Wire #79

  • Cerebral Investigation: Telehealth startup Cerebral received a subpoena from federal prosecutors for possible violations of the Controlled Substances Act following weeks of increasing scrutiny over its prescribing practices. The investigation arrives shortly after a former Cerebral executive alleged the company pressured its clinicians to prescribe stimulants without careful diagnoses, and failed to investigate duplicate shipping addresses in its database that were tied to patients suspected of making multiple accounts to access more medication.
  • Declining Experience Scores: The Leapfrog Group’s Adult Inpatient Care Report recently quantified the decline in hospital patient experience and safety scores seen throughout the pandemic. Only 63% of patients reported favorable ratings of the responsiveness of hospital staff in 2021 (vs. 67% in 2019), with staff communication about medicine scores also falling from 64% to 61% over the same time period. Scores were less favorable across all but one domain examined by HCAHPS, with the lone improvement coming from “quietness of the hospital.”
  • Amwell Earnings: Amwell’s first quarter earnings report showed a steady increase in its number of patients and providers as it invests heavily in new service launches. The telehealth company had 102k active providers at the end of Q1 (up from 91k in Q1 2021), and finished the quarter with 1.8M total visits (up 20% from the previous quarter). Although expenses outpaced revenue growth during the quarter, CEO Ido Schoenberg said the narrative would flip in the second half of the year as Amwell begins to recognize revenue from large launches like its Converge virtual care platform.
  • Interoperability Challenges: An OIG audit of the efforts by the Department of Defense and Veterans Affairs to make their Cerner systems interoperable found large gaps in its data exchange capabilities and an overall failure to consistently migrate old patient data into the new system. The audit also uncovered a lack of interfaces to automatically upload medical device data and poor controls over patient data access, which raises HIPAA concerns and makes it seem like we’re still a long way away from a seamless EHR for the federal government.
  • Small Practice Struggles: The federal government is far from the only institution facing interoperability challenges, with a recent analysis of 2019 National Electronic Health Record Survey data revealing that only 44% of solo practitioners were able to send and receive data from outside sources (compared to 76% of those in practices with over 50 physicians), while just 17% of solo practitioners were able to incorporate that data into their EHR (vs. 51% in large practices). The researchers state that these discrepancies lead to unequal benefits from information exchange, and that small practices require more incentives to encourage the use of interoperable EHRs.
  • Intermountain + General Catalyst: Intermountain Healthcare is entering a strategic partnership with venture capital firm General Catalyst to explore areas where GC portfolio companies can help drive innovation and accelerate the shift to value-based care. These companies include Transcarent, Olive, Aidoc, Sprinter Health, Commure, and Cadence, with broad expertise ranging from employer benefits to population health. GC has a stated vision to reduce the gross domestic product of healthcare by 20% by 2030, a goal well aligned for a collaboration with the not-for-profit health system.
  • Algorithms & Primary Care: The Harvard Business Review published an interesting article exploring how automation will become a “critical component” or primary care, as long as it’s developed responsibly. At the core of automated primary care systems are algorithms that guide the process of care to ensure clinical quality and operational efficiency. The authors argue that these algorithms should never be viewed as set in stone, and will require continuous oversight to assess their impact on patient safety, satisfaction, and outcomes.
  • ACP Effectiveness: Aledade recently published a study demonstrating the cost effectiveness of advanced care planning at the end of life. Researchers identified 335 patients across 45 practices at the highest risk of mortality, then divided the patients into a care-as-usual group and a treatment group that received comprehensive ACP from Iris Healthcare. Patients in the treatment group saw an average of $13,916 in reduced costs over the four year study, results that impressed Aledade so much that it acquired Iris Healthcare following the study.
  • Heard Series A: Behavioral health infrastructure startup Heard raised a $10M Series A round to develop its platform that helps therapists manage back office functions like accounting and taxes. Heard’s subscription model allows therapists to “spend less time accounting and more time listening” by offloading their administrative tasks, with most of the company’s current clients consisting of early-career providers looking to set up private practices.
  • Physician Mistreatment: A survey of 1,505 Stanford physicians conducted between September and October 2020 found that 23% had experienced mistreatment in the last year, with women more than twice as likely to experience mistreatment than men (31% vs 15%). Although those percentages alone are enough to highlight the severity of the issue, the study also found that mistreatment was associated with a 1.13 point increase in burnout (10 point scale), a 0.99 point decrease in professional fulfillment, and 129% higher odds of intent to leave.

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-- The Digital Health Wire team