be a central feature in the hospital and clinic of the future.

Just as Alexa and Siri are transforming the way we live our personal lives, voice and natural language processing are the future of health care. Expect innovation to accelerate around smart clinics and hospitals that make it easier for clinicians to treat and care for patients.  Voice commands that process and analyze information will support clinical decision making at the bedside and the exam room. As part of a new partnership between Providence and Microsoft to build the “care site of the future,” clinical communications and voice-activated technology will be a central feature.

  1. Simplifying the electronic medical record will become a rallying cry for clinicians.

With burnout on the rise among physicians, nurses and other caregivers, reducing the time it takes to chart in the electronic medical record will be key to improving the work environment for clinicians. Shifting the national conversation from EMR “interoperability” to “usability” will take on greater urgency. A simplified, more intuitive EMR means clinicians can spend less time on the computer and more time focused directly on patients, creating a better experience for clinicians and the patients they serve.

  1. The health care workforce will continue to evolve and adopt new skill sets. At the same time, talent shortages will become more pronounced.

As the sector changes at a rapid pace, the health care workforce will need to add new skill sets to keep up with innovations in medicine and care delivery. Clinicians will also need to become more proficient in managing the social determinants of health and caring for the whole person, not just physically, but also mentally and emotionally. Health systems will seek to stay competitive in a tough labor market by offering attractive pay and benefit packages. A commitment to investing in education and career development, as well as creating engaging work environments, will also be a key focus for retaining and recruiting top talent.

  1. Price transparency will remain a hot issue. But the focus needs to shift to giving patients the information they want most: what their out-of-pocket costs will be.   

Patients deserve to know what their health care costs will be up front, so they can make informed decisions as they shop for care. Rather than inundating them with a deluge of prices and negotiated rates for hundreds of services that may or may not be relevant to their personal situation, more emphasis needs to be placed on helping them understand what their specific out-of-pocket costs will be. The amount individuals pay is typically based on their insurance coverage. That’s why health systems like Providence are actively developing price estimator tools and self-service portals, based on blockchain and AI technology, to help patients more quickly and easily access this information.

  1. New alternatives to “Medicare for All” will emerge in the presidential debates. One viable option that should be taken seriously: free primary care for every American.

In the 2020 elections, concerns will be raised over whether Americans will lose their private commercial or employer-sponsored insurance under a Medicare for All plan. A new campaign platform — free primary care for all — should be considered as a more effective, affordable alternative. By guaranteeing access to primary care, the nation can focus on prevention, chronic disease management and helping Americans live their healthiest life possible. Providence is participating in the current administration’s innovative primary care pilots, which are showing positive results in terms of better outcomes and reduced costs.

 

 

 

 

Provider of the Year: Providence St. Joseph Health

https://www.healthcaredive.com/news/provider-providence-st-joseph-health-dive-awards/566477/

The 51-hospital system, which traces its roots back to the 1850s,​ has maintained a stable ratings outlook amid industry headwinds and pursued tech partnerships this year to bolster its portfolio.

Providence St. Joseph Health, the fourth-largest U.S. nonprofit health system by number of hospitals, marked a busy 2019 with multiple efforts to dive into the tech sector and seek out partnerships to tackle the industry’s biggest challenges.

The Catholic system now operates 51 hospitals in eight states as the result of a July 2016 merger of Providence Health and Services and St. Joseph Health. While the organization is the dominant inpatient provider in all its markets, no single area accounts for more than 30% of its net operating revenue, showing good portfolio diversification, ratings agency have noted.

The system, which can trace its roots back to the 1850s when the Sisters of Providence set up hospitals, schools and orphanages throughout the Northwest, posted $24 billion in operating revenue last year. That metric has shown year-over-year increases since the $18 billion posted in 2014.

Providence CEO Rod Hochman told Healthcare Dive the health system hasn’t shied away from seeking partnerships as the industry swings toward value based care and other systemic changes.

“I think the message is: ‘You can’t do it alone,'” he said. “You can’t go out there and just do it yourself — you don’t have the scale to do it.”

In that vein, the system (which is formally rebranding to Providence over the next few years) was one of the founding members of generic drug company Civica Rx, which opened its headquarters and made its first delivery this year. That’s a coalition of hospitals working to make their own drugs, starting with antibiotics.

It’s also grouping up with One Medical to increase access to primary care and teaming with Cedars-Sinai to build a patient tower in southern California. And in February, the organization launched the population health management company Ayin Health Solutions to provide benefits management as well as risk evaluation and care coordination tools.

Providence has maintained a stable outlook from the three main ratings agencies even as other nonprofits struggled to stay above water. Kevin Holloran, senior director at Fitch Ratings, said the system has managed to think about margins the way a public company must while still adhering to the mission-driven thought process nonprofit organizations trumpet.

“Blending those two thoughts together sounds easy, but it’s not,” Holloran told Healthcare Dive. “It’s hard to do.”

Moody’s Investors Service issued a credit opinion recently on Providence, finding the system’s integrated structure that includes a health plan and 7,600 employed physicians creates “further cashflow diversification, and strengthens the organization’s competitive position.”

The analysts wrote they expect operating margins to continue to improve going into next year as it implements dozens of initiatives updating operating practices, cost structures and revenue systems. They note, however, the organization faces a challenge in transitioning disparate EHRs and its numerous joint ventures “may also entail a certain amount of execution and integration risk.”

Holloran pointed to two relatively recent hires as leading the way for Providence — both poaches from Microsoft. CFO Venkat Bhamidipati joined the organization two years ago and CIO B.J. Moore came on in January.

They migrated from the tech world to the traditionally loathe-to-change healthcare landscape, and have made a difference for Providence.

It puts the company in a strategic place for growth, Holloran said. “Now they’re sort of adding that missing piece, which is optimizing what they’ve got,” he said. “And a big piece of that is the technology, and they’re doing it in a unique and interesting way.”

This year, Providence acquired Lumedic, which uses blockchain tools for revenue cycle management, and Bluetree, an Epic consultancy. The health system also allows patients to schedule appointments through Amazon’s smart speaker Alexa.

In July, the health system announced an agreement with Microsoft to use the tech giant’s cloud and artificial intelligence tools in an effort to foster interoperability, improve outcomes and drive down costs.

The organization still has traditional struggles, however. Hochman, who is also the incoming chairman of the American Hospital Association, said the ongoing litigation surrounding the Affordable Care Act, coupled with payment changes and other CMS changes, creates a chaotic environment for providers.

“Every day they come up with something new, and it’s been the lack of predictability that’s been the biggest problem for us,” he said.

 

 

 

Amazon launches new medical transcription service

https://mailchi.mp/1d8c22341262/the-weekly-gist-the-spotify-anxiety-edition?e=d1e747d2d8

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In addition to capturing your personal conversations at home through its ubiquitous Echos, Amazon is now in the business of recording physician-patient conversations. This week the company announced Amazon Transcribe Medical, a machine learning service for quickly creating accurate speech-to-text transcriptions for providers in clinical settings. Cerner, a co-developer, has already signed on as a customer “to develop a digital voice scribe that can ‘listen’ in the background during a patient’s visit”, transcribe the conversation into text, and automatically document the note in its electronic health record (EHR) system.

Amazon’s move into this space is a natural extension of both its “Transcribe Service”, which automatically converts speech to text with natural formatting and punctuation, and its “Comprehend Medical” technology, which can read and mine unstructured medical text for specific information.

While cloud rivals Microsoft and Google are also making a play for speech-to-text tools that work with EHRs, Amazon is looking to differentiate on the basis of providing highly accurate automatic speech recognition specifically designed to go directly into medical records. The company claims the service can understand the nuances of medical language, including the myriad abbreviations used by clinicians.

Amazon is focusing on an area ripe for improvement in cost, time, and patient experience. At a cost of less than a quarter of a cent per minute (!), Transcribe Medical looks like a very cost competitive alternative to what most providers are paying for medical transcription today—especially those who rely heavily on scribes.

It remains to be seen if providers and patients will be comfortable having their often very personal conversations added to Amazon’s cloud, word for word. Providers who adopt this new service should be as transparent as possible with their patients about their partnership with Amazon, as well as how personal data is being stored and used.

 

 

 

Infographic: 4 drivers of a sustainable physician workforce

https://www.managedhealthcareexecutive.com/articles/infographic-4-drivers-sustainable-physician-workforce

https://www.physicianspractice.com/sites/default/files/legacy/mm/digital/media/infographic-4-drivers-of-sustainable-physician-workforce_0.pdf

When physicians feel they have the tools, resources, and latitude they need to work at the top of their license and provide high-quality patient care, they’re more effective, more loyal, and less prone to burnout. Explore this infographic to understand 4 factors that correlate to more effective and satisfied physicians.

 

Healthcare mergers and acquisitions require sensible data sharing strategies, and a solid analytics framework

https://www.healthcarefinancenews.com/news/healthcare-mergers-and-acquisitions-require-sensible-data-sharing-strategies-and-solid?mkt_tok=eyJpIjoiTmpJME5qVTNOVEU1TXpRdyIsInQiOiJDdUIxQ1NKdng1b0FkQ1wvQlwvNFBTc1JIbmVwYUZOeUhCZ3VlNlZzdmhNbkhBQlhnXC9JeTI4c2NDeE80REk0YWJ1Nk1jSzl4QjFDbjFMTkxKdmVCblY1RUlSYTIwUmlhSEJ6VXpkOUZZdytUWDhaV1poaEljcVh5ZFdEOUdVZlQzZyJ9

While it’s important for disparate EHRs to communicate with one another, organizations need a better handle on analytics and dashboards.

Mergers and acquisitions in healthcare have been going along at a pretty good clip for a number of years now. The volume of deals remains high, and with larger entities primed to scoop up some of their smaller, struggling peers, the trend seems poised to continue.

There’s an issue that consolidating organizations consistently run into, however: data sharing.

Specifically, many organizations that have initiated merger activity fail to consider that not only will the consolidation necessitate integrating multiple electronic health records, but other ancillary systems as well.

These organizations need to produce the analytics that are required to manage what’s essentially a new business, and that starts with the development of some sort of analytics blueprint early on in the merger activity.

As two or more forces join into one, it’s important to have the analytics blueprint in place so leaderships knows which dashboards are going to be needed for success.

“There used to be a trend where everyone was converted onto the same EHR platform,” said John Walton, solutions architect for IT consulting company CTG. “I guess the thought is that if everyone is converted, the problem will go away. Now … they end up in a situation where they can’t produce the kind of dashboards that are needed.”

THE FRAMEWORK

A key component of an effective analytics blueprint is a conceptual data model — basically a visual representation of what domains are needed for the dashboards.

“It sounds difficult to produce, but if it takes more than four to six weeks to produce something like that, you’re overthinking it,” said Walton. “But that’s then starting point. The key component is that analytics framework.”

Failure to have a framework in place can result in the newly merged entity losing out in terms of revenue and productivity. And once the problem becomes manifest, there’s often a lot of manual effort that goes into serving, for example, the financial dashboards that are so needed by CFOs. A lot of the manual effort goes into putting the data into Excel spreadsheets, which only puts a Band-Aid on the problem.

“The framework essentially provides pre-built routines to extract data from multiple data sources, as well as from financial systems,” said Walton. “It also provides, for lack of a better term, the data plumbing to enterprise standards, and most importantly there’s an analytic layer. The endgame is that the dashboards need to sit on top of an analytics layer that is easy to do analytics on. What it contains is pre-computed performance indicators based on approved business rules with multiple levels of aggregation.”

An effective framework, as with so many other things, begins with C-suite leadership. Having executive sponsorship, or at least an understanding of the issue at an executive level, can translate into a vision for how to integrate the data and provide the analytics that are needed to successfully manage the business.

PLANNING PROACTIVELY

Walton once observed a national organization that acquired another entity, and after two years the CEO still didn’t have any executive dashboards — which means a lack of visibility into the performance metrics. The CEO hen issued what was effectively a mandate to the acquiring organization: Get this done within three months, or else.

Thus began a flurry of activity to et the dashboard situation straightened out, which is not where an organization wants to be. Proactive planning is essential, yet Walton doesn’t see a lot of that in healthcare.

“I’ve never seen an organization proactively plan for this,” he said. “That doesn’t mean it’s not happening, but in my experience I haven’t seen it.”

In the meantime, mergers and acquisitions keep happening. Even if merging organizations become aware of the problem and factor that into their decision-making there’s another issue to consider.

“Another extremely significant problem is data quality and information consistency,” said Walton. “That problem really is not universally dealt with, in healthcare or for that matter other industries. It’s almost like they’ve learned to live with it. It’s almost like we need a call to arms or something. You’re almost certainly going to have the need for an analytics framework that will apply the data to your standards.”

The data in question could encompass missing or clinically inappropriate data. Quality, in this case, has to do with the cleanliness of the data. In terms of consistency, a good example would be something like average length of stay. There’s an opportunity to ensure that the right data ownership and stewardship is in place.

Importantly, it’s primarily a business solution. It’s possible that one of the merging entities has a data governance strategy, but all too often that strategy was launched by the IT department — which is not where an organization wants to be, said Walton, because it’s primarily a business problem rather than one that’s purely technical.

Data governance is a very well-known concept, but people struggle with its actual implementation for a number of reasons,” he said. “One, there’s a technical aspect of it, which centers around how we identify data quality issues. What kinds of tools are they going to use to address data quality issues?

“Then there’s establishing ownership of the data, and who are the subject matter experts. And there’s a workflow aspect that most organizations fail to deal with.”

It all starts with the framework. Only then can merging organizations get an appropriate handle on its data and analytics landscape.