Nov 10, 2022

Plus: Paramus hospital opens eating disorder treatment center Crain's 40 Under 40: Daniel Brillman, co-founder and CEO, Unite Us A software platform that some hospitals and health systems use to log procedures and prepare for inspections had a vulnerability that allowed users to backdate their signoffs and sign in as other users, experts say, potentially enabling them to shirk compliance requirements. A demonstration video of the platform, sent by communications firm The November Team partner Bill O’Reilly and reviewed by Crain’s, showed that as of Jan. 22, 2021, Georgia-based software company MediaLab allowed users to override timestamps of when they signed off on policies and procedures and merge user profiles, and allowed administrators to view other users’ passwords in plain text. Hospitals use software like MediaLab to keep track of policy and procedure documents, such as Covid-19 inspection protocols. Employees use the software to sign documents attesting that they read and understood policies or completed inspection checklists. In a typical software system, the platform timestamps actions. Protocol documents can be used to bolster hospitals’ defenses if patients sue for malpractice. By allowing users to change when they signed off on documents or act as other users, O’Reilly said, MediaLab’s software allowed users to potentially erase evidence. (MediaLab software is not used for electronic medical records or other patient information.) “The main idea of quality management software is to have data accountability there so if something goes wrong, there’s a record of exactly what happened,” O’Reilly, who first noticed issues with the platform right before the pandemic started, said. “If there’s a malpractice case out there, the first thing the malpractice lawyers do is subpoena the quality management records.” A project coordinator at a health system, who asked not to be identified because of retaliation concerns, said their system did not choose MediaLab for its document control because of those vulnerabilities. They described situations in which, based on demonstrations they saw, the software also would not require employees to take quizzes on protocols or policies. “In a hard and fast document control system, there’s no going back,” they said. “There’s transparency if there’s anything missed or mistakes. There’s less opportunity to cover a breach in policy or procedure.” MediaLab’s current software seems to have addressed the vulnerabilities shown in the demo from 2021. MediaLab chief operating officer Tim Westover showed Crain’s a live demonstration of the software on Nov. 9, which illustrated that administrators cannot see other users’ plain-text passwords and users cannot manually date when they sign documents. Users can still merge profiles, which Westover said is most commonly used to delete duplicate user accounts. “MediaLab adheres to the strictest development and security standards, and we make continuous, routine improvements to our system to ensure the fidelity of recordkeeping for our customer,” Westover said. “Any suggestions that our software has security vulnerabilities are unfounded and an unnecessary distraction from our mission.” Such concerns are part of a larger conversation about document control software security, which remains largely unregulated in New York, according to former state senator David Carlucci. “If you’re going to use highly sensitive data, if you’re going to go back and make a correction, there should be proof of that, and that’s just common knowledge,” he said. “If you have software programs out there that manipulate that–being able to see users’ passwords or go back and change documents without timestamps in that program…there’s no real laws or regulations dictating that for some of our most sensitive information. There’s a big loophole…the laws around this are like the Wild West.” Carlucci attempted to patch these holes during his political tenure, when he served as chair of the Consumer Protection Committee and worked on the Shield Act for data privacy. During the 2019-2020 legislative session Carlucci introduced a bill that would ensure “no medical records software or quality software management systems shall permit the altering or backdating of information without established permissions.” The bill has not been re-introduced since Carlucci left office, he said. He now runs a private consulting practice. Westover would not share details about MediaLab’s New York customer base, but the company’s website reports that 4,250 companies—including hospitals, laboratories and health systems—use the software. —Jacqueline Neber Oscar Health reports another large loss as stock hits new low Oscar Health shares hit a new low Wednesday after the insurer warned losses would continue to widen even as membership grows. “We see strong signs of progress,” Chief Executive Mario Schlosser said on a conference call after third-quarter earnings were released late Tuesday. “We have confidence in the future.” Investors, however, seemed to put more weight on the fact the company expects to remain unprofitable for at least another year and that adjusted losses for 2022 will come in somewhat higher than Oscar expected. Oscar’s stock fell by 24% Wednesday, to $2.35 a share. The Tribeca-based company, which bills itself as a tech-forward insurer, has lost more than 90% of its value since going public last year. The insurance sector is particularly challenging for startups because large incumbents have more bargaining power with health-care providers and regulatory costs are high. Lemonade , a SoHo-based property insurer that also markets itself as an “insuretech,” has also lost about 90% of its equity value. Oscar, which targets the individual and smaller group plan markets, said membership nearly doubled last quarter, to 1.1 million. It has stepped back from offering Medicare Advantage, the privately administered Medicare plans that are delivering significant new customers to rivals. The insurer’s client base seems sicker than most and a lofty 90% of each dollar collected in premiums goes to pay medical claims. Combined with the firm’s 21% administrative overhead ratio, Oscar has $1.11 in expenses for every dollar coming in. Oscar officials said they’ve repriced policies and predicted the firm would turn profitable in 2024, a year earlier than forecast. To that end, Oscar’s chief financial officer was given the new role of chief transformation officer and tasked with aligning costs and revenues. A board member and former CFO was named interim CFO. The company posted a quarterly net loss of $193 million, a bit less than the year-earlier period’s $211 million loss. Oscar said that operating losses on an adjusted basis would come in “modestly above” the previous estimate of up to $480 million. The company has about $3 billion in cash, equivalents and short-term investments. That cushion is important because unprofitable companies pay punitive rates to raise cash these days. —Aaron Elstein Paramus hospital opens eating disorder treatment center  Bergen New Bridge Medical Center, a safety net hospital in Paramus, New Jersey, has opened a 2,000-square-foot center for eating disorder treatment that will serve between 200 and 250 patients each year. Hospital leadership decided to create the center after noticing that the prevalence of eating disorders among patients in the community had grown since the pandemic, said Deborah Visconi, chief executive of Bergen New Bridge. “Eating disorders are a significant mental health condition that have been stigmatized,” she said. “Being [the leader of] the largest hospital in the state of New Jersey and a safety net hospital, I have a sense of responsibility to respond to those health care needs.” The hospital, of more than 1 million square feet, carved out existing space for the center by relocating offices and practice areas, she said. Psychiatrists, therapists, nutrition counselors, social workers, doctors and registered nurses will be on staff to help patients, Visconi said, because eating disorders affect blood pressure, heart health and gastrointestinal health, in addition to psychology. The build-out cost $150,000, said Donnalee Corrieri, the hospital’s chief communications and marketing officer. The center, which opened Nov. 3, accepts public and private insurance, Medicare and Medicaid, and it works with uninsured patients. Bergen New Bridge sees more than 100,000 patients per year, Visconi said, and operates behavioral health and substance use detox divisions as well as a mobile outreach initiative for community members. The hospital is a clinical affiliate of Rutgers. Care Plus Bergen Inc., the not-for-profit operator of the hospital, reported about $267 million in revenue in 2021. —J.N. Crain's 40 Under 40: Daniel Brillman, co-founder and CEO, Unite Us Dan Brillman’s service in the Air Force took him as far as Iraq and Afghanistan, and it led him to his current perch as chief executive of tech startup Unite Us. Brillman transitioned in 2010 from pilot to MBA student at Columbia Business School, where he bonded with fellow veterans. They confided in him about struggles to find housing, employment and health insurance after leaving the military. “You get a discharge, and you’re on your own,” he said. “You don’t really have a support system around you.” Those conversations inspired Brillman to write a paper for class about integrating health and social services. He teamed up with Taylor Justice, a fellow student and veteran, and they started a company in 2013 to bring the coordinated-care model to life. Unite Us, which is based in Tribeca, initially focused on connecting veterans to services. Six years in, the platform boasted thousands of organizations, many of which served other populations too. Unite Us started to branch out, adding hospitals and insurance companies to the mix. The startup recently has used its technology to ink partnerships with states, including North Carolina, to build platforms that connect providers, insurers, community-based organizations and patients to local resources. Today Unite Us manages more than 18 million people and offers connections to more than 725,000 services across 44 states. Brillman said his next move is predictive analytics, which could make the platform into one that also predicts what care someone will require before they need it. —M.K. Loading… AT A GLANCE COVID STUDY: A study led by researchers at the NYU Grossman School of Medicine shows that adult patients with “major life stressors” such as the death of a loved one, food insecurity, or a newly-developed disability were at least twice as likely to have symptoms of long Covid such as depression, brain fog, fatigue and sleep problems than people without stressors. Gender was also a contributor to which patients experienced long Covid; women are more likely to have autoimmune and other diseases that make for worse Covid outcomes, the study found. IMPROVED OUTCOMES: The American College of Surgeons’ National Surgical Quality Improvement Program has recognized Mount Sinai Beth Israel for its improved surgical patient care outcomes, the hospital reports. The program evaluates hospitals based on surgery outcome data to see how mortality, cardiac arrest, pneumonia, unplanned intubation, ventilator use, renal failure, surgical site infection and urinary tract infection rates fluctuate over time. RETURN TO OFFICE: Pfizer will require employees to  come into the office  two to three days per week beginning in January, chief executive Albert Boula announced Tuesday. The company reports that about a third of employees have still not been back in the office. WHO'S NEWS: The "Who's News" portion of "At a Glance" is available online at  this link  and in the Health Pulse newsletter. "Who's News" is a daily update of career transitions in the local health care industry. 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