Zotec Partners Radiology Digest | September 18

September 18, 2020

Microsoft Partners with Nuance on ‘Ambient Clinical Intelligence’ for Telehealth
By Dave Pearson | September 15, 2020
Providers seeing patients remotely via Microsoft Teams make up the target market for a Nuance voice-recognition offering that automatically takes clinical notes during virtual visits and renders them useful immediately afterward.

In a Sept. 15 joint announcement, the companies position the integration of Nuance’s DAX (for Dragon Ambient eXperience) into Teams as a way to better serve both patients and clinicians.
The system counters physician burnout by cutting administrative burden and increasing efficiency while improving patient throughput, the companies claim.

AI enters the picture in the form of “ambient clinical intelligence” (ACI), which converts the conversation into structured clinical notes and sends them for quality review before loading them into the EHR.

A promotional video embedded in the announcement shows a physician speaking a command for a third party while his patient looks on. “Hey Dragon,” the doctor says, “order the medications as mentioned and send them to the pharmacy.”

On the patient service side, the system makes sure the provider doesn’t misunderstand, forget or otherwise fumble clinically relevant comments.

Diana Nole, Nuance’s executive VP and general manager of healthcare for Nuance, says the broad expansion of telehealth during the COVID crisis has opened an opportunity to “transform healthcare experiences and define what healthcare providers and consumers should expect from advanced digital health solutions.”
To read more, go to AI in Healthcare.

Pelosi: House to Stay in Session Until COVID-19 Rescue Pact
By The Associated Press | September 15, 2020
Speaker Nancy Pelosi said Tuesday the House will remain in session until lawmakers deliver another round of COVID-19 relief, a move that came as Democrats from swing districts signaled discontent with a standoff that could force them to face voters without delivering more aid.

“We are committed to staying here until we have an agreement, an agreement that meets the needs of the American people,” Pelosi said on CNBC.

Pelosi told her Democratic colleagues on a morning conference call that “we have to stay here until we have a bill.” That’s according to a Democratic aide speaking on condition of anonymity but authorized to quote her remarks.

Pelosi’s comments came as moderate Democrats, many from areas won by President Donald Trump four years ago, signed on to a $1.5 trillion rescue package endorsed by the bipartisan Problem Solvers Caucus, a group of about 50 lawmakers who seek common solutions to issues.

The plan contains many elements of COVID rescue packages devised by both House Democrats and Republicans controlling the Senate, including aid to schools, funding for state and local governments, and renewal of lapsed COVID-related jobless benefits.

The price tag is significantly less than the $2.2 trillion figure cited by Pelosi but it’s also well above an approximately $650 billion Senate GOP plan that failed last week due to Democratic opposition.

Talks between Pelosi and the Trump administration broke down last month and there had been little optimism they would rekindle before Election Day. And last week, Senate Democrats scuttled a scaled-back GOP coronavirus rescue package.

Pelosi has maintained a hard line in negotiations and has been at odds with White House chief of staff Mark Meadows. She orchestrated passage of a $3.4 trillion COVID rescue package back in May, but the effort was immediately dismissed by Senate Republicans and the Trump administration.

Tuesday’s remarks, said Pelosi spokesman Drew Hammill, don’t mean that the speaker is adopting a more flexible position. She instead seems to be signaling continued determination to press ahead and won’t adjourn the House without an agreement with the administration.

Success is by no means guaranteed and many people on Capitol Hill remain very skeptical that an agreement between the White House and Democrats is likely before the election.
To read more, go to Modern Healthcare.

Fitch Says Cares Act Payback Won’t be a Problem for Not-for-Profit Hospitals
By John Commins | September 15, 2020
The looming repayment of billions of dollars in federal pandemic emergency loans is not expected to “materially affect” the finances of not-for-profit healthcare providers, Fitch Ratings says.

The money, essentially six months of advanced payments under the Medicare Accelerated and Advance Payment Programs, is part of the massive $2.2 trillion Coronavirus Aid, Relief, and Economic Security (CARES) Act, a stopgap for hospitals that saw nonemergency procedures and services grind to a halt this spring because of the pandemic.

“Providers’ ratings are supported by ample liquidity and Fitch’s expectations are for a long-term volume recovery due to the essential nature of services,” the bond rating agency said in a brief Tuesday.

“Liquidity will gradually decline as advances are repaid but full and timely repayment is part of our rating assumptions for all issuers and we anticipate most providers will ultimately
maintain liquidity profiles consistent with current rating levels based on our expectations for continued volume recovery in the hospital sector,” Fitch said.

The Medicare payment advances under the AAP account for about 10% of unrestricted liquidity for some hospitals, Fitch said, “although this increases to almost 30% for some issuers with lower levels of liquidity.

“In terms of total revenues, funds under the AAP range from a low of around 5% of total revenues to around 15%, depending on a hospital’s commensurate amount of Medicare revenue,” Fitch said.

The pandemic shut down nonessential care delivery in most parts of the United States, robbing hospitals of revenue from money-making elective procedures and shredding patient volumes to ration personal protective equipment and prepare for a surge of COVID-19 patients.

The American Hospital Association estimates that hospitals will lose about $323 billion in 2020 because of the pandemic.
To read more, go to Health Leaders Media.

Medicare Shared Savings Program Saved a Record $1.19B in 2019
By Jacqueline LaPointe | September 15, 2020
Medicare Shared Savings Program (MSSP) generated $1.19 billion in total net savings to Medicare in 2019, representing the third consecutive year for net program savings and the largest annual savings for the program to date, CMS Administrator Seema Verma recently reported.

In a Health Affairs blog post yesterday, Administrator Verma shared the results from the MSSP’s 2019 performance year. It was the first year accountable care organizations (ACOs) in the program could participate under new tracks through Pathways to Success.

In 2019, MSSP ACOs had the option of joining a new Pathways to Success track starting in July or continuing in one of the existing participation or “legacy” tracks. In total, 541 ACOs participated in the program during the performance year.

But ACOs in the Pathways to Success tracks performed better than their counterparts in legacy tracks, according to Verma.

ACOs under Pathways to Success options generated net per-beneficiary savings of $169 per beneficiary versus $106 per beneficiary for legacy track ACOs.

Even new entrants to the MSSP that joined through a Pathways to Success track saved (net per-beneficiary savings of $150) despite the long-standing record of first-time ACOs not achieving savings in their first performance year, Verma highlighted.

Rural ACOs, which have also had a rocky past with program savings, improved their performance under Pathways to Success, she reported.

Urban ACOs and rural ACOs participating in the new tracks generated $170 net per-beneficiary savings and $158 net per-beneficiary savings, respectively, while among all the
MSSP ACOs in 2019, urban ACOs generated $125 net per-beneficiary savings and rural ACOs generated $64 net per-beneficiary savings.

Additionally, Verma reported that ACOs that took on downside financial risk under both participation options in 2019 saved more per beneficiary than those that remained in upside-only tracks ($152 per beneficiary compared to $107 per beneficiary). Physician-led ACOs also continued to outperform their hospital-led counterparts as demonstrated by low-revenue ACOs producing net per-beneficiary savings of $201 per beneficiary compared to $80 per beneficiary among high-revenue ACOs.
To read more, go to Revcycle Intelligence.

Medical Imaging Turns to Teleradiology to Handle COVID-19 Outbreak
By Joe Constance | September 14, 2020
Teleradiology has always been a vital technology in the world of radiology. But the COVID-19 pandemic has sparked a boom in remote reading as radiology departments and imaging centers turn to teleradiology to keep their operations flowing smoothly in an era of social distancing.

There are signs this boom may continue for some time, particularly as a rebound in radiology volume appears to be on the immediate horizon. And even after the COVID-19 pandemic fades, radiologists and administrators may make permanent their embrace of remote reading, thanks to the many benefits that teleradiology confers.

Harnessing teleradiology
Teleradiology first came into common use in the 1990s with the adoption of the DICOM 3.0 image standard and higher-bandwidth internet connections. Initially developed to allow radiologists to read from home while on call, it soon contributed to an explosion of teleradiology providers that offer after-hours coverage and subspecialty expertise to healthcare providers. But during normal working hours, most hospitals and imaging centers continued to rely on the traditional model of radiologists interpreting images from centralized reading rooms onsite.

That began changing when the COVID-19 pandemic arrived in the U.S. in March 2020. Many institutions shut or reduced staffing in their radiology reading rooms to keep both patients and radiologists safe. They harnessed teleradiology as an internal social distancing tool to protect vulnerable radiologists and hospital workers, while simultaneously assuring seamless radiologic interpretation capabilities.

A small survey of radiologists published in July in the Journal of the American College of Radiology (JACR) reveals the trend. It shows that the majority of radiology practices surveyed have leveraged internal teleradiology for normal workday shifts and found sufficient benefit to potentially continue internal teleradiology services after the pandemic passes.
To read more, go to Aunt Minnie.

Google Donates $8.5M to Fund Coronavirus AI, Analytics Projects
By Jessica Kim Cohen | September 10, 2020
Google.org, Google’s philanthropy arm, has donated a collective $8.5 million in grants to support 31 organizations’ COVID-19 response efforts, the tech giant said Thursday.

It’s part of a $100 million commitment to COVID-19 relief that Google.org announced in May.

The latest $8.5 million in funding goes to projects at academic institutions and not-for-profits that apply artificial intelligence and data analytics to better understand four areas related to COVID-19: monitoring the spread of the disease, addressing health equity and secondary effects of the disease, slowing transmission, and supporting healthcare workers.

That includes projects like Beth Israel Deaconess Medical Center’s research into COVID-19’s effect on patients seeking routine and preventive care; Florida A&M University and Shaw University’s research on how COVID-19 has affected racial minorities; and University College London’s work to model COVID-19’s spread using aggregated search trends data.
Google.org did not share the funding amount each of the 31 organizations received.

“COVID-19 has had a disproportionate effect on vulnerable populations,” wrote Mollie Javerbaum, program manager at Google.org, and Meghan Houghton, university relations program manager at Google Research, in a blog post Thursday. “We’re supporting efforts to map the social and environmental drivers of COVID-19 impact.”

One of the projects Google.org highlighted in its latest announcement, an effort to develop a COVID-19 health equity map of the U.S., was initially awarded in May.

Google.org had awarded the Satcher Health Leadership Institute at Morehouse School of Medicine a $1 million grant to create a database with information about COVID-19 cases, hospitalizations and deaths as part of that project, with an option to drill down into those cases by race, ethnicity, gender, socioeconomic status and other demographic factors.

The project aims to understand why black and Latino populations have been disproportionately affected by COVID-19, so that policymakers can better target resources to those populations.

A team of Google engineers has been working on the project as part of a fellowship program at Google that lets employees work on pro bono projects full-time for up to six months.

Google has made numerous moves into the healthcare market in recent years, many of which have entangled the company in controversies related to privacy and concerns over data access.
To read more, go to Modern Healthcare.