News 10/5/17

Top News

The Senate confirms Eric Hargan (Greenberg Traurig) as deputy secretary of HHS – now second in command to new acting Secretary Don Wright. The Chicago-based lawyer, whose mother worked at the family’s local rural hospital for 58 years, was part of President Trump’s transition team, and worked at HHS during the George W. Bush administration. When asked during his confirmation hearing why he would like to get back into government work, he said it was an opportunity he just couldn’t pass up. “The challenges are so great,” he explained, “whether in public health, in healthcare finance, in facilitating innovation in healthcare and in the administration of human services, that I cannot imagine not wanting to participate, and to lend to the government both my past experience at HHS, as well as the fruit of my years of work in the healthcare sector since then, to help as much as I can.”

HIStalk Practice Announcements and Requests

Check out HIStalk’s Must-See Exhibitors Guide for MGMA 2017. Map out your trip to the exhibit hall using the guide, which includes descriptions of the products and innovations (and giveaways!) our sponsors plan to showcase. We’ve also included contact information for sponsors that will be walking the show floor.

Webinars

October 17 (Tuesday) noon ET. “Improve Care and Save Clinician Time by Streamlining Specialty Drug Prescribing.” Sponsored by: ZappRx. Presenter: Jeremy Feldman, MD, director, pulmonary hypertension and advanced lung disease program and medical director of research, Arizona Pulmonary Specialists. Clinicians who treat pulmonary arterial hypertension can spend an average of 20 minutes to prescribe a single specialty drug and untold extra hours each month completing prior authorization (PA) paperwork to get patients the medications they need. This webinar will describe how Arizona Pulmonary Specialists automated the inefficient specialty drug ordering process to improve patient care while saving its clinicians time.

October 19 (Thursday) noon ET. “Understanding Enterprise Health Clouds with Forrester:  What can they do for you, and how do you choose the right one?” Sponsored by: Salesforce. Presenters: Joshua Newman, MD, chief medical officer, Salesforce; Kate McCarthy, senior analyst, Forrester. McCarthy will demystify industry solutions while offering insights from her recent Forrester report on enterprise health clouds. Newman and customers from leading healthcare organizations will share insights on how they drive efficiencies, manage patient and member journeys, and connect the entire healthcare ecosystem on the Salesforce platform.

October 26 (Thursday) 2:00 ET. “Is your EHR limiting your success in value-based care?” Sponsored by: Philips Wellcentive. Presenters: Lindsey Bates, market director of compliance, Philips Wellcentive; Greg Fulton, industry and public policy lead, Philips Wellcentive. No single technology solution will solve every problem, so ensuring you select the ones most aligned to meet your strategic goals can be the difference between thriving or merely surviving. From quality reporting to analytics to measures building, developing a comprehensive healthcare strategy that will support your journey in population health and value-base care programs is the foundation of success. Join Philips Wellcentive for our upcoming interactive webinar, where we’ll help you evolve ahead of the industry, setting the right strategic goals and getting the most out of your technology solutions.

November 8 (Wednesday) 1:00 ET. “How Clinically Integrated Networks Can Overcome the Technical Challenges to Data-Sharing.” Sponsored by: Liaison Technologies. Presenters: Dominick Mack, MD, executive medical director, Georgia Health Information Technology Extension Center and Georgia Health Connect, director, National Center for Primary Care, and associate professor, Morehouse School of Medicine;  Gary Palgon, VP of  healthcare and life sciences solutions, Liaison Technologies. This webinar will describe how Georgia Heath Connect connects clinically integrated networks to hospitals and small and rural practices, helping providers in medically underserved communities meet MACRA requirements by providing technology, technology support, and education that accelerates regulatory compliance and improves outcomes.

Previous webinars are on our YouTube channel. Contact Lorre for information on webinar services.

Announcements and Implementations

ZyDoc releases an Android version of its mobile dictation app used in conjunction with its cloud-based transcription service.

The Western New York-based HealtheLink HIE announces that 1 million patients have signed up to share their data.

MyMipsScore adds a payment adjustment estimator to its app, giving physicians the ability to estimate MIPS payments based on historical data from CMS.

New Mexico Orthopaedics selects the Outcomes-Based Electronic Research Database (OBERD) platform from Universal Research Solutions to aggregate outcomes, satisfaction, education, and operative data; and to expedite participation in MIPS.

Seven Hills Foundation selects population health management and care coordination software from Netsmart to help improve communication and outcomes amongst its network of primary care, acute care, and behavioral health providers.

Nextech adds RCM services including claims management and patient collections to its EHR and PM technologies for specialty practices.

People

Tom Nix (CDG) joins Ria Health as CEO. The company launched this week with a mobile app designed to help people stop or reduce their alcohol consumption.

Outpatient chronic wound care center operator Healogics names Kelly Priegnitz (Kindred Healthcare) chief compliance officer.

Caravan Health appoints Anna Loengard, MD (The Queen’s Clinically Integrated Physician Network), CMO and Tim Gronniger (The Brookings Institution) VP of strategy.

Government and Politics

In Cincinnati, the Hamilton County Heroin Coalition will use half of a $400,000 federal grant to incorporate predictive analytics into its efforts to help prevent overdoses and get drug users into treatment. The coalition will equip its Quick Response Teams with analytics they can use to not only predict overdoses, but to reach out to the social network of drug users to let them know about the prediction and options for care.

Research and Innovation

A UnitedHealthcare survey finds that consumer interest in telemedicine has increased from 37 percent in 2016 to 42 percent in 2017, though it doesn’t go into detail about how many have actually used the service to access care. I’d also be interested to know why 46 percent feel telemedicine isn’t for them, as that would clue physicians in to what may be key to successfully implementing their own telemedicine service. The payer began covering virtual visits in 2015. Other interesting finding include:

• 28 percent of survey takers first turn to the Internet to research their health concerns.
• 32 percent used the Internet to compare cost of services – a figure that’s more than double the number of consumers who conducted such searchers five years ago.
• 71 percent of savvy consumers believe (and rightly so) that there is no correlation between cost and quality of healthcare services.

Other

Toy maker Mattel cancels development plans for Aristotle, a kid-friendly device akin to the Amazon Echo that, accompanied by a small camera, could interact with kids as they grow. Originally announced in January, ads for the device showed it acting as a video sleep monitor, then nightlight, then homework assistant as its camera recorded the growth and habits of the child it was stationed near. Privacy experts cried foul, though the company hasn’t attributed the cancellation to those concerns. Perhaps the Campaign for a Commercial-Free Childhood’s petition with 15,000 signatures prompted the halt, or concerns from pediatricians like Jennifer Radesky, MD who fears the device would encourage parents to substitute technology for human interaction.

Contacts

Jenn, Mr. H, Lorre

More news: HIStalk, HIStalk Connect.

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Contact us online.
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News 10/4/17

Top News

Rock Health’s latest report puts digital health funding for 2017 at $1.2 billion, making it the biggest year yet for such investment since the company began tracking figures. The total includes 268 deals across 261 companies, with $334 million from 17 deals involving EHR and clinical workflow technology companies.

HIStalk Practice Announcements and Requests

Check out HIStalk’s Must-See Exhibitors Guide for MGMA 2017. Map out your trip to the exhibit hall using the guide, which includes descriptions of the products and innovations (and giveaways!) our sponsors plan to showcase. We’ve also included contact information for sponsors that will be walking the show floor.

Webinars

October 17 (Tuesday) noon ET. “Improve Care and Save Clinician Time by Streamlining Specialty Drug Prescribing.” Sponsored by: ZappRx. Presenter: Jeremy Feldman, MD, director, pulmonary hypertension and advanced lung disease program and medical director of research, Arizona Pulmonary Specialists. Clinicians who treat pulmonary arterial hypertension can spend an average of 20 minutes to prescribe a single specialty drug and untold extra hours each month completing prior authorization (PA) paperwork to get patients the medications they need. This webinar will describe how Arizona Pulmonary Specialists automated the inefficient specialty drug ordering process to improve patient care while saving its clinicians time.

October 19 (Thursday) noon ET. “Understanding Enterprise Health Clouds with Forrester:  What can they do for you, and how do you choose the right one?” Sponsored by: Salesforce. Presenters: Joshua Newman, MD, chief medical officer, Salesforce; Kate McCarthy, senior analyst, Forrester. McCarthy will demystify industry solutions while offering insights from her recent Forrester report on enterprise health clouds. Newman and customers from leading healthcare organizations will share insights on how they drive efficiencies, manage patient and member journeys, and connect the entire healthcare ecosystem on the Salesforce platform.

October 26 (Thursday) 2:00 ET. “Is your EHR limiting your success in value-based care?” Sponsored by: Philips Wellcentive. Presenters: Lindsey Bates, market director of compliance, Philips Wellcentive; Greg Fulton, industry and public policy lead, Philips Wellcentive. No single technology solution will solve every problem, so ensuring you select the ones most aligned to meet your strategic goals can be the difference between thriving or merely surviving. From quality reporting to analytics to measures building, developing a comprehensive healthcare strategy that will support your journey in population health and value-base care programs is the foundation of success. Join Philips Wellcentive for our upcoming interactive webinar, where we’ll help you evolve ahead of the industry, setting the right strategic goals and getting the most out of your technology solutions.

November 8 (Wednesday) 1:00 ET. “How Clinically Integrated Networks Can Overcome the Technical Challenges to Data-Sharing.” Sponsored by: Liaison Technologies. Presenters: Dominick Mack, MD, executive medical director, Georgia Health Information Technology Extension Center and Georgia Health Connect, director, National Center for Primary Care, and associate professor, Morehouse School of Medicine;  Gary Palgon, VP of  healthcare and life sciences solutions, Liaison Technologies. This webinar will describe how Georgia Heath Connect connects clinically integrated networks to hospitals and small and rural practices, helping providers in medically underserved communities meet MACRA requirements by providing technology, technology support, and education that accelerates regulatory compliance and improves outcomes.

Previous webinars are on our YouTube channel. Contact Lorre for information on webinar services.

Announcements and Implementations

The Cohen Veterans Network selects AI-driven clinical decision support from Raiven Healthcare to optimize treatment for veterans within its network of 11 mental health clinics.

In an effort to enhance transparency and accountability, medical marijuana technology company Alternate Health adds blockchain ledger technology to its newly rebranded CanaPass Patient Management System.

MRI of Woodbridge (NJ) selects RCM and PM services from Healthcare Administrative Partners.

EClinicalWorks adds a self-service option for customers to connect with CommonWell and Carequality.

People

VillageMD names Michael Pape (US Congress) head of growth strategies and business development in Kentucky.

Seth Darmstadter (Michelman & Robinson) joins Outcome Health as general counsel.

Government and Politics

Abdul Haq, MD pleads guilty to charges related to his involvement in a $19 million Medicare fraud scheme that involved a number of Detroit-area providers, all of whom seem to have colluded on prescribing Medicare beneficiaries medically unnecessary controlled substances, requiring them to undergo medically unnecessary procedures in exchange for prescriptions, and fraudulent billing, among other crimes.

Telemedicine

Griffin OB-Gyn Clinic (GA) will implement Women’s Telehealth services for maternal fetal medicine.

Premium Health Connections selects white-labeled technology from Teladoc to power its virtual consult offerings.

Other

Former US Surgeon General Vivek Murthy, MD points to the workplace is a big contributor to today’s loneliness epidemic, which he considers to be a public health issue due to its correlation with decreased life spans stemming from heart disease, depression, anxiety and dementia. “For better or worse, people understand the language of epidemics,” Murthy says. “I think of loneliness as an epidemic because it affects a great number of people in our country, but also because one person’s loneliness can have an impact on another person. This is not a condition that is developing in isolation. I talk about this as an epidemic because it’s far more widespread than people believe, and like many illnesses that are related to our mental and psychological state, it gets swept under the rug and exists in the shadows. That’s why I speak about this with the urgency that I do.”

Sponsor Updates

• Nordic posts a podcast titled “How do I plan for a successful EHR go-live?”
• AdvancedMD will exhibit at the American Society for Dermatologic Surgery October 5-8 in Chicago.
• Aprima will exhibit at the American Osteopathic Association Conference & Exhibition October 7-9 in Philadelphia.

Blog Posts

• Utah Hospital Aftermath: What Police Precincts Need to Do (AdvancedMD)
• Disaster Preparedness (Aprima)
• Epic Provider Efficiency Profile (PEP) (Culbert Healthcare Solutions)

Contacts

Jenn, Mr. H, Lorre

More news: HIStalk, HIStalk Connect.

Get HIStalk Practice updates.
Contact us online.
Become a sponsor.

News 10/3/17

Top News

WebPT acquires physical therapy-focused patient relationship management software startup Strive Labs for an undisclosed amount. WebPT has already begun to roll out the EHR-agnostic StriveHub PRM product to its EHR/PM customers. Strive Labs co-founders Scott Hebert and Ryan Klepps previously helped launch TheraVid, a developer of PT-prescribed Web-based rehab programs.

HIStalk Practice Announcements and Requests

Check out HIStalk’s Must-See Exhibitors Guide for MGMA 2017. Map out your trip to the exhibit hall using the guide, which includes descriptions of the products and innovations (and giveaways!) our sponsors plan to showcase. We’ve also included contact information for sponsors that will be walking the show floor.

Webinars

October 17 (Tuesday) noon ET. “Improve Care and Save Clinician Time by Streamlining Specialty Drug Prescribing.” Sponsored by: ZappRx. Presenter: Jeremy Feldman, MD, director, pulmonary hypertension and advanced lung disease program and medical director of research, Arizona Pulmonary Specialists. Clinicians who treat pulmonary arterial hypertension can spend an average of 20 minutes to prescribe a single specialty drug and untold extra hours each month completing prior authorization (PA) paperwork to get patients the medications they need. This webinar will describe how Arizona Pulmonary Specialists automated the inefficient specialty drug ordering process to improve patient care while saving its clinicians time.

October 19 (Thursday) noon ET. “Understanding Enterprise Health Clouds with Forrester: What can they do for you, and how do you choose the right one?” Sponsored by: Salesforce. Presenters: Joshua Newman, MD, chief medical officer, Salesforce; Kate McCarthy, senior analyst, Forrester. McCarthy will demystify industry solutions while offering insights from her recent Forrester report on enterprise health clouds. Newman and customers from leading healthcare organizations will share insights on how they drive efficiencies, manage patient and member journeys, and connect the entire healthcare ecosystem on the Salesforce platform.

November 8 (Wednesday) 1:00 ET. “How Clinically Integrated Networks Can Overcome the Technical Challenges to Data-Sharing.” Sponsored by: Liaison Technologies. Presenters: Dominick Mack, MD, executive medical director, Georgia Health Information Technology Extension Center and Georgia Health Connect, director, National Center for Primary Care, and associate professor, Morehouse School of Medicine;  Gary Palgon, VP of  healthcare and life sciences solutions, Liaison Technologies. This webinar will describe how Georgia Heath Connect connects clinically integrated networks to hospitals and small and rural practices, helping providers in medically underserved communities meet MACRA requirements by providing technology, technology support, and education that accelerates regulatory compliance and improves outcomes.

Previous webinars are on our YouTube channel. Contact Lorre for information on webinar services.

Announcements and Implementations

OptimizeRx integrates its prescription savings messaging with EHRs from Aprima and ISalus.

CareCloud partners with investor and global payments technology company First Data to develop Breeze, a mobile patient intake and payment system that also incorporates access to First Data’s marketplace of 300 business apps.

People

Kidney- and dialysis-focused healthcare technology company Cricket Health names Danny Shapiro (Home Care Assistance) chief business officer.

Richard Morel, MD (WestMed) joins CareMount Medical – New York’s largest independent multispecialty medical group – as deputy CMO.

Acquisitions, Funding, Business, and Stock

US Physical Therapy saw operations at 81 of its 567 outpatient PT clinics affected by the recent spate of hurricanes, with 7,1000 patient visits cancelled to the tune of $635,000 in lost revenue.

MTBC uses a $6 million public offering of non-convertible preferred stock to help fund its recent acquisition of MediGain, a medical billing company headquartered in Dallas. The company reports it has signed contracts with physicians in 42 states for its new voice-enabled TalkEHR.

Telemedicine

Teladoc updates its mobile app with specialty consult services and technology from Best Doctors, which it acquired in July.

Government and Politics

A former Hewlett-Packard Enterprise employee faces a federal indictment related to charges of computer fraud. The allegations contend that Hossein Heydari purposefully shut down Oregon’s Medicaid computer system for 24 hours in retaliation for being let go as part of a workforce reduction. Heydari, who has pleaded not guilty, provided technical support for Oregon’s system, as well as those of three other states.

Research and Innovation

An evaluation of complaints from cancer outpatients and their families finds that management issues (48 percent) and relationship issues (41 percent) rank higher than those related to quality and safety. The authors particularly hone in on the importance of clear lines of communication, patient-staff dialogue, and humanness and caring in the cancer patient’s journey. The study seems to emphasize the fact that genuine human interaction during treatment means more to patients than whether or not their care is powered by the latest, heavily marketed AI.

An MGMA survey conducted with help from Navicure finds that practices are outpacing their hospital counterparts when it comes to healthcare pricing transparency: Nearly eighty percent of ambulatory organization respondents provide cost estimates on demand, versus 69 percent of hospital survey-takers. Despite strong patient interest in electronic billing options – and the fact that 27 percent of practices already offer online bill pay – 77 percent of practices still send their patients paper statements.

Other

Northwestern Children’s Practice produces a totally 80’s flu vaccine promo video. Kudos to them for incorporating a “Say Anything” reference.

Contacts

Jenn, Mr. H, Lorre

More news: HIStalk, HIStalk Connect.

Get HIStalk Practice updates.
Contact us online.
Become a sponsor.

News 10/2/17

Top News

CMS reminds physicians that it’s not too late to participate in the first year of MIPS. Data collection for the 2017 transition year must begin today. Physicians can submit data for a full year, data for at least a consecutive 90-day period, or a minimum amount of less than 90 days. Don’t forget that CMS offers free technical assistance to providers working in small, underserved, and rural practices.

HIStalk Practice Announcements and Requests

I’m getting back up to speed this week after taking a bit of time off to enjoy some end-of-season sun and sand. My visit to the more southern part of the North Carolina coast marked the first time I’ve ever seen beach-front houses with roofs strapped down, and pools swallowed whole courtesy of last year’s Hurricane Matthew and chronic erosion. After this year’s hurricane season, I’m 99 percent sure I’ll never own a house on the beach.

That being said, I did find time to publish two interviews with physicians working in very different environments. I hope you’ll check them out. Volunteers in Medicine Clinic Executive Director Raymond Cox, MD discusses the role data access plays in caring for the working poor. PeakMed Direct Primary Care founder and CMO Mark Tomasulo, DO shares his thoughts on the ways health insurance reform are driving the DPC business model.

Webinars

October 17 (Tuesday) noon ET. “Improve Care and Save Clinician Time by Streamlining Specialty Drug Prescribing.” Sponsored by: ZappRx. Presenter: Jeremy Feldman, MD, director, pulmonary hypertension and advanced lung disease program and medical director of research, Arizona Pulmonary Specialists. Clinicians who treat pulmonary arterial hypertension can spend an average of 20 minutes to prescribe a single specialty drug and untold extra hours each month completing prior authorization (PA) paperwork to get patients the medications they need. This webinar will describe how Arizona Pulmonary Specialists automated the inefficient specialty drug ordering process to improve patient care while saving its clinicians time.

October 19 (Thursday) noon ET. “Understanding Enterprise Health Clouds with Forrester: What can they do for you, and how do you choose the right one?” Sponsored by: Salesforce. Presenters: Joshua Newman, MD, chief medical officer, Salesforce; Kate McCarthy, senior analyst, Forrester. McCarthy will demystify industry solutions while offering insights from her recent Forrester report on enterprise health clouds. Newman and customers from leading healthcare organizations will share insights on how they drive efficiencies, manage patient and member journeys, and connect the entire healthcare ecosystem on the Salesforce platform.

November 8 (Wednesday) 1:00 ET. “How Clinically Integrated Networks Can Overcome the Technical Challenges to Data-Sharing.” Sponsored by: Liaison Technologies. Presenters: Dominick Mack, MD, executive medical director, Georgia Health Information Technology Extension Center and Georgia Health Connect, director, National Center for Primary Care, and associate professor, Morehouse School of Medicine;  Gary Palgon, VP of  healthcare and life sciences solutions, Liaison Technologies. This webinar will describe how Georgia Heath Connect connects clinically integrated networks to hospitals and small and rural practices, helping providers in medically underserved communities meet MACRA requirements by providing technology, technology support, and education that accelerates regulatory compliance and improves outcomes.

Previous webinars are on our YouTube channel. Contact Lorre for information on webinar services

Announcements and Implementations

Richland Medical Center, a multispecialty medical group in Richland Center, WI, selects Aprima’s EHR and PM system.

HealthLynked adds over 880,000 physician profiles to its consumer-facing medical record and appointment scheduling service.

Acquisitions, Funding, Business, and Stock

The Texas Medical Association offers physicians whose practices are in federally declared Hurricane Harvey disaster areas relief funds through its Disaster Relief Program. According to the association, 65 percent of affected physicians had to close their offices temporarily, and 35 percent had to cut back on availability. “We want physicians to be able to apply for support as quickly as possible so we can send funds to them as fast as we can,” explains TMA President Carlos Cardenas, MD. “Their … patients are struggling, their staffs are hurting, and they are straining to get their practices get up and running again, so we want to help ease those burdens.” 

After severing ties with John Muir Health System (CA), Muir Medical Group IPA decides to merge with Hill Physicians under the Hill Physicians Medical Group brand. Both IPAs are in the process of expanding their Epic utilization.

Downers Grove, IL-based DuPage Medical Group kicks off its new Catalyst Program, which provides residents with a final-year stipend in exchange for agreeing to work at DMG after graduation. “The Catalyst Program will be instrumental in creating a world-class network of top-tier residents and bringing them into the DMG family of physicians,” says Chief Development Officer Henry Tobie, “especially at the early stages of their medical careers. This program is vital to our long-term organizational growth, and we see it as a win-win for the resident as well as our patients.”

People

Gigi Sorenson (Northern Arizona Healthcare) joins telemedicine software and hardware company GlobalMed as director of clinical integration.

First Healthcare Compliance, a Wilmington, DE-based compliance program management software vendor, promotes Sheba Vine to VP and general counsel.

Just days ahead of its annual convention in Los Angeles, AHIMA announces it is in need of a new CEO. VP of Policy and Government Relations Pamela Lane has served as interim CEO since Lynne Thomas Gordon left the association in July.

Telemedicine

MedExpress opens its second telemedicine center as part of a new urgent care clinic in Marion, VA. The company, an offshoot of Optum, plans to open a third telemedicine site when it opens a new clinic in nearby Franklin later this year.

MyTelemedicine rolls out new virtual consult offerings for employers that include around-the-clock physician access, prescription savings, consultations with counselors and specialists, and patient advocacy services.

Government and Politics

The Kansas Board of Pharmacy will use a $178,000 grant from the DoJ to provide quarterly prescribing benchmarking reports culled from its K-TRACS PDMP to every prescriber in the state. The board is working to integrate the six year-old PDMP with users’ EHRs for faster lookups.

Other

HITRUST and the AMA partner to offer cybersecurity workshops to small practices. The first will take place in Dallas on October 9 in conjunction with HITRUST’s Community Extension Program.

Sponsor Updates

• Versus Technology will exhibit at MD Expo October 5-7 in Orlando.
• EClinicalWorks will exhibit at Health 2.0 October 1-4 in Santa Clara, CA.
• Intelligent Medical Objects Senior Software Engineer Yunwei Wang becomes the first to successfully complete the Health Level Seven International inaugural HL7 Proficiency Exam.

Blog Posts

• Health Literacy – Not All Patient Education is Created Equal (Healthwise)
• Integrated workflow benefits to patients and physicians (AdvancedMD)

Contacts

Jenn, Mr. H, Lorre

More news: HIStalk, HIStalk Connect.

Get HIStalk Practice updates.
Contact us online.
Become a sponsor.

HIStalk Practice Interviews Mark Tomasulo, DO Founder and CMO, PeakMed Direct Primary Care

Mark Tomasulo, DO is founder and CMO of PeakMed Direct Primary Care in Colorado.

Tell me about yourself and the organization.

I started medical school a little later in life. I started undergrad at about 25 or 26 years old. I spent four years in the Navy. I was an airplane mechanic, and then worked as a civilian for the government, and ended up hurting myself, and used the GI Bill to put me through the first two years of undergrad school. I got a scholarship for the second two years of undergrad, and then when I got accepted to medical school, I applied back to the Navy, as well as the Army. I liked the Army package a little bit better, and so they helped put me through medical school. In doing so, I spent about eight years in the Army, and four years in the Navy prior to that. All of my time in the Army was spent as a physician. I did my residence training at Fort Benning, at Martin Army Community Hospital. Then I was attached to the Big Red One, the 1st Infantry Division. And then got stationed at Fort Carson after a deployment to Iraq.

When the time finally came for me to decide whether or not to stay in the military, I ended up going into the civilian workforce. I spent a lot of time in the ER as an ER physician, as well as an urgent care physician. I really started to understand the barriers to healthcare when it came to civilian medicine. I’m a family physician, board certified, so my heart has always been with primary care, and so working in the ERs and the urgent care facilities, I really started recognizing that most of what we deliver in the ER is primary care. It’s lack of access to your primary care physician that forces you into an environment like the ER. I would venture to say that 95 percent of all urgent care visits are truly primary care visits. There’s a lack of access to primary care that has allowed urgent care facilities to flourish throughout the country over the last 10 years.

Lack of primary care access and the cost of living in a high deductible health plan world has created an environment where the patient waits until the very last minute to go see a provider. We’re living in a sick world, not a healthy world. And that’s why PeakMed was founded. When I started the company, it was really to solve the equation of access to your doctor, and the cost of going to see your primary care physician – to change the economic model, creating a viable primary care practice outside of third-party payers.

What role does technology play in PeakMed operations?

I think technology in the 21st century is a massive resource and a powerful tool, especially when you put it in a healthcare space. PeakMed really looks at technology as a means to providing care to our members in a manner that suits them best. Whether that care is through a brick and mortar location, like a traditional setting, or a text message, an email, or even telemedicine. What we want to do is leverage technology so that it enables access for our patients, creating an exchange of information between a doctor and a patient, so that the patient feels like they are taken care of, when it’s convenient for them. When all of those things work out well, and you allow your physician to drive that relationship, technology is a really key component to care access.

We use a lot of technology on the back side of the practice, which allows us to validate what we’re doing for our patients. It allows us to validate our model, compared to a fee-for-service environment, to see if we’re actually taking better care of our patients. It creates a way for us to validate what we do, and how we do it.

 Do you use a traditional EHR and PM system?

It’s a combination of a lot of things, because what we do is outside the norm of a fee-for-service clinic. A typical EHR is really based on transactions. It’s based on the ability to code for a specific encounter that allows the practice to bill for that event. It also, as a system, provides a technology that allows you to measure population health inside of your practice. It prompts providers to do specific things for a specific type of patient. With our EHR, we don’t concern ourselves with having to code an encounter for the purpose of reimbursement. We want to be able to quantify that encounter, or the visit, for population health measures and for internal purposes that allow us to improve our delivery model.

We do use an EHR, but we also have created our own technology because there was none available that allowed us to start looking at claims data for the total cost of care on a patient by patient basis. It allows us to really start identifying where the patient is spending money in the system, where we can influence some of that spend outside of the scope of primary care. It helps us understand where the money is being spent, and how much we can impact that outside the scope of primary care services in a way that helps us validate the savings that we generate for our members, as well as our employers.

You’ve mentioned that PeakMed will start looking at telemedicine, courtesy of a recent $5.5 million funding round. Why now? Are you looking at certain vendors?

We have lots of strategic partners in terms of technology platforms. When we talk about telemedicine, it’s a functionality inside of our encounters, or our EHR, that allows us the ability to have a video conference with a patient. Do we use a vendor like TelaDoc? No. It’s a totally different model. We use technology to make the connection face-to-face, through video. Everybody knows that as telemedicine. We don’t need a vendor in order to do that, but we do have some strategic partners that provide the HIPAA-compliant environment in which that occurs.

Is PeakMed looking at adding mental health or behavioral healthcare services?

Yes, absolutely. In our country, it’s one of the more underserved areas of healthcare. We need to start changing the way we talk about behavioral health and the way patients access it. And, once again, the cost that’s associated with therapy. To answer your question, the answer is absolutely. We have created a partnership with a behavioral health organization that is going to deliver behavioral healthcare to all of our patients, in our clinics, under the same type of membership model. You’ll have one fixed cost that includes PeakMed and behavioral health, which is done inside of the clinic. Everything from pediatric psychology to pediatric psychiatry, adult psychology, adult psychiatry, addiction counseling, group counseling, individual counseling. Those will all be offerings inside of our per member, per month cost.

Circling back to technology, how have you seen it improve access and outcomes at PeakMed?

Patient buy-in to management of their disease is critical to increasing compliance, which influences outcomes. If I can diagnose a patient with diabetes, have enough time to explain what diabetes is, more time to explain how we’re going to manage it, and then allow the patient to ask every question they can think of .… If those things can happen, and I have buy-in from that patient, the compliance is enormous. And the return on compliance influences the outcome of that disease. It’s all about exchanging information and knowledge. If we can use technology to help facilitate exchange of information between a doctor and a patient, it allows us to really start changing how we manage, and how we influence, a disease state.

For example, in the fee-for-service environment, patients are typically seen by the physician 1.4 times per year. That’s a national average. Inside of our facilities, we’re at about six times per patient, per year. We engage with them more frequently than the traditional model of care because we have time for the providers to reach out and be proactive and preventative with our patients. In doing so, the compliance, the outcome, the quality, the satisfaction, and the reduction of total cost of care is enormous. If I can keep the diabetic patient from an ER visit and an ICU admission, which can potentially cost $100,000, that’s an enormous win for PeakMed, the patient, and the healthcare industry. We’re saving money from every angle that we can think of, and we’re using technology to help facilitate that.

Healthcare in this country has been under enormous strain over the last several years, in terms of policy, cost, and access. Have you seen this drive interest in the direct primary care model?

Yes, I believe it has, but I think what it’s really done is creat an understanding that there’s a massive difference between healthcare, and health insurance. I think the ACA was always about health insurance reform. It wasn’t really about healthcare reform. With health insurance reform, it’s created an environment that is exceptionally expensive for individuals. They feel like they’re paying more on an annual basis, and getting less every year.

We need to shift the conversation to help consumers understand the difference between health insurance, which is really there to keep you out of medical bankruptcy, and healthcare, which is there to prevent you from having your hypertension lead to a heart attack or a stroke. People need to understand where their money is going and what value they’re getting. Today’s health insurance environment has led individuals to look for solutions outside of a traditional model. There used to be a time, 20 years ago, when health insurance was very synonymous with healthcare. I think those times have changed dramatically, and I think PeakMed is really starting to impact the healthcare component, and helping consumers and employers understand how to purchase both those things in a transparent, conscientious way.

You mentioned in an interview several years ago that the biggest challenge to being a physician was politicians, government, and bureaucracy. Do you still find that to be the case?

I think when a practice is required by a government entity to validate what they’re doing, in the form of creating more administrative burden … I think it’s very discouraging for the practitioner to continue doing what they’re doing. What a doctor really wants to do is take care of a patient. The more administrative burden that you place upon a doctor takes away from the patient/doctor relationship. It leads to a tremendous amount of burnout in our industry. I think a lot of physician burnout stems from the administrative burden that it takes to maintain a viable practice.

I think there are a lot of similarities from several years ago that really haven’t been fixed. They may have even gotten worse. Reimbursement-related mandates, for example, put a lot of pressure on the practice, and I think it creates a wedge between a viable practice and patient care. The doctor has to make a choice at some point. I think those are still very valid barriers in our current system that haven’t been addressed through legislation, or politicians. It’s going to take some innovative companies like PeakMed to create a solution and share it with others – a solution that shows a different way of practicing medicine, and an economic model that allows it to be viable.

Contacts

Jenn, Mr. H, Lorre

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