News 3/31/16

Top News

The White House Rural Council hosts the first Rural Telemedicine Summit in an effort to foster discussion between healthcare and broadband advisors and government officials. News reports suggest that participants “identified and made recommendations on barriers and opportunities to increase deployment and participation in telehealth services,” including the potential for telemedicine to aid in the fight against opioid abuse.

Webinars

April 1 (Friday) 1:00 ET. “rise of the small-first-letter vendors … and the race to integrate HIS & MD systems.” Sponsored by HIStalk. Presenters: Frank L. Poggio, president and CEO, The Kelzon Group; Vince Ciotti, principal, HIS Professionals. Vince and Frank are back with their brutally honest (and often humorous) opinions about the rise of the small-first-letter vendors. Athenahealth and eClinicalWorks are following a growing trend toward real integration between hospital and physician systems, but this is not a new phenomenon. What have we learned from these same efforts over the last 30 years? What are the implications for hospital and ambulatory clients? What can clients expect based on past experience?

April 8 (Friday) 1:00 ET. “Ransomware in Healthcare: Tactics, Techniques, and Response.” Sponsored by HIStalk. Presenter: John Gomez, CEO, Sensato. Ransomware continues to be an effective attack against healthcare infrastructure, with the clear ability to disrupt operations and impact patient care. This webinar will provide an inside look at how attackers use ransomware; why it so effective; and recommendations for mitigation.

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

Announcements and Implementations

Medical Transcription Billing Corp. offers New York-based physicians free access to its e-prescribing technology for one year, provided they sign up for service by May 1. New York’s mandatory e-prescribing law went into effect March 27.

CityMD goes live with EClinicalWorks  10e EHR at its 52 locations across New York City.

Mount Nittany Exchange, an HIE serving providers in central Pennsylvania, joins the Pennsylvania EHealth Partnership Authority’s Pennsylvania Patient & Provider Network, which offers participants a single point of contact for reporting into the state’s health registries via its Public Health Gateway. MNE is the fourth such organization to join P3N this year.

Reliance ACO, a group of independent physicians in Southeast Michigan, becomes the first US-based provider organization to implement CSC’s chronic care management service.

AdTel International adds patient payment reminders to its DoctorConnect interactive patient communication service.

OB/GYN EHR vendor DigiChart taps wire data services vendor ExtraHop to help with a large-scale datacenter migration.

People

Access Community Health Network promotes Jairo Mejia, MD to CMO. Mejia’s bio notes that he helped lead the network of FQHCs in its adoption of Epic EHR and PM technology. ACHN has been recognized by HIMSS as a Stage 6 facility.

Telemedicine

The Bougainvilla House (FL) joins MAP Health Management’s recovery network. Membership in the network will enable the addiction treatment facility for teenagers to capture and act upon outcomes data through the telemedicine component of the MAP platform.

The States of Washington and West Virginia pass telemedicine-friendly legislation this week. In addition to promoting the delivery of safe and effective telemedicine practices and relaxing certain regulatory standards, Washington’s Telemedicine Advancement Law establishes a collaborative that will work to develop recommendations for how to identify best telemedicine practices, expand access, and improve coverage and payment. West Virginia’s House Bill 4463 emphasizes telemedicine’s real-time audio-video conferencing nature. For those keeping score: West Virginia enacted the Interstate Medical Licensure Compact last year, while Washington introduced it in January.

Research and Innovation

Researchers from Johns Hopkins University, Ohio State University, and National Cancer Institute anticipate that 75 percent of consumers will adopt PHRs by 2020 – an astonishingly high estimate in my opinion, especially given the rash of cyberattacks hitting healthcare organizations over the last several weeks the subsequent gun shyness many consumers will likely feel about sharing their health data with any sort of third-party service. The researchers correlate this skyrocketing adoption with a correspondingly low Meaningful Use threshold for patient engagement, and suggest that the program rethinks its criteria to ensure “more ambitious uptake and functionality availability.”

Other

File this under “How is this still happening?” Reporters uncover a dumpster full of medical records and “other medical stuff that shouldn’t be thrown out like a dead hamburger or a sack of beer bottles” behind an abandoned holistic medical practice in Albuquerque, NM. The investigation has been turned over to the New Mexico Board of Nursing, who will likely pursue the practice’s director, who is also an NP.

Contacts

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

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HIStalk Practice Interviews Dominic Mack, MD Director, National Center for Primary Care

Dominic Mack, MD is the new director of the Morehouse School of Medicine’s National Center for Primary Care.

Tell me about yourself and the National Center for Primary Care.
I have been practicing family medicine for 25 years. I am the founder and past president of Mack Medical Consultants, and am now an associate professor and director of the National Center for Primary Care at the Morehouse School of Medicine in Atlanta. As part of that role, I also serve as the executive medical director of the Georgia Health Information Technology Center and principal investigator for the Health Policy Center of the NIH Trandisciplinary Collaborative Center at MSM.

The mission of the NCPC is to promote excellence in community-oriented primary health care and optimal outcomes for all Americans, with a special focus on underserved populations and eliminating health disparities. Our team provides training for primary care practitioners, conducts both population-level and practice-based research to improve health outcomes, and shares protocols and tools for improving primary care effectiveness in culturally-diverse settings.

How will you steer the center in expanding its portfolio and allocating grant funds?
Going forward, we will be inclusive of the greater primary care system supporting physicians and other health professionals and stakeholders including primary care entities such as hospitals, health professional organizations, community based organizations and state/federal health agencies, to name a few. We will continue to be a research and training center, but our programs will produce best-practice models that hinge on our four core competencies -education and training, research, health IT, and quality improvement.

My objective in 2016-17 is to continue our development and growth using collaborative models focusing on care-integration opportunities that highlight primary care, mental health, and addiction. Expertise in these areas along with HIT will enable us to develop education and training curriculum that add value to the Morehouse School of Medicine system. My aim is to complete the development of our NCPC Learning Center/ Virtual Community Concept, which engages stakeholders through a national Web presence and distance learning programs. Competencies are integrated into a learning center platform that centralizes learning (synchronous and asynchronous) and resources to support outreach, education, and training for healthcare stakeholders. This allows the NCPC to support education programs for an array of healthcare audiences. Public awareness of NCPC/MSM programs will be heightened to support the acquisition of new contracts and grant opportunities with external partners across the nation. This concept engages national audiences who reference us as a resource center and seek our consultation for the development of their programs.

A 2016 objective is to hire a new research director who will also serve as the research leader in Family Medicine. This director will assume the NCPC research duties and responsibilities, which include research mentorship, grant writing, publications, and the development of new funded research programs. I will continue our focus on population-based health equity and practice-based research including big data research using our Medicaid database; and also expand to dissemination and implementation research projects. Anne Gaglioti, MD will lead our efforts to rekindle the Southeastern Research Network to develop practice-based research projects with primary care associations and FQHCs across the Southeast. Once our research director is on board, I will continue to provide strategic direction and ensure our research focus continues to align with the overall direction of the NCPC/MSM. We will seek collaborative partnerships within MSM to successfully compete for new funding opportunities.

We also plan to expand our Meaningful Use and HIE services throughout Georgia and the Southeast. To my understanding, we are the only HIT center that is located at an African-American institution and the only minority center that is focused on increasing HIT adoption in practices that serve rural and underserved communities. This gives us a significant opportunity to develop best-practice models that simplify adoption for smaller practices/hospitals at an equitable cost. Importantly for health equity research, it allows access to practice-based clinical data for real-time practice- and population-based research. This includes telehealth and other cloud-based quality management services that support EHR/HIT adoption. We are also evaluating HIT policy to better influence equitable EHR adoption in our national community.

What are the biggest healthcare IT challenges PCPs face when it comes to caring for the underserved populations? How is the center helping them to deal with these challenges?
Affording the latest and best technology for their practices. Innovative analytics that help practices with the implementation of quality programs are expensive and require resources that smaller practices and hospitals don’t have. We are developing affordable models that are innovative and made to fit these organizations. Rural and urban practices that serve these communities need support to exchange, analyze, and report data in a way that adds value to the practice.

Can you share any success stories relating to healthcare technology impacting healthcare access and outcomes in underserved populations?
We have multiple stories about the success of small practices. One of those involves a small one-doc pediatric practice that has been assisted by GaHITEC over the last five years. This practice has moved from paper records to an HER, and is now exchanging information through Georgia Health Connect, an HIE established through our GaHITEC work to serve underserved areas.

How are you seeing PCPs incorporating public health and population health management strategies into their care?
We truly believe that everyone has a right to access quality healthcare and our practices are on the front line of this care. Some are accessing these innovative platforms through collaboration or being acquired by larger health systems. In many cases, our segment of practices are lagging in the adoption because of the lack of resources (finances, staff, etc.)

What healthcare technologies excite you most in terms of their potential to have the biggest impact on access and outcomes across patient populations?
Mobile telehealth has the potential to impact underserved populations significantly because of accessibility. Most people don’t know that these populations are the biggest consumers of cellular data.

Do you have any final thoughts?
We hope to develop models that can be sustainable and enable smaller hospitals and independent practices to stay successful and autonomous. I believe the disappearance of independent practices is to the healthcare system as the closing down of all small businesses would be to the business community. Hopefully we aggregate these small practices and hospitals to create a virtual ACO through our HIE products.

Contacts

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

More news: HIStalk, HIStalk Connect.

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News 3/30/16

Top News

Today marks the 25th anniversary of National Doctors Day. Signed into law by President George Bush in 1991, the day serves as a nice excuse to recognize physicians, their commitment to patients, and their contributions to the community (not to mention the healthcare IT-related suffering they’ve endured over the last several years.) With physician burnout reaching new highs, do your favorite MD a favor and send them a note of thanks – preferably through their patient portal so they can check that patient engagement box for MU.

Webinars

April 1 (Friday) 1:00 ET. “rise of the small-first-letter vendors … and the race to integrate HIS & MD systems.” Sponsored by HIStalk. Presenters: Frank L. Poggio, president and CEO, The Kelzon Group; Vince Ciotti, principal, HIS Professionals. Vince and Frank are back with their brutally honest (and often humorous) opinions about the rise of the small-first-letter vendors. Athenahealth and eClinicalWorks are following a growing trend toward real integration between hospital and physician systems, but this is not a new phenomenon. What have we learned from these same efforts over the last 30 years? What are the implications for hospital and ambulatory clients? What can clients expect based on past experience?

April 8 (Friday) 1:00 ET. “Ransomware in Healthcare: Tactics, Techniques, and Response.” Sponsored by HIStalk. Presenter: John Gomez, CEO, Sensato. Ransomware continues to be an effective attack against healthcare infrastructure, with the clear ability to disrupt operations and impact patient care. This webinar will provide an inside look at how attackers use ransomware; why it so effective; and recommendations for mitigation.

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

Announcements and Implementations

Illinois Cancer Specialists – part of The US Oncology Network – partners with Blue Cross and Blue Shield of Illinois to launch the state’s first oncology intensive medical home pilot. The program will enroll 150-200 patients annually, each of whom will participate for six-month stints. “This program with BCBSIL gives us valuable data that providers can use to improve the care our patients receive,” says ICS Practice President David Hakimian, MD. “This is a real opportunity for direct access to quality and cost data that will help inform decisions about how best to care for our patients. Blue Cross is making this level of transparency possible, something that wouldn’t otherwise be available to us.”

Jersey City, NJ-based ITelagen integrates TransFirst payment processing tools into its EHR.

Telemedicine

HealthTap announces its US network of virtual care physicians has grown to over 100,000. A fun HealthTap fact on this National Doctor’s Day: The Palo Alto, CA-based company’s physicians have received nearly 29,000 notes thanking them for saving a patient’s life.

Government and Politics

An Office of Management and Budget analysis shows that federal agencies have quite a bit of work to do when it comes to meeting their cybersecurity responsibilities. Agencies scored 68 out of 100 overall in 2015 – an 8-percent drop from 2014 that the office attributes to a more thorough scoring methodology. HHS scored 58 last year – quite an improvement from its 2014 score of 35.

NIST publishes a new computer security standard that it claims will help protect credit card numbers and potentially protect personal health information. I don’t pretend to completely understand the ins and outs of the two new techniques for “format-preserving encryption,” but I can surmise that it may help to disassociate Social Security numbers from sensitive health data used for treatment research. Security experts can check out NIST’s FPE recommendation here.

Other

Looks like employers have their work cut out for them in this new era of rampant cyberattacks: A SailPoint survey finds that one in five employees would sell their company passwords for less than $100 – a stat that has risen from last year’s one in seven. US-based staff were most willing to sell out their employers, though France beat them in terms of a willingness to accept low offers. Equally sad is the fact that two-thirds of respondents use the same password for multiple apps; a third confessed to sharing passwords with colleagues.

Privacy concerns surface as wearables come to schools. A school board in Connecticut debated the benefits and drawbacks of purchasing Polar heart-rate monitors for seventh and eight graders as part of a monitoring activity in PE. Concerns ranged from what Polar employees may do with student data to how to de-identify the data without impacting the purpose of the project. “I just don’t view [student names and heart rates] as particularly problematic if it were to get out there,” said one school board member. “If you had your address, parent names, social security number, that sort of stuff, which is frankly shared on a daily basis by all of us, I think that’s a lot more problematic.”

Similar concerns are associated with site-tracking software installed on school-provided laptops. Ontario Christian Schools provided students with GoGuardian-equipped laptops, which, in addition to blocking “timewaster” sites like Netflix, also alerted school officials to suicide-related search histories. The alerts, which successfully led to school and parental intervention, have also prompted privacy concerns. “On the surface,” says Carolyn Stone, ethics chair of the American School Counselor Association, “it sounds like a very good idea to err on the side of caution when it comes to student suicide. But this is something that sounds like it could spin out of control. … It’s a slippery slope.”

Sponsor Updates

• Aprima will exhibit at the Texas MGMA Annual Meeting March 30-April 1 in Dallas.
• EClinicalWorks will exhibit at the 2016 Health Care Symposium April 1 in Costa Mesa, CA.
• Healthwise will present at the Society of Behavioral Medicine meeting March 30-April 2 in Washington, DC.

Blog Posts

• EHR Improvements After the AMA “Hateful 8” List (AdvancedMD)

Contacts

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

More news: HIStalk, HIStalk Connect.

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News 3/29/16

Top News

The CVS Health Foundation awards $1.5 million in grants to 46 community health centers and free clinics. The funds will be used for a variety of improvement programs including care coordination, chronic disease management, outcomes measurement, and telenursing. Hunterdon Healthcare Foundation (NJ), whose team is pictured above, will use its $10,000 to fund its Visiting Health and Supportive Services Telehealth Program. Many of the recipients will also use the funds to hire additional staff, and expand hours and services.

Webinars

April 1 (Friday) 1:00 ET. “rise of the small-first-letter vendors … and the race to integrate HIS & MD systems.” Sponsored by HIStalk. Presenters: Frank L. Poggio, president and CEO, The Kelzon Group; Vince Ciotti, principal, HIS Professionals. Vince and Frank are back with their brutally honest (and often humorous) opinions about the rise of the small-first-letter vendors. Athenahealth and eClinicalWorks are following a growing trend toward real integration between hospital and physician systems, but this is not a new phenomenon. What have we learned from these same efforts over the last 30 years? What are the implications for hospital and ambulatory clients? What can clients expect based on past experience?

April 8 (Friday) 1:00 ET. “Ransomware in Healthcare: Tactics, Techniques, and Response.” Sponsored by HIStalk. Presenter: John Gomez, CEO, Sensato. Ransomware continues to be an effective attack against healthcare infrastructure, with the clear ability to disrupt operations and impact patient care. This webinar will provide an inside look at how attackers use ransomware; why it so effective; and recommendations for mitigation.

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

Acquisitions, Funding, Business, and Stock

Louisville, KY-based startup Lucina Health (fka CerviLenz) unveils its headquarters and announces its first customer, Passport Health Plan. The six-employee company uses data analytics to help health plans identify pregnant women with a variety of risk factors for preterm birth, and provides steps the moms-to-be can take to avoid complications. It anticipates hiring another 10 to 15 staff within the year, and expanding its services to other conditions like diabetes and obesity.

Physicians looking for a change of scenery way want to consider moving to Mississippi, Iowa or Minnesota – ranked by WalletHub as the top three states for physicians based on opportunity, competition, and medical quality. Rhode Island, New York, and Washington, DC make up the bottom three.

Announcements and Implementations

Kids First Pediatrics (GA) implements PatientPay’s paperless billing software across its three locations.

Patient reminders business PatientlySpeaking now supports PracticePro PM software from Medical Transcription Billing Corp.

ChartLogic partners with Change Healthcare to add a lab ordering system to its EHR. The partnership will also enable ChartLogic users to connect to labs across the country via Change Healthcare’s Clinical Network.

Telemedicine

WellCare’s StayWell health plan offers its Medicaid members in Florida access to behavioral healthcare via telemedicine. Orlando-based Impower, a nonprofit mental health and child wellbeing organization, has been a key partner in piloting the service. It was previously the only organization of its kind in Florida with permission from the state to prescribe controlled substances to telemedicine members. The Florida Board of Medicine loosened its regulations earlier this month to allow other telemedicine providers to also prescribe under the appropriate conditions.

The FTC applauds proposed “procompetitive” legislation from Alaskan lawmakers that would give out-of-state doctors the ability to treat in-state patients. “These provisions would likely increase the supply of telehealth providers, enhance competition, and reduce health care costs,” the FTC writes, “thereby benefiting Alaskans, especially underserved populations with limited access to health care.”

A study of California Public Employee Retirement System HMO claims finds that office-based doctors were more likely to order the appropriate step test than were Teladoc physicians, who also inappropriately ordered antibiotics for bronchitis more often than their brick-and-mortar counterparts. The study also found that Teladoc users were not located in underserved communities. It’s worth noting the data was collected between 2012 and 2013; perhaps Teladoc has improved its prescribing practices.

Government and Politics

AHRQ looks to fund grant proposals focused on researching safe healthcare IT practices related to design, implementation, and usability by all users including patients and caregivers. The agency hopes to use resulting projects and their evidence to guide health IT certification and policy.

Research and Innovation

Anti-addiction advocacy group Shatterproof compiles a 52-page report on prescription drug monitoring programs and the state legislation needed to make them truly effective. The New York-based organization includes 12 guiding practices, many of which focus on linking, sharing, and tracking data.

Other

Consumer Reports rolls out primary care practice ratings for eight states based on how well they provide evidence-based care for common health problems. The data seems to be culled from commercial payers, HMOs, and voluntary and state-mandated reporting from the practices. “These regions all deserve credit for pushing for this effort,” says medical consultant John Santa, MD “as do practices that have agreed to share the information — especially those who may not do so well. That takes courage and a commitment to honesty and transparency — qualities that are also essential to good medicine.”

Contacts

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

More news: HIStalk, HIStalk Connect.

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DOCtalk with Dr. Gregg 3/29/16

Post-HIMSS 2016: Settled Dust & Workflow Friendliness

It’s been long enough now that the 2016 post-HIMSS dust has settled. Monitoring each and every one of the showtime products, vendors, events, and such isn’t possible, nor is monitoring all of the post-HIMSS analysis that inevitably follows. Add to that the fact that at this time of year, and at this year’s HIMSS, I have barely had time to breathe, no less stay up on the blogosphere and email blasts, and I admit to feeling a little not-so-in-touch with the usual pre-, post-, and intra-HIMSS hoopla.

However, this year seems different. It seems there’s less rave and more yawn. Maybe it’s just my somewhat disconnectedness, but maybe it’s that there just wasn’t quite as much to get excited about this year. That settled dust seems to have gathered on my EHR brain.

Or, perhaps, it’s that we’re moving from the entrepreneurially-dominated, disruptive-type early phase of HIT adoption into the more sedentary and, well, dull phase of incremental HIT advancement, such as in Gartner’s Hype Cycle “Plateau of Productivity.”

If this is true, then it wouldn’t be a big surprise that while the HIMSS bacchanalia is as big or bigger than ever, the upshot hype would be somewhat less adrenalin-inducing.

Given my schedule, my rather poor connectivity of late, and the above, I thought I’d wait until after all the dust had settled to see what rose to a radar blip that might be worth checking into. And, a couple of things that really floated my HIT boat did ping the scanner, though both are definitely more incremental advances than cool new tool tech. Perhaps they caught my attention because both are heavy on near-and-dear-to-my-heart workflow-friendliness, but thank goodness for such advances!

The first is the new “Quippe Clinical Lens” from the folks at Medicomp Systems. If you didn’t make it by any of their now-annual Jeopardy-like events (“Quipstar” as they call them), then you missed out on a very clinician-friendly, new middleware tool that any provider would enjoy, especially docs, nurses, etc. who provide care for multi-problem patients, or who see patients with multiple providers, or who just like to be able to find truly relevant information with as little fuss and muss as possible.

Providers – you know how difficult it can often be to find what you need in long patient charts, voluminous problem lists, extensive medication lists, and laboriously lengthy lab histories. Even with EHRs, finding relevant bits and pieces of info amidst the ones and zeroes can often be about as problematic as it was with paper, despite the notion that digitized records are supposedly so much better than paper charts for information manipulation and retrieval. With Clinical Lens integrated into your EHR, data finding becomes what it should be in a digitized world.

Pick a problem, pick a drug, pick something you want to know more about, and Clinical Lens immediately shows its clinical savvy via massive mappings between SNOMED-CT, Medcin, HL-7, LOINC, Rx-Norm, ICD-10, CPT, etc. to put related data right to your eyes. Medicomp provides an “easy to use SDK” allowing your EHR vendor to fully integrate this tech into your current system. Imagine not having to leave your well-rehearsed current workflow, yet now being able to immediately find related, relevant data simply by highlighting one particular data element. Very, very provider-friendly!

The other really cool HIT “wowzie woozie” I’ve seen of late actually didn’t come via HIMSS; in fact, I don’t think they even participated in Vegas. But, they did connect with me during the post-HIMSS period and I loved what they’re doing so much, I couldn’t help but include it in my post-HIMSS considerations.

InLight EHR, from the folks at Pri-Med, has been making great strides since it launched last year. They take their vision from HIT grandfather Lawrence Weed, MD and put the problem-oriented medical record (POMR) front and center. Any physician alive today will attest to training in the POMR format; it’s a standard for medical documentation and truly “a way doctors think.” (Virtually every EHR/EMR out there claims to “work the way doctors think” – virtually none of them do.)

Not only does InLight organize all information – labs, meds, orders, notes, referrals, etc. – around the patient problem list, but it does so within a very eye-friendly, Web 2.0-sort of way. Very easy to use.

As if this weren’t enough, they have also acquired the IP behind the very best patient portal I have ever seen – my dear, sort-of-departed konciergeMD. InLight now calls it “Thrive,” and though it hasn’t yet been deployed, I was able to see a sneak peek. I can verify that it is in very good hands! (Still the best looking, most patient-friendly, and workflow-savvy patient portal I’ve ever seen.)

Such workflow-friendly and/or -enhancing tools as the ones above may be putting a little hype back into the HIT Plateau of Productivity. (They certainly have blown the settled dust off my EHR-frustrated brain!)

From the trenches…

“When the dust settles and the pages of history are written, it will not be the angry defenders of intolerance who have made the difference. The reward will go to those who dared to step outside the safety of their privacy in order to expose and rout the prevailing prejudices.” – Bishop John Shelby Spong

Dr. Gregg Alexander, a grunt in the trenches pediatrician at Madison Pediatrics, is chief medical officer for Health Nuts Media, an HIT and marketing consultant, sits on the board of directors of the Ohio Health Information Partnership, and is the semi-proud author of “Monsters Don’t Fart!”

Contacts

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

More news: HIStalk, HIStalk Connect.

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Contact us online.
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