News 8/2/16

Top News

Albert A. Talone, DO heads up a class-action lawsuit representing 32,000 osteopaths against the American Osteopathic Association. The lawsuit contends that AOA’s requirement that physicians purchase AOA memberships in order to obtain and maintain board certifications is illegal, has no reasonable connection to the advanced certification, and violates antitrust laws. “There is no legitimate reason why a physician should also have to purchase an annual membership in the AOA and pay additional hundreds of dollars a year to the AOA in dues on top of the costs of certification,” James Greenberg of the representing law firm (and former general counsel of the New Jersey Association of Osteopathic Physicians and Surgeons). “Our doctors should never have had to pay these fees, and we’re suing to recover these fees and to establish that the doctors won’t have to pay them anymore.”

While I can’t comment on the AOA’s legal wranglings or how much merit the lawsuit might have, I can, just for fun, compare the membership rates of the AOA and the AMA, which seems like the more affordable association at first glance.

Webinars

August 10 (Wednesday) 1:30 ET. “Taming the Beast: CDS Knowledge Management.” Sponsored by LogicStream Health. Presenters: Luis Saldana, MD, MBA, CMIO, Texas Health Resources (THR); Maxine Ketcham, clinical decision support analyst, THR; Kanan Garg, senior applications analyst, THR; Patrick Yoder, CEO, LogicStream health. This presentation will review THR’s systematic process for managing clinical decision support assets, including identifying broken alerts, addressing technical and clinical issues, modifying order sets, and retiring tools that have outlived their usefulness. Attendees will learn how THR uses a robust knowledge management platform to better understand how clinicians are interacting with their clinical content to maintain their order sets and reduce the number of alerts fired.

Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.

Announcements and Implementations

Eighty-three districts across the country sign on to CareDox’s EHR for school-based healthcare. The New York City-based startup has raised $6.9 million since launching in 2014. In addition to providing EHRs to schools free of charge, the company seems intent on leveraging the de-identified health data for pediatric research through partnerships.

Telemedicine

American Well partners with Academic HealthPlans to offer its virtual visit services – including psychologist visits – to AHP’s student members at over 100 US universities and colleges.

The Los Angeles School District – the second-largest in the country – will pilot telemedicine technology from Boynton Beach, FL-based LifeMD at five schools this fall in hopes of expanding the service countywide in the near future.

Research and Innovation

Astellas Pharma US teams with health tech incubator Matter Chicago (of which it’s a platinum sponsor) to launch the Astellas Oncology C3 Prize competition, which seeks innovative ideas for cancer care from early stage entrepreneurs. The winner will receive a $50,000 grant, while two runners-up will receive $25,000 grants. Winners will also receive a free year of membership at Matter. C3 Prize Program Director Tyler Marciniak emphasizes that the competition isn’t looking for medicines or medical devices, but rather digital health tools that help improve medication adherence and caregiver coordination. Applications are due August 8.

Other

I have fond memories of my first and thus far only trip to Paris. The Eiffel Tower sparkling at night, amazing shopping (of the window variety given it was during my student days), and an overload of art at the Louvre more than made up for the push-button shower at my youth hostel. At the time, I didn’t notice much of a traffic jam on the Seine, but the founders of SeaBubbles have lately thought otherwise. The startup is looking to develop airborne water taxis capable of speeds up to 25 knots (29 mph) to sell to individuals and local governments. The company has already received the support of Paris Mayor Anne Hidalgo, who has pledged to cut pollution levels in the city.

Contacts

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

More news: HIStalk, HIStalk Connect.

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

Readers Write: Physician Engagement in Cancer Care Delivery Redesign

Physician Engagement in Cancer Care Delivery Redesign
By Nicole Hartung, MD

CMS Innovation’s Oncology Care Model began on July 1st. This alternative payment model tests whether specific changes in cancer care delivery can result in “better care, smarter spending, and healthier people.” There are numerous process, outcome, financial, and patient-reported metrics being evaluated throughout the course of the program. Practice success in the program will depend on a practice’s ability to consider, create, and implement redesign activities to enhance the delivery of cancer care. This task will take a tremendous amount of thoughtful input from numerous stakeholders; to be successful, physicians will need to take a lead role in both care changes and peer-to-peer discussions of implementation to ensure consistent, evidence-based delivery of care to every patient, every time.

Knowing how to begin the daunting process of integrating physicians in quality and performance projects can be intimidating — yet there is excellent literature available to help lead the way. The Institute for Healthcare Improvement’s (IHI) Innovation Series 2007 white paper on the subject provides an excellent starting place.¹ This article provides a framework to engage physicians in hospital-based quality improvement. However, the elements of their structure can easily be adapted to oncologist engagement in cancer care redesign in the context of the OCM. Using the implementation of the OCM-required Institute of Medicine-derived treatment plan, we can review how the IHI engagement structure can support physicians.

Discover a Common Purpose

As cancer care providers, we all have a common goal — to provide the best patient care possible. The OCM requires specific treatment plans delivered to the patient: Documenting stage of disease and important biomarkers, prognosis, treatment, intent of treatment, expected outcomes of treatment and side effects, along with other components. This is an additional physician-specific administrative burden. To set up realistic yet hopeful expectations for all, we have to remind physicians that the outcome of this document is to engage and educate patients in their disease and treatment, and to create a common mental model of what treatment is trying to accomplish. This includes transparency of goals of care not only within the treatment team, but also with the patient and family.

Reframe Values and Beliefs

Oncologists work long hours in a rapidly changing and increasingly complex field that is also emotionally dense. High rates of burn out (emotional exhaustion and depersonalization) are being reported in oncologists nationwide. Adding meaningless administrative overhead to a physician’s day is not helpful when trying to enact change. However, physicians can proactively partner in the process of meaningful change rather than react to it. The administrative system needs to ask physicians and expect them to partner in projects such as designing, reviewing, or testing new forms and documents such as the treatment plan.

Segment the Engagement Plan

Numerous opportunities for physician engagement exist in the thoughtful approach to change management. Prioritizing the necessary provider changes, implementing them in a step-wise fashion, and regularly communicating the overall vision and timeline for care redesign gives all participants a better sense of control and creates a joint culture of engagement.

The treatment plan is the most significant physician-required change within the OCM. Every practice has physicians that are early adopters. Finding and empowering them to speak to their experience using the treatment plan as a communication tool to patients and their families can begin an open discussion of a physician’s experience – good and bad. Utilizing these champions of positive experience can help to manage and temper the ‘laggards’ who may not yet see or understand the benefit of this form of patient-directed communication. These individuals can also be self-sustaining champions for other new activities. Lastly, creating an overall governance plan within the physician practice that supports redesign activities is needed (i.e. what to do with outliers that might not participate in the required documentation and disbursement of the treatment plan).

Use Engaging Improvement Methods

A quote attributed to Benjamin Franklin states, “Experience is the best teacher, but a fool will learn from no other.” We all learn most memorably from the projects we have struggled over. However, there are best practices that can more easily influence physician engagement. One opportunity to observe this is in the attempt to standardize.

Some standardization is good and necessary to minimize unexplainable clinical variation, streamline care, and reduce practice administrative burden. However, rigidity is not feasible or advisable in dealing with healthcare change and healthcare providers. The practice of medicine has too many unique features to subscribe to one inflexible model. Therefore, the IHI rightly promotes standardizing care processes, but allowing customization within those processes to meet the unique patient and situational demands. Within the treatment plan, this can be seen with having one standard form within a practice with a standard expectation of physicians completing the treatment-specific components. Within those expectations, variation of wording and processes of the form can occur.

Show Courage

Physician engagement in quality improvement cannot champion change alone. There is an obvious need for practice leadership, boards of directors, and others to back up the care delivery changes occurring not just in closed-door meetings, but also publically at points of contention. Therefore, when expected resistance to a new requirement, such as the treatment form, occurs, the group leadership and board members need to vocally support the change.

Adopt an Engaging Style

Much like using ‘engaging’ methods, adopting an engaging style in interaction with physicians can be the key to OCM success. For example, with the treatment plan implementation, it will be important to involve physician champions from the start and then have practice-wide messaging to create visibility of the proactive, productive behavior. Regular communication with the greater group of physicians is the most important effort that can be made. Succinct, clear messaging with obvious indication of expectations of physicians is helpful. Lastly, making regular site visits and meeting with physicians to explain the treatment plan and answer questions shows you value their effort and time.

Productively engaging physicians in the OCM-required care redesign activities will take time, attention, and effort. Yet this program offers a great opportunity to learn how to create an ongoing engagement strategy for physicians and, ultimately, better patient care.

Nicole Hartung, MD is medical director of quality for Minnesota Oncology and director of OCM for The US Oncology Network.

References

¹ Reinertsen JL, Gosfield AG, Rupp W, Whittington JW. Engaging Physicians in a Shared Quality Agenda. IHI Innovation Series white paper. Cambridge, Massachusetts: Institute for Healthcare Improvement; 2007

Contacts

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

More news: HIStalk, HIStalk Connect.

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

News 8/1/16

Top News

CMS opens up applications for the Comprehensive Primary Care Plus model in 14 regions across 16 states. Eligible practices, which can choose from one of two tracks, must apply by September 15 to participate in the five-year, primary care medical home program that kicks off January 1. CPC+ participation can help practices qualify for additional incentive payments tied to Advanced Alternative Payment Models through the proposed Quality Payment Program.

Webinars

August 10 (Wednesday) 1:30 ET. “Taming the Beast: CDS Knowledge Management.” Sponsored by LogicStream Health. Presenters: Luis Saldana, MD, MBA, CMIO, Texas Health Resources (THR); Maxine Ketcham, clinical decision support analyst, THR; Kanan Garg, senior applications analyst, THR; Patrick Yoder, CEO, LogicStream health. This presentation will review THR’s systematic process for managing clinical decision support assets, including identifying broken alerts, addressing technical and clinical issues, modifying order sets, and retiring tools that have outlived their usefulness. Attendees will learn how THR uses a robust knowledge management platform to better understand how clinicians are interacting with their clinical content to maintain their order sets and reduce the number of alerts fired.

Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.

Recent webinars and their associated YouTube video views are:

• Your Call is Very Important (185)
• Provider-Led Care Management: Trends and Opportunities in a Growing Market (198)
• Ransomware in Healthcare: Tactics, Techniques, and Response (896)
• rise of the small first letter vendors (223)
• Six Communication Best Practices for Reducing Readmissions and Capturing TCM Revenue (132)
• Looking at the Big Picture for Strategic Communications at Children’s Hospital Colorado (127)

HIStalk Practice Announcements and Requests

The school year kicks off today in many of the counties in and around my metro area, which seems like a great time to remind HIStalk Practice readers of the ways they can support our DonorsChoose efforts to equip schools in need with STEM-related supplies:

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 a receipt for tax purposes.
4. He’ll pool the money, apply matching funds, and publicly report at HIStalk.com which projects he funded, with an emphasis on STEM-related projects as the matching funds donor prefers.

I always get a kick out of reading the teacher thank yous Mr. H posts in his updates. Sometimes we forget that what seems like a small gesture to us can have a big impact on the recipient.

Acquisitions, Funding, Business, and Stock

Healthcare business processing outsourcing company UnityBPO plans to hire 300 FTEs over the next several years, the majority of which will be entry-level clinical analysts tasked with helping providers handle healthcare IT issues. The Albuquerque, NM-based company was spun off from Kemtah Group, an IT management and engineering firm, earlier this year.

Clinical trial management software company CRF Health acquires Entra Health, a vendor of wireless remote patient monitoring tech, for an undisclosed sum. Entra Health seems to be best known for its Entra360 platform, which aggregates biometric data from a variety of devices for providers, payers, and clinical researchers.

People

Adam Pelligrini (Walgreens Boots Alliance) joins Fitbit as vice president of digital health.

Announcements and Implementations

Carlsbad, CA-based Breg debuts the latest version of its EHR-agnostic Vision durable medical equipment, prosthetics, orthotics, and supplies workflow management software for orthopedic practices.

X-Ray Associates of New Mexico goes live on MedInformatix’s RIS V7.6 software suite across its seven facilities.

Telemedicine

American Well rolls out psychiatry services from Online Care Group in nine states, with plans to expand to the rest of the country by year’s end. In related news, the company has named Zereana Jess-Huff (Beacon Health Solutions) vice president of behavioral health. (Check out my recent interview with American Well’s new CTO, Jon Freshman, here.)

EWellness Healthcare will offer commercial licensing of its Phzio telemedicine platform to third-party physical therapy practices in early September. Practicing physical therapist and personal trainer Darwin Fogt launched the company in 2013. He also runs Evolution Fitness, a Canadian fitness company geared towards corporate execs.

MedicalMine adds telemedicine capabilities to its Charm EHR and PM suite of technologies. The company introduced its products earlier this summer to Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates via a reseller agreement with EMDI Emergency Medicine & Disaster Institute.

Other

Anthem Blue Cross Blue Shield partners with health screening kiosk vendor Pursuant Health (fka SoloHealth) to incentivize its Medicaid members in Indiana to take a health survey, the results of which will help Anthem enroll them in more specialized health management programs. Members who take the survey at the kiosks, which are installed in Walmarts, will receive a $10 store gift card. I’m not a huge fan of the retailer, but I have to give Anthem kudos for attempting to reach their members where they already are, rather than assuming they have smartphones, wearables, and other hot-off-the-shelf tech gadgets with which to take the survey.

AAFP held its annual National Conference of Family Medicine Residents and Medical Students over the weekend in Kansas City, MO. ZDoggMD made an appearance, as did AAFP CEO Doug Henley, MD who, according to the tweet stream, believes IBM Watson can’t learn family medicine because it’s too complicated.

Contacts

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

More news: HIStalk, HIStalk Connect.

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

Population Health Management Weekly Wrap Up 7/31/16

Dorothy Fisher, MD (Sentara Quality Care Network) joins Forward Health Group as chief clinical officer.

Mihir Shah (Unitek Information Systems) joins Apollo Medical Holdings as CFO. In related news, California-based APCN ACO and Allied Physicians ACO select the company’s population health management services. The MSSP ACOs care for a combined 16,000 Medicare beneficiaries.

Chicago-based predictive analytics and employee engagement company Evive Health will double its office space to 16,000 square feet in August. The company anticipates immediately adding several new staff roles, and expanding to 70 employees by the end of the year.

Covenant Health (TN) chooses Cerner’s clinical, financial, and population health management systems.

Consumer health site Sharecare, founded in 2010 by Dr. Oz and WebMD founder Jeff Arnold, acquires the population health business of publicly traded Healthways. The business and its 1,700 employees will remain in Franklin, TN. Healthways announced in 2015 that it was exploring strategic alternatives.

Healthstar Physicians (TN) selects population health management services from Transcend to help it better care for Medicare Advantage patients across 14 locations in Knoxville.

The County of Renfrew Paramedic Services in Ontario implements the Philips Tailored Ambulatory Care Program to remotely monitor elderly patients from the home and reduce readmissions. The program includes fall-predicting wearables and tablets for patients, and corresponding monitoring an analytics software for physicians.

Sponsor Updates

• Healthwise is certified as a Great Place to Work.

Blog Posts

• Self-service analytics: Empower your team to make data-driven decisions [podcast] (Nordic)
• Delayed or not, it’s time to prepare for MACRA (Nordic)

Contacts

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

More news: HIStalk, HIStalk Connect.

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

News 7/28/16

Top News

Medstreaming acquires Physician Billing Partners for an undisclosed sum. The Redmond, WA-based company, which acquired registry software vendor M2S in March, will incorporate PBP’s RCM and PM services into its ambulatory software for cardiologists and radiologists.

Webinars

August 10 (Wednesday) 1:30 ET. “Taming the Beast: CDS Knowledge Management.” Sponsored by LogicStream Health. Presenters: Luis Saldana, MD, MBA, CMIO, Texas Health Resources (THR); Maxine Ketchum, clinical decision support analyst, THR; Kanan Garg, senior applications analyst, THR; Patrick Yoder, CEO, LogicStream health. This presentation will review THR’s systematic process for managing clinical decision support assets, including identifying broken alerts, addressing technical and clinical issues, modifying order sets, and retiring tools that have outlived their usefulness. Attendees will learn how THR uses a robust knowledge management platform to better understand how clinicians are interacting with their clinical content to maintain their order sets and reduce the number of alerts fired.

Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.

Acquisitions, Funding, Business, and Stock

Constellation will sell its health IT consulting business to JDL Technologies. Terms of the deal, expected to close in October, were not made public. Constellation’s MMIC business employs 30 in Minneapolis, all of which will be retained by JDL as it works to increase its healthcare HIPAA compliance and cybersecurity business in the Midwest.

Announcements and Implementations

Boston-based EveryPatient develops a set of patient satisfaction tools including real-time collection and automatic analysis of experience data, as well as corresponding provider alerts.

CRM vendor Silverline develops patient contact center software based on Salesforce’s Fullforce technology.

Inovalon signs a multiyear EHR data integration agreement with Athenahealth, linking users of AthenaClinicals to its analytics technology.

Community Care Collaborative implements the Bridge Patient Portal across its partner safety net organizations in Travis County, TX, including 24 CommUnityCare health centers. 

MedEvolve adds InstaMed’s patient payment tools to its EHR, PM, and RCM software and services for specialty practices.

EHR vendor Medent will process its customer data through Patient IP’s matching software to help end users identity patients that may be eligible for clinical trials.

NextGen reseller TSI Healthcare adds patient intake kiosks from OTech Group to its service line.

Atlanta-based HealthAsyst adds payment processing options from Vantiv Integrated Payments to its patient check-in software.

People

Mike Hairston (Greenway Health) joins Across Healthcare as principal.

Douglas Berkson (Berkson Consulting) joins Accretive Health as senior vice president.

Government and Politics

ONC updates its Health IT Dashboard with the latest count of MU-attesting EPs by ambulatory vendor (of which there are nearly 600). Epic, Allscripts, and EClinicalWorks take the top spots.

Research and Innovation

A study of 321 type 2 diabetics in the UK finds that self-monitoring of blood glucose levels isn’t as effective as telemonitoring in improving glycemic control, contradicting previous studies. Patients that measured and transmitted their glucose readings to a secure website for review by a family physician achieved greater control of their levels, including blood pressure, with little change to physician workload.

Contacts

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

More news: HIStalk, HIStalk Connect.

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