News 11/16/16

Top News

Humana doles out nearly $94 million to 4,465 provider organizations that participate in the payer’s Provider Quality Rewards Program, a program Humana has run since 2012. Sixty-three percent of Humana’s Medicare Advantage members receive care from PCPs involved in the company’s valued-based payment programs, which incentivize physicians for improved outcomes related to breast and colorectal cancer screenings, and diabetes treatment management, among others.

HIStalk Practice Announcements and Requests

Don’t miss the latest batch of practice-oriented interviews:

• ACO CVCHIP Board Chair Lerla Joseph, MD shares insight into the challenges practices face when it comes to reporting for value-based payment programs.
• Coordinated Care Oklahoma Chief Administrative Officer Brian Yeam, MD outlines the increasingly important role secure messaging and advanced directives play in health information exchange.
• Northwest Physicians Network CEO Rick MacCornack sheds light on the role physician networks play in connecting disparate EHRs and the value of working with startups.

Webinars

None scheduled in the coming weeks. Contact Lorre for webinar services. View previous webinars on our HIStalk webinars YouTube channel.

Acquisitions, Funding, Business, and Stock

Point-of-care patient education company Context Media acquires competitor AccentHealth for an undisclosed sum. AccentHealth’s content is produced by Harvard Medical School and CNN’s Medical Unit, and hosted by Sanjay Gupta, MD.

People

FQHC operator Family HealthCare Network (CA) promotes Paramvir Sidhu, MD to deputy chief clinical officer.

Avi Fichman (Center for Public Integrity) and Jeff Goldman (Valence Health) join the Primary Care Coalition as COO, and vice President for population health, respectively.

Announcements and Implementations

Aprima offers a cloud-based faxing solution for its EHR.

Chesapeake Regional Information System for our Patients selects real-time patient matching technology from Verato to better match and link patient identities across HIE members in Maryland and Washington, DC.

Sikka Software adds schedule alerts and estimated patient arrival times to its Practice Mobilizer app for optometrists, dentists, and veterinarians.

Telemedicine

SnapMD adds new features to its Virtual Care Management app including the ability to enter, view, and manage appointments; view and manage billing details; and access health insurance information. The Los Angeles based company closed its latest round of funding in June, and has raised $7.5 million since launching in 2013.

Nuance-affiliated My Client Notes leans on teletherapy technology from E-Psychiatry to launch a telecounseling service for church teams and ministries.  

Government and Politics

The Alameda County Health Care Services Agency receives a $140 million grant from the California Dept. of Health Care Services that it will use to partially fund Alameda County Care Connect. The $280 million program, which aims to improve health outcomes for the homeless and mentally ill, will focus $15 million on creating a countywide data-sharing and care coordination system. “We’re going to develop a universal consent for sharing information,” says HCSA Medical Director Kathleen Clanon, “so that patient information can be shared with different agencies so … they don’t have to start from scratch.”

AMA members adopt a number of policies and resolutions at the association’s interim meeting in Orlando this week, including those that promote the safe and effective use of digital health apps with an eye towards security and protecting physicians from liability. The association also stressed the need for interoperability between state prescription drug monitoring programs and EHRs so that physicians can learn when their patients receive controlled substances from other prescribers.

Research and Innovation

A study finds that patients with chronic conditions are more apt to take their medication on a regular basis when they are part of a patient-centered medical home. In analyzing Aetna claims data on 300,000 patients between 2011 and 2013, researchers found that PCMH patients were adherent 64 percent of the time versus 59 percent of patients in non-PCMH practices. PCMH medication adherence rates were slightly higher for patients with diabetes, high cholesterol, and high blood pressure.

Sponsor Updates

• Intelligent Medical Objects exhibits at the AMIA 2016 Annual Symposium in Chicago.

Blog Posts

• Optimization with Provider and Patient Experience (Culbert Healthcare Solutions)

Contacts

Jenn, Mr. H, Lorre

More news: HIStalk, HIStalk Connect.

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News 11/15/16

Top News

CareCloud raises a $31.5 million Series C thanks to support from new, leading investor Blue Cloud Ventures. The Miami-based company will use the cash infusion to expand its team and further develop its line of EHR, RCM, PM, and patient engagement software. It has raised $103 million since launching in 2009 – $46 million of which have been raised under the leadership of Ken Comée, who joined the company as CEO in April 2015. You can read my interview with him, conducted shortly after he took the helm, here.

HIStalk Practice Musings

Last night’s “Supermoon” (the closest the orb has been to Earth since 1948) prompted lots of drive-time talk this morning about its effect on school-aged children (who are normally so well behaved). Anecdotes abound relating to the number of births and ED visits during lunar events. Researchers have even determined that people, on average, sleep 13 minutes less on nights of such moonlit activity. I wonder if practices see an influx of illness during these times? Feel free to share anecdotes in the comments below.

Webinars

None scheduled soon. Contact Lorre for webinar services. View previous webinars on our HIStalk webinars YouTube channel.

Announcements and Implementations

FitLyfe adds clinical analytics and automation to its digital health and wellness technologies geared to member-based programs. The new capabilities will offer users care plans based on their health data, as well as proactive messaging related to preventive screenings and recommendations.

IHealth Innovations develops a set of wellness and revenue assistance program services to help physician practices and medical groups implement quality improvement programs under MACRA. In a refreshing turn of phrase, the company stresses that “more technology is not the answer” when it comes to transitioning to value-based payment programs. “For practices with the right strategic guidance and resources in place,” explains Chief Growth Officer Justin Barnes, “QPP incentives could represent significant earnings as well as penalty-avoidance between now and 2020.” I interviewed Barnes shortly after he joined the company several months ago, and am looking forward to his fireside chat with Acting CMS Administrator Andy Slavitt at the Health IT Leadership Summit in just a few weeks.

Behavioral health services organization Centerstone Tennessee selects real-time predictive analytics technology from Faros Healthcare to help its clinicians better determine treatment paths and associated costs for members of the state’s Medicaid program.

Acquisitions, Funding, Business, and Stock

Bloomberg reports that Apple is looking into developing smart glasses, a move that, in my mind, either reeks of desperation as the company loses smart phone market share or belies some greater plan related to innovations in augmented reality. Unnamed sources say the company is already looking into potential suppliers, and has ordered small batches of near-eye displays for testing. The picture above comes from a YouTube video posted in 2014, which means the idea has been ruminating for some time.

Government and Politics

CMS updates its interactive drug-pricing tool to include data on the $57 billion states spent on drugs within the Medicaid program, and information relating to rebates from drug manufacturers that offset costs. The latest stats show that drug costs accounted for 16.7 percent ($457 billion) of personal healthcare spending last year, up from 15.4 percent ($367 billion) in 2012.

Research and Innovation

Virginia-based cardiologist Ather Anis, MD creates TREEMER, a personal health record app that he hopes will help patients keep all of their health data in one place, share data with caregivers, and take advantage of built-in social networking features to connect with other patients. “People who have the same disease in an area can connect,” explains Anis. “It is a localization of the disease process we believe is going to be very powerful. We hope TREEMR can help educate patients as they share photos of procedures, therefore empowering them.”

Contacts

Jenn,  Mr. H, Lorre, Dr. Jayne, Dr. Gregg

More news: HIStalk, HIStalk Connect.

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HIStalk Practice Interviews Lerla Joseph, MD Board Chair, Central Virginia Coalition of Healthcare Providers

Lerla Joseph, MD is an internal medicine specialist and board chair of the Central Virginia Coalition of Healthcare Providers, a Medicare ACO created for solo physicians and small practices.

Tell me about yourself and the organization.
I have been a practicing internal medicine specialist for 36 years, and have been in private practice for 33 of those years. My practices are located in a medically underserved community in Richmond, and in the small town of Petersburg. I am very much interested in the availability of quality care for all persons and have advocated for more access to care my entire career. Central Virginia Coalition of Healthcare Providers (CVCHIP) was developed to ensure the triple aim of Medicare and to ensure the sustainability of the private practice of medicine. It is particularly interested in serving the small medical practice. We have 20 medical practices affiliated with CVCHIP, all of which are located in Virginia and North Carolina. We were approved as a Track 1 ACO in the Medicare Shared Savings Program in December 2015. We are primarily primary care practices, but have a few specialty practices as well.

CVCHIP implemented chronic care management technology last month. Why prompted the ACO to consider this type of software?
CVCHIP recognized early on that in order to achieve the quality metrics required by CMS, we need to engage in care coordination. Many of our patients suffer with two or more chronic diseases and are not accustomed to care management with emphasis on prevention and a holistic approach to care. Additionally, participating in the CCM program meets several of the MACRA measures that heretofore were PQRS and Meaningful Use. We believe earlier engagement in CCM rather than later will greatly benefit our patients and the quality and cost of care our providers give.

How do you envision this type of health IT impacting outcomes in the near future?
Our initial expectation is better patient engagement. We believe that having multiple touch points with the patients will give them a better understanding of their disease process, improve their lifestyle choices, and give them confidence in doing self-management. We also expect the providers to be better informed about the total patient including their support network, socioeconomic situation, and the patient’s ability to execute the recommendations for care we give. This should all translate into more collaborative care with decreased emergency department and hospital utilization.

What other types of healthcare IT is CVCHIP looking at right now (or will be looking at in the near future)?
We have in place a population health tool. Going forward, however, we will look at forecasting and data analytics tools.

When it comes to implementing new health IT, what are the biggest obstacles/pain points for CVCHIP physicians?
Cost is always a major concern for our practices when we look at implementing new IT solutions. At the same time, we want to be certain that the solution we select gives us data that is actionable and efficient – one that does not require additional human resources to utilize.

The MACRA final rule is still making headlines. How will MACRA affect CVCHP and its participants? What will 2017 and 2018 look like for the ACO in terms of reporting?
As an ACO, one of the selling features is our ability to do reporting for our participants. Many have not done PQRS or Meaningful Use reporting, and those that had found it confusing and cumbersome. With the ACO reporting GPRO, this removes some of the burden for the practices. What is disappointing is that the practices will still need to report Advancing Care Information because Track 1s are not Advanced APMs. We are gearing up for the 2017 reporting, and our population health tool will help with that.

Is CVCHIP doing anything to help its physicians with their population health management programs? Is the ACO leveraging relationships with local payers in this area?
We have started integrating participant EHRs into our population health tool. We have the ability to share claims data submitted by CMS to our participants. We have targeted quality metrics to keep them abreast of emergency department utilization and annual wellness visit utilization by practice. We have not engaged as yet with any of the local payers.

What do you consider to be the number-one challenge facing practices in ACOs right now? How have you seen your members overcome this?
CVCHIP is a physician-led and governed ACO. The challenge for our participants is time management in finding the balance between caring for their patients and devoting the time necessary to make CVCHIP all it can be. We are dedicated to preserving the private practice of medicine. This requires our input in decision -making and implementation of our strategies for success. It is called physician engagement and workflow management. I prefer to look at it as the time necessary to advocate for our patients and our practices. No one can do that better than we can. We are trying to overcome this by committee assignments for our participants, conference calls for quality reviews, and quarterly in-person governing meetings.

Do you have any final thoughts?
I truly believe physicians are the best advocates for their patients. This new era of health care delivery de-compartmentalizes the care delivery we have created over the last 40 years, placing the patient at the center of care. It is a shift for all of us. However, I believe that ultimately patients and physicians alike will be more satisfied and gratified with the change. Change is always daunting, but the providers of CVCHIP are ready to embrace the change for better care and healthier lives.

Contacts

Jenn,  Mr. H, Lorre, Dr. Jayne, Dr. Gregg

More news: HIStalk, HIStalk Connect.

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News 11/14/16

Top News

Access to retail clinics does not, in fact, reduce trips to nearby ERs, according to a new study published in the Annals of Emergency Medicine. Though retail clinics have increased exponentially over the last decade – jumping from 130 in 2006 to 1,400 in 2012 alone – only a miniscule decrease in ER visits was seen amongst retail clinic patients with private insurance. The primary effect of retail clinic access thus far seems to be increased utilization of services by those newly insured under the ACA – a fact that surely gives area PCPs cause for concern.

Webinars

None scheduled soon. Contact Lorre for webinar services. View previous webinars on our HIStalk webinars YouTube channel.

Here’s the video of one of our webinars from last week, “CMIO Perspective on Successful 25-Hospital Rollout of Electronic Physician Documentation.”

Here’s the recording of another webinar from last week, “How to Create Healthcare Apps That Get Used and Maybe Even Loved.”

Announcements and Implementations

HealthAsyst adds payment technology from Worldpay to its patient intake software.

ACO Arizona Connected Care selects The Diary’s CarePro care management app to help it better care for its 300 members with chronic conditions. Designed on Apple’s CareKit framework, the app’s patient-facing features include symptom tracking, messaging, and incentives.

Radiology Associates of Atlanta’s Piedmont division renews its RCM agreement with Zotec Partners.

The North Carolina Dept. of Health and Human Services implements Therap’s developmental disability software, which includes messaging, billing, and HIE capabilities.

People

XG Health Solutions promotes Steven Pierdon, MD to CMO.

Telemedicine

Greater Oregon Behavioral Health partners with fiber optics company LS Networks to launch a telemedicine program for 16 communities across the state, courtesy of a $436,506 Distance Learning and Telemedicine Grant from the USDA Rural Development Program.

Web-enabled hearing solutions company IHear develops EarPing, a collection of direct-to-consumer services including virtual screening and hearing-aid programming.

Government and Politics

STAT taps “early and often anonymously sourced reports” to put together a list of likely HHS appointees in President-elect Trump’s impending administration.

Other

Uber donates 6,000 gift cards to the Fisher House Foundation, a nonprofit that provides housing for veterans undergoing medical treatment at local VA facilities. The foundation will distribute the cards to vets and their family members in Los Angeles, St. Louis, Houston, and Washington DC. The ride-sharing company has also added a feature to its app that informs riders when their selected drivers are veterans (should the driver opt to share that information to Uber). “As we’ve all learned as a country in the last couple of days, it’s important to find things that keep us together,” says Uber Chief Business Officer Emil Michael. “And what keeps us together are our veterans and their service for our country.”

Physician burnout takes center stage: Playwright and actor Michael Milligan will stage “Side Effects” November 17 at Mayo Clinic’s Geffen Auditorium in Rochester, MN. As Dr. William McQueen, Milligan will offer up a look at the side effects of practicing medicine and what it means to be a doctor in America.

Seguin Dermatology (TX) is hit with ransomware that the practice says it was able to remove. It did not disclose the number of patient records affected, though it did maintain that the compromised server did not contain medical records, lab reports, or financial information. Computer security expert Matt Snider believes hackers included the office in a broad sweep that detected vulnerabilities in its server, then unleashed the malware.

Contacts

Jenn,  Mr. H, Lorre, Dr. Jayne, Dr. Gregg

More news: HIStalk, HIStalk Connect.

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HIStalk Practice Interviews Brian Yeaman, MD Chief Administrative Officer, Coordinated Care Oklahoma

Brian Yeaman, MD is chief administrative officer of Coordinated Care Oklahoma, an HIE based in Norman, OK.

Tell me about yourself and the organization.
I am a family physician still actively practicing, and have done work as a hospitalist in the past. I was CMIO for Norman Regional Health System for 10 years and have been doing work with health information exchange for 10 years. I am currently the chief administrative officer for Coordinated Care Oklahoma.

I’m particularly intrigued by CCO’s decision to implement/offer MyDirectives. How will this be marketed to physicians and their patients? How will these directives integrate with the HIE?
This is a project we have been passionate about for over three years. As a family physician, I recognize that when an elderly patient presents to the hospital, they frequently do not come with an advance directive. Usually, their healthcare proxy is not necessarily there at the same time, and at that point, without a current up-to-date copy of the advance directive, we have to fully resuscitate, even if that was not what the patient necessarily wanted. Providers rapidly understand the problem we are trying to solve; hospitalists and emergency room physicians are especially embracing this approach. We have begun outreach to patients with a simple message for encounters on individuals over 45 years of age.

Why did CCO feel the time was right to implement secure messaging technology?
A lot of form factor drove this decision. We started doing a lot of work in the post-acute care space connecting many SNFs, nursing homes, home health and hospice. The HIE is basically doing automated medical record requests, but we still have to talk to one another. With RAC and MACRA/MIPS we have to talk to larger and larger care teams that are outside a health system that is acutely discharging a patient. Secure messaging across regions and universal contact lists was just a no brainer. Providers love Backline. Bringing HIE data into the mobile form factor in Backline makes a lot of sense for providers who are mobile across orgs, facilities, and patient homes.

Is the organization working on any other healthcare IT implementations? 
Oh yes, sitting still is not what we do. We are going live with LightBeam analytics right now, and that should be fully launched by Q1 2017. We are also working with Nuance and their PowerShare application to launch image sharing in parallel with CCO using the power of our master patient index. It is going to knock people’s socks off.

What sort of IT adoption challenges are unique to HIEs?
Interop equals challenges. The biggest one is actually trying to meld federation and centralized data connections in being a hybrid HIE data consumption model and delivering some of the services. The MPI provides a tremendous anchor and the way we stage and time connections is obviously key to add federated connection data to some solutions or add on solutions to the HIE core service.

How is the HIE helping its provider members – particularly independent physician practices – overcome interoperability challenges?
We help providers care for their patients – it is just that simple. We crossed the threshold years ago when providers began to demand the HIE data to expedite and have more complete medical record requests and sharing. We check the boxes on MU and with MACRA/MIPS coming, we add an integral service there. At the end of the day though, if we do our job right and deliver a comprehensive HIE service with the right add-ons, quality and cost organically improve and patients get much more coordinated care. That is our ultimate goal and mission.

How do you see HIEs fitting into the new MACRA landscape? What role will they play in helping the healthcare industry transition to value-based care/payment models?
Obviously, they’ll help with requirements around data sharing, completing quality reports, and helping enhance condition management tasks. We help by bringing data forward and soon-to-be images forward to avoid duplicative tests and improve savings, and we help avoid complications by sharing drug allergy information, etc.

Do you have any final thoughts?
I think HIE is a funny thing in the marketplace right now. Everyone now knows it has to mature into a business and leave the more academic and grant-based foundation we all started on. I see HIEs evolving into two models – one that is service oriented and leverages the MPI and data to enhance additional services that directly impact care and outcomes. This is a bedside-up approach to administrative tasks and analytics, and is focused on treatment and operations.

The second model is one that is more focused on monetizing the clinical data and is heavily focused on payer initiatives. This approach around payment makes a lot of sense on the surface and represents an analytics down-to-the-bedside approach to healthcare reform. This model has additional challenges as you start to drill down into consent models, how the patient consent was administered, and how that holds up as the data is moving to more and more third parties separated from the original patient consent for care under TPO. Throw in to this mix ACOs and health systems that compete …  the politics and logistics start to become extremely complicated. Keeping it simpler and delivering HIE like a service – just like cable and Internet providers with the privacy and security necessary in healthcare.

Contacts

Jenn,  Mr. H, Lorre, Dr. Jayne, Dr. Gregg

More news: HIStalk, HIStalk Connect.

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Contact us online.
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