News 4/26/12

Quality Systems, the parent company of NextGen, acquires Matrix Management Solutions, a NextGen reseller that provides RCM, implementation, and support services. Quality Systems says the acquisition will “enable NextGen Practice Solutions to expand its footprint among private and hospital-based physicians and groups by leveraging Matrix’s RCM expertise.”

Emdeon completes the re-pricing of its existing senior secured credit facilities and borrows $80 million of additional term loans for general corporate purposes, including potential acquisitions.

Phreesia adds an electronic version of the M-CHAT autism screening tool for toddlers to its patient check-in system.

Cokingtin Eye Center (KS) goes live on MedInformatix’s EMR on May 1.

eClinicalWorks opens a Chicago office to provide a central US presence.

Hawaii Island Beacon Community implements a physician practice redesign program to transform up to 30 independent primary care physician practices into PCMHs. Participating practices will receive at no charge practice assessments, educational tools, and PCMH recognition upon program completion.

The Houston Chronicle reports that that Medicare has overpaid physicians millions of dollars in bonuses, including $33 million in 2010 alone. The overpaid physicians practiced in areas that were once considered underserved but which have since been reclassified. The federal Health Resources and Services Administration is responsible for updating the records of qualified communities, but failed to adjust its lists from 2003 until November 2011. As a result, physicians in at least 311 communities have been incorrectly paid bonuses equal to 10% of each Medicare claim filed. Good luck getting those funds back.

Even though as many as 91% of US physicians were eligible to participate in the Meaningful Use program last year based on Medicare revenue or Medicaid volume, only 11% of EPs had both an EHR with at least 10 of the 15 capabilities required for Stage 1 and had plans to apply for incentives. That’s a far lower participation rate that CMS originally estimated (as high as 36% for the Medicare MU program and 47% for Medicaid’s.)

Overall physician compensation fell in from 2010 to 2011, though the  average pay in several specialties averaged more than $300,000. Radiologists had the highest average compensation ($315,000) and pediatricians the lowest ($158,000.)

Occasional HIStalk Practice contributor Lyle Berkowitz, MD is profiled here discussing Healthfinch, an HIT start-up company he co-founded. Healthfinch’s productivity apps include RefillWizard, which connects to a practice’s EMR and runs prescription refill requests through a Web service.

E-mail Inga.

News 4/24/12

Through the end of March, the EHR Meaningful Use program paid Eligible Providers $1.4 billion in incentives. Of the 39,000 MDs or osteopaths receiving checks, 17,000 were specialists in family practice or internal medicine.

Cuyuna Regional Medical Center (MN) selects PatientKeeper technology to aggregate data from the MEDITECH system used by the hospital and the  ambulatory care offices’ Allscripts system.

The US e-prescribing market is predicted to reach $205 million by 2017, which is far less than the $508 million forecasted for Europe for the same period.

Meritas Health Corporation (MO) chooses eClinicalWorks’ EHR for it 72 employed physicians. Meritas will interface eCW with its inpatient Cerner system, as well as LabCorp and Quest.

Wide River Technology Extension Center, Nebraska’s REC, announces that it has surpassed its goal of registering 1,000 primary care providers for its program. The REC has over 670 physicians live on EHRs and 145 have met Stage One MU requirements.

The 90-physician Allied Pediatrics (NY) selects Isabel Healthcare’s diagnosis decision support technology, which will be integrated with Allied’s EMR (GE Centricity I believe.)

Midwest Radiology Associates (OK) signs a long-term agreement with Affiliated Professional Services to provide billing and practice management services.

Brad Blakey, former VP of sales for NextGen, joins CareCloud as VP of sales.

Minnesota Eye Consultants selects the NextGen Ambulatory EHR for its 22 providers.

Lakeside Orthopedics (NE) contracts with SRS for EHR.

I am thrilled to announce simplifyMD as HIStalk Practice’s newest platinum sponsor. The six-year old company is based in Atlanta and offers an ONC-ATCB-certified EMR platform that’s been deployed by doctors in 27 specialties and thousands of end-users. The EHR is cloud-based, but practices also have the option to store data on a local server in their offices, just in case the Internet is temporarily unavailable. Unlike most traditional software vendors, simplifyMD offers a “pay as you go” option that can be discontinued at any time and costs a mere $395 per month. Last November the company announced it had secured $4.5 million in funding and named former McKesson SVP Mike Brozino as president. Founder Matt Ethington once sent me a photo of his very young son wearing some very red shoes, so I already had warm fuzzy feelings for this company. Many thanks for simplifyMD for supporting HIStalk Practice!

Every week I read new stories about medical office employees who are caught stealing thousands of dollars from their employers. This article, however, caught my eye because of the total lack of checks and balances in the practice. The Mandeville, LA woman, who has pled guilty of embezzling over $700,000 in less than four years, was in charge of payroll and over-compensated herself. She was also responsible for paying the plastic surgery practice’s American Express credit card and routinely used the card to cover personal expenses. Additionally she had access to the practice’s bank accounts and regularly transferred money to pay her rent and phone bills. Finally, she was the only employee authorized to make bank deposits and over time stole at least $60,000 in cash. Crazy.

2K Networking (PA) partners with gloStream to offer gloStream’s EMR solutions.

E-mail Inga.

News 4/19/12

Orthopedic urgent care franchise OrthoNow selects CareCloud’s practice management solution for its network of facilities.

Practice Fusion introduces a messaging feature that allows providers to communicate securely with one another. The service is available at no charge to both Practice Fusion EMR users and non-users. It does not support sending chart notes or referrals, but that enhancement is in the works.

Louisiana becomes the first state to make Year Two Medicaid Meaningful Use payments, issuing its first check to SuccessEHS client Winn Community Health Center.

Emdeon CEO George Lazenby will head an IT Recruitment Task Force sponsored by the Nashville Area Chamber of Commerce. The initiative aims to attract workers to fill the 1,000 available IT jobs in the region.

Phoenix Cardiac Surgery (AZ) agrees to pay HHS a $100,000 settlement for failing to comply with HIPAA privacy and security rules. In addition to posting clinical and surgical appointments on an Internet-based calendar that was publically accessible, the practice failed to implement policies and procedures to safeguard PHI, did not document training of employees on HIPAA rules, and neglected to obtain business associate agreements with the Internet-based e-mail provider.

MGMA opens registration for its 2012 Annual Conference. See you in San Antonio October 21-24!

TransEngen announces new integrations of its Revenue Maximizer platform with practice management systems from GE, NextGen, Medisoft, and Cerner.

PM and EHR provider eCareSoft releases an Android application for its Nimbo product.

Tampa Eye Clinic (FL) partners with TSI Healthcare to deploy NextGen EPM and EHR for its 10-provider practice.

E-mail Inga.

More news: HIStalk, HIStalk Mobile.

News 4/17/12

Southern Orthopaedic Surgeons (AL) selects the SRS EHR for its 11 providers.

eClinicalWorks recognizes several customers for achieving NCQA Level 3 Physician Practice Connections PCMH status, including solo physician Salvatore Volpe MD (NY) and Ninth Street Internal Medicine Associates (PA.)

The e-MDs folks let me know they’ve got a brand new Web site which features improved navigation and easier access to information. While checking it out, I noticed that e-MDs is hosting is 8th Annual User Conference & Symposium June 21-23 in Austin, TX.

Former Medical Present Value CEO Tom Stampiglia joins RCM/BI provider Origin Healthcare Solutions as CEO. He was also previously president and COO of WebMD’s practice services division.

Physicians will ignore medication alerts if: (a) their EMR generates too many of them; (b) the alerts to not apply to a particular patient situation (e.g., the patient has already been taking the medication without problems); or (c) the alert provides too much information. That’s the conclusion of a VA/Regenstrief Institute study of 30 prescribers in 13 clinics. The authors recommend that systems provide only the details users need to make decisions.

American Medical News profiles a couple of physicians who have converted a portion of their homes into a medical office. There’s nothing IT related to this story, but since I work out of my house, I appreciate the benefits of having a 20-yard commute between my bedroom and work space. The downside, which the doctors didn’t mention, is that it’s sometimes hard to step away from the office.

Medicomp Systems promotes Dave Lareau  from COO to CEO. Company founder Peter Goltra will remain as chairman and president.

E-mail Inga.

More news: HIStalk, HIStalk Mobile.

Bowtie Confidential: 5 Steps to Managing Change in Healthcare 4/15/12

It’s interesting. When one mentions the word “change,” it puts the listener on the defensive. If you use the words “modify,” “improve” or “alter,” it does not create the same stress level. Perhaps we should call change management “improvement management.”

Nevertheless, change is paramount in healthcare right now, and managing it is not easy. I have found that there are five areas of focus for successful change management: communication, sponsorship, coaching, education, and understanding resistance.

1. Communication is important because it mitigates surprise, which is very stressful. To communicate well, healthcare leaders and project managers should create a communication plan with milestones and a timeline. Many of our clients have been successful using tools such as town hall sessions, newsletters, e-mails, social media, etc.

2. Sponsorship is a critical change management tool. If there is not strong leadership behind the change, resistance will keep it from happening. Sponsorship for change begins at the highest leadership level. It is imperative that as management, we become positive change agents so that our staff members receive the direction that they need.

3. Coaching provides hands-on help to move from A to B. As management/change agents, we are de facto coaches. It is effective to have senior leadership coach management, who can then coach their staff members. These activities build trust and acceptance of change, predominantly because they facilitate the behavior change.

4. Education is similar to coaching, but does not have to be 1:1. It builds knowledge and ability, which are antidotes to resistance. While it is important to provide functional knowledge transfer, it is also important to talk about change management coping techniques. For example, it is important to let staff know the reason that the change is happening and what is in it for them.

5. Understanding resistance helps deflect the defensiveness around change, which facilitates moving ahead. Understand why there will be resistance. People are used to doing their job one way and are concerned about how the change will impact their work and their experience of work. Planning is an important component to change management. When people know ahead of time (again, try to eliminate any surprises), there will be less resistance than if it is forced into place in a hurry. Bring on the naysayers and ask them to be part of the process. Their point of view will be helpful in planning and design. Also, develop appropriate committees and messengers that can communicate to the organization at different and varying levels.

The goal is to become an organization in which change is OK. These five components should be part of any change and should be an everyday theme for the organization. This will build trust and will take time. Yet as trust is established and change is experienced as making things better, more people will become change agents. A healthcare organization’s ability to flex and adapt to change will become a competitive advantage as well.

Rob Drewniak is vice president, strategic and advisory services, for Hayes Management Consulting.