News 1/4/11

Day One of registration for EHR incentive money is now over. I wonder if the ONC’s new portal is  bustling, or, if Blumenthal will need to invest a few dollars to better inform providers of the specifics for the attestation process? If you are an Eligible Professional and ready to register, make sure you have on hand your NPI, NPPES user ID and password, and tax ID number if you are reassigning benefits.

Medicity receives modular ONC-ATCB certification for its iNexx platform technology for ambulatory care providers. Aetna, by the way, announces that its $500 million purchase of Medicity is complete.

Sutter Health (CA) patients can access their personal medical records using Epic’s MyChart for the iPhone. The app also allows patients to message their doctors, check lab and test results, view appointments, and receive health reminders.

Happy New Year, by the way. I’ve reinstated a few of my regular resolutions for 2011, such as making time for regular exercise and losing a few pounds. I’ve also decided to step away from the computer a bit more and make time for things like have lunch with friends every once in awhile. I already get up pretty darned early and rarely watch TV, so I don’t exactly know how I am going to “make” this extra time. But what the heck, I’ll give it a whirl for a few weeks.

With the new year, HIStalk Practice is adding some new sponsors. A big welcome to 3M Health Information Systems, which is already a supporter of HIStalk Mobile. The 3M HIS division offers a variety of software and consulting services for clinical documentation and improving financial performance, including computer-assisted coding technology, ambulatory revenue management software, mobile transcription, and an assortment of charting tools. Click on their ad to the left or the link to your right to learn about some of their many offerings. A big thank you to 3M HIS for their support of HIStalk Practice!

Also lending their support to HIStalk Practice: Nuesoft. The great folks at Nuesoft are spreading their Platinum love across by HIStalk and HIStalk Practice, which makes Mr. H and me most appreciative. Some of Nuesoft’s products include NueMD PM and billing software, NueMD EHR, and the Nuetopia medical billing service. In addition, they offer a suite of clinic billing and management products for student health clinics and college health billing services. They are also the creators of the very fun Lady Gaga video that we’ve posted on HIStalkTV. Thanks, Nuesoft, for your support!

If you are not already signed up to receive automatic e-mail updates for HIStalk Practice, the new year is a great time to take care of such housekeeping details. Take two seconds to sign up at the top right hand corner of the page. I promise you will instantly feel the calm that comes with knowing you will never miss a post. It’s also a great time to share your love with our sponsors. Take a moment to click on their ads and see what offerings might make your life more complete, or at least might address some of the pesky HIT problems in your life. And thanks for reading.

CMS launches its new Physician Compare Web page, which provides online tools to help patients locate area health professionals. A later phase of the project will specify which providers participate in e-prescribing and will eventually include quality of care profiles.

Two aspects of last year’s healthcare reform package may be a boon for house call providers. The Independence at Home initiative will launch in 2012 and include incentives for primary care teams providing house calls. There may also be a place for house call providers in emerging ACOs. Proponents believe that incorporating house calls into care programs can increase quality and reduce costs. And here is an interesting statistic: 2.3 million house calls were paid for by Medicare in 2009, up from 1.5 million in 1995.

The use of online appointment scheduling services is growing, with 16% of family doctors now allowing patients to schedule appointments online. As doctors incorporate more technology into their practices, providers are warming up to online tools and realizing the potential to reduce overhead costs and attract new patients. Pricing for online scheduling models vary: ZocDoc charges doctors $250 a month to be listed in an online directory; Health in Reach charges providers only when a doctor gets an appointment.

Neurological Services of Orlando selects Waiting Room Solutions’ EHR and PM system.

We are looking for a few physicians willing to share their insights into the technology in use in their practices. If you are a physician using an ambulatory EMR or some other cool technology, and willing to share your impressions, send me a note.

Ingenious Med wins a 2010 Mobile Star Award in the Healthcare Management category. The category recognizes vendors providing “breakthrough mobile application enhancing quality of care and practice management.”

E-mail Inga.

News 12/28/10

Sign of the times: more physicians look to escape the hassles of non-clinical obligations and improve life balance by leaving private practice. In Chattanooga, TN, one hospital reports it has tripled its number of employed physicians over the last three years, from 40 to 120. A second hospital says it has grown from 10 employed physicians to 25 in the last three years. Meanwhile, WakeMed Health & Hospitals (NC) adds three new practices and 13 physicians to its physician practice division.  |

More tidbits of information on eClinicalWorks’ new 100,000 square foot office space. The site will include workout facilities (including showers), a cafeteria with an on-site chef, and an outdoor volleyball court. Also, plenty of natural lighting and glass conference rooms throughout the building.

Practice Velocity, a developer of VelociDoc urgent care EMR, is named a semi-finalist in Innovative Illinois 2010, which recognizes entrepreneurial and innovation achievement.

JPS Health Network (TX) launches an innovative initiative to increase the number of physicians in rural areas. JPS is asking small communities to pay the salary of new doctor resident. In exchange, the doctor must make a five-year commitment to the community. According to JPS officials, underserved communities are willing to participate because the program improves access to healthcare, which can drive economic growth.

A Cleveland physician submits a guest column to the local paper, complaining about his recent EMR implementation. He claims that after three months, the product has not saved time or money or improved practice efficiency or employee morale. Patients don’t prefer it over paper, but he points out it is a “bonanza” for document-scanning companies. He continues to rant about how EMR “disrupts the doctor-patient relationship” and suggests that EMRs could be the end of medical rapport (he also writes that Obamacare is unconstitutional, so maybe he’s not going to like very many government-sponsored changes to the practice of medicine). He sounds like every vendor’s worst nightmare. I hope he writes  a follow-up report in another six months to let the world know if things have improved.

I’m only semi-working this week, in part because I am in a location with horrible Internet access. Good thing it will likely be a slow week in HIT, unless you are a vendor trying to pad year-end revenue by implementing as many last-minute systems as possible. Or, perhaps a desperate sales type attempting to close a big deal or two. Regardless of whether you are one of the really working folks, a semi-worker type like me, or perhaps just a bored vacationer, I’ll do my best to make sure you get your HIT news fix this week. 

E-mail Inga.

News 12/23/10

From Frosty: “Re: OK REC. Have you seen this, before? It’s the new REC fundraising method: pay to play.” The Oklahoma Foundation for Medical Quality sends an e-mail to certified EHR vendors, giving them the opportunity to post a demo on the REC’s site for a mere $5,000 a year. OFMQHIT will use the site to walk customers through the vendor’s options and drive traffic to the company’s site. OFMQHIT adds that its model is “completely vendor neutral.” I also see on OFMQHIT’s website that organizations can “sponsor” a provider for $700, and earn recognition on the REC’s website. I’ll give them the benefit of the doubt and accept their neutral stance. On the other hand, I hope their technical expertise is superior to their marketing and financial strategies.

Colorado Regional Extension Center (CO-REC) announces its approved list of 14 EHR products.

Practice Fusion commits to donating $1 to Doctors Without Borders for each new healthcare provider signing up for its free EMR. The promotion is part of company’s Care for the Holidays drive and runs through January 15, 2011.

ONC reports that more than 28,000 providers are now signed up with 62 regional extension centers across the country. Each center has a goal of at least 1,000 physicians in its first two years of operations, with a total target of 100,000 for all RECs.

Speaking of ONC, it now lists 137 certified ambulatory EHRs on its website. Mindless trivia for those wishing to impress co-workers at the holiday luncheon: 102 products are designated complete EHRs and 35 modular EHRs. CCHIT is the certifying body for 79 products, Drummond for 53 products, and InfoGard for five.

Researchers at Northwestern Medicine find that the use of a subtle yellow light on the side of doctors’ computers help boost preventive care of chronically ill patients. The light works with the practice’s existing EMR and lights up when a physician opens the chart of a patient with a chronic condition, such as diabetes and cardiovascular disease. The study’s lead author says the system is effective because, unlike some alert systems,  it doesn’t waste doctors’ time and is not intrusive. Northwestern also tied doctors’ interactions with the reminders to their performance reviews (likely contributing to the success of the reminder system). Some of the noted improvements after one year: a six percent increase in heart disease patients receiving cholesterol-lowering medication and a five percent gain in colon cancer screenings.

McKesson wins anti-trust approval to complete its $2.16 billion purchase of US Oncology.

Oregon, West Virginia, and New York are among a handful of states creating electronic databases that include patient directives for life-sustaining treatment. Oregon’s program is different than a typical  living will because the database includes actual medical orders signed by a physician.

With three days to go, I’m happy to report I have completed most of my Christmas shopping, done a bit of baking, and even sent a few holiday cards. If you are still rushing to complete such tasks, best of luck. And best wishes to all for a wonderful holiday!

E-mail Inga (who is on good terms with the guy above)

News 12/21/10

Top issues influencing the health industry next year include: increased demand for HIT professionals as providers spend more on HIT; new risks and opportunities resulting from new payment models, such as accountable care organizations; and, more mergers and acquisitions as providers look for ways to share administrative and IT costs. Those predictions courtesy of PwC’s Health Research Institute.

eClinicalWorks CEO Girish Navani chats with a local paper about company’s upcoming move, eCW’s history, and recent financial performance. Here are a few tidbits:

• eCW is spending $18 million for the new site, which includes the purchase of a 100,000 square foot building, renovations, and furniture. The move is scheduled for early next year.
• The company anticipates its 2010 revenues will hit $130 to $150 million, up from $100 million in 2009.
• Over the next 12 months, eCW plans to hire an additional 100 to 200 more employees to its existing 1,300 person workforce.

Wills Eye Health System (PA) contracts with NextGen for its EHR and PM products.

athenahealth tells investors its FY2011 earnings won’t meet expectations with predicted earnings of $0.68 to $.78/share versus expectations of $.85. Shares slipped on the news Thursday but were moving back up by Monday.

Employment in doctor offices fell by 500 employees in November but grew by 8,000 in hospitals, according to the Bureau of Labor Statistics.

This won’t help employment statistics: Gulfcoast Oncology Associates of St. Petersburg (FL) plans to lay off 197 employees by February. The 70-physician group was recently purchased by Florida Cancer Specialists.

Geolocation technology will likely play an increasingly larger role in healthcare, despite HIPAA privacy concerns. Geolocation services, such as Foursquare and Facebook Places, allow patients to voluntarily check in various locations, including their doctor offices. Possible benefits for provider: attracting new patients or for promoting certain services, such as flu clinics.

The one-size-fits-all design for EHRs does not address workflow demands of all physicians, according to a new UC Davis study. Physicians who have invested time using various EMRs would likely draw the same conclusion. After implementing an EMR, physician productivity dips a painful 25 to 33%, though some specialties eventually return to better than original productivity. Other specialties (in this case FP and pediatrics) didn’t return to original productivity levels. The conclusion: there is a  “mismatch between technology design and the work-flow requirements and health administration expectations” for different specialties.

Slow week in the HIT world, but since Mr. H is still slaving away, I figured I better show moral support and dig deep for industry news. Feel free to send me an email with your juicy news, holiday greetings, or last minute shopping tips.

E-mail Inga.

Intelligent Healthcare Information Integration 12/19/10

Look Out, Pretty Mama, I’m On the EMR Road Again

(Prizes go to the first to name the two bands most relevant to the bastardized title above. No Googling.)

Reminder to self: Don’t promise what you’re going to be blogging about “next time” ever again. It stifles the few creative juices you have left and disrupts those last couple of remaining neurons.

Please pardon the short redirect from my previously stated next blog topics, because as I continue the hunt on down The Next EMR Road, I keep coming across cool features and, sometimes, even cooler people. That occurred today when I had a really enjoyable, refreshingly honest conversation with Physician’s Computer Company’s (PCC’s) Chip Hart. I know them a bit from their generous sponsorship and well-done exhibit presentation at the Pediatric Office of the Future.

I haven’t done a deeper dive with them – yet – but I sure will, as much due to Chip’s forthright attitude as anything. To wit: he told me he assumes I won’t end up choosing their EHR, but he says they have some really cool features and he is just as excited to share them despite his conjecture. He also gives props to Office Practicum, who is the standard for doing pediatrics EMR stuff, says he.

Chip had a lot more wonderful insights as he and PCC have been at this since 1990 and 1982, respectively. But, what really struck me were those two statements, certainly not comments any upstanding sales, marketing, or PR team leader would condone. How can you not appreciate a company so self-satisfied in a niche market like pediatrics? I read an interview where he’s quoted saying the pediatric software market is “not a pond you would fish in. Pediatricians are poorly paid compared to other medical specialists.” (Amen, brother!) And, yet, here they are, pole in hand, strolling the banks of our poor, little pediatric puddle, and even willing to point out where the fish may be biting better to another fisherman. I like that kind of straight shooting.

Now, back on track down EMR Road. I don’t know about you, but this HIT world gets about as dry and tasteless sometimes as a salt-free Saltine. That’s why I just adore those spicy little folks and jokes that pop up every now and then along the trail. (You read Mr. H and Inga’s stuff; you must enjoy some HIT humor, too!) One of the masters at this entertainment value add is, hands down, Jonathan Bush. (No surprise there to anyone who reads HIStalk or hits their Reception at HIMSS.) Agree with him or not, he adds a whole heap of color to this sometimes dreary, sales-pitch heavy road. Keep on keepin’ it real, JB.

A new challenger to the HIT comedy throne, though, has got to be the happy staff over at Nuesoft. If you’ve seen their Lady Gaga’s Pokerface parody over on HIStalkTV, you know what I mean. If you’d have seen them in their Star Trek garb and 1970s leisure suits during a recent exhibition hall outing, you’d agree that they’re definitely in the running for a “Most Fun HIT Vendor” award at next year’s HISsies. (I don’t think such an award category now exists, but I’m hereby suggesting it and placing a nomination!) I was lucky enough to spend an evening dining with a bunch of Nuesoftians at the aforementioned conference/exhibition. They are, without question, one of the happiest gaggles of gleeful, goofy geeks with whom a guy could gulp, gobble, and gossip a night away. (Thanks, again for the laughs, y’all.)

One exciting relative newcomer system with which I recently became acquainted is Mitochon Systems and their “Virtual Medical Community.” Their founder, Dr. Andre Vovan, is a practicing critical care specialist who is as sharp as they come and wonderfully impassioned, as any great entrepreneur should be! To say their EMR is “free” is misleading. They are developing a way to have the right people pay for it, the people who derive the most monetary value from the healthcare industry – pharma, medical suppliers, inscos, etc. The docs get their great new connectivity between providers, patients, and hospitals without charge; sponsors, who reap financial value by targeting relevant markets, bring the money to drive the ship.

They are very focused upon simplicity, the preeminence of the physician-patient relationship, and the integration of EHR, PHR, and HIE – which is where we’re all heading one day anyway, right? (He said, hopefully.) Mitochon’s COO, Chris Riley, came out of an early, self-imposed retirement because of his enthusiasm for their model. Even though a well-funded early retirement sounds pretty good to me some days, I can see why he’s so enthused. Mitochon is young and needs maturation, but they have some tremendous connectivity and information sharing, as well as some pretty cool interface concepts that I find very exciting.

OK, I didn’t finish what I started last time, so next time…oops…almost forgot. (See first full paragraph.)

From the trenches…

“I had nothing to offer anybody except my own confusion.” – Jack Kerouac

Dr. Gregg Alexander, a grunt in the trenches pediatrician, directs the “Pediatric Office of the Future” exhibit for the American Academy of Pediatrics and is a member of the Professional Advisory Council for ModernMedicine.com. More of his blather…er, writings…can be found at his blog, practice web site or directly from doc@madisonpediatric.com.