NIH Director Monica Bertagnolli on the problem of government-funded clinical trials lagging behind pharma-funded research.

Patient Engagement

Hospitals Don’t Know If Patients Are Dead

An interesting research letter in JAMA Internal Medicine highlighted a grim trend in health system record keeping: EHRs frequently overlook patient deaths.

That’s a major issue for plenty of reasons, which UCLA Health researchers laid out after analyzing roughly 11,700 seriously ill primary care patients across 41 clinics (2020-2022).

Almost 700 patients whose medical records showed them as alive were actually deceased according to California public health filings, nearly 20% of the entire cohort. 

The discrepancy led to hundreds of unnecessary interactions such as prescription refills and appointment reminders, needlessly straining resources and staff bandwidth.

Of the patients found to be deceased:

• 310 had an active appointment on the calendar
• 541 had an appointment still pending
• 221 received 920 letters about preventative care such as flu shots or screenings
• 166 received 226 mailed correspondence
• 158 had 184 orders placed for vaccines and other care
• 88 medications were authorized 

That’s a serious amount of wasted outreach for healthcare workers that don’t exactly have extra slack in their workflows, and the authors point out that addressing just this issue would provide immediate benefit to staff (at least at one California academic health system).

It’s worth noting that California prohibits death file information from being shared with any party except for financial institutions, so the issue varies state to state.

The Takeaway

Not knowing which patients are dead isn’t ideal for provider operations, hindering everything from effective rev cycle processes to quality improvement programs. We’ve covered countless studies related to burnout caused by administrative tasks, but this is the first research we’ve seen that suggests a decent chunk of that burden could be alleviated by simply knowing which patients are still alive.

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Glooko Outcomes Using Real-World Data

Modern diabetes management requires personalized, always-on, and connected care. Explore Glooko’s latest clinical studies to see how remote patient monitoring is making real-word improvements across multiple glycemic outcomes.

Creating an Exceptional Engagement Experience

With a surge in experience‑oriented disruptors entering the healthcare industry, patient engagement is becoming a crucial competitive differentiator. Get your copy of Nuance’s guide to  delivering intelligent interactions and a better experience at every touchpoint.

The Wire

• CB Digital Health 50: CB Insights released its annual Digital Health 50 rankings of the most promising private digital health startups (previously had 150, sign of the times?), selected from a pool of over 10k applicants based on “proprietary Mosaic scores.” The list is packed with movers and shakers, leaning heavily toward early-stage startups that support clinicians rather than companies delivering care themselves like in years past. Surprisingly absent is any mention of startups building in the white hot ambient AI / clinical documentation space.

• Breakdown of EHR Time: An analysis of 300 primary care physicians at Mass General Brigham found that PCPs spend an average of 36 minutes in the EHR per visit, as well as an additional 8 minutes keeping on top of their inbox. The researchers point out that there isn’t a one-size-fits-all remedy for EHR burden due to substantial variation between individual doctors and clinics, although team collaboration on orders, support for medication refill functions, and practicing in a community health center were all associated with less EHR time.

• Notifications Don’t Cure Depression: A meta analysis of 13 randomized clinical trials in JAMA Network Open found that app-based interventions show promise for depression, especially if they’re not barraging patients with notifications. Interventions with in-app notifications were associated with significantly lower treatment outcomes, suggesting that less is more when it comes to prompting those with mental illness to stick to the care plan.

• athenahealth Rolls Out AI Features: athenahealth announced a range of new AI capabilities through athenaOne, its integrated suite of EHR, rev cycle, and engagement solutions. The fresh features include automated inbox response drafting, identification of missing prior auth info, care plan summarization, and a potentially-great-depending-how-well-it-works app update that predicts the most likely next action in response to an inbox item and suggests it as a “one-click” action at the top of the provider’s list.

• Mental Health Crisis Escalates: Some startling statistics just released by the CDC underscore the heavy toll of the nation’s mental health crisis, with a record ~50k Americans taking their own life last year. That’s a 3% year-over-year increase, and the suicide rate of 14.3 deaths per 100k people was the highest seen since 1941. Interestingly, suicides decreased significantly among younger people (-18% for ages 10-14, -9% for ages 15-24), which might suggest that efforts to address youth mental health are working.

• Hippocratic AI Provider Partnerships: Hippocratic AI launched the Early Access Partnership Program teased during its seed round as a way to ensure responsible AI through co-development with industry stakeholders. The program will work to identify workflows in need of an LLM overhaul and pilot early use cases, with several health systems and digital health companies already on board (OhioHealth, Roper St. Francis Healthcare, Evernow, HarmonyCares, Guidehealth).

• Epic Integrates Patient Experience Data: Epic is partnering with Qualtrics to integrate patient experience data directly into its EHR, with the insights “strategically placed” within easy reach for providers. Example: If a patient is growing increasingly frustrated with scheduling an appointment, Qualtrics will identify the sentiment and notify relevant teams through Epic. The integration will also streamline data exchange for regulatory reporting requirements like HCAHPS.

• Trilliant Market Explorer: Trilliant Health released a new Market Explorer solution that aims to provide an understanding of network performance at the local market level. Market Explorer combines Trilliant’s directory of 2.9M providers with its national claims dataset of 300M Americans to let users track market share (both inpatient and outpatient), assess total addressable market (shows volume by service line and procedure type), and identify growth areas (targeted recommendations by ZIP code).                          

• Twin Study Shows Vegan Heart Benefits: A Stanford Medicine-led identical twin trial provided solid evidence that a vegan diet improves overall cardiovascular health. The researchers randomized 22 pairs of identical twins to follow vegan or a healthy omnivorous diet for eight weeks (1 twin per diet), finding that the vegan group had far greater average decreases in LDL-C (−13.9 mg/dL), fasting insulin level (−2.9 μIU/mL), and body weight (−1.9 kg) compared to the omnivore twins.

• Google Debuts Gemini: Google upped the ante in the generative AI race with yesterday’s launch of Gemini, a new model designed to take on OpenAI’s GPT algorithms. Gemini is built from the ground up as a multimodal model that can accept inputs from text, images, audio, video, and code, giving it “sophisticated multimodal reasoning and advanced coding capabilities” that are already getting pushed to consumers through new Bard and Android features.

• GenAI Beats the Productivity Paradox: History has shown that new tech often fails to live up to expectations, and a recent JAMA viewpoint explores whether generative AI tools for healthcare are likely to continue the pattern. While healthcare isn’t exactly the easiest industry for new tech to break into, the authors make the case that genAI will be able to overcome the “productivity paradox” that leads to slow adoption due to its rapid improvement cycles and ability to accelerate the development of complementary tools.

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The New Standard for Prescription Safety

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Four Ways to Connect Fragmented Provider Data

Automation is transforming our industry, and Medallion is digging into the ripple effect that fragmented provider data has on healthcare organizations. Check out Medallion’s open access E-Book to gain a better understanding of data management models and strategies, uncover solutions that will streamline operational tasks from provider onboarding to license renewals, and much more.