TTA’s VERY Last Swing of Summer: UHG can complete Change buy, Oracle transforming Cerner, Meta Pixel health data privacy scrutinized, Redesign Health raises $65M, more!

 

 

Weekly Update

We wind up Summer with UHG finally receiving an OK from District Court to complete Change Healthcare buy–unless DOJ pursues appeal. Oracle set to Oracleize Cerner but VA hedges Cerner training with AWS. The Meta Pixel/health data privacy story continues, catching attention from the Senate. Some fundings and buys large and small.

(Note to Readers: no updates until 28 September)

Meta facing some Senate scrutiny on Meta Pixel’s health data collection–and how it’s used (Bad, bad Facebook)
Weekend reading: HHS Office of Information Security presentation on security risks in AI, 5G, nanomedicine, more (Warning, 34 page presentation)
ATA organizes Telehealth Awareness Week this week (And beyond)
Breaking: Judge permits UnitedHealth acquisition of Change Healthcare, denies DOJ motion (updated) (But beware DOJ taking it to appeal)
News roundup: Oracle’s modernizing Cerner’s tech, but VA hedges training with AWS; Redesign Health’s $65M raise; Kyruus buys Epion Health; Zócalo Health raises $5M seed; Cigna Evernorth adds to digital formulary

Back from Two Weeks in Another Town (except for a few extra days), the August-September ‘quiet time’ certainly was not. CVS’ big win in Signify’s auction was on Labor Day. Change may or may not be joining UHG/Optum after October. FTC doesn’t much like Amazon’s acquisitions, including One Medical. And Elizabeth Holmes’ legal team was busily filing–and delaying the (maybe) inevitable, including a declaration straight out of Perry Mason. The passing of a Queen and crowning of a King.

Elizabeth Holmes’ three swings and a miss in overturning her trial verdict reveal a crafty strategy (She’ll be in court long after Sunny Balwani toddles off to prison)
News briefs, catchup edition: UnitedHealth/Change decision October?, CVS wins $8B Signify Health auction, Walgreens majority buy of CareCentrix, FTC requests more info on Amazon-One Medical (Home care wars and a long-awaited decision)
Perspectives: Creating consistent standards isn’t a once and done job (The safety of digital treatment tools)
On the passing of HM Queen Elizabeth II

$130M to Alma’s mental health platform, Cadence Care RPM with ScionHealth, NIH funding telehealth in cancer care, and more.

News roundup: RPM at 79 ScionHealth hospitals, 74% of employers like virtual care despite concerns, Alma Health garners $130M, NIH’s $25M for cancer care telehealth research, Parks’ virtual Connected Health Summit 30-31 Aug

Amazon threw in its beach towel on Care, put its bets on One (Medical), and paddle up in Signify’s auction closing after Labor Day. Babylon Health is eliminating distractions with the NHS to concentrate on the US. Oracle’s hit with charges of massive privacy violations, on top of massive Cerner VA dysfunctionality. But back to the future–Fitbit’s reviving with three new fitness watches.

Oracle in Federal court class-action lawsuit on global privacy violations; Cerner VA EHR had 498 major outage incidents, 7% of time since rollout (Misery upon misery)
Week-end news roundup: Fitbit revives with 3 new watches, Sena Health hospital-at-home, SteadyMD surveys telehealth clinicians, 9.4% fewer adult dental visits in England, save the date for ATA 2023
Perspectives: why digital apps need an in-house clinical safety lead (A Perspective from Wysa, more to come in September)
Breaking: Amazon Care shutting down after three years–what’s next? (updated) (Care an expensive course at the University of Healthcare Delivery)
Babylon Health exits last NHS hospital contract as a ‘distraction’, looks to US market for growth (Tighten your seatbelts)
Signify Health bidding war ensues, waged by Amazon, UnitedHealth Group, CVS, Option Care Health (A scrum with unknown outcome)

An action-packed mid-August. No one seems to be sitting on the beach unless you’ve been laid off. Meanwhile, companies are scrambling. No, Babylon Health is not being bought. But elsewhere, there is some good news around acquisitions and funding. 

Rounding up the week with good news: AliveCor’s Series F round, Scotland’s Smplicare gains £750K for fall research (A needed and refreshing drink!)
Friday short takes: was there a bidding war for One Medical? A concussion risk wearable tested. Get Well’s monkeypox digital care plan (One Medical’s gamble and a return to one of our old follow topics)
Week-end news roundup: +Oscar data tech platform pauses, BD buys MedKeeper pharmatech for $93M, Novant’s Meta misconfiguration reveals PHI, Mt Sinai’s Sema4 genomics spinoff releases 250 + founder (Reality bites in a lot of different areas)
Babylon Health: fending off bubbly rumors of acquisition this week (No, they’re not. Being. Bought.)

Big companies eager to snap up companies to fill out portfolios. Small (and not so small) companies drastically cutting staff and spending, looking for the Magic Survival Formula. Amwell finally closing a Big Deal with CVS Health. Babylon Health’s mixed picture as they grow. Cerner and VA’s miseries continue, but data and IoMT breaches thrive. And ISfTeH not only returns to live conferences, but also comes to the US.

Weekend short takes: May telehealth claims up to 5.4%; three health plan breaches, one at its law firm–affecting over 400,000 patients; layoffs hit Calm, Truepill (updated)
ISfTeH Global Connections for Sustainable Telehealth: 6-7 November, San Jose (International telehealth finally reaches the US)
Week-end news roundup: Allscripts on the acquisition hunt, Amwell’s CVS telehealth deal, Cerner’s $1.8M racial discrimination settlement, predicting Parkinson’s progression via smartwatch data
Mid-week news roundup: CVS eyeing Signify Health for in-home/VBC (updated); Babylon Health mixed pic of revenue and losses up; Geisinger doubles telemed specialties; connected IoT devices expand cyber-insecurity footprint; Owlet layoffs
More Oracle-Cerner VA/DOD EHR misery with 4 hour+ outage; 51% of VA iPads unused for video appointments (Not only VA’s
EHR, but also inventory management gone sideways)

This week’s big news centered on Oracle’s layoffs at Cerner–and Oracle–DOJ versus UnitedHealth Group, and telehealth nearing needed legislative change in the US. In UK news, NHS Digital trials wireless to compensate for looming staff shortages–and Cera raises £264 million. Advances in dementia diagnosis and therapy plus news from all over: multiple raises, VA, Cionic, Withings, Orion Health, Coviu, and more!

Week-end wrapup: CVS plans to expand primary care, home health; Cera Care raises £264M; Linus Health’s AI enabled dementia screener, Cognito’s cognitive therapy slows brain atrophy
Short takes for Thursday: Diagnostic Robotics $45M raise; Sage’s $9M seed; VA names EHR ‘functional champion’; Aussie telehealth startup Coviu arrives in US
NHS Digital trialling Wireless Center of Excellence–in face of ‘crisis’ level staffing shortages (Can one compensate for the other?)
Mid-week roundup: UnitedHealth-Change trial kicks off; Amazon’s One Medical buy questioned; Cionic’s neural sleeve designed by Yves Behar; Medable-Withings partner; Orion Health’s new CEO; IBM Watson Health’s Simon Hawken passes (Line up your bets on DOJ vs UHG)
Telehealth waivers take critical step in extending to 2024 in House bill now passed (About time, Congress)
Oracle’s Big Vision will be missing a lot of people; layoffs hit Cerner, customer experience, marketing staff (Didn’t take long for the guillotine to fall)

 


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News roundup: Oracle’s modernizing Cerner’s tech, but VA hedges training with AWS; Redesign Health’s $65M raise; Kyruus buys Epion Health; Zócalo Health raises $5M seed; Cigna Evernorth adds to digital formulary

Oracle’s Q1 2023 earnings call (Motley Fool transcript here) wasn’t much of a surprise. Earnings were up 23% to $11.4 billion. Cerner contributed $1.4 billion but was partly responsible for a 34% rise in operating expenses along with their business mix of our business. The Q2 forecast is 21% to 23%. But what should not be a surprise to anyone was the rapid Oracleization of Cerner’s tech. Answering a question about what value Oracle is delivering to Cerner’s products, Larry Ellison outlined that Cerner will have its first “pretty complete” health management product out within 12 months, using the Oracle Autonomous Database that runs itself without human labor, plus an all-new application development tool called APEX, a low-code tool. Ellison claims that the APEX low-code tool has security built into the tool, thus not requiring audits, and if the application fails, it rolls over into another data center and keeps running. In contrast, using standard methods, the product would take three to four years to build. Becker’s Health IT

The Department of Veterans Affairs (VA) is relying on Amazon Web Services for training services in transitioning from VistA to Cerner Millenium. The AWS programs will train VA Office of Information Technology staff in three areas: ENCOR implementation, operating Cisco enterprise network core technologies, architecting Amazon Web Services, and Red Hat System administration. The training will cost $54,000 over a base period of about two months. Becker’s Health IT

Redesign Health’s Series C racks up $65 million from General Catalyst, CVS Health Ventures, UPMC Enterprises, TriplePoint Capital, Eden Global Partners, Euclidean Capital, Declaration Partners, and Samsung Next. Redesign is an unusual enterprise that creates startups from its own research, assembles management teams, brands, and funds them. Since 2018, they have created 40 healthcare startups. The funding will be used not for funding additional startups but to expand Redesign’s capabilities in startup creation. Some of their startups: Ever/body (cosmetic dermatology), Calibrate (weight loss, which brutally lost a quarter of the company in July), Jasper (cancer care), Vault Health (virtual diagnostics), and MedArrive (EMS dispatch). Fast Company, FierceHealthcare.

Kyruus adds patient engagement to provider search with Epion Health buy. Kyruus, headquartered in Boston, connects providers in healthcare organizations with people needing the right care, as well as for organizations to maintain provider information and data management. Epion Health, headquartered in Hoboken NJ (near NYC), developed a platform to connect patients with their providers including services such as online check-in, telehealth, integrated reminders for scheduling, and patient education. The acquisition expands Kyruus to 500 health systems and medical groups. Terms and management transitions were not disclosed. For Kyruus, which acquired patient navigation too. HealthSparq from investor Cambia Health Solutions, this helps them build out an end-to-end provider-patient platform. Kyruus release, Mobihealthnews

Startup Zócalo Health raised seed funding of $5M to launch virtual healthcare in California, Texas, and Washington. Zócalo (Spanish for plaza or town square) will offer in those states “virtual first family medicine service designed by Latinos, for Latinos”. Already operating in California, Texas and Washington will be added by end of year. Promotoras de salud will serve as health coaches to their patients. Mobihealthnews

Cigna’s health services/tech arm, Evernorth, announced that it is adding two digital health apps to its formulary: UK/US Big Health’s Sleepio for insomnia and Daylight for anxiety, Quit Genius’ alcohol use disorder and opioid use disorder programs, and HealthBeacon’s injectable medication adherence tool for inflammatory conditions. They also announced pilot programs for Jasper Health (Redesign Health, above), Zerigo Health for psoriasis and eczema, Hinge Health’s new women’s pelvic health program, and Lid Sync’s medication adherence tool. Mobihealthnews

Oracle in Federal court class-action lawsuit on global privacy violations; Cerner VA EHR had 498 major outage incidents, 7% of time since rollout

Oracle’s miseries multiply, both in Federal Court and with the VA. The first is taking place in the US District Court for the Northern District of California. Three plaintiffs in a class-action suit charge in a complaint filed on Friday 19 August that Oracle is running a giant ‘surveillance state’ on billions of people. From the complaint, “the regularly conducted business practices of defendant Oracle America, Inc. (“Oracle”) amount to a deliberate and purposeful surveillance of the general population via their digital and online existence. In the course of functioning as a worldwide data broker, Oracle has created a network that tracks in real-time and records indefinitely the personal information of hundreds of millions of people” and sells this information to third-parties, without consent of course.

The complaint, filed 19 August, states that Oracle’s BlueKai Data Management Platform, which includes the Oracle Data Marketplace–likely the world’s largest commercial data exchange–and to the point, the Oracle ID Graph “synchronizes the vast amounts of personal data Oracle has amassed; that is, it matches personal data that can be determined to share a common origin with other personal data.” The charge is essentially that Oracle spies on you and has set up the world’s largest surveillance database of billions of people using the billions of data points most everyone generates online over decades.

All three plaintiffs are privacy-rights advocates: Michael Katz-Lacabe of the Center for Human Rights and Privacy; Dr. Jennifer Golbeck, director of the University of Maryland’s Social Intelligence Lab; and Dr. Johnny Ryan, a Senior Fellow at the Irish Council for Civil Liberties (ICCL), and at the Open Markets Institute. 

Dr. Ryan’s organization, the ICCL, stated that “Oracle’s dossiers about people include names, home addresses, emails, purchases online and in the real world, physical movements in the real world, income, interests and political views, and a detailed account of online activity: for example, one Oracle database included a record of a German man who used a prepaid debit card to place a €10 bet on an esports betting site.”

No dates have been set for hearings or as requested, a jury trial.

In Europe, Oracle had faced similar action along with Salesforce on privacy violations under GDPR. The Privacy Collective’s case was ruled inadmissible by a judge in the Netherlands last year, but is being appealed.

If the action proceeds, this strikes at the heart not only of Oracle’s data business but also Google and any data analytics or brokerage company. Look over your shoulder…someone’s coming after you.  TechMonitor.ai

Meanwhile, back at the endless tsuris called the VA EHR implementation, Oracle Cerner got more verbal beatdowns from the VA’s Secretary of Veterans Affairs and Senate committee members. FedScoop, through a FOIA (Freedom of Information Act) request living up to its name, was able to quantify the system outages in the Cerner Millenium system between 8 Sept 2020 and 10 June 2022. Of the 640 days the system was in place, it was out or nearly out for about 45 days, or 7%, when time lost in all of the 498 incidents is calculated.

  • 428 incomplete functionality incidents (930 hours of the system partially not working)
  • 49 degradations (103 hours of degraded performance)
  •  24 outage incidents (40 hours of complete down time) 

Where responsible parties could be identified, Oracle Cerner was responsible for about two-thirds of the incidents. Interestingly, the remainder were attributed to the VA. As to root causes, the VA could not identify them in about 50% of the cases. There’s some squirreliness in VA’s internal reporting on multi-day outages, which are more serious because the longer the outage, the more damage and the harder it is to pin down a cause.

Secretary of Veterans Affairs Denis McDonough said to FedScoop: “The bottom line is that my confidence in the EHR is badly shaken.” which has to count as an understatement significant enough to hold off further implementation until 2023. House Veterans Affairs Subcommittee on Technology Modernizing Ranking Member Mike Bost, R-Ill., said: “The number of incidents listed in this disclosure is alarming. Some part of the Cerner system has been down more often than not for nearly two years.” 

The Showboat of Misery keeps Rollin’ Down the River: the 4 Aug outage, the Senate hearing with Oracle’s Mike Sicilia, the infamous ‘unknown queue’ 21 July and 21 June

Short takes for Thursday: Diagnostic Robotics $45M raise; Sage’s $9M seed; VA names EHR ‘functional champion’; Aussie telehealth startup Coviu arrives in US

Tel Aviv-based Diagnostic Robotics gained a $45 million Series B. The company has developed AI predictive analytics for health plans, providers, government, and employers for clinical assessment and decision support. The Series B was led by StageOne investors, with participation from Mayo Clinic, thus becoming a Mayo Clinic Platform portfolio company, plus Technion – Israel Institute of Technology, as well as other existing investors. Total funding since 2019 is $69 million (Crunchbase) Release, Mobihealthnews

NYC-based Sage received $9 million in seed funding to further develop and market its app that rethinks the nurse call system in use in senior living. The platform provides caregivers with data to coordinate incident responses and triage quickly and effectively, plus provide care managers with tools to better understand resident needs, provide proactive care, and view staff performance. The round was led by Goldcrest Capital, with existing investors ANIMO Ventures, Distributed Ventures, and Merus Capital. Release

VA names ‘functional champion’ for their VistA to Oracle Cerner transition. Dr. David Massaro will work as the clinical executive representing the Veterans Health Administration (VHA). He will lead functional initiatives to support the department’s medical personnel during the transition. Dr. Massaro is a long-time VA-er, previously acting chief health informatics officer for the Office of Community Care and before then director of integrated health practice within the Office of Health Informatics, as well as a practicing physician who joined VA in 2006. FedScoop

Coviu, an Australian telehealth startup, is launching its platform in the jammed US market. It’s marketing as an ‘all-in-one virtual engagement platform’ and is clearly appealing to primary care practices that need a less expensive solution. Its difference is apparently with modular apps that can extend a provider’s clinical work: behavioral health, speech pathology, and audiology. Base pricing starts at $25 monthly with the highest level package $65/month. Integrated apps are the Wechsler Individual Achievement Test, pulse oximeter remote monitoring, and a checklist for PTSD. They are also developing a new digital wound care toolkit in collaboration with the Commonwealth Scientific and Industrial Research Organisation and the Western NSW Primary Health Network, for release in 2026 (!!). Coviu claims use by 90,000 clinicians worldwide who deliver a daily average of over 14,000 telehealth consultations. Their US base is in Dover, Delaware and is HQd in Brisbane and Sydney. Release, Mobihealthnews

Oracle’s ‘new sheriff’ moving to fix Cerner EHR implementation in the VA: the Senate hearing

Last week’s (20 July) hearing on the VA’s increasingly wobbly EHR transition from VistA to Cerner showcased Oracle’s executive vice president for industries Mike Sicilia. His testimony to the Senate Committee on Veterans’ Affairs had a heaping helping of ‘the new sheriff has arrived in Dodge City’.  As of six weeks ago, after the Transformational Big Vision kvelling faded, Cerner’s painful stumbles became Oracle’s VA Migraine [TTA 21 July, 21 June]. Cerner is now part of the Oracle Global Health business unit that falls under him.

First, the pledge made in his statement: “Unlike Cerner alone, Oracle brings an order of magnitude more engineering resources and scale to this formidable challenge.” After outlining the work that Oracle has done for CDC and NIH on Covid-19, he testified:

You should consider that in effect the VA, the Department of Defense (DoD) and the Coast Guard obtained a new, vastly more resourced technology partner overnight to augment Cerner. We also strongly believe in this mission and consider it not only a contractual obligation but a moral one to improve healthcare for our nation’s veterans and their caregivers. We intend to exceed expectations. 

Of the list of 36 issues detailed by the committee to VA Deputy Secretary Remy, Sicilia condensed them into three main areas: performance, design, and functionality. The concrete moves are:

  • Oracle will move the implementation to the cloud and rewrite Cerner’s pharmacy module, completing both tasks within 6-9 months
  • They have set up a ‘war room’ consisting of Oracle’s top talent of senior engineers and developers, working on the entire DoD/VA EHR systems as priority #1, with the first order of work a top-to-bottom analysis. While integrating with the Cerner team, the statement makes it clear that Oracle “brings an order of magnitude larger engineering team than Cerner”.
  • The Cerner EHR system is currently running on a dated architecture with technology that is in some cases two decades old and thus will be moved within 6-9 months to Oracle’s Generation 2 cloud. (That must be reassuring to thousands of hospitals and practices!)
  • Shortly after the closing, Oracle fixed a database bug that caused 13 of the last 15 outages, and as of last week there were no further outages. 
  • Testifying on the status of the “unknown queue”,  he stated it was designed to account for human error rather than to mitigate it, so it will be redesigned–it will be automated more on the front end and on the back end will have a better process.
  • Oracle will “start over” with the Cerner pharmacy module, rebuilding it as a showcase of a cloud-optimized web application.

VA’s EHR leaders also testified at the Senate hearing. Terry Adirim, Executive Director of the Electronic Health Record Modernization Integration Office at the VA, confirmed that unsurprisingly, Cerner’s next rollouts scheduled for the Boise VA Medical Center and other centers have been postponed indefinitely due to multiple ongoing system stability issues: change control and testing; challenges with increased capacity; basic functionality; its resilience design, and its response in last resort disaster situations. These specific issues overlapped but were more specific than those covered in Sicilia’s statement, which focused on the actions that Oracle would take.

Adirim and Kurt DelBene, the VA’s CIO, were roasted by the senators as painting a “very rosy picture”. The OIG report itemized at least 60 recommendations before going further. Adirim, to his credit, noted that DoD had similar stability issues in its system which was a warning, but the VA’s system is far more complex and care oriented than DoD which presumably exacerbated those issues. FedScoop and especially HISTalk’s Monday Morning Update 7/25/22

VA’s final, troubling OIG ‘unknown queue’ report on Cerner Millenium rollout; Oracle’s Sicilia to testify before Senate today

The Office of the Inspector General (OIG) report on the troubled rollout of Cerner Millenium at the VA continues to reverberate. The final report, revealed last month in draft [TTA 21 June], detailed a flaw in Cerner’s software that caused the system to lose 11,000 orders for specialty care, lab work, and other services – without alerting health care providers that the orders (also known as referrals) had been lost. This was the infamous ‘unknown queue’. The final report identified 149 adverse events related to the lost orders, including a homeless veteran at risk of suicide whose follow up appointment was lost, threatened to kill himself, but fortunately was helped (and hospitalized) outside the VA system. None of these problems surfaced before the go-live at Mann-Grandstaff VA Medical Center, but did four days later–and apparently other end users weren’t informed of the problem until a year later.

In FierceHealthcare’s update published today, “The OIG called it “troubling” that the deputy secretary [Donald Remy] “appears to absolve Oracle Cerner for its failure to inform VA of the unknown queue while placing the blame for outcomes from the unknown queue on VHA end-users.”” and “In a second report (PDF) released last week, the federal watch agency says VA project executives misrepresented its EHR training program” starting with Mann-Grandstaff. Two VA senior staffers responsible for training employees there gave inaccurate data to inspectors.

Cerner Millenium and the VA implementation (and other problems around the DOD implementation) are now Oracle’s headache. Executive Vice President Mike Sicilia was scheduled to testify Wednesday afternoon at a Senate hearing this afternoon to answer the many questions raised about the EHR rollout and safety problems. 

Weekend news, deal roundup: Teladoc CEO’s tapdance interview, VA EHR cost reporting now law, Tunstall-Doncaster Deaf Alliance partner, Cleveland Clinic’s $33M medtech spinoff

Teladoc CEO Jason Gorevic’s curious tapdance of an interview. Teladoc has had a rough 2022 to date. Their 2022 Q1 financials [TTA 4 May] were disastrous, their share price has not recovered since it cracked in late April with a 62% year-to-date plunge, the Livongo acquisition is shaping up to be the healthcare equivalent of Eastern Airlines’ takeover by Texas Air Corporation circa 1986, and shareholders are filing class action lawsuits. Now this Editor doesn’t mean to pile on. As a professional in two fields, she does understand the value of the press and leadership being available. But FierceHealthcare’s Heather Landi cleverly got Mr. Gorevic to stake his ground for growth yet again on “holistic, integrated solutions” that combine multiple care services from primary to complex care as the ‘longitudinal’ way to go. Yet Ms. Landi does have the nerve to bring up recent history and their long-time competitors like Amwell and Doctor on Demand (now Included Health) in the same space. Then there are the slices taken by players in the direct-to-consumer and niche target players (she cites troubled Cerebral and Talkspace–I’d offer DTCs like Babylon Health and the ‘white-labels’ like Bluestream Health and Zipnosis, now owned by BrightHealth, which are directly and cost-effectively working with providers). Think of this: in an economic downturn, will providers buy the ‘premium spread’ that requires a big implementation lift, or get by a less comprehensive solution that’s easier to implement and costs less?  Surprisingly, given the ‘everyone wants everything’ strategy, he again blames the cost of paid search advertising and brushes off Microsoft and Amazon. I’m not so sure that so soon after their Q1 bad news in May, with lawsuits centering on statements to investors, and nothing new in good news, this interview was particularly good timing.

VA corralled by Congress on Cerner EHR. The Department of Veterans Affairs now, by Federal law enacted late last week, has to prepare quarterly reports on its transition to the Cerner Millenium EHR to both House and Senate Veterans committees on performance and cost, including a breakdown of program funding sources. The new bipartisan law’s title is the VA Electronic Health Record Transparency Act.  Healthcare Dive

Tunstall Healthcare is now working with a local trust, the Doncaster (UK) Deaf Trust, to provide support for deaf and hearing-impaired children and adults. With Whitley Parish Council, Tunstall is working with the specialist gardening team at Communication Specialist College, part of Doncaster Deaf Trust, to secure over 100 plants for the planters which have been grown at the Trust’s gardens. Tunstall volunteers planted them in the planters across the village. Doncaster Free Press

Cleveland Clinic’s successful spinoff, Centerline Biomedical, closed a $33 million Series B equity financing. Leading it was Cleveland Clinic with participation by GE Healthcare, RIK Enterprises, JobsOhio, Jumpstart Ventures, and G2 Group Ventures. Centerline’s technologies improve visualization and guidance of stents, catheters, and guidewires in endovascular procedures, reducing dependence on radiation and contrast agents with the goal of improving patient outcomes. These include sensors and electromagnetic tracking that create 3-D color visualization and navigation of the human vascular system. Release, Becker’s

More bad news for Cerner’s VA rollout–draft report cites 150 “cases of harm” due to the ‘unknown queue’

A serious revelation that may derail the Cerner Millenium rollout. A draft report by the Department of Veterans Affairs (VA) Office of Inspector General (OIG) states that a flaw in Cerner’s software caused the system to lose 11,000 orders for specialty care, lab work, and other services – without alerting health care providers the orders (also known as referrals) had been lost. This created ‘cases of harm’ to at least 150 veterans in care. Moreover, the flaw was known prior to the Mann-Grandstaff VA Medical Center rollout in October 2020, and Cerner failed to either fix or inform the VA of it prior to the implementation.

The lost orders in the quaintly termed ‘unknown queue’ resulted in delayed care at minimum. The VA patient safety team classified dozens of cases of “moderate harm” and one case of “major harm.” The major harm cited affected a homeless veteran, aged in his 60s, who was identified as at risk for suicide and had seen a psychiatrist at Mann-Grandstaff in December 2020, after the implementation. After prescribing medication to treat depression, the psychiatrist ordered a follow-up appointment one month later. That order disappeared in the EHR and not scheduled. The consequences were that the veteran, weeks after the unscheduled appointment date, called the Veterans Crisis Line. He was going to kill himself with a razor. Fortunately, he was found in time by local first responders, taken to a non-VA mental health unit, and hospitalized.

The draft report implies that the ‘unknown queue’ problem has not been fixed and continues to put veterans at risk in the VA system.

There may be as many as 60 other safety problems. Other incidents cited in the draft report include one of “catastrophic harm” and another case the VA told the OIG may be reclassified as catastrophic. Catastrophic harm is defined by the VA as “death or permanent loss of function.”

The news broke in the Spokane Spokesman-Review today (20 June). Their reporters obtained the draft report from multiple sources. Mann-Grandstaff VA Medical Center is located in Spokane. The final report is expected to be released later this summer.

Those of us who have been following the migration from warhorse EHR VistA to Cerner Millenium recall that a year ago, OIG already had criticized the Mann-Grandstaff implementation for multiple “governance and management challenges” as well as patient safety concerns and system errors, resulting in a grilling of VA Secretary Denis McDonough and Cerner executives before the Senate Veterans Affairs Committee last July. A remark by the committee’s chair, Frank Mrvan, D-Indiana. that the three-month review at the time “raises more questions than it answers,” is proving to be remarkably prescient.

According to the article, “the department did not respond to questions about the draft report, but on Friday, after The Spokesman-Review sent the questions, VA officials told Military Times they would delay the system’s planned launch in Seattle, Portland and other large facilities until 2023″. Military Times noted that the congressional committees were not informed until Friday night. The delays are as follows: Puget Sound VA Health Care System (American Lake and Seattle VA Medical Centers) from August to March 2023 and VA Portland Health Care System (Portland and Portland-Vancouver VA Medical Centers) from November to April 2023. The Central Ohio Healthcare System implementation in May has gone as planned and the VA maintains that the two delays are not indicative of other problems.

Local Representative (R-5th Congressional District, eastern Washington state) Cathy McMorris Rodgers has already had at Cerner since last year. Her press release is illustrative of her activism around Mann-Grandstaff and further rollouts of the Cerner EHR, while Mann-Grandstaff continues to have problems and outages.

Oracle has a great deal riding on a smooth implementation of Cerner Millenium at the VA. More Congressional hearings are not a good look for Oracle and its ambitions of transforming healthcare. Damage control is snapping in place. This Editor noted that Oracle’s SVP for global corporate communications was quoted in the Spokesman-Review article, not a Cerner staffer. Also EHR Intelligence.

 

Thursday news roundup: bet on Oracle-Cerner closing next week, VA EHR progress reports mandated, Homeward-RiteAid rural care, Medtronic-DaVita kidney JV, Withings reenters RPM, Lightbeam buys Jvion AI

The Oracle acquisition of Cerner will close as early as Monday next week, no later than mid-June. Mid-June is the prediction of Seeking Alpha. They based it on Oracle-Cerner already passing Australia’s Foreign Investment Review Board, no questions posed by the UK antitrust authority, and the US waiting period expiring in February. As rumored [TTA 25 May], European Commission regulators approved it today (Barrons, paywalled) which predicts the close will be next Monday. Hat tip to HISTalk for their alert yesterday.

Scrutiny of Cerner’s $16 billion EHR implementation with the Department of Veterans Affairs by Congress ramps up. New legislation due to be signed by the president shortly will require the VA Secretary to submit regular reports 30 days after the last day of each fiscal quarter on the VA’s Electronic Health Record Modernization (EHRM) program. Content will include spending, performance metrics, outcomes, safety, transitioning from VistA to Cerner Millenium, interoperability, and progress or issues with all. Text of Senate bill, FierceHealthcare  TTA’s previous article on Cerner EHR interoperability problems with DOD and VA

Bringing healthcare to rural America is Homeward with a freshly inked deal with RiteAid. Founded by former Livongo president Jennifer Schneider, MD, Homeward will set up distinctive purple mobile van clinics at up to 700 Rite Aid location parking lots in rural communities starting Q3 this year. Michigan will be the first market. Homeward will accept regional Medicare Advantage plans and Medicare.

The company is targeting the 60 million Americans who live in rural areas and have been losing access to basic medical care as local practices and clinics close. Their technology enablement will be for appointments, checkins, telehealth, remote patient monitoring, and scheduling home visits. Homeward announced its launch at the recent ViVE2022 in March including $20 million in funding from General Catalyst. Other Livongo alumni with the new company are Brian Vandenberg, former general counsel, Amar Kendale, former chief product officer, and Bimal Shah, MD, former chief medical officer at Livongo. Nice to know that they have moved to another healthcare chapter of real need, versus cruising the Caribbean in very large yachts. FierceHealthcare, Homeward release

Medical device giant Medtronic and DaVita are establishing a joint venture by next year to advance kidney care therapies and technologies, including new products to be used in clinics and in the home. The intent of the JV is to increase the availability of kidney care including dialysis. 10% of adults worldwide–700 million people–have chronic kidney disease. 2.6 million have kidney failure. The JV is expected to be formed in early 2023 with each company owning an equal share. Initial investment is not disclosed. According to the release:

  • Medtronic will contribute its Renal Care Solutions (RCS) business including the current product portfolio (renal access, acute therapies, and chronic therapies), product pipeline, and global manufacturing R&D teams and facilities.
  • Both companies will provide an initial investment to fund the new company (NewCo) and future certain operating capital.

FierceBiotech, Medtronic release

Withings reenters remote patient monitoring with Withings RPM. Their initial entry was with MedProCare back in 2019 but apparently in the repositioning of the company since the buyback from Nokia in 2018, it was back-burnered. The new RPM will be based on an app that will:

  • track time for CMS-compliant billing reports and uploadable to the provider EHR
  • support billing for CMS codes 99453, 99454, 99457, 99458
  • a digital patient-facing assistant
  • full connectivity to Withings devices such as scales, blood pressure monitors, and sleep monitors
  • implementation support by their Health Solutions teams

Withings RPM page, Outsourcing-Pharma

Looking hard for an M&A that relates to us in this very quiet market, Lightbeam Health Solutions, a population health software company, is acquiring Jvion Inc. Jvion has AI-enabled prescriptive analytics and social determinants of health (SDoH) solutions which will be combined with Lightbeam’s health analytics and outcomes for payers and providers. Terms of the acquisition and leadership transitions were not disclosed. Lightbeam release

Wednesday news roundup: Oracle-Cerner reportedly OK’d by EU, VitalTech RPM raises $14.1 M, Aging 2.0 interoperability challenge, what do rough times mean for investors and startups, employees cause 39% of healthcare IT breaches

One regulatory hurdle down for Oracle’s $28 billion Cerner acquisition? The EU has reportedly given an unconditional EU antitrust clearance to Cerner, three sources informed Reuters. The formal announcement will be made 1 June. In the US, the long and winding road of Federal antitrust scrutiny and review began in February by the usual alphabet agencies–DOJ, FTC, and SEC–that show no sign of wrapping up [TTA 11 Feb]. Cerner continues to run into headwinds in its VA EHR implementation including spotty interoperability with the Military Health Service DOD version [TTA 18 May].

In a small confirmation that RPM is on the rise, Texas-based VitalTech raises $14.1 million in a Series B equity raise. The company offers an app-based remote patient monitoring platform for vital signs, med and nutritional reminders for use by home and hospital/acute care. Investors were not disclosed and the total offering has about $2.1 million remaining in unsold equity. Their undisclosed Series A funding dated back to 2019 and funded by Concord Health Partners and Stanley Ventures. SEC filing

The international Aging2.0 organization announced the Global Innovation Search (GIS), an opportunity for innovators around the world to showcase innovations that enable and promote a system-level approach to improving quality, continuity, and efficiency of care through interoperability. The eight finalists will participate in a Care Tech Pitch at OPTIMIZE, Aging 2.0’s annual conference on 21-22 September in Louisville, Kentucky. Applications close 12 June. The GIS is associated with the Louisville Healthcare CEO Council (LHCC) and will require the winner to relocate to Louisville. More information here.

What does this mess of a market mean for healthcare investors, startups, and companies looking for equity or VC investment? Industry figure Lisa Suennen, who has been to this rodeo before, has a POV in her Venture Valkyrie blog that HISTalk has summarized neatly, if not cheerfully. Major points: the downturn in funding will lag the market by 3-6 months, VCs will stuff the cash and wait for deals at lower valuations, few exits mean that portfolion companies will be burning through cash and dependent on existing investors, and there will be less-well-funded companies and funds which will go belly-up. This Editor’s disagreement is only that VCs lag downturns. In 2008, heading marketing in an early sensor-based monitoring company running out of funds, funding became scarce months ahead of the downturn.

39% of healthcare data breaches are caused by employees, according to Verizon’s latest cybersecurity Data Breach Investigations Report–more than any other industry at 18%. Incidents hit an all time high in healthcare, with 849 incidents and 571 breaches last year. 76% of breaches centered on basic web application attacks (attacks against a web-facing app–30%), system intrusions (malware, hacking–26%), and miscellaneous errors (mostly unintentional–21%).  Personal data was nearly 60% of the data compromised, while 46% was medical. Much more in the report. Healthcare Dive

Cerner EHR implementation with both DOD and VA running into interoperability, other problems: Federal audit

DOD, VA Cerner implementations stumbling on their raison d’être–interoperability. Those of us with pre-Covid memories recall that the Department of Defense and the Department of Veterans Affairs had separate and ancient EHRs that didn’t speak well with each other. Going back to the Federal FY 2008 National Defense Authorization Act (NDAA), both DOD and VA had to become interoperable. Thus Cerner became the one-stop-shopping solution for both, after attempting to modernize their warhorse systems (AHLTA and VistA, respectively). DOD went first in 2015 and rolled it out through the Military Health System (MHS). The VA awarded it in 2018 and started to roll it out in 2020. (No one said that the US government works quickly.) This would also include the US Coast Guard, which is under the Department of Homeland Security.

Earlier this month, a joint VA and DOD audit by their respective Inspectors General (IG) found that both departments, plus the FEHRM (Federal Electronic Health Record Modernization) Program Office established by DOD and VA to oversee the process, as well as the joint health information exchange (HIE) established in 2020 by the FEHR, did not ensure interoperability between their systems. Specifically, they did not:

  • Consistently migrate patient healthcare information from the legacy electronic health care systems into Cerner to create a single, complete patient EHR
  • Develop interfaces from all medical devices to Cerner Millennium so that patient healthcare information will automatically upload to the system from those devices
  • Ensure that users were granted access to Cerner Millennium for only the information needed to perform their duties

Most of the audit pointed responsibility at the FEHRM for not taking an active role in the program, instead acting as a facilitator. The IGs recommended a review by DOD and VA of FEHRM’s procedures, develop processes and procedures to ‘comply with its charter’ and the recommendations of the audit, as well as the NDAA.

VA’s problems with the first implementation at Mann-Grandstaff VA Medical Center in Spokane, Washington in late 2020 blew up embarrassingly last year before the Senate Veterans Affairs Committee [TTA 28 July 2021]. GAO further barked at them in a ‘watchdog’ report published in January. It followed VA’s own “mea culpa/go forth and sin no more” reorganization plan in December. Healthcare IT News, Healthcare Dive

Thursday roundup: UHG/Optum, Change extend merger deadline to 31 Dec, buys Kelsey-Seybold; $2B Tivity Health sale; General Dynamics enters derm AI diagnostics; MobileHelp PERS sold to Advocate Aurora

UnitedHealth Group’s Optum unit and Change Healthcare, to no one’s surprise, have cast the die and extended their merger deadline to 31 December. Originally, the acquisition was to be completed at end of 2021 and later pushed to 5 April.

In a joint release, they touted their shared vision for a “simpler, more intelligent and adaptive health system for patients, payers and providers”. Backing this up is a break fee of $650 million from Optum to Change Healthcare in the event the court scuppers the deal.

On 25 February, the US Department of Justice filed a lawsuit in US District Court in Washington, DC to stop the acquisition on anti-competitive grounds [TTA 25 Feb]. UHG/Optum and Change, despite divestitures, could not evade DOJ’s reasoning that Optum was buying its only major competitor in areas such as hospital claims data, claims processing, claims editing, and EDI clearinghouse, which facilitates the transfer of electronic transactions between payers and physicians, health care professionals, or facilities. Less than a month later, Optum and Change responded, contesting the charges in that same District Court, and contending that it would be ‘economic suicide’ for Optum to be anti-competitive, since Optum’s business model is dependent on payers other than UnitedHealth. Fighting rather than switching off the deal, it’ll be heard on 1 August [TTA 23 March]. FierceHealthPayer

As noted last week, Optum is writing big checks for LHC Group home care/management services and Refresh Mental Health. This week’s jumbo buy is the Kelsey-Seybold Clinic of Houston. This is a multi-faceted operation with multiple multi-specialty care centers, a cancer center, a women’s health center, two ambulatory surgery center locations, and a 30-location specialized sleep center. It also has a highly regarded ACO and KelseyCare Advantage, a 5 Star Medicare Advantage plan, in addition to partnering with insurers on commercial value-based health plans. If it closes, Optum will be more than likely well over its goal of owning or controlling over 5% of US providers. Terms were not disclosed, but TPG’s private equity arm made a minority investment in Kelsey-Seybold two years ago. At the time, the valuation was rumored to be $1.3 billion.

Tivity Health is being acquired by funds managed by Stone Point Capital for $2 billion. The $32.50 per share is a 20% premium to the 90-day price average, which reflects its 40% financial share growth in the past year. Having sold its original name of Healthways and a sizable chunk of its original business to the digital health conglomerate Sharecare, it rebranded in 2017 as Tivity and concentrated on fitness businesses: senior-targeted SilverSneakers, gym chain Prime Fitness, and alternative/complementary medicine WholeHealth Living. Closing is anticipated to be Q3. CEO Richard Ashworth will remain with the company, and headquarters stay in Franklin, TN. Release, Becker’s

A palate cleanser: a division of defense/aerospace giant General Dynamics, General Dynamics Information Technology (GDIT) has developed an AI diagnostic for remote dermatologic use for the active service/veteran market. It classifies images of skin lesions, determines if they are indicative of skin disease, and will recommend follow-up care. According to the GDIT release, “the GDIT skin lesion classifier tool won third place in the VA National AI Tech Sprint 2020-2021, a competition organized by the Department of Veterans Affairs (VA) National Artificial Intelligence Institute (NAII) to match private sector talent with veterans, VA clinicians and other experts to brainstorm AI-based solutions that can improve veteran health and well-being.” Also Healthcare IT News

MobileHelp, one of the earliest mobile PERS, and sister company Clear Arch Health, a remote patient monitoring provider, have been purchased by Advocate Aurora Enterprises. Terms were not disclosed, but management will remain in place in Boca Raton. MobileHelp was private, so estimates of valuation are difficult, but their private equity backing included ABRY Partners and Topmark Partners (Crunchbase). Their PERS market claimed 300,000 households. Clear Arch had a separate clinical base with provider care management of chronic condition patients connected to EHRs. For AAE, a division of Advocate Aurora Health systems in Illinois and Wisconsin, MobileHelp’s acquisition will complement their recently acquired home health provider Senior Helpers and Xhealth clinical digital solution ordering. The traditional PERS and call center business continues to be of interest, but blending into other businesses. Release, Healthcare IT News

The devil is in the (migrated) data: GAO watchdog barks at the VA’s transition from VistA to Cerner

The US Government Accountability Office (GAO) released their “watchdog” report on the Department of Veterans Affairs’ first, failed implementation at Spokane’s Mann-Grandstaff VA Medical Center in October 2020. Their 52-page whopper of a report came to a simple conclusion: the VA didn’t ensure the quality of the data migrating from the EHR warhorse VistA and their Corporate Data Warehouse to Cerner Millenium. Thus clinicians couldn’t use Cerner two ways–one was training in how to use it (as noted in VA’s own analysis) so they could not find the patient information they needed–and the fact that even if they knew how to use it, the data migration apparently was incomplete. The GAO found that the VA did not establish performance measures and goals for migrated data quality based on Federal guidance. The result was inevitable. According to the report, “clinicians experienced challenges with the quality of migrated data, including their accessibility, accuracy, and appropriateness.” 

There is also a method called a stakeholder register which helps to identify and engage all key stakeholders. VA did not use this, so some areas were overlooked in the continuity of reporting and preservation of records. This affects not only patient records, but also scheduling.

The main takeaway is that GAO recommends to VA that they establish performance measures and goals that ensure the quality of migrated data and use a stakeholder register managed by the VA’s deputy secretary to engage all the relevant stakeholders in the migration in reporting needs. VA published its own analysis of its implementation and rollout failures in December. Healthcare IT News

News, deals, rumors roundup: Cerner’s DOD and VA go-lives, Akili’s ADHD therapy SPACs, Talkiatry’s $37M raise, Alto sings a $200M supper–and the Cigna-Centene rumors don’t stop

While Cerner’s acquisition by Oracle is winding its way through regulatory approvals, their EHR implementations are moving forward through both the Military Health System (Department of Defense) and the Department of Veterans Affairs (VA).

  • Within the MHS, Brooke Army Medical Center and Wilford Hall Ambulatory Surgical Center, both in the San Antonio (Texas) Market, went live with MHS GENESIS on 22 January. The change most visible to patients is the transition from TRICARE Online to the MHS GENESIS Patient Portal which enables 24/7 access for visit notes, secure messaging, test results, appointment scheduling, and online prescription renewal. MHS covers military retirees, active military, and family beneficiaries. According to the MHS’s website, the goal this year is to get to halfway–to implement MHS GENESIS in more than half of all military hospitals and clinics. It’s been taking place since 2017 and, in true military fashion, it’s planned in waves. Coming up are Naval Medical Center Camp Lejeune in South Carolina on 19 March and William Beaumont Army Medical Center in El Paso in summer.
  • VA is moving far more slowly, just getting to its second hospital. The Columbus VA go-live has been pushed back from 5 March to 30 April, citing training slowdowns due to a spike in staff COVID cases. Walla Walla, Washington is set for after Columbus, but the date is to be confirmed. The first, failed implementation at Spokane’s Mann-Grandstaff VA Medical Center in late 2020 was the subject of Federal hearings and a complete redo in VA’s plans and procedures in cutting over from VistA to Cerner Millenium. TTA 28 July and previous. Federal News Network

Akili Interactive, which has developed tech-driven, game-based cognitive therapies for ADHD and other psychiatric and neurological conditions, has gone public through a SPAC via a merger with Social Capital Suvretta Holdings Corp. I, The transaction is expected to close in mid-2022. Akili will be listed on the Nasdaq stock market under the new ticker symbol AKLI.

The SPAC is expected to provide up to $412 million in gross cash proceeds and value the company at over $1 billion. Investors in the $162 million PIPE are Suvretta Capital Management’s Averill strategy, Apeiron Investment Group, Temasek, co-founder PureTech Health, Polaris Partners, Evidity Health Capital, JAZZ Venture Partners, and Omidyar Technology Ventures. The funds raised will support the commercial debut of EndeavorRx, a FDA-cleared and CE-marked prescription digital therapeutic for pediatric ADHD. The technology is termed the Selective Stimulus Management Engine (SSME) and will be rolled out for ADHD, ASD, MS, and MDD treatment.

TTA noted Akili last year in a trial of AKL-T01 at several hospitals for treatment of long-COVID-related cognition problems. Unfortunately, the writing in their SPAC release made this Editor feel like she needed a few treatments.

Mentalhealthtech (psychtech?) continues to attract funding. Psychiatric care startup Talkiatry topped off its July $20 million raise with an additional $17 million from Left Lane Capital for a $37 million Series A financing round. CityMD founder Dr. Richard Park, Sikwoo Capital Partners, and Relevance Ventures also participated. Talkiatry uses an online assessment for a preliminary diagnosis and then matches you with a participating psychiatrist.  It is in-network with payers such as Cigna, Aetna, UnitedHealthcare (Oxford Health Plan), Oscar, and Humana. Funding will be used to expand beyond NYC. Mobihealthnews

Digital pharmacy is also hot. Alto, which promises same-day filling and courier delivery, raised a $200 million Series E led by Softbank Vision Fund. Their total to date is over $550 million. Alto serves selected areas mainly in California, Nevada, Texas, and NYC (Manhattan, Queens, Brooklyn). Competitors Capsule had another raise of $300 million in April for a total of $570 million and Medly raised a $100 million Series B in 2020. Mobihealthnews

In the wake turbulence of Centene’s dramatic management shakeup last month [TTA 18 Dec], rumors continue to surface that insurer Cigna is interested in acquiring all, or possibly part, of Centene. Bloomberg News in publishing its article earlier this week cited ‘people familiar with the matter’ said that talks took place last year, but that they are not ongoing. Seeking Alpha picked this up, adding market activity boosting Centene. Perhaps the disclosure and the ‘denials’ align with what this Editor has heard–that it’s very much ongoing but under wraps.

A Centene buy makes sense, but only with Cigna. While Cigna is almost double the market value of Centene, it does not have the sprawling business model the latter has, nor do their businesses overlap much. However, some divestiture would be needed to do a deal, given the constrained regulatory environment in the US on the Federal and state levels. Any insurer merger is seen as anti-competitive, unless it is an acquisition of a smaller, struggling plan. 

It certainly would vault Cigna into the top rank of insurers with non-Centene branded exchange, Medicare Advantage and Medicaid plans, a provider network, an established MSO, and other lines of business including Magellan behavioral health management. Cigna might also value Centene’s international holdings, such as private hospitals Circle Health in the UK and Ribera in Spain. A sale would also create a quick and profitable ROI for Politan Capital Management, the activist investor company that initiated the retirement of 25 year CEO Michael Neidorff last month, rather than managing and reorganizing the sprawl of Centene’s businesses to make it more profitable.

Oracle in negotiations to buy Cerner for $30B (sold!)

2021 may go out with a bang! The Wall Street Journal (paywalled) reported late Thursday that software colossus Oracle was in discussions with EHR giant Cerner to buy it, lock stock dropdown menus and workflows. And soon, according to the WSJ‘s sources. The reported amount is $30 billion.

It would be Oracle’s most expensive purchase ever, much more than PeopleSoft (HR) in 2005 and NetSuite in 2016. Given their valuations, Cerner is a snack at $23 billion for Oracle at $280 billion. But Cerner gives Oracle four-star entree to healthcare and practice systems. Oracle has long seen healthcare as a growth area for cloud computing services targeted to payers, hospitals, and health systems, and has clients like Cleveland Clinic and Kaiser. Back in June 2020, they launched a cloud service collecting clinical data from sensors, patient apps, EHRs, and labs supporting therapy development. 

As our Readers know, David Feinberg, MD left Google Health to join Cerner as president and CEO on 1 October [TTA 21 August] in a $34.5 million compensation package [TTA 24 August]. An acquisition by Oracle, in such a short time, can be interpreted as either a coup he engineered for the shareholders (and for his benefit, as change of control usually vests the package!), or he can be viewed as a placeholder for the top spot on a previously moving deal. Both are mature companies. While Cerner has been losing market share to Epic and has had many woes with its $18 billion VA Cerner Millenium implementation [TTA 3 Dec, 28 July], it also generates $1 billion per year in free cash flow and Oracle can institute operational efficiencies to increase profit margins. In the view of some, Oracle is returning to an aggressive market strategy that most felt it left behind.

Oracle shareholders didn’t like it much today, with shares declining over 6% on Friday to $96.67. But Cerner’s liked it a lot, increasing price nearly 13% to $89.77. Kansas City-based Cerner also had 150 layoffs in November in its 28,000 employee staff. Oracle recently relocated from California to Austin, Texas, shrinking its office footprint. Seeking Alpha 17 Dec, 17 Dec AM; Kansas City Star, Becker’s HealthIT

Updated–see our short article on the sale for $28.3 billion here.

News and deal roundup: Best Buy’s $400M for Current, VA’s Cerner restart 2022, CVS-Microsoft product deal, and Athenahealth (finally) sold for $17B

Whew! Best Buy revealed on its quarterly earnings call that they paid $400 million for Edinburgh/Boston-based RPM developer Current Health [TTA 13 Oct]. It’s near the end of the call transcript published on the Motley Fool. There will be no impact on their financial performance this year and will have a slightly negative impact on the Q4 non-GAAP operating income. Hat tip to HISTalk

Also today in HISTalk is a nifty summary of the Department of Veterans Affairs (VA) Cerner implementation timing and restaffing. There’s a graphic on the 2022-23 (FY 2022-24) rollout plus the new organization. VA has appointed a new Program Executive Director, Terry Adirim, MD, MPH, MBA, moving from Acting Assistant Secretary of Defense for Health Affairs, and established a new EHR Integration Council. VA release. VA also published a 10 page analysis on what went wrong with the initial tests and lessons learned, such as creating an EHR ‘sandbox’ for clinician training.

CVS Health and Microsoft continue with a new partnership, this time for digital health products. The five-year deal will include development in two areas: personalizing health recommendations that direct consumers to when and where they need a CVS, and operationally to leverage technology and machine learning for automation to reduce waste. Microsoft release, Healthcare Dive, HealthcareFinanceNews

And in the biggest non-surprise of the past few days, Athenahealth’s (or as they prefer, athenahealth) sale closed before the end of the year in a deal valued at $17 billion. The buyers were, as expected [TTA 19 Nov], Bain Capital and Hellman & Friedman, along with Singapore’s sovereign wealth fund GIC and a wholly-owned subsidiary of the Abu Dhabi Investment Authority. The 24 year-old Athenahealth, one of the EHR pioneers, was acquired by Elliot Investment Management’s PE arm Veritas and Evergreen Coast Capital in 2019 for about $5.7 billion. Its base is down to about 140,000 ambulatory care providers, having exited the small hospital market some time back. In the EHR market dominated by Epic and Cerner, surely Veritas and Evergreen are relieved to be at least getting some cash back. But there’s Misery Sharing, as they are both retaining a minority investment. (A small hint from a marketer–never lower-case the first letter in any part of your name. You make yourself unimportant and it hasn’t been ‘modern’ for a loooong time. It wasn’t lucky for British Airways, either. Perhaps the new majority owners will get this.)  Healthcare Dive, Business Wire