EPIC Goes AI (and so does eClinicalWorks) – from HIMSS 2023

AI Healthcare

EPIC Goes AI

From fiercehealthcare.com 4/18

Announcement from HIMSS by EPIC that it is collaborating with Microsoft and Azure OpenAI services on AI services.  They are not showing any live demo.

In Brief Summary

  • reduces administrative burden with message response
  • UC San Diego Health, UW Health in Madison and Stanford Health Care
  • A lot like restaurants where the people don’t need to do it anymore and can focus on more important tasks
  • EPIC SlicerDicer will see integration – nice explanation on UC Davis – interestingly UC Dicer is Citrix. Here is SlicerDicer blahblah — SlicerDicer is a self-service reporting tool that provides physicians, department managers, and other users with intuitive and customizable data exploration abilities.
  • According to KLAS (respected) EPIC is 33% share of acute care hospitals in the U.S. market
  • 2022 Numbers— Globally 2130 use EPIC and Oracle Cerner is 2389.  EPIC increased its share from 2021.
  • EPIC in 2021 had a series of news where its AI was delivering inaccurate info.
  • In November 2022 EPIC announced deal with Google Cloud for AI (Hackensack Meridian Health)

Excerpt

Health systems and hospitals are facing intense financial pressure with rising costs and increasingly tight margins. Approximately half of U.S. hospitals finished 2022 with negative margins as widespread workforce shortages and increased labor expenses, as well as supply disruptions and inflationary effects, caused expenses to meaningfully outpace revenue increases, according to data from Kaufman Hall.

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Google Health and AI 3 weeks ago

EPIC Welcome Kiosk by KIOSK

Epic Welcome Kiosks Improving Patient Experience

The EPIC Welcome Kiosk is the standard by which all patient check-in kiosks are judged.  This is KIOSK Information Systems iteration with case study on it.

LINK TO EPIC WELCOME KIOSK FULL CASE STUDY

At a Glance  – Summary

improve overall patient satisfaction

The Challenge

lengthy check-in process that involved filling out paperwork and waiting in line to see a receptionist.

The Solution – EPIC Welcome Kiosk

Implement Epic Welcome Kiosks

The Result with EPIC Welcome Kiosk

Reduced Wait Times – The kiosks have reduced wait times

Improved Data Accuracy – improved data accuracy

Social Distancing

Learn more about Healthcare & Medical Kiosks.

Contact us to start your patient check-in solution.

About KIOSK Information Systems

As an industry leader in the design and manufacturing of complete self-service solutions since 1993, our team of experts provide superior service while delivering complete customized solutions.

End-to-end solutions keep deployments simple while maintaining superior uptime.
  • Software Application and Hardware Enclosure Design
  • Hardware Integration Module APIs that are licensable
  • Flexible Volume Manufacturing
  • ISO9001:2015 Certified Quality Systems
  • ISO14001:2015 Certified Environmental Systems
  • Turnkey Safety Agency Certifications (UL, FCC)
  • Fully Managed Deployment, Monitoring, & Field Services

VA to Support Two EHR Systems Indefinitely

VA EHR Kiosks

Cerner and VistA EHR Systems for VA

From Federal News Network March 2023

In Brief Summary

  • 24 migrated and 54 slated to migrate to cloud
  • Cerner went live October 2020
  • Congressional leaders frustrated by lack of progress
  • Another 5-10 years expected
  • VistA relys on MUMPs programmers, many due to retire and no new ones coming online
  • VistA doesn’t support mobile and web access very well, and no support for AI

Excerpt

The Department of Veterans Affairs is telling Congress a new multibillion-dollar Electronic Health Record is the best way to provide care for its patients — despite a troubled rollout and House lawmakers threatening to pull the plug on the project.

Whether or not the VA can get the rollout of its Oracle-Cerner EHR back on track this summer as planned, agency officials told members of the House VA Committee that the VA would need to rely on its legacy EHR, VistA, for another five-to-10 years, if not longer.

“In essence, we are supporting two EHR systems simultaneously until the Cerner implementation is complete,” Daniel McCune, VA’s executive director of software product management, told the technology modernization subcommittee in a hearing Tuesday. “In the interim, VistA remains our authoritative source of veteran data.”

VA officials told the subcommittee that VistA is not suited for meeting the agency’s long-term health care needs, but McCune said the VA plans to modernize VistA over the coming years to provide “uninterrupted care and continually improve the veteran service.”

In a survey of VA employees currently using the Oracle-Cerner EHR, 78% of respondents said the new system didn’t help them deliver high-quality care, but 64% agreed that the legacy VistA system did help them provide quality care to veterans.

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Related News

  • 3/10/2023 — Oracle reports Q3 results: revenue up 18%, adjusted EPS $0.68 versus $0.84, beating earnings expectations but falling just short on revenue. The company’s much-watched cloud revenue jumped 45%. ORCL shares dropped 5% in after-hours trading following the announcement as investors reacted to revenue of $12.4 billion versus the average analyst expectation of $12.41 billion. Chairman and CTO Larry Ellison highlighted the contributions of its June 2022 Cerner acquisition, saying that its healthcare contract base has increased by $5 billion. He says Oracle is pleased with those results, but expects new healthcare contract signings to accelerate further over the next few quarters. The Cerner business contributed $1.5 billion in revenue for the quarter, 12% of Oracle’s total revenue.

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Telehealth News – Teladoc Historic Net Loss Reported

teladoc stock price

Teladoc Telehealth News

Teladoc said fourth-quarter revenue increased 15% year-over-year to $637.71 million, which beat average analyst estimates of $633.65 million, according to Benzinga Pro. The company reported quarterly earnings of $23.49 per share due to non-cash goodwill impairment charges of $23.26 per share.

Excluding the impairment charge, Teladoc’s net loss came in at 23 cents per share versus consensus estimates for a loss of 25 cents per share.
“Despite a challenging macro environment, we were able to expand our product offerings and enhance the level of care delivered across our integrated whole-person platform,” said Jason Gorevic, CEO of Teladoc Health.

All in all it was a bit of OMG kneejerk headline for basically pretty good news. Teladoc has been around 30 for stock share price (after hitting 34 in early Feb)  and the loss knocked it down 10% to 25.  It has recovered since back to 27.43 on 2/23

Dive Brief:  From HealthCareDive Feb 2023

  • Teladoc Health reported a historic net loss in 2022 of $13.7 billion off revenue of $2.4 billion, mostly from an impairment charge related to the shrinking value of its Livongo acquisition. By comparison, the virtual care company reported a loss of $429 million in 2021.
  • The non-cash goodwill impairment charge of $13.4 billion reported over the past year reflects the waning market value of Teladoc’s $18.5 billion acquisition of chronic care company Livongo in late 2020. The impairment charge doesn’t impact the company’s financial position or its ability to invest in the business going forward, CFO Mala Murphy said on a call with investors Wednesday.
  • The New York-based telemedicine vendor beat Wall Street expectations for revenue but missed on earnings in fourth-quarter earnings released aftermarket Wednesday. Teladoc also issued 2023 guidance below analyst consensus, causing stock to slide in morning trading Thursday.
teladoc stock price

Click for full size – teladoc stock price

AI Artificial Intelligence and Patient Acceptance

AI Healthcare

AI Healthcare News

From HealthCare Dive

Excerpt

While public opinion on AI is still evolving, knowledge about the technology also determines patients’ hesitance levels.

Patients who said they have heard little or nothing about AI were more likely to be uncomfortable with their provider using them than those who said they had heard about them, the survey found.

Ultimately 75% of respondents said they are worried their providers are moving too fast, implementing the tools without fully knowing the risks, compared to just 23% who said they are moving too slow.

Dive Brief:

  • About six in 10 U.S. adults said they would feel uncomfortable if their provider used artificial intelligence tools to diagnose them and recommend treatments in a care setting, according to a survey from the Pew Research Center.
  • Some 38% of respondents said using AI in healthcare settings would lead to better health outcomes while 33% said it would make them worse, and 27% said it wouldn’t make much of a difference, the survey found.
  • Ultimately, men, younger people and those with higher education levels were the most open to their providers using AI.

Read full article including insights From HealthCare Dive

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VA Patient EHR Proposal to Terminate Oracle Contract

VA EHR Kiosks

VA EHR News

A proposed bill would end the VA’s Oracle Cerner implementation and revert live sites back to VistA.  From FCW Jan 2023

House bill would scrap VA’s $20 billion-plus electronic health record program

Rep. Matt Rosendale (R-Mont.), who was the top Republican on a subcommittee conducting oversight of technology at the Department of Veterans Affairs,  introduced a bill Friday that would aim to scrap the VA’s $20 billion-plus program to modernize the electronic health records system used by 9 million veterans.

The bill is titled: “To terminate the Electronic Health Record Modernization Program of the Department of Veterans Affairs.” Full text has not been published online but the aim of the bill has echoes in comments from Rep. Mike Bost (R-Ill.), the chairman of the House Veterans Affairs Committee, who  warned in July 2022 about possibly pulling the plug on the technology contract “if there isn’t major progress by early next year.”

Bost is a cosponsor of the legislation, which has been referred to the House Committee on Veterans’ Affairs.

FCW emailed Rosendale’s office and the committee for the full content of the bill but did not obtain the text.

The bill landed days after the pilot site of the VA’s Oracle Cerner system in Spokane, Wash. suffered a service interruption because of updates being made to the overall system by the Department of Defense.

The VA contracted with Cerner on a sole-source basis in 2018 to supply the same commercial electronic health record that was being deployed by the Department of Defense to support record sharing and collaboration between DOD’s medical services and VA. The program was initially budgeted at $16 billion over 10 years, with $10 billion for Cerner and the remainder for infrastructure updates and program management.

Cerner was acquired by Oracle for $28.3 billion in a deal that closed in June 2022.

But the implementation and migration of health records were soon hobbled by software outages and technical issues, complicated further by the onset of the pandemic. Various oversight bodies have estimated that VA has more than $20 billion on the books for the program.

A July 2022 report by the VA’s Office of Inspector General found that the health record software sent 11,000 clinical orders to a queue assigned for requests with incomplete routing information and failed to alert clinicians that the orders didn’t reach their intended destination.

As a result, the report noted that the error “placed patients at risk for incomplete care, and caused multiple events of patient harm” to nearly 150 veterans.

VA officials postponed further rollouts until January, but Rosendale said last July that the department might be better off sticking with the legacy system.

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Patient Kiosks News Wrap December 2022

patient kiosk logo

Come see us in NY at NRF 2023 —

The Association is again exhibiting at NRF 2023 in New York. Here are some preliminary items.

Dead-Simple Signage Application For Health Care Reduces Interactive To A Button Pad

sixteen-nine.net

December 19, 2022 by Dave Haynes There has never been a shortage of whiz-bangery offered up to make simple visual display tasks more difficult, and

Apple and Epic Systems team up to launch macOS-friendly health records software

9to5Mac – Chance Miller

Apple is continuing to push into health care, this time striking a deal with Epic Systems for a Mac-friendly version of its health records app. As reported by Axios, the deal will see Epic Systems create a version of its health records tool that “is easier to run on Apple devices.” Apple had …

HLTH22: Google, Epic ink deal to migrate hospital EHRs to the cloud to ramp up use of AI, analytics

fiercehealthcare.com – Heather Landi

Fierce Healthcare LAS VEGAS—Google Cloud and Epic, one of the largest medical records software companies in the U.S., inked an infrastructure …

Health system data breach due to Meta Pixel hits 3 million patients

bleepingcomputer.com – Bill Toulas

Advocate Aurora Health (AAH), a 26-hospital healthcare system in the states of Wisconsin and Illinois, is notifying its patients of an unintentional …

Elotouch Healthcare Solutions

Healthcare patient check-in

Elotouch Healthcare and Patient Check-in

healthcare kiosk solutions Elotouch

healthcare kiosk solutions Elotouch

For more information visit https://www.elotouch.com/healthcare

— the email contact for Elo is [email protected]

Elotouch has a wide variety of solutions for the healthcare space. For major EHR systems Elo supports Epic Welcome Kiosk and their entire EHR system plus Cerner (now Oracle).

Below are some of the solution packages.

 

Create collaborative experiences in the patient room across the care journey.

Elo’s software agnostic solutions make it easy to integrate your electronic health records platform such as Epic Systems and Cerner, to better engage patients and streamline care.

Enhance clinical review with medical grade monitors with DICOM Part 14.

Explore Medical-Grade Monitors

Boost patient experience with bedside infotainment.

Add an interactive platform to view educational content and explore entertainment applications to keep patients connected and informed during the course of their treatment.

Improve pharmacy operations with intuitive touchscreen displays.

Because accuracy is essential for patient safety, a touch interface is the fastest, easiest way for pharmacists to receive, fill and double-check orders against electronic medical record (EMR systems) before medications are dispensed.

Drive efficiency with interactive displays at every nurse station.

Medical touch monitors provide easy-to-use platforms for accessing and updating electronic health record (EHR systems), managing patient requests and enabling better collaboration amongst interprofessional healthcare teams.

Add interactive displays to support visitors and provide tailored solutions for critical healthcare needs.

Explore interactive displays

Engage doctors and patients with digital whiteboards.

Replace your whiteboard with a modern interactive information hub capable of communicating care plans, staff assignments, electronic medical records (EMR system), lab results, imaging and more – unifying key patient care components in one solution.

Connect to visitors with interactive digital signage.

Implement wayfinding and point of information touchscreens to make it easier for people to find what they need and where they are going.

Improve capacity management with touchscreen solutions.

By introducing interactive technologies to support capacity management, healthcare providers can streamline staffing and better plan for patient admissions, discharges and transfers as well as improve efficiency by reducing the turnover time between cases.

Support your patients with digital front door healthcare kiosk solutions.

Elevate patient self-service with digital front door kiosks that make it easy to check-in, manage account information, update electronic medical record (EMR systems), make payments, complete telehealth appointments and simply checkout at the cafeteria.

Explore self-service solutions

More Resources

Resources available include the 2021 Epic Welcome Vendor Hardware Guide. For more information contact [email protected] (editor)
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Epic & Google Partner on AI and Analytics

Epic and Google Partnership

Epic and Google Partner on AI & Analytics

Wait long enough and natural fit companies eventually partner, even after deliberately not partnering anymore.

Google Cloud and Epic, one of the largest medical records software companies in the U.S., inked an infrastructure agreement to enable hospital customers to run their Epic workloads on the tech giant’s cloud technology. From Fiercehealthcare – Epic’s agreement with Google is a major pivot from two years ago when the EHR vendor said it would no longer pursue integrations with Google Cloud. (Google)

Excerpt

New Jersey-based Hackensack Meridian Health plans to move its Epic workloads to Google Cloud, the health system announced this week. The health system aims to accelerate digital transformations by moving to the cloud. The 17-hospital system also plans to leverage technology like analytics and AI to improve patient outcomes while benefiting from enhanced security.

“Our mission to innovate requires accessible, cutting-edge technology,” said Robert Garrett, CEO for Hackensack Meridian Health, in a statement. “With our Epic EHR on Google Cloud, we’ll be able to innovate faster, and benefit from a more efficient and secure cloud environment.”

“We expect running Epic on Google Cloud will be simpler for our IT and developers,  and will allow them to focus more on uncovering creative ways to improve patient care,” said Kash Patel, executive vice president and chief digital information officer for Hackensack Meridian Health, in a statement. “Having everything with Google Cloud will provide a huge opportunity for discoveries. For example, data from our AI Avatar for natural language processing will already be in Google Cloud, ready for us to ask questions. This will speed up our work and make information more accessible.”

Read full article From Fiercehealthcare

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VA Accessibility Issues – Visually Impaired Patients

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VA Accessibility Problems

Oracle, Cerner and the VA get taken to the woodshed in this article. Visually impaired users are virtually shut out of the systems. From Kaiser Health News via USAToday Oct. 2022

In Brief Summary

  • Lack of magnification capability
  • incompatible screen reader for text-to-voice
  • Struggle to log in
  • Struggle to enter basic information
  • Oracle insists all fixes can be done “in short order”
  • Situation first identified in 2015
  • Multiple high resolution monitors required to display single record and that technology not often available
  • “Deep inaccessibility plagues the burgeoning telehealth sector. A recent survey from the American Federation for the Blind found that 57% of respondents struggled to use providers’ proprietary telehealth platforms.”

Excerpt

Over 1,000 Section 508 complaints are in a backlog to be assessed, or assigned to Oracle Cerner to fix, Veterans Affairs spokesperson Terrence Hayes confirmed. That section is part of federal law guaranteeing people with disabilities access to government technology.

Hayes said the problems described by these complaints don’t prevent employees and patients with disabilities from using the system. The complaints — 469 of which have been assigned to Oracle Cerner to fix, he said — mean that users’ disabilities make it more difficult, to the point of requiring mitigation.

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