News 3/28/16

Top News

There’s no stopping I-STOP: New York’s mandatory e-prescribing mandate goes into effect over the weekend despite an uncertain level of prescriber readiness even after the 12-month postponement a year ago. Paper or call-in prescriptions can be issued upon patient request or upon technology failure, which then requires the prescribing physician to report the prescription to the state’s Department of Health, which has not implemented appropriate reporting technology and suggests that prescribers just note it in the EHR instead. Medical Society of the State of New York President Joseph Maldonado, MD has asked for two exceptions to the new requirement – exempting providers that write less than 25 prescriptions per year and reducing documentation requirements when technical problems temporarily force physicians back to paper.

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.

Here’s the recording of last week’s webinar, “Six Communication Best Practices for Reducing Readmissions and Capturing TCM Revenue.”

Acquisitions, Funding, Business, and Stock

Japan’s NTT Data will buy Dell’s IT services business, the former Perot Systems, for $3.05 billion. Dell is selling the business, which it acquired for $3.9 billion in 2009, to raise money to finance its $60 billion acquisition of storage vendor EMC.

On-demand healthcare provider and payer Zoom+ will relocate its Portland headquarters to the capitol’s Pearl District next year. The company’s new offices will take up 30,000 square feet, house 300 employees including medical professionals and technologists, and will include a virtual care hub and innovation lab.

People

Erika Running (Jacobus Consulting) returns to Sisu Healthcare IT Solutions in the new position of vice president of analytics.

Andrea De La Bruere (Ingenuity Health) joins Vermont Information Technology Leaders as senior solutions specialist.

Anna Baird (RadiumOne) and Baljeet Singh (Twitter) join Livongo Health as CFO and vice president of product management, respectively.

Telemedicine

A study of 500 insured consumers who use Web-based health tools and apps finds that telemedicine may have a consumer awareness problem. Thirty-nine percent of those surveyed hadn’t heard of telemedicine. Ninety-three percent of those that have report that it has lowered their healthcare costs. Over 25 percent are unsure of when and when not to use telemedicine. Given that just a third of the respondent health plans offer telemedicine, it seems there’s a big opportunity for payers to help bridge this knowledge gap and lower member costs.

Blue Cross Blue Shield of Massachusetts partners with American Well to offer its members telemedicine services. The launch comes a year after the start of what was initially a two-year BCBSMA/American Well telemedicine pilot program with several physician practices and Blue Cross nurse care managers.

The ATA takes the Washington, D.C. Department of Health to task for its proposed telemedicine rules, which the association deems “onerous and arbitrary” due to ambiguous phrasing; lack of consistency; the need for additional, potentially burdensome patient consent; and an emphasis on tools over clinical expertise.

Government and Politics

The National Association of ACOs and 20 supporting organizations write to Acting CMS Administrator Andy Slavitt in response to the ACO benchmarking proposed rule issued by CMS early last month. The signers voice their support for incorporating regional cost data into benchmarks, and advocate for the designation of all MSSP ACOs as qualifying alternative payment models under MACRA.

ACT | The App Association urges The White House to rethink its draft data security policies for the Precision Medicine Initiative, particularly as they pertain to small- and medium-sized entities who may face prohibitive costs in complying with them.  “For example,” writes the association, “small- and medium-sized entities may find difficulty in attaining independent third-party reviews of their security plans that, at minimum, include ‘a review of the organization’s adherence to its security plan; regular vulnerability assessments; and evaluation and adjustment of the security program in light of vulnerability assessments and evolving circumstances’ without facing prohibitive costs that are not scaled to the risk they should be managing per the NIST Cybersecurity Framework’s approach.”

Other

Drumroll please: The HIStalk Practice Award for Best Headline goes to … “All Right Stop, Collaborate and Listen! CMS is Back with its Brand New Invention, Preparing for CJR Gainsharing” and “America’s Med Students are a Bunch of Drunks” (from Vice’s Munchies microsite, of course). I’ll let you take time out of your day to read these winners.

The New York Times calls for federal oversight to ensure that employees aren’t discriminated against by their employers based on supposedly de-identified health data provided by companies like Castlight Health, which helps employers anticipate health insurance needs by analyzing employee healthcare claims and demographic data. “As data analysis techniques evolve, such services will be able to draw ever more sophisticated conclusions about people based on their health use,” NYT editors write. “Americans need federal protections to make sure that those conclusions don’t cost them their jobs.”

Sponsor Updates

• Medicity CEO Nancy Ham writes for the HFMA blog on “Determining the ROI of Clinical Care Technology.”
• EClinicalWorks releases a podcast recapping EClinicalWorks Day.
• The Boston Globe features Healthwise CMO Adam Husney, MD in an article on how perks from pharmaceutical companies influence prescribing medicine.
• PerfectServe and Versus Technology will exhibit at the AONE Annual Meeting March 30-April 2 in Fort Worth, TX.

Blog Posts

• Rise in Opioid Deaths, Driving Changes in Prescribing (E-MDs)

Contacts

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

More news: HIStalk, HIStalk Connect.

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Population Health Management Weekly Wrap Up 3/27/16

Population health management technology vendor Chess selects cloud procurement software from Verian to streamline its process for ordering goods and services. Chess will initially roll out the new WeProcurement system at Cornerstone Health Care (NC), its largest group practice client of over 300 physicians and advanced practice providers.

In the UK, integrated primary and acute care system Wirral Partners chooses Cerner’s HealtheIntent for population health management.

And speaking of Cerner, the company holds a topping-out ceremony for its $4.45 billion Cerner Trails campus in Kansas City, MO. The 16-building, 4.7 million square foot complex with two, 15-story towers will house up to 16,000 employees. Kansas City will pay $1.1 billion of the project’s cost.

Collaborative for Children and Families (NY) selects care coordination and population health technology from GSI Health to assist with its state-led Children’s Health Home, Medicaid Redesign Team Delivery System Reform Incentive Payment (MRT DSRIP), and Medicaid Health Home population health programs.

Contacts

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

More news: HIStalk, HIStalk Connect.

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News 3/24/16

Top News

HHS Secretary Sylvia Burwell takes to Bloomberg  to lay out the next steps for healthcare reform. They include alternative payment models, encouraging better coordination and prioritizing wellness and prevention, and “unlocking” healthcare data. “With information that can move where it’s needed, we can give doctors what they need to provide the best possible care and empower patients,” she writes. “Progress isn’t easy, but what we have accomplished in six short years is undeniable: 20 million now covered, billions of dollars saved and changes that are making our system work better for everyone.”

Webinars

None scheduled soon. Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.

Telemedicine

San Francisco-based Doctor on Demand earns accreditation from the American Telemedicine Association, HITRUST, and the National Committee for Quality Assurance. The company signed its 400th customer in January, and added psychiatry to its line of services a month later.

Consulting firm Gorman Healthcare Group offers its clients telemedicine services via EVisitMyDr.com. EVisit CEO Rick Krieger and CMO Doug Smith, MD established QuickMedx/MinuteClinic in 1999 and sold it to CVS in 2006.

Research and Innovation

A DrFirst report finds that providers lag far behind their pharmacist counterparts in electronic prescribing of controlled substances. While over 82 percent of pharmacies are EPCS enabled, just under six percent of providers have the capability. Nearly 100 percent of pharmacies in New York are EPCS enabled thanks to the state’s Internet System for Tracking Over-Prescribing Act, which takes effect March 27. New York providers, however, lag far behind their pharmacist counterparts, with just 27 percent using the functionality. 

Researchers at the University of Texas at Austin are working to develop a “biological tattoo” – a skin-adhering electronic device thinner than a human hair that could potentially record heart rate, glucose levels, hydration, oxygen levels, muscle movement, and perhaps even brain waves. “If you have a chronic illness, and your doctor wants to check up on you, you can just wear this patch, and then you could use your phone to upload the data to the doctor,” says graduate student Luke Nicolini. “Either the doctor or automatic analysis software can determine if something is going wrong.”

Other

The local paper highlights the success Connecticut-based Community Health Center’s 13 FQHCs have had with e-consults, including study results published in the Annals of Family Medicine that showed the consults have helped to reduce the number of in-person specialist visits and trips to the ED. CHC, which is the only organization of its kind in the state that provides e-consults, has successfully worked with the state to establish Medicaid reimbursement, and is hoping to expand the practice to other providers across the state.

MIT’s Abdul Latif Jameel Poverty Action Lab launches the Health Care Delivery Innovation Competition. Selected applicants will gain access to pilot funding of up to $50,000 to help launch a randomized evaluation of programs that launch health and social services to improve outcomes, accessibility, and affordability; plus technical assistance and strategic consulting from J-PAL staff and its network of academic researchers. Applications due on June 17. Winners will be announced by July 15.

Contacts

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

More news: HIStalk, HIStalk Connect.

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Readers Write: Empowering Value-Based Technologies with Standardization, Agreement, and Leadership

Empowering Value-Based Technologies with Standardization, Agreement, and Leadership
By David Fryefield, MD

Community-based oncology practices, like other healthcare organizations, are struggling to understand value-based care, how to deliver it, and what resources they need to be successful in this increasingly complex and evolving landscape.

When discussing value-based care, talk quickly turns to the need for cutting-edge technologies to track and measure the quality of services provided. In a value-based world, value is defined as the ratio of quality over cost, and the focus is on measuring quality. In our volume-based world, quality was always there, but we did not necessarily measure it, since it wasn’t a requirement in the reimbursement system. Now, however, measuring quality is critical, and that is where technology can play a vital role.

Many organizations are moving forward with technology solutions to help measure quality in this new value-based environment. However, it is important to realize there is much work to do before deploying these technologies, as technology alone is not going to be the catch-all solution.

Several things must happen to enable the technology solution to be an effective tool, and it all starts with standardization of care processes and consensus within the practice. First, quality must be defined; determining what the critical components of quality care are and what will be measured and analyzed. Then there must be agreement within the practice on the components of the care delivery process and how each step will be performed, as this enables the ability to measure whether or not steps and tasks were completed as defined. If the goal is to measure a component of care delivery and every physician does it differently, the end result is immeasurable. So, unlike the fee-for-service world, the value-based environment requires standardization. This is a critical first step, and possibly the hardest, on the road to quality and must occur before technology can effectively be used to measure the various quality components.

Once consensus and standardization have been achieved, technology can be utilized to determine the quality over cost ratio, or the value definition, which can drive both cost and quality improvements. Each step of the care delivery process can be measured and analyzed to identify opportunities for reducing costs while improving or maintaining quality.

For example, a growing concern is the number of oncology patients who visit the ER or are admitted to the hospital. Many of these patient trips to the ER are unnecessary, creating a drain on the healthcare system financially. By being proactive in patient care, this number can be reduced. Technology can track how often it is happening and then predictive analytics can identify risk factors that, if measured ahead of time, can allow clinicians to help patients avoid a trip to the ER or hospital.

End-of-life care is another area where predictive analytics can support better care and help lower costs. Ensuring patients understand treatment options and giving them a voice in their care decisions are important factors in the perceived value of care. If oncology practices have a system in place to measure variables that can predict when a patient could benefit from end-of-life counseling, a better patient experience could be provided.

What is required from a technology standpoint to get where we need to go? First, changes must be made to EHRs. Accurate, comprehensive data needs to be captured in the EHR so it can be easily accessed, shared across the care continuum, extracted, and analyzed. Several technologies come into play here, including EHR and interoperability platforms, as well as data analytics. Once analyzed, the data needs to be presented back to clinicians and others in the practice in a simple format, such as user-friendly dashboards, providing actionable insight for fact-based decisions. Additionally, real-time data will play a crucial role in value-based care. To provide proactive care, information must be timely, ongoing, and constantly monitored – key areas in which technology solutions will be invaluable.

Leadership will also be required to help the organization evolve. Practice leadership is an important part of the equation, guiding the consensus and standardization needed to achieve measurable results to support quality care and lower costs. Technology by itself will not yield much progress on the journey to value-based care. The transition requires the full package ― advanced technologies and leadership ― to drive development of the framework needed to empower the technology solution. The practice workflow and culture that the technology is deployed in is really the critical issue. A practice can have the most advanced technology available, but if a plan has not been developed and agreed upon on how to effectively deploy it, and leadership is not in place to drive the plan, a great deal of the technology solution’s power and potential is lost.

David Fryefield, MD is medical director of operational excellence for The US Oncology Network, and practice president and radiation oncologist with the Willamette Valley Cancer Institute and Research Center.

Contacts

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

More news: HIStalk, HIStalk Connect.

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News 3/23/16

Top News

Allscripts forms a join venture with private equity firm GI Partners to acquire behavioral healthcare technology vendor Netsmart Technologies. Allscripts, which will contribute $70 million to the deal, will merge its homecare software business unit with Netsmart. Netsmart CEO Mike Valentine will continue in that role for the combined company.

Webinars

None scheduled soon. Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.

Here’s the video from last week’s webinar, “Looking at the Big Picture for Strategic Communications at Children’s Hospital Colorado,” sponsored by Spok.

People

Missy Krasner (Box) joins DigiSight’s Board of Directors. For those keeping score, Krasner helped pass out HISsies at HIStalkapalooza 2014. I still remember Mr. H’s admiration of her dancing skills.

IPC Healthcare founder Adam Singer, MD joins MDVIP’s Board of Directors.

Trade association Health IT Now promotes Robert Horne to executive director. He takes over from Joel White, who will remain involved as a senior advisor.

Announcements and Implementations

Statewide ACO OneCare Vermont selects care management software from Care Navigator, a subsidiary of BluePrint Healthcare IT. Roll out will begin with care coordinators who will initially focus on high-risk patients with complex conditions. OneCare will expand its use of the new software in phases, eventually adding physicians, other clinical staff, patients, and family caregivers.

Telemedicine

Indiana Governor Mike Pence signs House Bill 1263 into law, enabling physicians, PAs, and APNs to offer telemedicine services to patients without a prior in-person visit.

Government and Politics

Just in time to celebrate the Affordable Care Act’s sixth anniversary, GAO releases a report that covering actions that are needed to enhance data security and privacy controls at Healthcare.gov. Turns out the federal exchange was the victim of 300 cyberattacks over the course of 18 months, none of which “successfully compromised sensitive data.” The 55-page report specifically points out weaknesses in the site’s ability to protect data flowing through the Federal Data Services Hub, a portal used to exchange information between the marketplace and CMS partners. Red flags include insufficiently restricted administrator privileges for data hub systems, inconsistent application of security patches, and insecure configuration of an administrative network.

ONC will hold its annual meeting May 31-June 2 in Washington, DC.

Other

HealthcareSource adds 1,000 courses to its Elearning library for healthcare professionals. New courses and updates include the fields of regulatory compliance, leadership, ICD-10/RCM, and desktop skills.

Sponsor Updates

Blog Posts

• High Performance Telemedicine for Your Practice (AdvancedMD)
• The Value and Challenge of Patient Generated Health Data (Culbert Healthcare Solutions)

Contacts

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

More news: HIStalk, HIStalk Connect.

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