study design

This study is a secondary qualitative analysis of responses from a nationwide online survey of medical students and practicing clinicians conducted between December 2020 and February 2021 during the development and evaluation of the P5RJ curriculum. Participation was voluntary and written informed consent was obtained from all participants. There was no incentive to complete the survey. The study was approved by the Stanford School of Medicine IRB.

Survey development and distribution

The P5RJ curriculum and survey is based on the Presence 5 Framework for Humanism in Medicine and was developed by the Presence 5 for Racial Justice research team (including all authors) at Stanford University School of Medicine. The original Presence 5 framework was developed through a systematic literature review, patient and clinician interviews, and a Delphi panel. This framework was used to develop an anti-racism curriculum for medical education, the P5RJ curriculum, which aims to teach medical students evidence-based anti-racism communication strategies to promote health equity for black patients. The P5RJ curriculum was developed through literature review, online Qualtrics feedback survey, and structured feedback synthesis by the research team. The feedback survey surveyed clinicians and medical trainees with DEI experience including health inequalities, health equity, anti-racism, medical education and racial justice. Respondents were recruited through convenience sampling and email listservs (N=52) from clinicians and medical trainees with experience in DEI; These listservs contained chapters of national medical school diversity organizations (e.g., White Coats for Black Lives, American Medical Students Association, Student National Medical Association). In addition, the survey was distributed to individual professional contacts (N=123) involved in DEI efforts and medical education. Participation in the survey was limited to medical trainees and clinicians. The P5RJ curriculum has been implemented in various medical education settings, including local academic institutions and national conferences, and participants were unfamiliar with this curriculum.

The survey questions included feedback on the P5RJ strategies, examples and suggestions for additional recommended language/phrases to be used for communicating against racism in the clinical encounter. Survey participants were provided with the titles and descriptions of each of the P5RJ strategies: (1) Prepare Consciously, (2) Listen Carefully and Fully, (3) Agree What Matters Most, ( 4) Connect to the patient’s story, and (5) Explore emotional cues. Participants were asked to record free-text style responses with specific phrases or actions that they use directly in their communication with patients as they clearly relate to the given definition of each strategy, e.g. B. “What specific phrases or sample language do you use with patients? for this practice (preparation on purpose)?” Respondents could submit more than one answer per question, and each question was optional. Respondents were also asked about demographics, role/level of clinical practice, and DEI involvement.

secondary analysis

We performed a secondary analysis of survey participants’ qualitative feedback, focusing on specific phrases/languages ​​and actions used for each of the P5RJ strategies using inductive qualitative analysis [7]. To develop the codebook, authors BK and RG (medical students and medical students at the time of the study) derived key terms from previous research on anti-racism communication [8] can be found in the survey responses. We then conducted a literature search in PubMed on these terms such as “empathetic statement”, “allyship” and “self-accountability”. We developed codebook definitions by snowball sampling from relevant articles in the initial literature search. The codebook was validated by JC, DZ and MS (a qualitative researcher, physician-scientist and physician-educator) through independent review and group discussion. Authors BK and RG independently and manually coded all responses using Microsoft Excel, and then discussed the coding of each response until thematic saturation was achieved according to definitions from the literature. All answers were coded with one or more of the four codes.

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Published: February 28, 2023 at 4:11 pm ET

Hello market watchers. Don’t miss these top stories.

What’s Worth Streaming in March 2023: Succession, Ted Lasso, The Mandalorian, and more

Some of the year’s best shows are about to close, so it may be worth checking out an extra streaming service or two. Continue reading

‘Mortgage financing remains a headwind for home prices’: Home price growth slows in December, with San Francisco leading the way

The…

Hello market watchers. Don’t miss these top stories.

What’s Worth Streaming in March 2023: Succession, Ted Lasso, The Mandalorian, and more

Some of the year’s best shows are about to close, so it may be worth checking out an extra streaming service or two. Continue reading

‘Mortgage financing remains a headwind for home prices’: Home price growth slows in December, with San Francisco leading the way

Case-Shiller’s 20-city home price index fell 0.5% in December from the previous month. Continue reading

The key to expanding your family budget could be in your methods: try these ideas to save more

With inflation taking a toll on household budgets, many families are trying to incorporate savings into their daily lives. Here are some tips that actually work. Continue reading

The stylish 2023 Audi e-tron is all Audi-ness inspired

The all-electric 2023 Audi e-tron luxury mid-size SUV offers all the usual upscale Audi attributes while reducing vehicle emissions to zero. Continue reading

My ex-partner “demanded” that I pay 50% of our daughter’s medical expenses. He earns three times my salary. is that fair

“When there’s a big pay gap – are 50% of the expenses for dinner, mortgages, medical bills, vacations, utilities and other common expenses justified?” Read more

I am a widow and want to move from Chicago to a warmer climate. But most of the houses I’ve found need a lot of work. Are there disadvantages when buying a new house?

“I’m thinking about downsizing to a three bedroom ranch and moving somewhere warmer. I also hope to sell my house and list it at $265,000.’ Continue reading

Warren Buffett wants you to visualize Berkshire Hathaway’s tax bill. Get out your binoculars.

“At Berkshire, we hope and expect to pay a lot more taxes over the next decade,” Buffett said in his annual letter to shareholders. Continue reading

Forget “silent stop”. Some workers are now embracing the “minimum Monday”.

The latest office trend calls for a relaxed start to the working week. Continue reading

The post House-price development slows in December, with San Francisco main the best way and my ex-partner ‘demanded’ that I pay 50% of our daughter’s medical bills. He earns 3 occasions my wage. Is that honest? appeared first on DAILY SAN FRANCISCO BAY NEWS.

By Belis Sly and Trish Donnelly

Pan-Med Enterprises, located in the prestigious Pacific Professional Building in San Francisco, has been serving the health needs of the Bay Area since 1984. Although the building was considered state-of-the-art when it first opened, it had not been updated since then.

Pan-Med’s Tony Najera checks out the newly installed HVAC controls.

Tony Najera, a veteran Pan-Med engineer and recently appointed Building Manager, recognized there was an opportunity to bring his building into the 21st century with modern, energy-efficient equipment updates. As soon as he took charge of the building’s energy management, Najera rolled out a complete overhaul project focused on achieving the company’s long-term energy goals while increasing occupant and patient comfort.

“When my board asked me about my 5-year energy savings plan, I told them we can get it done in 2 years with the help of PG&E,” said Najera.

(Hear more in this video about how Pan-Med Enterprises worked with PG&E to help save both energy and money.)

Due to the building’s expansive footprint, financing a complete energy overhaul out-of-pocket would not be feasible. Working closely with his PG&E account manager and energy solutions company, Gridium, Najera quickly put together a plan that outlined $2.6M worth of equipment upgrades to maximize energy and money savings. This planning enabled Pan-Med Enterprises to retrofit the whole building with PG&E’s 0% interest On-Bill Financing Program, and pay for the total project cost with monthly energy savings and no out-of-pocket costs.

Once the project plan was complete and the On-Bill Financing loan was approved, PG&E trade pro partner Gridium worked with design and construction partner NuWave Energy Solutions to install LED lighting, variable frequency drives, HVAC controls, and a smart building automation system to monitor and manage it all. All the work was done while the building was occupied, with no effect on Pan-Med’s operations.

Since completion, Pan-Med is saving 30% of electricity usage and 60% of gas usage, bringing in $270,000/994,000 kWh in yearly energy savings – meaning they can turn their focus back to caring for the members of their community.

Email Currents at Currents@pge.com.

The post Pacific Gasoline and Electrical : San Francisco Medical Constructing Strikes into twenty first Century with Power Effectivity Upgrades appeared first on DAILY SAN FRANCISCO BAY NEWS.

Healthy eating is an important part of your overall health. We all make food decisions daily and have opportunities to make a positive impact on our health.

Our dietitian staff will work with you and your care team to help you learn to optimize your diet to improve your health. Our dietitians can help develop a personalized nutrition plan to improve your eating habits to help better manage health conditions. Healthier eating can also decrease the risk for future health conditions.

Nutrition education and counseling is offered through group, individual, and telehealth sessions. We provide nutrition education and counseling in areas such as:

• weight management
• diabetes
• hypertension
• Cardiovascular Disease
• Chronic Kidney Disease
• Underweight/Malnutrition Risk
• Digestive Health
• Eating habits and eating disorders
• General Nutrition Questions and Healthy Meal Planning Ideas

If you are interested in our MOVE Weight Management program, we offer individual, telehealth or virtual video groups focused on making diet and lifestyle changes for weight management. Virtual MOVE Group Sessions are weekly series of classes aimed at helping develop healthier eating habits and meal planning strategies.

• Virtual MOVE Weekly Classes: offered on Thursday at 1PM-2PM

• Virtual MOVE Weekly Alumni group: offered Friday at 2PM-3PM
• Virtual Diabetes Education Group: 10AM-12PM(Noon) on 2nd and 4th Wednesday each month
• Other Nutrition Group Options/Topics are offered through the year

If you are interested in meeting with a dietitian and setting up a Nutrition appointment, please call our Nutrition Clinic: 415-221-4810 ext: 24262 or ext: 22895.

You can also discuss with your Primary Care Provider if you would benefit from a Nutrition Referral and they can help enter a Nutrition Consult to set up a future appointment.

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Get your records in person

We can help you get copies of your VA medical records. We can also help you update your records. Call or come to the Release of Information office at our San Francisco campus.

what to bring

• A completed and signed Individuals’ Request For a Copy of Their Own Health Information (VA Form 10-5345a). Download VA Form 10-5345a
• Your Veteran Health Identification Card (VHIC)

Release of information office locations

Release of Information Office
building 2
First floor
Room 176
Map of San Francisco campus
phone: 415-750-6607
Hours: Coming soon!

Get your records by mail or fax

To request a copy of your VA medical records by mail or fax, send a signed and completed VA Form 10-5345a to our Release of Information office.

Download VA Form 10-5345a

VA San Francisco Medical center
release of information
4150 Clement St
San Francisco, CA 94121

Fax your signed form to
415-750-2210

We process mailed or faxed requests within 10-14 days. For privacy reasons, we cannot accept requests for medical records by email.

How we share your records with providers outside VA

The Veterans Health Information Exchange (VHIE) program lets us electronically share your health information with health care providers who treat you, including participating non-VA providers if you receive care outside of VA.

This program is voluntary, and you can choose not to share your information (opt out of sharing).

Learn more about VHIE

To opt out of sharing

Fill out, sign, and date VA Form 10-10164 (Opt Out of Sharing Protected Health Information).

Mail the signed, completed form to our ROI office. You can also bring it with you or ask for this form when you visit us.

Download VA Form 10-10164 (PDF)

Grade: If you had revoked your permission to share, before September 30, 2019, your opt out status will stay active. You don’t need to submit form 10-10164.

To allow sharing after opting out

If you change your mind and want to share your health information, you’ll need to submit VA Form 10-10163 (Request for and Permission to Participate in Sharing Protected Health Information).

Mail the signed, completed form to our Release Of Information office. You can also bring it with you or ask for this form when you visit us.

Download VA Form 10-10163 (PDF)

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OAKLAND (CBS SF) — A medical response team was called on Tuesday morning to treat a pair of Oakland teachers who were in the eighth day of a hunger strike, protesting at an Oakland Unified School District plan to close or merge more than a dozen schools.

In a statement, supporters of Moses Omolade and André San-Chez said the pair were suffering from failing health.

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“Convocation hunger strikers, Moses Omolade and André San-Chez are having health difficulties this morning,” the release stated. “Medical teams are on the way to Westlake Middle School now to support.”

A statement was included in the update, San-Chez told the board — “If I die, I want the board to know my death was at your hands.”

A heated battle has been waged by teachers, students and parents for several weeks over the plan which comes up for a vote on Tuesday night.

The proposed closure list was released to the public at the end of January. Six schools — Brookfield, Carl Munck, Prescott, Grass Valley, Parker, Community Day School — are recommended for closure at the end of this academic year. Two other schools — Horace Mann Elementary and Korematsu Discovery Academy — would close after next year, with their students then being reassigned to other schools.

Additionally, three schools would merge onto other campuses after this school year with Manzanita Community School moving to join Fruitvale Elementary the following year.

OUSD says for the amount of students in the district, there are far too many campuses and the budget is blown. OUSD has 33,000 students and 80 campuses. Fremont has 34,000 students and 42 schools. In Stockton, 48 schools serve 35,000.

READ MORE: California College of the Arts Employees to Start Strike This Week

OUSD parent of four Vanessa Gutierrez says if Brookfield and Grass Valley close, the move will cost her close to $100 a day in Uber fees to get her kids to class, because she doesn’t drive.

“They’re not thinking about the people that are less fortunate than them,” Gutierrez told KPIX5. She’s also worried about losing the Brookfield special ed teacher her son relies on.

“For him to get sent to another school with different teachers, that’s honestly something that I will always try to fight for my kids,” she said. “I don’t like them being switched from one teacher to another.”

Corrin Haskell, a teacher at Brookfield for the past 25 years, says this is about losing a valuable community school and resource and putting kids in danger.

“There’s not really a school that’s within safe walking distance from here if you’ve ever been to the Brookfield/Sobrany Park area. It’s not really a place where people walk around freely for miles,” said Haskell. “Taking these kids and making them walk another one and a half, two miles to get to another school on top of that is really unfair.”

In a statement, OUSD said this about the hunger strikes and protest:

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“We support everyone’s right to protest, including protesting possible decisions by the Board of Education. Of course, the District cares deeply about the health and well-being of our staff, and hopes that any staff member engaging in a hunger strike explores other means of protest that don’t involve harming themselves. We know that our students, staff, and families all agree that we need a district of thriving schools, yet not everyone necessarily agrees on how best to get there.”

The post Medical Responders Referred to as In To Help Ailing Oakland Faculties Starvation Strikers – CBS San Francisco appeared first on DAILY SAN FRANCISCO BAY NEWS.

The six-story building would not just be a workplace, but a treatment center treating 60,000 patients annually – one of the first facilities of its kind to combine neuroscience research and outpatient care under one roof. Aiming to create a hopeful environment for patients and scientists alike, he developed a conceptual design that was all about light: a glass box with a central atrium.

The key to the concept was a filigree brise soleil that shades the glass facade and diffuses the light. This aluminum screen allowed the architects to strip back the low-e coating on the glass, giving it greater transparency and less color distortion than the tinted glass found in countless office buildings. Cavagnero notes that this approach is a throwback to early modernism, when buildings had to do more and HVAC systems less to mitigate heat; he was inspired by past companies like MMM Roberto and Olgyay and Olgyay. “Unfortunately, being made of concrete, many of these screens were cumbersome and obscured the view. We wanted to create something with great openness and sophistication that expresses the precision science in the building,” he says. According to the company, the screen, made of 1-inch thick louvers spaced 7 inches apart, outperforms standard solar tint; The combination of glass and screen was also inexpensive to construct.

COURTESY OF TIM GRIFFITH

In contrast, the interior design focuses on the warmth of wood: Sycamore, chosen for its rich color and visible grain, is used throughout for wall and ceiling paneling. Patients and researchers face the open plan area of ​​UCSF’s main building, which is directly to the west. A long balcony on the fifth floor offers an expansive view of the park. This view is also shared by the event rooms on the top floor, which offer the university a compelling place to connect with industry partners and peer institutions.

The scientists began moving early last year and the feedback has been overwhelmingly positive, says Dr. Stephen Hauser, director of the UCSF Weill Institute for Neurosciences. “What the architects have achieved with the outer wall is simply spectacular,” he says. “The building makes full use of the available light throughout the day and the interior environment is balanced, comfortable and quiet.”

The post Mark Cavagnero Associates Slathers Sunscreen on a San Francisco Medical Constructing appeared first on DAILY SAN FRANCISCO BAY NEWS.

SACRAMENTO (AP) – A new California policy could send dozens of paralyzed, paraplegic, or otherwise permanently incapacitated inmates from nursing homes back to state prisons.

Prison officials say a change in federal regulations caused them to restrict medical parole to inmates who are so ill that they are connected to ventilators to breathe, meaning their movement is restricted so that it does not pose a public hazard . The state previously encompassed a much wider range of permanent disabilities that made it possible to care for inmates in nursing homes outside the prison walls.

CONTINUE READING: Man charged with 4 crimes in Danville, San Ramon

Steve Fama, an attorney for the nonprofit Prison Law Office, said the court-appointed federal agency that oversees health care in California prisons had told him the change could affect about 70 of the 210 inmates under the current medical probation system were released and started in 2014.

“It would be a terrible shame if these people were taken back to prison,” said Fama. “These patients have been shown not to need a prison facility because of their medical conditions.”

Political change comes as the state reduced its prison population due to the coronavirus pandemic, and more generally urge voters and lawmakers to free older and frail inmates who are less likely to commit new crimes.

California officials say they have no choice in a new approach to enforcing federal nursing home licensing requirements through the Centers for Medicare & Medicaid Services. This is a division of the US Department of Health under the direction of former California Attorney General Xavier Becerra.

The federal agency’s position is that probation officers cannot impose conditions on inmates in community medical facilities, the state says. This includes a rule that inmates only leave with the permission of their probation officer – a restriction that state officials believe is necessary to maintain public safety.

In response, only those with ventilators will be placed in the community, correctional department spokeswoman Dana Simas said.

Federal officials disagree that the state’s only option is to lift medical parole and put incapacitated inmates back behind bars.

They say California could leave inmates in nursing homes with no travel restrictions or place them in facilities that are not regulated by the federal government – “assisted living or non-certified qualified facilities that a state may wish to license to serve.” Probation officers who have additional health needs. “

Simas replied that sending offenders to such uncertified facilities would “require the establishment of an entirely new program to monitor and audit the care provided in these facilities”. The health care of the offenders in the current facilities is checked by the federal administration and several external agencies.

CONTINUE READING: OPD: “Violent caravans” confront police on the streets of Oakland

The state’s ruling affects incapacitated inmates believed to still need some form of supervision, but does not affect court-approved, unconditional, compassionate dismissals. Detainees can seek compassionate release if they are diagnosed with an illness that is likely to cause death in 12 months or less and is a condition they did not have when they were sentenced.

Several other states had to deal with the same problem, although federal officials couldn’t immediately tell which, when, or how they complied.

Almost every state allows prisoners with serious illnesses to be released on parole, according to the National Conference of State Legislatures. But the organization said in a 2018 review that such laws are rarely used.

Researchers at the Vera Institute of Justice, a national nonprofit research and advocacy group, said obstacles included limited eligibility criteria and the difficulty of applying for a release. Their 2017 report found that Alabama had released 39 people on medical grounds over eight years, while Texas approved 86 of more than 2,000 requests in 2016.

California dwarfed those releases by approving 210 medical releases and declining 110 requests since 2014, though that’s a tiny fraction of the nearly 100,000 inmates currently incarcerated in the most populous state.

California MP Phil Ting, who chairs the congregation’s powerful Budgets Committee, is putting forward a bill to expand the criteria and create a simpler process for placing incapacitated inmates in community health facilities.

“The ventilator restriction is arbitrary and not based on medical science,” he said. “Public safety will not be improved if this policy is unnecessarily narrow.”

Ting’s bill would include those who qualify for hospice care or have debilitating pain or a debilitating illness. Rather than leave the decision to the state parole board, which is largely made up of law enforcement officers, a new medical parole board made up of health care providers would be created in each prison. It would also keep patients in off-site facilities even if they no longer meet the criteria for medical parole.

Originally worn by former MP Rob Bonta, now the Attorney General, it cleared the gathering before it stalled in the Senate last summer. Ting plans to try again next year.

Those sentenced to death, life without parole, or the murder of police officers are not eligible under California law, and that would not change even after Ting’s suggestion.

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© Copyright 2021 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

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Three counties in the San Francisco Bay Area suspended deliveries of COVID-19 vaccines to One Medical offices after the private health care provider allowed unauthorized people to queue for vaccines, the San Francisco Chronicle reported on Wednesday.

According to the Chronicle, San Francisco, San Mateo, and Alameda counties have stopped shipping doses of vaccine to One Medical and are aiming to return more than 1,600 doses. NBC Bay Area later confirmed the report.

The San Francisco Department of Public Health was investigating complaints that the company was administering vaccines to individuals who did not meet the state’s early eligibility criteria, the report said, and the company’s response suggested that individuals were indeed ineligible before their time had been vaccinated.

California only vaccinated people over 65, as well as health care workers and other important people. Early supply shortages forced some local health officials to limit vaccinations to those over 75 or health workers.

In a letter to One Medical executives, the San Francisco Health Department requested the immediate return of 1,600 doses of vaccine because they were unable to verify the eligibility of some vaccine recipients. The cans had been reserved for “other uses,” the letter said, which had not been approved by the health department. The company was allowed to keep enough doses to give a second shot to those who had already received an injection.

Officials from the San Mateo and Alameda counties also found discrepancies, the Chronicle reported, and canceled their assignments.

NPR reported Wednesday that One Medical disregarded local regulations by causing people in several states to cut the limit on vaccinations, including employees who did not interact with the public. Forbes reported similar claims earlier this month.

In a statement to MarketWatch, One Medical said, “Any allegation that we generally and knowingly disregard regulatory compliance guidelines directly contradicts our actual approach to vaccine delivery.

“The recent media coverage of One Medical perpetuates dangerous public misunderstandings about our COVID-19 vaccine protocols and, more importantly, has built on our corporate values ​​in our efforts to work with health officials across the country to deliver COVID-19 vaccines Asked a question. While this type of reporting is discouraging for our team members who have worked tirelessly nights and weekends on the complexities and challenges of introducing the vaccine, we remain determined to serve our communities and hope this report continues our ability to do so do not handicapped. this vital work, ”the company said, adding that 96% of those vaccinated had proof of eligibility and the other 4% were“ vaccinated according to zero waste protocols ”.

One Medical is a member-based health clinic with offices in 12 major markets and works with more than 7,000 companies. In November, One Medical reported more than 511,000 members.

Shares in One Medical parent company 1Life Healthcare Inc. ONEM, + 2.35%, fell more than 4% on Wednesday. After going public in January 2020, stocks are up 126% over the past 12 months, compared to the S&P 500’s SPX, + 0.75% 26%.

The post San Francisco cuts off COVID vaccine doses to One Medical for vaccinating ineligible sufferers: report appeared first on DAILY SAN FRANCISCO BAY NEWS.

Diving letter:

• Medical billing startup Cedar is acquiring health tech company Ooda Health for $ 425 million in a mixture of cash and equity, thereby entering the insurance market for the first time.
• Cedar, based in San Francisco, works in the complex billing process between patients and providers and can now also integrate insurance bills into its platform.
• The move is intended to help the fintech player expand its products to focus on new functionality built into both the payers and providers, Cedar said, and to more automate the billing workflow. The transaction is expected to close this month, subject to required regulatory approvals.

Dive Insight:

Medical costs in the US have skyrocketed for years, causing more patients to go through a fragmented and complex billing process that is slightly confusing at best and a direct detriment to their financial health at worst. One in ten US consumers says they won’t pay their bills if they don’t understand the administrative process. This comes from a 2020 study that Forrester Consulting conducted on behalf of Cedar.

Streamlining the payment process can then make consumers more likely to pay their bills, which can reduce administrative burdens for payers and providers and contain rising costs. According to studies, administrative costs account for between 8% and 25% of all national health expenditure.

These high costs could be reduced if the numerous routine transactions were digitized, according to a McKinsey report from 2019.

This is a major destination for healthcare fintech startups like Cedar. With the acquisition of Ooda, Cedar will bring both the provider and payer side of the billing process into its payment platform, which is currently used by more than 12 million patients annually to pay a pending bill, review their insurance, or review their copayment before a doctor’s visit.

Ooda enables consumers to receive a single statement from their payer, which includes deductibles and various payment options, rather than a few records of performance, itemized invoices and other documentation.

Ooda’s platform connects workflows for approximately 20 organizations including CommonSpirit Health, Arizona Blue Cross Blue Shield, and Massachusets Blue Cross Blue Shield. Cedar currently works with 35 providers across the country including Summit Health, Yale New Haven Health, Novant Health and ChristianaCare.

Cedar, which was founded in 2016, saw significant growth over the past year during the digital health boom of the coronavirus pandemic. Cedar said the size of its business quadrupled over the course of 2020, and investor interest also increased. Recently, a $ 200 million Series D funding round was closed. That brings total funding to more than $ 350 million and valuation of $ 3.2 billion, the company said.

Florian Otto, CEO of Cedar, will continue to serve as chief executive for the combined company, while Seth Cohen, CEO of Ooda, will continue to serve as President and join Cedar’s Board of Directors. The combined company will be headquartered in New York City with additional offices in San Francisco and Salt Lake City.

The board of directors of Cedar and Ooda and the shareholders of Ooda have already approved the transaction.

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