News 8/11/11

Two legislators introduce a bill that would allow physician assistants and nurse practitioners to qualify for Meaningful Use incentives. PAs and NPs could qualify for EHR incentive payments if Medicaid beneficiaries account for at least 30% of their patient load.

Aprima Medical Software acquires the Richardson, TX-based Health Care Strategies, an RCM provider and Aprima reseller.

CORHIO and the Colorado REC partners with BridgeFront to offer providers discounted pricing for its HIPAA education tools and online education.

eClinicalWorks client Primary Health Medical Group (ID) becomes the first practice in Idaho to attest and certify for Meaningful Use of its EHR.

The NYeC REC reports that it is nearing its capacity for helping primary care providers progress toward Meaningful Use, with 2,857 providers signed on. NYeC is offering its services for free through the end of August for providers already live on EHR and for $750 per provider for practices on paper records. Prices will increase to $4,000 -$5,750 as of September 1.

Epocrates releases its Q2 financials: net sales of $27.9 million, up 10% from 2010; net income of $3.4 million compared to last year’s $0.8 million.

The AMA and 81 other physician organizations request that CMS allow providers to review their data for accuracy before making it public and to standardize the process for developing the public reports and the type of information they will include.

Last month I mentioned a few highlights from AAFP’s 2011 EHR User Satisfaction survey. Surprisingly, AAFP has now made the report available without a subscription (hurry and take a peek just in case it is some sort of mistake!) In addition to providing ratings on 30 EHRs, AAFP offers some insight into physicians’ perceptions of EHRs. For example:

• Only 39% of respondents agreed that they would purchase their current system a second time.
• The lowest-ranking category was vendor support and training.
• Only 49% expressed overall satisfaction with their system.
• Respondents ranked the ability to customize their EHR system at the top of their satisfaction list; 78% said they were satisfied with this aspect of their system. The next highest priorities were electronic prescribing (70%) and electronic messaging  (69%).

I signed up for Google+ a few weeks ago, but  haven’t invested much time figuring out what it could offer me that I didn’t already have with Facebook, Twitter, LinkedIn, and other social networking sites. However, a couple of physicians offer good insight into why Google+ might be a great solution for doctors. Physicians who want an online social presence may find it difficult to  balance their personal and professional online identities. (I know a lot about managing multiple identities, but that is another story.) Google+ allows you to establish multiple circles of acquaintances, such as family, friends, colleagues, and patients. That means a physician could set up a single Google+ account and control the content viewed by his/her connection, based on the connection’s designated circle. It’s an alternative that certainly seems less time-consuming and easier to maintain that having multiple Facebook accounts to handle professional versus personal relationships.

E-mail Inga.

News 8/9/11

Highmark, West Penn Allegheny Health System, Allscripts, and Accenture team up to provide EHR to independent physicians in Western Pennsylvania.

A survey finds that the opportunity to earn Meaningful Use incentives is one of the strongest drivers for most physicians adopting EHRs, while insufficient capital continues to be a key barrier to adoption. Thirty-nine percent of the respondents ranked improved and timely access to accurate patient information as the most important reason to achieve their EHR goals, followed by reduced time spent in information search and management (34%.)

Dell and NextGen announce plans for Dell to sell and support NextGen’s ambulatory and inpatient solutions and to provide hosting services for NextGen clients. Dell also becomes the platform of choice for NextGen solutions and for NextGen’s internal use.

The 300-doctor DuPage Medical Group (IL) will implement Phytel’s population health management tools following a successful three-month pilot.

CMS claims that results from the initial Physician Group Practice (PGP) Demonstration indicate significant improvements in quality and savings in Medicare expenditures. Under the PGP Demonstration, groups earn incentive payments for meeting a minimum quality performance benchmark. Seven of the participating groups achieved benchmark performance in all 32 performance measures, while the other three achieved performance on at least 30 benchmarks. Four of the groups will receive incentive payments totaling $29.4 million, out of a combined savings to Medicare of $36.2 million.

The five-physician Meli Orthopedics (FL) selects the ChartLogic EHR suite.

In a survey of its clients, SuccessEHS finds that customers have increased their production an average of 11% per physician within the first months of go-live on its EHR/PM product. Clients also report average revenue increases of 19% within six months.

CureMD Healthcare announces that its solutions are now 5010 compliant.

The 15-doctor Coastal Eye Associates (TX) contracts with VersaSuite for its EHR, PM, PACS, and inventory optical sales system.

Online scheduling provider ZocDoc expands to the Phoenix area, giving patients the ability to find physicians and make appointments using ZocDoc’s free app for the iPhone and Android.

In support of National Health Center Week, Sage employees are providing volunteer assistance at several CHCs this week and the company is making financial contributions to CHC causes.

e-MDs hosted its 2011 User Conference & Symposium last week in Austin, TX. The e-MD folks tell me the three-day event was sold-out with 800 participants.

Greenway Medical reports that its customers have secured more than $1 million in combined Medicaid and Medicare Meaningful Use incentive funds.

EyeMD EMR Healthcare Systems and Advanced Data Systems (ADS) announce an integrated solution running EyeMD and ADS’s MedicsPremier PM.

Medicare has issued Meaningful Use checks to 2,384 eligible providers and 100 hospitals to date. Another 3,500 providers in 21 states have also received payments, and an additional 137 EPs applied for funds but attested unsuccessfully. A total 77,000 providers have registered under both programs, which suggests it must take awhile to get those checks cut.

Merge Healthcare completes its acquisition of Ophthalmic Imaging Systems.

Want to be hip with the 26 year-old crowd? If you are a physician, using an EMR will definitely score you some points.  An estimated 7.5 million individuals between the ages of 19 and 26 will gain insurance by 2014 as a result of health system reform; at least two-thirds of them want to schedule appointments online and exchange e-mails with their providers. Physicians interested in attracting a bigger share of the 20-something crowd will definitely need to get their digital on.

E-mail Inga.

Readers Write 8/5/11

Submit your article of up to 500 words in length, subject to editing for clarity and brevity (please note: I run only original articles that have not appeared on any Web site or in any publication and I can’t use anything that looks like a commercial pitch). I’ll use a phony name for you unless you tell me otherwise. Thanks for sharing!

Why IN-Eligible Professionals Should Still Buy and Implement Certified EHRs
By Mary Stroupe

If you don’t bill Medicare or Medicaid, you don’t qualify for federal Electronic Health Record (EHR) incentives. However, you should still implement a certified EHR if you want to keep patients and fellow physicians highly satisfied.

Our Movement Toward National Information Exchange and Interoperability

The US healthcare system is moving toward electronic health information exchange (HIE). Today, data is shared electronically among providers using Regional Health Information Organizations (RHIOs). Soon, a Nationwide Health Information Network (NHIN) will enable immediate, authorized access to patient data (similar to banking access provided by the ATM network). The goals of a NHIN are to reduce medical errors, duplicate tests and healthcare costs. Another goal is to provide patients with access to medical records, which are currently scattered across multiple medical entities.

How Interoperability Supports that Movement

The goals of the NHIN can only be realized by interoperability among EHRs: the ability to send and receive clinical data that means the same thing in whichever system it is viewed. The key to interoperability is standardized data. Just as data is standardized in other industries (like banking, to make ATMs work), medical data must be standardized so clinicians can properly interpret it.

How Certified EHRs Support that Movement

Certification is the single variable ensuring the EHR you purchase meets national interoperability standards. Two types of certification exist: ONC-ATCB (ARRA) certification and CCHIT Certification 2011. ARRA (or “Meaningful Use”) certification is what is minimally required for government reimbursement. CCHIT Certification 2011 provides an additional level of assurance that the product meets a more rigorous security inspection and complies with specific functionality, workflow, and usability criteria.

Why a Certified EHR? For Patient and Physician Satisfaction

With the steady growth of Personal Health Records (PHRs), patients will expect you to provide their health data electronically. Why? For eligible professionals to receive government reimbursement, they must be able to supply patient data electronically when it is requested of them. Once savvy patients realize they can get it, they will start asking for it – from all their providers, not just the ones who received incentive payments! Without an EHR and data that certifiably meets national standards, you will be unable to provide patients with data that can be shared with their PHR. If patient satisfaction matters, this matters.

As the wave of EHR adoption rolls across the US, physician offices will no longer staff to levels required to deal with paper (e.g., hard copy referral notes). Providers will exchange data electronically, using standardized data sets that make it possible. It is reasonable to expect, then, that referral providers may avoid colleagues who cannot provide data electronically. If physician satisfaction matters, this matters.

The Bottom Line

Providers who do not implement interoperable, certified EHRs risk becoming data islands to their patients and fellow providers (like a bank that cannot connect to the ATM network).

Mary Stroupe is President of Integritas, Inc. in Monterey, CA.

A Field Trip to athenahealth 8/5/11

My recent big adventures around the Boston area included a visit to athenahealth’s headquarters in Watertown. athenahealth’s offices are in a decommissioned World War II military arsenal near the Charles River. The main building is in a 111,000 square foot facility that has been transformed from its original cavernous shell to a more functional office building, but keeping its brick walls, warehouse atmosphere, and abundance of natural lighting.

John Hallock, athenahealth’s director of communications, met me at the company’s adjacent smaller building, which holds executive offices, the corporate cafeteria, and customer training rooms. It has conference rooms, and for less formal gatherings, tables and couches in open areas.

The company was in the midst of an off-site sales meeting, so a good number of employees were out the office, including CEO Jonathan Bush. However, I took at a peek at his office, which was  as eclectic and scattered as one might think if you have ever experienced the hyper Bush. It has no desk per se, just a conference table, since Bush apparently likes to work standing up.

The windows, couch, and walls were covered with giant Post-it notes, which Hallock joked could very well represent athenahealth’s five-year operating plan. In addition to lots of photos of Bush’s five kids, there are pictures of some of his more politically connected family members and his celebrity brother. I am not quite sure what the two-foot Batman figure was all about, but it seemed appropriate.

Hallock then took me over to the main building, which serves as home base for the rest of athenahealth’s 800 Watertown employees. I found the Network Operations Center (NOC) particularly impressive. The NOC is a single room with multiple monitors that display aggregated performance metrics for athenahealths’ hosted systems.

Employees monitor performance 24×7 (the third shift is covered by offshore workers) and can pinpoint performance issues down to the individual practice level. On that particular day, employees were tracking the system performance of a large practice that was going live.

The overall layout of the building was interesting. athenahealth handles payment posting and insurance follow-up for its clients, which means designated employees have access to vast amounts of personal health information. For that reason, corridor walls are curved to minimize unintentional viewing of data.

Departments are segmented into large work areas with high ceilings, huge windows, and low-profile cubicles. Modest-sized offices and conference rooms are sprinkled throughout. Employees can decorate their work spaces and the variety suggests an abundance of creativity. In both buildings, framed news articles featuring athenahealth and Bush adorn the walls.

The company scans literally every financial and clinical document that comes in the door using the most sophisticated scanners I’ve ever seen. In every work area and hallway, monitors display the status of incoming support calls and visually flag those that have been holding for too long.

Security cameras are everywhere and badges are required to open almost every door. The IT guys wouldn’t share the exact location of their offsite servers. Employees are required to follow strict protocols for how their badges are displayed.

athenahealth has preserved the best of the complex’s arsenal roots with the technology and infrastructure needed to support its creative employees.

E-mail Inga.

A Field Trip to eClinicalWorks 8/4/11

With the notable exceptions of HIMSS and MGMA, my HIStalk reporting rarely takes me away from my little laptop in my home office. Because a girl needs to get out now and then, I recently paid a visit to the brand new headquarters of eClinicalWorks in Westborough, MA. eCW moved to its new digs in May after spending over $18 million for the property and remodeling.

Sam Bhat, eCW’s VP of sales and one of the company’s five co-founders, was my host. About 600 employees work in the two-story facility, which includes customer training rooms, an employee cafeteria, lots of work surfaces (aka cubicles), and not too many offices.

CEO Girish Navani, who was traveling the day of my visit, has a 10×10 office. Outside, in open space adjoining several rows of cubicles, is a conference table where he and others conduct meetings. The design promotes transparency and collaboration and suggests the availability and willingness of execs to be in the trenches with their employees.

Though there are rows and rows of work spaces throughout the building, the walls of each cube are low. As a result, employees can sit at their desks and still see outside. The facility also has multiple break rooms with colorful walls and fun touches like the orange mobile-like structures hanging from the ceiling.

eCW also created multiple open areas that employees can use for meetings. Sam explained that the colors for these spaces are all slightly different (greens, oranges, blues) and suggest an East meets West theme. I don’t know about that, but I do know I liked the vibrant colors and the abundance of non-traditional work areas.

Because the facility is new, a few areas are still getting finishing touches. For example, an on-site gym for employees is opening soon. A few areas are also awaiting furniture or artwork, and I noticed several workmen doing their thing throughout my tour.

eCW has six customer training rooms as well as break areas specifically for clients. Customers enter the building through a separate entrance for security reasons. The office park has two hotels, which allows out-of-town customers (or employees) to literally walk across the street to attend classes or meetings.

eCW has several additional classrooms for internal employee training. On the day I was there, about 45 new hires were attending orientation and training. Sam told me most employees (at least in technical positions, implementation, and support) are recruited from graduate schools and typically have earned degrees in engineering or similar fields. The main hiring criterion is analytical ability.

I rounded out my visit with lunch at the employee cafeteria. The daily menu includes traditional American grub as well as an Indian entree. I went for the Indian, which was an excellent choice. OK, I must confess I really don’t know what I ate, although I know it was vegetarian and included rice and some sort of squash. It was delicious and a ton of food for an affordable $5.

The cafeteria has a huge screen and projector at either end. The space can be reconfigured as needed for large employee gatherings. In fact, Sam told me that a couple of weeks before move-in, a few dozen employees tried out the room and its AV setup to watch the world cricket finals at 5:30 a.m. on a Saturday.

eCW established the new headquarters to accommodate its rapid growth, but expects to outgrow the space in the next year or so, expecting to secure additional space in the same office park.

My conclusion is that the facility itself is lovely and functional, but not over the top. Its design reflects eCW’s culture, which strikes me as family-oriented and collaborative, with a heavy emphasis on transparency.

A big thank you to Sam and eCW for giving me a peek.

E-mail Inga.