News 5/26/11

Aetna earned the top spot for major payers in athenahealth’s sixth annual PayerView Rankings, while BCBS-RI was named the overall best performer. The rankings consider ease of doing business based on a variety of performance criteria. Compared to last year, payers averaged payment one day faster with 5% fewer denied claims. State Medicaid providers were the worst performers in terms of AR and denial rates.

Kareo publishes a clever piece entitled, “How to Handle Medical Billing After a Zombie Apocalypse.” The strange title is based on a recent CDC post on how to prepare for a zombie apocalypse (or other emergencies like hurricanes, earthquakes, and the like.) Kareo’s recommendations for medical billing include using a Web-based, easy-to-use software that allows employees to work remotely and includes code-scrubbing tools and free EMR.

The Massachusetts REC leads the country in enrolling primary care providers for its services. Massachusetts eHealth Institute’s goal was to recruit 2,500 PCPs and is the first REC to fulfill its enrollment milestone.

Seven US senators send Secretary Sebelius a letter urging HHS to withdraw its proposed ACO rules, saying “the proposed ACO regulation will fail to accomplish its purpose” of better quality care and lower costs. The senators claim the proposed rules do not align incentives and accountability and include requirements that are too complex and an ROI that is uncertain.

MED3OOO announces the general availability of InteGreat V6.4, which includes the components required to meet Meaningful Use standards. The release also includes an enhanced visit entry module and improved patient communication capabilities.

Doctors behaving badly:  more than 70% of physicians say that disruptive physician behavior occurs at least once a month at their organizations, and more than 10% say that such incidents occur on a daily basis. The types of disruptive behavior physicians encountered range from profanity to refusal to follow established protocols and occasionally physical assault.

Phreesia announces its patient check-in system now integrates with over 85 unique workflow solutions.

Baylor Health Care System (TX) affirms its plans to implement GE Centricity EMR across its entire HealthTexas Provider Network of more than 500 physicians. A reader tells me the “affirm” wording alludes to the fact that Baylor was at one time consider switching vendors, though clearly they changed their mind.

MGMA reports that median compensation for first-year specialists in multispecialty practices was $258,677 in 2010, compared to $240,596 for specialists in single-specialty practices. Median compensation for primary care doctors was $172,400 in multi-specialty groups versus $165,000 in single specialty practices. More than half of first-year doctors were paid signing bonuses and relocation packages.

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News 5/24/11

Interesting fact that I’m assuming is true: 17 vendors represent 87% of providers live on EHRs. Keep in mind that so far 487 products have earned ONC-ATCB certification. This statistic comes from Thomas Tsang MD, ONC’s medical director of meaningful use and quality, who made the remark while speaking at last week’s RI Quality Institute Health IT Expo. He also noted that 68,780 primary care providers are now enrolled in the Medicare EHR Incentive Program.

AMA reports profits of $23.9 million for 2010, a 45% increase over the previous year. Membership fell about 5% to approximately 216,000.

PwC’s Health Research Institute predicts medical costs will increase 8% in 2011 and 8.5% in 2012. The report also notes that provider consolidation will continue and more costs will shift to Medicare and Medicaid.

e-MDs reports that its client Dr. Ben Brull is the first physician in Kansas to receive Meaningful Use funds from Medicare. Meanwhile, Greenway Medical says their client Childs Medical Clinic (AL) also picked up a big check.

Kent Rowe, a former GE Healthcare VP/GM and IDX sales VP, joins Culbert Healthcare Solutions as VP of information technology services. He will lead the team that serves the GE and Allscripts client base and will expand the company’s overall service line.

In fashion news, the New York Senate proposes a ban on physicians wearing long sleeves, ties, and watches in an attempt to reduce hospital-acquired infections. Critics of the legislation claim studies have failed to establish a link between contamination of clothing and patient infection.

Florida Pulmonary Consultants picks Benchmark Systems’ EMR/PM solution.

A big welcome to Gateway EDI, our newest HIStalk Practice sponsor. The St. Louis, MO-based EDI provider serves over 21,000 offices in all 50 states and more than 85,000 providers. Gateway submits to over 3,000 payers and  also offers such services as electronic eligibility, remittance, patient statements, and credit card processing. Gateway’s customer support stats are impressive: 98% of calls are answered by a real person and 92% of customer questions are answered on the first call. In addition, clients using Gateway’s claim processing tools typically lower their average error rate below seven percent. Gateway is also sponsoring HIStalk, so a double thank you for the support.

The Minneapolis paper profiles 3M’s Mobile Physician Solution, which allows providers to track patient clinical data, dictate, and capture charges. It was introduced in October and is licensed for $2,000 a year per user.

athenahealth is named a 2011 Best Place to Work in Massachusetts by The Boston Business Journal. Results were based on employee-satisfaction surveys.

Most curious: a Illinois man is arrested for impersonating a doctor and running a medical office without a license. George Fleming ran an advertisement for his “services” in a Bulgarian newspaper. A “patient” visited the office and claims Fleming inserted what appeared to be toothpicks into his chest. He then gave him a bottle of "Prosperous Farmer Dietary Supplements," whose label had a 2002 expiration date. Fleming then asked the patient for $150 cash. The patient called the police.

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DOCtalk by Dr. Gregg 5/22/11

A Confident Nobody

Most all of you who read what is written anywhere within the HIStalk realm know that our world, the world which straddles healthcare and technology, is rife with egos galore. (Actually, I should probably write that “EGOS”.)

Doctors are notorious for their inflated senses of self. Heck, even many a nurse or med tech gets in on the medical godhead fun.

Tech-heads aren’t far behind. In fact, sometimes when I listen to two technophiles go at it as to who has the superior program design or some such, the haughty disregard each expresses for the potential validity of the other’s opinion often exceeds that evidenced amongst medicos.

Confidence in our abilities and our decisions is vital to achieving anything. Sadly, its evil cohort, arrogance — which is really just a Girls Gone Wild version of confidence — often takes an otherwise fun time and turns it into a “whose is bigger / better” contest.

This seems particularly counterproductive to our current HIT drive. I say this because of many recent conversations where I see chest-flashing bravado circumvent honest progress. Whether it’s among HIT industry types or between medical folks discussing HIT or medicos taking on HIT-men (or HIT-women), all too often I see chest pounding (or, in keeping with the theme, chest flashing) prevent real potential progress.

Sure, we all like to think we know stuff. But, when “knowing stuff” turns to “showing off,” ears tends to close as pumped out chests start to grow. One knower stops hearing the other knowers. Even though all knowers know they don’t know it all, their know-it-all-manship takes a hold and makes unknown knowing unknowable because the knower thinks they now know no one knows as well as they know. Ya’ know?

I’m seeing more and more really good partial solutions coming down the HIT trail. Some are standalones, some are within larger products. The problem is that virtually none of them do as well on their own as they might if they were hooking up with some of the others. Yet, despite all the chest-flashing going on, few are moving on to the hookup. So many are so mired in the showing off that they forget that the flash is only a part of the fun; the hookup is where the real pay off happens.

With everyone thinking that they have the best answer(s), few are truly open to hearing how the other answers out there might sweeten a mutually satisfying association. Our endless egos, which are probably a large part of the reason for healthcare’s late arrival to the technological party, are also likely a prime source for its continuing negative inertia despite all the beads being thrown about these days. The bountiful beads, it seems, are making it pretty hard for most of the HIT “somebodies” to keep their shirts down. Everybody wants to show what they have; few are really looking at the bigger picture (i.e., it’s the hookup, not the flash, that is the goal.)

I worry about this for myself, too. I’m probably far worse than most since I have both geek and doc genes. I’m probably doubly inclined to start unbuttoning. But, honest, I try to keep an open ear and a closed shirt. I try to keep my brain engaged and my chest hairs covered. I try to think “listen,” not “talk,” because most of the time odds are pretty darn good that I’ll hear something I don’t know. When I’m not in the “gone wild” mode, goodness knows that I know just how little I really know.

So, if you ever catch me writing or talking as anything other than a “confident nobody,” please tell me to button my shirt. And, please, be you on the “H” or the “IT” side, keep your top down, too. There are some really good answers out there and they don’t just come from you or me. Remember: tops down, ears open, and we’ll all get to the hookup.

From the buttoned down trenches…

“In heaven, an angel is nobody in particular.” – George Bernard Shaw

Dr. Gregg Alexander, a grunt in the trenches pediatrician at Madison Pediatrics, is Chief Medical Officer for Health Nuts Media, directs the Pediatric Office of the Future exhibit for the American Academy of Pediatrics, and sits on the board of directors of the Ohio Health Information Partnership (OHIP).

News 5/19/11

CMS announces that the first Medicare EHR incentive payments will be issued this week. Eligible Professionals, who can receive a maximum of $18,000 during the first year, will be paid via electronic funds transfer or by check.

Massachusetts governor Deval Patrick helps eClinicalWorks CEO Girish Navani and COO Mahesh Navani cut the ceremonial ribbon on eClinicalWorks’ new Westborough headquarters. Patrick then took some time to meet and greet eClinicalWorks staff members.

Carmel Foot Specialists (NC) partners with TSI Healthcare to deploy NextGen’s PM/EMR/Patient Portal.

Patient check-in company Phreesia wins the Triple Tree I Award for Operational Effectiveness at the recent Wireless-Life Sciences Alliance Convergence Summit.

Billing service provider MedData introduces an online patient portal option.

Florida’s Center for the Advancement of Health IT says over 700 physicians have signed up for assistance. The REC has funding for 2,000 providers and is waiving membership enrollment fees for eligible participants. I wonder if the waived fees are a result of too few providers enrolled for services?

ADP AdvancedMD earns ONC-ATCB certification from CCHIT for its 2011 Summer release.

CCHIT announces plans to certify ambulatory EHRs in obstetrics, oncology, and clinical research. CCHIT’s specialty-specific certifications are separate from its ONC-ATCB certification program.

Capario says it is now processing inbound 5010 claims (Errata version) and providing 5010 ERAs with submitters.

Sage Healthcare Division President Betty Otter-Nickerson is featured in the May issue of Imaging Economics discussing the need for industry leaders to bring technology tools and connectivity to patients and physicians.

I realize today’s post is a bit short. I am blaming it on a slow news day, though it could be a hot date or a need to catch a shoe sale.

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Practice Wise 5/18/11

Since I didn’t formally introduce myself in my initial posting last month, Inga asked me to take a brief moment to do so now. I’m the founder of a practice management consulting firm. Although we do soup to nuts practice management consulting, we have focused on filling the information gap between the ambulatory medical practice and their technology solution providers. We consult on some software, sell a few products, but mostly consult on practice management and performance as a whole.

This is not a platform for me to sell my products or services, but to do more of what I do every day: share information and opinions. I’m not banking that everyone will agree with what I have to say, nor does it matter.

What I know is that most technology vendors have a disadvantage communicating with their clients – the medical care providers. I come from both a hospital and ambulatory clinic background. My perspective in this blog is to give voice to the needs of the medical staff and providers as they wind their way through this crazy technology landscape.

Where the Workers Are

We keep hearing that with the great rush towards EHR adoption, there is going to be a serious shortage of HIT people to handle all the implementations and support roles. I was recently invited by our local community college (Portland Community College) to speak to a group of students completing their HIT program. A consortium of five Oregon community colleges have joined the nationwide effort to train and find employment for workers to help fill the projected HIT worker gap.

The consortium is targeting unemployed individuals with health care or information technology backgrounds as well as currently employed workers in both fields who are ready to take advantage of the opportunity to expand their professional portfolio. The colleges will use their connections with local employers to help place newly-trained HIT workers in jobs that will promote the adoption and meaningful use of EHR systems in Oregon.

The program received seed money through an ONC 2 year grant. The Health Informatics Concentration of Study Award is a short-term training program, created to meet the needs of two types of professionals:

• The healthcare professional with high computer literacy who is interested in acquiring programming, networking, and database development skills in order to enter the health informatics industry.
• The IT professional who is interested in acquiring knowledge of medical terminology, medical records, and health information management in order to enter the health informatics industry.

Going into it, I knew that this was a program to retrain adult students who were looking to change up their careers. What I didn’t know was that this program is a treasure trove of amazing talent. Although I was there to share my industry experience and an employer’s perspective of the industry to these students, I ended up getting an education about the caliber of students these programs are producing.

If you are an EHR vendor, a hospital HIT manager, an ambulatory medical practice, or a consulting firm, you can’t afford to overlook this deep pool of talented individuals. I stayed after the presentations were done to meet with the students. I found myself talking with a computer programmer with dual degrees, an RN with practical clinic experience in EMR implementation, a SQL programmer/DBA, and a bevy of IT folks who had some health care experience or none at all, but many years of IT experience and a deep desire to break into this industry.

Every one of these folks had a well-crafted resume, an excellent elevator presentation of themselves, and a passion to find a job that offers them some level of security for the near future. As an employer, I’m really excited about the value of the potential employees coming out of this program.

You, too can tap into this gold mine. This program curriculum is currently being used in 82 community colleges that received grants from ONC, but the curriculum is going to be available for free to the 1200-1400 community colleges nationwide this summer.

There was a dual grant for this program, the second part being a curriculum development grant awarded to top universities such as Oregon Health & Science University, Duke, U of Alabama, Columbia, and Johns Hopkins. This ensures a robust and content rich program that guarantees that the students are getting course work that is readily applicable in our industry.

Did I mention that I’m excited about this program for my own business, the industry, and my clients as well? There is a talent pool waiting for us to dive into and show them where the jobs are. I’ve already started interviewing several of these folks for both positions with my company and with clients of ours who are starting EHR implementations. I’ve forwarded a few resumes to local healthcare IT support vendors. Check it out in your community.

Julie McGovern is CEO of Practice Wise, LLC.