Wire #75

  • State of EMR Market: KLAS’ latest report on the EMR market highlighted Epic’s continued growth story throughout 2021, with the vendor now commanding a 32.9% share of all hospitals (up 45% year-over-year). Cerner ranked second with a 24.4% share (up 5%) despite the fact that “no net-new large health systems have selected Cerner since 2013.” These share gains have come largely at the expense of CPSI (8.7% share) and Allscripts’ (4.3%), which saw their share decline 29% and 26%, respectively.
  • Stanford Strike: Nurses at two Stanford hospitals began striking on Monday to fight for higher wages and new contracts that focus on retaining a staff feeling burnt out and underappreciated two years into the pandemic. The strike has no end date in sight and arrives following over 30 failed bargaining sessions over the past three months. Hospital execs issued a statement that service volumes are currently reduced while some elective procedures are getting rescheduled, not at all surprising given the 5k nurses participating in the strike.
  • Clipboard Funding: Nurse staffing company Clipboard Health raised $80M to put toward hiring across all areas of its business, pushing the company’s valuation to $1.3B after raising $94M to date. Clipboard’s app-based marketplace matches nurses with facilities that post open shifts, with similar competitors like connectRN and Trusted Health also securing huge funding rounds over the past few months. The investor attention highlights the winner-take-all nature of marketplaces that require a large supply of nurses to fill posted shifts, with the demand usually outpacing available nursing talent (especially in the Stanford area).
  • Telehealth Follow-Ups: Whether or not telehealth results in duplicative care could depend on if a patient has an acute or chronic condition, according to a recent study published in JAMA Network Open. After analyzing data from over 40M members of private Blue Cross Blue Shield plans between July 2019 and December 2020, researchers found that telehealth patients with acute conditions were more likely to have a follow-up encounter or inpatient admission than in-person patients (OR: 1.44), while telehealth patients with chronic conditions were less likely to require follow-up (OR: 0.94). 
  • Holoportation: Although not quite in the orbit of our usual coverage, NASA flight surgeon Dr. Josef Schmid recently became the first human “holoported” from Earth into space to conduct a telehealth visit with ISS astronaut Thomas Pesquet. The experience was made possible using Microsoft’s HoloLens technology, which enables users to interact with 3D representations of remote participants in real time. The technology is designed to create no-latency experiences that feel as if both parties are in the same room, which has exciting implications for better patient interactions on space as well as on Earth.
  • Tech’s Growing Role: A new survey of nearly 3k clinicians from Elsevier Health found that “technology literacy” is predicted to become clinicians’ most valuable capability over the next decade, ranking even higher than “clinical knowledge.” Despite the anticipated growth in technology’s role within medicine, 69% reported feeling overwhelmed with their current data volume, while the same share predicted that the burden will become greater in the future. As a result, 83% said that training needs to be overhauled to keep pace with changing tech.
  • Digital Health Education: With a clear need for more digital health training showing up in surveys on a weekly basis (see above), the Digital Medicine Society, Rocky Vista University, and the American College of Osteopathic Family Physicians launched a new library of continuing medical education courses to help practicing clinicians learn how to effectively leverage digital approaches to caring for patients. The Digital Health CME Certificate consists of eight modules on topics such as telemedicine best practices and AI, each intended to close the training gap for tools used in real clinical environments.
  • Makeshift LoS Predictions: Hospital length of stay (LoS) is a key measure used by providers to forecast resource needs, but a systematic review of 93 studies in PLOS Digital Health found that current LoS prediction approaches have a “makeshift nature” with several drawbacks. These include data cleaning practices and overly specific model tuning that limit generalizability beyond individual institutions. The researchers call for a unified framework to yield a more reliable estimate of LoS, which would allow different approaches to be shared across several hospitals.
  • Concert Series B: Behavioral health medical group Concert Health recently closed $42M in Series B financing to help scale its services that aim to bridge the gap between physical and mental healthcare. Concert partners with primary care, pediatric care, and women’s health groups in 11 states to screen their patients for those who might benefit from behavioral health services, then connects them with behavioral care managers through its telehealth platform.
  • The Case for Prior Authorization AI: A new McKinsey report highlighted prior authorization AI solutions’ potential to improve healthcare efficiency, noting healthcare’s significant PA labor burden and estimating that AI tools could automate 50% to 75% of PA tasks. McKinsey is far from the only observer promoting AI’s potential to improve healthcare’s administrative efficiency, coming just a few weeks after an MIT Sloan Management Review editorial suggested that administrative healthcare AI will find greater short-term acceptance and provide more straightforward ROI than clinical AI.

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