News 11/30/16

Top News

Excellus BlueCross BlueShield will roll out telemedicine services from MDLive to its members in New York beginning January 1. The local news reports some pushback from physicians, which has prompted the payer to invite them to join the telemedicine company’s network. "It’s not to take away from them, but increase availability, accessibility, and timeliness of visits they may not always be able to provide,” explains Excellus BCBS VP and CMO Richard Lockwood, MD. The payer tested out the virtual consult service in an employee pilot program earlier this year. Over 60 percent of those that used the service rated their experience as excellent.

HIStalk Practice Musings

I have been watching coverage of the fires in Eastern Tennessee with a heavy heart, having vacationed in the Gatlinburg area just a few months ago. Deemed the state’s worst wildfire in a century, the area has seen over 15,000 acres within the Great Smoky Mountains National Park burn to the ground, 700 homes destroyed or damaged, and seven confirmed fatalities. Though local Red Cross coordinators have let it be known they have more donations than they know what to do with, I can’t help but wonder how the families that have lost homes and livelihoods will cope heading into Christmas. I’m hopeful that one or two telemedicine companies will take notice and, as they did in the aftermath of Hurricane Matthew, offer affected citizens free virtual consults.

Webinars

December 6 (Tuesday) 1:00 ET. “Get Ready for Blockchain’s Disruption.” Sponsored by PokitDok. Presenter: Theodore Tanner, Jr., co-founder and CTO, PokitDok. EHR-to-EHR data exchange alone can’t support healthcare’s move to value-based care and its increased consumer focus. Blockchain will disrupt the interoperability status quo with its capability to support a seamless healthcare experience by centralizing, securing, and orchestrating disparate information. Attendees of this webinar will be able to confidently describe how blockchain works technically, how it’s being used, and the healthcare opportunities it creates. They will also get a preview of DokChain, the first-ever running implementation of blockchain in healthcare.

December 7 (Wednesday) 1:00 ET. “Charting a Course to Digital Transformation – Start Your Journey with a Map and Compass.” Sponsored by Sutherland Healthcare Solutions. Presenters: Jack Phillips, CEO, International Institute for Analytics; Graham Hughes, MD, CEO, Sutherland Healthcare Solutions. The digital era is disrupting every industry and healthcare is no exception. Emerging technologies will introduce challenges and opportunities to transform operations and raise the bar of consumer experience. Success in this new era requires a new way of thinking, new skills, and new technologies to help your organization embrace digital health. In this webinar, we’ll demonstrate how to measure your organization’s analytics maturity and design a strategy to digital transformation.

Acquisitions, Funding, Business, and Stock

Quartz co-founder Kevin Delaney offers his take on the growing pains startups typically reach when they hit the 150-employee mark. “Our structure and communication undoubtedly could be improved,” he explains, adding that the company now tops 200 employees with plans to add more globally in 2017. “I myself find that it remains an ongoing challenge to add structure without crimping the creativity, speed, and individual empowerment responsible for our success to date.” Consultant and original Netflixer Patty McCord refers to it as the “stand-on-a-chair number. Once a startup leader gets up on a chair to address the staff and someone yells out, ‘We can’t hear you,’ she says, “it’s time to start rethinking how you’re communicating.”

Announcements and Implementations

CompuGroup Medical adds a rehabilitation module focused on physical, occupational, and speech therapy to its WebEHR. The Weston Group, a Pennsylvania-based rehabilitation services company, worked with CGM to develop the module, which it will use at its facilities nationwide.

Modernizing Medicine adds clinical, financial, and benchmarking analytics to its EHR and PM technology. The company has also added Apple Watch functionality to its Pocket Practice smartphone app, giving physicians the ability to view upcoming appointment details with the (almost) flick of a wrist.

DrFirst adds genetics-based e-prescribing capabilities from Translational Software to its Rcopia medication management technology. The new tool will serve up genomic decision support and alerts to drug efficacy, toxicity, and known interactions as part of the physician’s e-prescribing workflow.

People

The Pennsylvania Podiatric Medical Association appoints Maryann Hartzell, DPM (Advanced Podiatry Associates) president.

Greg White (Allscripts) joins PerfectServe as COO.

Telemedicine

Pacific Gas & Electric installs a telemedicine kiosk from LiveHealth Online at its Fresno, CA facility. Employees covered by the company’s Anthem Blue Cross policy can use the virtual care service for a $4.90 co-pay.

Government and Politics

Sen. James Lankford publishes the second edition of his “Federal Fumble: 100 Ways the Government Dropped the Ball” report, which – you guessed it – highlights $247 billion in wasteful and inefficient federal spending. Healthcare-related chapters include “Drug addicts need to chill out,” “While rural hospitals in America close,” “High-priced healthcare for convicted murders,” “Only dropping two newborns is pretty good, right?” and “Two health plans but not for the price of one.”

Contacts

Jenn, Mr. H, Lorre

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News 11/29/16

Top News

Media outlets are abuzz with President-elect Donald Trump’s decision to appoint Rep. Tom Price, MD (R-GA) secretary of HHS and Seema Verma head of CMS. Price has served as a representative since 2004, and served as Georgia’s first Republican Senate Majority Leader in 2002. An orthopedic surgeon by trade, Price has been a fierce opponent of the ACA, attempting to repeal and replace the legislation multiple times. Verma is president and founder of health policy consulting company SVC, and has extensive experience with Republican-led Medicaid expansion efforts. Both appointments are contingent upon Congressional approval.

HIStalk Practice Announcements and Requests

In honor of #GivingTuesday, I encourage you to give to HIStalk’s DonorsChoose efforts. A generous vendor has provided significant matching funds to double the impact of donations made via HIStalk. You can donate as follows:

1. Purchase a gift card in the amount you’d like to donate.
2. Send the gift card by the email option to mr_histalk@67.225.140.230/~histalk (that’s Mr. H’s DonorsChoose account).
3. He’ll be notified of your donation and you can print your own receipt for tax purposes.
4. He’ll pool the money, apply the matching funds, and publicly report on HIStalk.com which projects he funded, with an emphasis on STEM-related projects as the matching funds donor prefers.

Webinars

December 6 (Tuesday) 1:00 ET. “Get Ready for Blockchain’s Disruption.” Sponsored by PokitDok. Presenter: Theodore Tanner, Jr., co-founder and CTO, PokitDok. EHR-to-EHR data exchange alone can’t support healthcare’s move to value-based care and its increased consumer focus. Blockchain will disrupt the interoperability status quo with its capability to support a seamless healthcare experience by centralizing, securing, and orchestrating disparate information. Attendees of this webinar will be able to confidently describe how blockchain works technically, how it’s being used, and the healthcare opportunities it creates. They will also get a preview of DokChain, the first-ever running implementation of blockchain in healthcare.

December 7 (Wednesday) 1:00 ET. “Charting a Course to Digital Transformation – Start Your Journey with a Map and Compass.” Sponsored by Sutherland Healthcare Solutions. Presenters: Jack Phillips, CEO, International Institute for Analytics; Graham Hughes, MD, CEO, Sutherland Healthcare Solutions. The digital era is disrupting every industry and healthcare is no exception. Emerging technologies will introduce challenges and opportunities to transform operations and raise the bar of consumer experience. Success in this new era requires a new way of thinking, new skills, and new technologies to help your organization embrace digital health. In this webinar, we’ll demonstrate how to measure your organization’s analytics maturity and design a strategy to digital transformation.

Acquisitions, Funding, Business, and Stock

Orb Health raises a $3.2 million Series A round of funding led by Mt. Vernon Investments. The Phoenix-based company will use the financing to further develop its collaborative care technology, which aggregates data from EHRs, wearables, and other patient engagement tools to better enable providers in their chronic care management initiatives.

Announcements and Implementations

Coordinated Care of Oklahoma deploys Nuance’s PowerShare Network for HIE, enabling its participants to access full imaging records across facilities via the cloud. I interviewed the Norman, OK-based HIE’s chief administrative officer, Brian Yeaman, MD (still a practicing family physician) earlier this month.

InteliScript develops real-time, drug-pricing comparison software that can be incorporated into e-prescribing workflows. The new tool also offers up the most affordable pharmacies closest to a patient’s residence via the EHR.

Surescripts makes available technology that delivers real-time medication adherence-related messages and alerts to physicians via their EHR.

Xerox develops a printer for ambulatory providers capable of securely sharing patient documents via the cloud.

People

Tom Reedinger (Athenahealth) joins Zotec Partners as director of business development, enterprise solutions.

Telemedicine

Hawaii-based KTA Super Stores rolls out telemedicine visits via DocNow at its store in Hilo, with plans to expand the service to additional stores in the coming months. The Hawaii-based telemedicine company opened for business earlier this year and has already signed contracts with several island-based pharmacy chains. State lawmakers passed a bill in July that will require its Medicaid managed care and fee-for-service programs to cover telemedicine services beginning January 1.

Managed services organization Femwell Group Health makes telemedicine capabilities available to its network of Topline MD physician practices in Central and South Florida. The MSO has also added online bill pay and practice management “checkups” to its service line.

Get Real Health adds virtual consult capabilities from VSee to its InstaPHR platform.

Government and Politics

OCR warns providers and business associates that a fake phishing email is being circulated with mock HHS letterhead with the fake signature of OCR Director Jocelyn Samuels. The email links to a website marketing company’s cybersecurity services.

Other

For the Internet activist who has everything: UK retailer Lush markets the “Error 404” bath bomb, with proceeds going to supports groups like Access Now that fight for digital rights and campaign to prevent Internet shutdowns across the globe. It might also be the perfect gift for that practice manager who is trying so hard to keep up with cybersecurity best practices.

Contacts

Jenn, Mr. H, Lorre

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From the Consultant’s Corner 11/29/16

The Potentially Big Business of Consumer-Directed Telehealth

If you think about it, health systems have used limited forms of telehealth for years. Take a typical radiology workflow, for example. Stored digital images are read by radiologists in distant locations, and reports from those radiologists are subsequently reviewed by the ordering physicians. More recently, clinicians have moved from such “store and forward,” asynchronous telehealth to synchronous telehealth that enables teleneurology for stroke victims in community hospitals, and teleICU for monitoring critically ill patients.

Why, then, all the recent excitement about telehealth? The answer is simple: For the first time, the patient is at the center of the decision to use telehealth rather than the clinician. Thus, telehealth is now as much about consumerism as healthcare dollars.

Driving Factors

Although consumerism has been slow to enter the healthcare environment, patient expectations are increasing. An astounding 98 percent of the population has Internet access, and 40 percent of adults have used an on-demand service such as Uber. Patients are looking for both convenience and access. The healthcare system has been a disappointment in both of those areas. Analysts predict a physician shortage of at least 90,000 by 2025. The national average wait time for a family practice physician is already nearing 20 days. Now that patients are paying more healthcare costs due to high-deductible health plans, they are demanding care that meets their convenience expectations.

Patients value high quality care when they want it, which includes having access to care during evenings, weekends, and holidays. According to Merchant Medicine, that’s one reason the number of retail clinics have grown from 258 in 2007 to 1,866 in 2015. In addition, cost-sensitivity means that price transparency and low cost have become as important to patients as whether or not their insurance is accepted. Taken together, these factors have weakened the allegiance to specific physicians in favor of convenience. It should come as little surprise that more than 75 percent of adults say they would use telehealth.

Employers also see the benefit of offering direct-to-consumer telehealth to their employees. The average telehealth visit is $75 less than an office visit, and can also reduce an employee’s time away from the office. More than 70 percent of employers report that they plan to offer telehealth in 2017.

Overcoming Obstacles

If patients and employers want direct-to-consumer telehealth, why hasn’t it taken off faster in traditional healthcare settings? There are four primary reasons:

1. Technology: Although telehealth technology is advancing rapidly, much consumer-facing telehealth is independent from traditional hospital IT infrastructure. Direct-to-consumer telehealth is offered to the market through companies such as Teladoc, Doctor on Demand, and American Well. Since EHR vendors have been busy with implementations, usability, and Meaningful Use, their technology is generally not as advanced as that of independent telehealth vendors. Therefore, bringing sophisticated telehealth into healthcare organizations requires either partnering with one of these vendors or integrating a telehealth platform into current IT infrastructures and clinician workflows. Either way, it is resource-intensive and requires clear strategy, funding, integration, and change management. Despite the complexity, healthcare executives acknowledge it is the wave of the future; the majority list implementing telehealth as a top priority.

2. Reimbursement: To date, Medicare only provides telehealth reimbursement through Medicare Advantage and for rural locations. Commercial insurance coverage is similarly limited. While proponents argue that increasing access at a low cost will improve healthcare quality and cost, payers worry that it may result in overutilization, thereby increasing costs.

3. State regulations: There are numerous interest groups battling over telehealth. Some are trying to restrict access, while others want to increase it. In some states, for example, telehealth can only be used after an in-person relationship with a clinician is established. Other groups are at odds over whether telehealth must include a live video component versus just a telephonic component. With state regulations changing rapidly, it is important to keep abreast of them prior to making significant investments.

4. Physician capacity: Physicians already are burdened with substantial administrative work and packed patient schedules. The waves of regulation from MU, PQRS, and now MACRA’s Quality Payment Program have resulted in enormous “change fatigue.” Even the technophile physician excited about telehealth finds adding new processes, technologies, and workflows daunting. With all that physicians need to do, it’s hard to tell them they must also compete with retail and telehealth vendors through on-demand, consumer-directed telehealth services.

Make no mistake: Deploying consumer-facing telehealth isn’t easy. Organizations need a clear strategy. However, those who figure it out sooner will certainly have an advantage. It’s time to get back to what patients want – convenient access to high-quality healthcare at a fair price from providers they can trust. By better engaging patients through telehealth, the industry should indeed become more efficient and effective.

Nancy Gagliano, MD is CMO of Culbert Healthcare Solutions in Woburn, MA.

Contacts

Jenn, Mr. H, Lorre

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News 11/28/16

Top News

Just in time for Cyber Monday: UpGuard grades the top 25 retailers on their cybersecurity practices. (As a Prime addict, I’m happy to see Amazon on the “Good” list.) In an effort to help consumers shop safely online, the company has created a Google Chrome extension that scores websites based on cybersecurity risk. Its November survey of 1,200 consumers found that nearly all are concerned about the security of their information online, and over 50 percent would avoid their favorite retailers if those companies had poor cybersecurity practices.

On a side note, it would be interesting to see such a scoring system created for developers and users of health IT. I’d be especially interested in seeing if there was correlation between providers with high cybersecurity scores and other areas, such as quality, patient satisfaction, and cost.

HIStalk Practice Announcements and Requests

Thanks to renewing sponsor Healthwise for supporting HIStalk Practice. Contact Lorre before the HIMSS rush if you’d like to learn more about becoming a sponsor.

Webinars

December 6 (Tuesday) 1:00 ET. “Get Ready for Blockchain’s Disruption.” Sponsored by PokitDok. Presenter: Theodore Tanner, Jr., co-founder and CTO, PokitDok. EHR-to-EHR data exchange alone can’t support healthcare’s move to value-based care and its increased consumer focus. Blockchain will disrupt the interoperability status quo with its capability to support a seamless healthcare experience by centralizing, securing, and orchestrating disparate information. Attendees of this webinar will be able to confidently describe how blockchain works technically, how it’s being used, and the healthcare opportunities it creates. They will also get a preview of DokChain, the first-ever running implementation of blockchain in healthcare.

December 7 (Wednesday) 1:00 ET. “Charting a Course to Digital Transformation – Start Your Journey with a Map and Compass.” Sponsored by Sutherland Healthcare Solutions. Presenters: Jack Phillips, CEO, International Institute for Analytics; Graham Hughes, MD, CEO, Sutherland Healthcare Solutions. The digital era is disrupting every industry and healthcare is no exception. Emerging technologies will introduce challenges and opportunities to transform operations and raise the bar of consumer experience. Success in this new era requires a new way of thinking, new skills, and new technologies to help your organization embrace digital health. In this webinar, we’ll demonstrate how to measure your organization’s analytics maturity and design a strategy to digital transformation.

People

The North Carolina Medical Board elects Eleanor Greene, MD (Triad Women’s Health and Wellness Center) president. Greene will no doubt lead the board in its continued efforts to crack down on dozens of physicians of patients that have died from opioid overdoses within the last year.

WEDI elects new board members including Pam Grosze (PNC Bank), David Haugen (Minnesota Dept. of Health) (not pictured), Teresa Rivera (Utah Health Information Network), and Michael Wilson (HealthCare Information Management).

Telemedicine

AbleTo adds care coordination capabilities, including streamlined referrals, to its behavioral health telemedicine program for payers. The New York City-based company has been on a bit of an executive hiring spree over the last six months, bringing on Rob Rebak (ShareCare) as CEO and Dorothy Gemmell (Practice Fusion) as chief commercial officer. Its last funding round seems to have been a $12 million Series C in June 2015.

Research and Innovation

A study of 333 PCPs finds that most would not provide full disclosure of a medical error when presented with two fictional cases – one involving a delayed cancer diagnosis, and one involving a care coordination breakdown. Most noted they would offer patients a limited or no apology, limited or no explanation, and limited or no information about the cause of the error – findings that the study’s authors say fall alarmingly short of national guidelines and patient expectations. The study didn’t delve into the reasons behind the lack of ethics, but it’s worth noting that 56 percent of PCPs have questioned whether the demands of practice are worth the toll, and that 37 percent have thought about leaving practice all together.

Other

The local paper puts the nation’s perceived physician shortage into perspective, calling the lack of family MDs more of an education and distribution problem than a genuine dearth of doctors:

“From our organization’s point of view,” says Family Medicine Education Consortium CEO Laurence Bauer, “more primary care is better. We just created a system that’s out of balance and continues to be out of balance,” Mr. Bauer said. “Family physicians, general internists and psychiatrists all are low on the pecking order and that creates an issue. We’ve created medical schools that, in my opinion, select people not generally wanting to go into general medicine and much more likely to go into sub-specialties. If you have a primary care physician serving as quarterback and allow him or her to make referrals, fewer people will be referred. But when they are, they don’t get lost in the system.”

I missed this a few weeks ago: ScottCare Cardiovascular Solutions, parent company of remote cardiac device monitoring brand Ambucor Health Solutions, notifies the cardiology offices of Conemaugh Physician Group (PA) that a former employee downloaded patient data from a company-issued computer to thumb drives. While no nefarious activity has been detected thus far, ScottCare is offering patients one year of identity protection and recovery services, and $1 million of identity theft insurance. The employee’s actions were discovered during a seemingly separate investigation that ended in his termination. 

Sponsor Updates

• AdvancedMD donates 600 necessity bags to Ronald McDonald House Charities.
• EClinicalWorks releases a recap video from its annual conference.
• GE Healthcare announces several products at RSNA that include patient-controlled mammography pressure, an imaging collaboration suite, and enhancements to Centricity Solutions for Enterprise Imaging.

Blog Posts

• What won’t change with the election (and the next wave of health IT focus) (Nordic)
• Introducing the Versus Consulting Team (Versus Technology)
• CMS Finalizes 2017 Physician Fee Schedule (E-MDs)

Contacts

Jenn, Mr. H, Lorre

More news: HIStalk, HIStalk Connect.

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News 11/23/16

Top News

Black Friday and Cyber Monday sales mean big business for retailers and cyber criminals, according to new reports from Experian and CyberReason. Its study found that, though 62 percent of shoppers are worried about being hacked, 40 percent won’t alter their shopping patterns to avoid it. Seventy percent believe finding “the right deal” would make them more likely to buy from a website they’d never heard of. Also alarming is the fact that 23 percent would “risk becoming a victim of identity theft for a good Cyber Monday deal.” Shop safely, my friends.

HIStalk Practice Musings

Happy Thanksgiving, dear readers! I hope the next several days find you surrounded by family and friends, with ample opportunity to reflect on the many blessings in your life. Should you find yourself in need of healthcare, be sure to thank your provider for working over the holiday weekend.

Webinars

December 6 (Tuesday) 1:00 ET. “Get Ready for Blockchain’s Disruption.” Sponsored by PokitDok. Presenter: Theodore Tanner, Jr., co-founder and CTO, PokitDok. EHR-to-EHR data exchange alone can’t support healthcare’s move to value-based care and its increased consumer focus. Blockchain will disrupt the interoperability status quo with its capability to support a seamless healthcare experience by centralizing, securing, and orchestrating disparate information. Attendees of this webinar will be able to confidently describe how blockchain works technically, how it’s being used, and the healthcare opportunities it creates. They will also get a preview of DokChain, the first-ever running implementation of blockchain in healthcare.

December 7 (Wednesday) 1:00 ET. “Charting a Course to Digital Transformation – Start Your Journey with a Map and Compass.” Sponsored by Sutherland Healthcare Solutions. Presenters: Jack Phillips, CEO, International Institute for Analytics; Graham Hughes, MD, CEO, Sutherland Healthcare Solutions. The digital era is disrupting every industry and healthcare is no exception. Emerging technologies will introduce challenges and opportunities to transform operations and raise the bar of consumer experience. Success in this new era requires a new way of thinking, new skills, and new technologies to help your organization embrace digital health. In this webinar, we’ll demonstrate how to measure your organization’s analytics maturity and design a strategy to digital transformation.

Announcements and Implementations

Bizmatics adds an employer portal to its PrognoCIS EHR for occupational health clinics. The new tool will enable employers to securely communicate with providers, and  track information about injured employees, including health and recovery status.

Former palliative and hospice care provider Joseph Dorn, MD will open the Medical Marijuana Treatment Center of Florida in Tallahassee, FL next week. Dorn is one of three physicians in the city who have completed the eight hours of training required by the Dept. of Health before they can order medical marijuana for their patients. “What makes me different from other folks,” Dorn explains, “is I’ve got extensive hospice background and experience as medical director oversight of a dispensing organization.”

Slightly related random fact: Marijuana dispensaries sell 58 percent more edibles and 72 percent more beverages the day before Thanksgiving than on an average Wednesday. “Sometimes, it’s a little stressful to see family,” says Kaya Cannabis CEO Amanda Gonzalez. “In the same way some people might pick up a bottle of wine, some people are looking to pick up recreational cannabis. Maybe it’ll make your slightly racist uncle a little bit more tolerable."

Acquisitions, Funding, Business, and Stock

Mashable digs into the newest venture of John Sculley, former Apple CEO and now founder of cloud-based pharmacy benefits platform RxAdvance, an endeavor he calls “the most important thing I’ve done since my time at Apple.” Sculley, who bounced around several verticals before landing on the digital side of pharmacy benefit management, doesn’t seem to have much faith in the digital health ecosystem:

“People in digital health have to be willing to do the heavy lifting of learning how the healthcare system really works. It’s tempting for entrepreneurs to say, ‘I can build a cool product and measure a lot of different things.’ They haven’t taken that same philosophy to say how to solve problems for people who are sick, and not just for people who are well who want to measure their fitness. Companies making wearable devices, for example, are going to get smarter to solve problems for people who are sick, not just people who are well.”

People

GNS Healthcare CEO Colin Hill joins the newly formed Massachusetts Digital Health Council, created by Gov. Charlie Baker to bolster the state’s digital health ecosystem. The council, which includes representatives from 38 healthcare technology and life sciences companies, has been tasked with creating a three-year innovation growth plan to the Governor by August 2017.

The American Medical Informatics Association names incoming Regenstrief Institute President and CEO Peter Embi, MD chair-elect of its Board of Directors.

Government and Politics

The National Quality Forum invites industry stakeholders to comment on the 97 metrics it is reviewing (with an eye to removing some) for the federal government’s use in various health programs, including MACRA and MIPS. The measures, 39 of which are related to outcomes, may “help patients and families choose the nursing home, hospital, or clinician that is best for them, and can help providers deliver the highest quality of care to their patients,” according to Kate Goodrich, MD director of the CMS Center for Clinical Standards & Quality. Comments are due December 2.

Other

A perfect way to wind down at the end of Black Friday: Zeel brings its in-home massage delivery service to New Orleans. Customers can book their session via the company’s app or website, and expect delivery within the hour. A quick visit to the website finds that Zeel’s services are available in 40 cities (including mine!).

Contacts

Jenn, Mr. H, Lorre

More news: HIStalk, HIStalk Connect.

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