News 1/25/16

Top News

CMS releases the application for hardship exemptions from Meaningful Use penalties in 2015. Physicians have the ability to request an exemption based on an “extreme and uncontrollable circumstance in the form of EHR certification/vendor issues.” This is one box-checking opportunity I’m sure many physicians won’t mind taking advantage of. Penalties will occur in 2017, totaling 3 percent of Medicare payments for physicians who don’t attest or qualify for the exemption. EP exemption applications are due March 15.

Webinars

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

Acquisitions, Funding, Business, and Stock

Specialty-focused healthcare IT vendor Nextech Systems acquires SupraMed, a developer of EHR and PM systems for plastic surgeons, for an undisclosed sum. SupraMed founder Robert Pollack, MD will step into an advisory role for the newly combined organization.

Telemedicine

The state of Mississippi’s insurance department selects telemedicine services from Teladoc as part of its new virtual care plan for volunteer firefighters and their dependents.

The Federation of State Medical Boards announces that Alaska, Arizona, Colorado, Kansas, New Hampshire, and Washington have introduced Interstate Medical Licensure Compact legislation in 2016. Twelve states have already enacted the compact, which when fully developed will offer streamlined licensing process for physicians interested in practicing medicine in multiple states. The Interstate Medical Licensure Compact Commission, which is working to put the compact into practice, will meet again on March 16.

Emerge Urgent Care opens today in Buda, TX. The four exam room facility bills itself as the first telemedicine-based urgent care center in the US.

Research and Innovation

University College London researchers develop the Dementia Risk Score, an algorithm that can estimate a patient’s chance of developing dementia within the next five years. The algorithm, which has demonstrated an accuracy of up to 85 percent in patients between 60 and 79, uses health data collected from 377 practices in the UK. The researchers feel the score has potential as an addition to clinical software systems, though they stress additional pilots should be done with more populations.

Other

Cerner CEO Neal Patterson reveals he is suffering from soft tissue cancer and will plan to undergo treatment immediately. His physician has assured him that this type of cancer is treatable and curable. “I plan to stay involved in the business, but with less travel and fewer meetings,” Patterson said in a company statement. “In reality it will not be a big change compared to how we run Cerner day-to-day already. It’s not often I’m forced to slow down, but the silver lining will be having some extra ‘think’ time to reflect on all the extraordinary opportunities we have in health IT. After years of studying healthcare systems around the world, this unique opportunity already has my gears turning.” Patterson’s ability to find the silver lining is admirable, and one he has likely honed during his wife’s years-long battle with breast cancer – a diagnosis that he has cited as an impetus for CommonWell’s interoperability efforts.

Alaska Orthopedic Specialists, which closed in March 2015, notifies patients that a former employee sent copies of patient information to the employee’s personal email account without permission. AOS is taking steps to secure the return of all information. No foul play seems to have occurred.

Contacts

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

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Population Health Management Weekly Wrap Up 1/24/16

Apollo Medical Holdings appoints Thomas Lam, MD (Network Medical Management) to its Board of Directors.

Scott Maratea (Orion Health) joins Health Dialog as senior vice president of sales.

Remote patient monitoring company AMC Health adds business intelligence services including analysis, reporting, predicting, and simulation to its product line. Prior to founding AMC Health in 2002, Nesim Bildirici co-founded RSL Communications and was managing director of R. S. Lauder, Gaspar & Co., a venture capital fund formed by the Lauder Family of Estee Lauder.

ZeOmega’s Jiva PHR earns ONC HIT 2014 Edition Modular EHR certification.

Sponsor Updates

• Leidos Health will exhibit at the CHIME Spring Forum January 28-29 in Las Vegas.
• EClinicalWorks releases a new podcast on the benefits of RCM at HCA.

Blog Posts

• Apply supply and demand to grow strategically while increasing revenue and reputation (Nordic)
• Health Systems Call for a Halt to Meaningful Use Stage 3 (E-MDs)

Contacts

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

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News 1/21/16

Top News

Athenahealth, EClinicalWorks, Epic, NextGen Healthcare, and Surescripts implement the Carequality Interoperability Framework released last month by The Sequoia Project. The companies will initially focus on query-based document exchange, acting as HIEs between their end users, who will in turn benefit from a more affordable method of developing health data-sharing agreements.

Webinars

None scheduled in the next few weeks. Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.

Acquisitions, Funding, Business, and Stock

LogixHealth (fka Medical Reimbursement Systems Inc.) pays $500,000 to resolve allegations that it submitted false claims to the federal TRICARE Program on behalf of a Watertown, NY-based physician practice, which seems to have knowingly asked the company to make the false claims. The company, which has a history of unsatisfied customers, has agreed to hire a trained compliance officer to ensure better billing practices.

Telemedicine

An American Academy of Family Physicians survey of 5,000 members finds that just 15 percent used telemedicine in the previous year despite enthusiasm for its benefits. Barriers to adoption included reimbursement and regulatory concerns, and the high cost of technology.

Announcements and Implementations

AnzuMedical releases a searchable, multi-media reference library for physicians. The Knowledge Sharing and Collaboration Platform includes content from medical journals, white papers, newsletters, and videos.

Aledade signs an agreement with the Arkansas Health Information Network enabling its Arkansas-based ACO physicians to tap into the State Health Alliance for Records Exchange HIE. The Maryland-based company has also partnered with the Mississippi Academy of Family Physicians to create a primary-care driven Medicare Shared Savings Program ACO amongst MAFP’s 1,016 members.

Government and Politics

An HHS audit of the state of Washington’s health insurance marketplace finds that it failed to ensure consumers were enrolled according to eligibility requirements, verify household income and eligibility for minimum essential coverage, and data resolve inconsistencies – issues that have plagued exchanges in Kentucky and New York. Washington Health Benefit Exchange CEO Pam McEwan has promised to fix the problems, including rewriting software code, by July.

Research and Innovation

A three-year survey of 68 ACOs reveals that interoperability is still a challenge, despite each organization’s advanced use of healthcare technology including analytics, EHRs, care management software, and CPOE. Nearly 40 percent of ACOs are capable of integrating data from 1-10 health IT systems, while just 11 percent can integrate data from over 50 systems (a figure that emphasizes the ordeal of getting to true interoperability, and makes me want to better understand how those 11 ACOs did it.) There’s no doubt interoperability is a big business: 11 percent of the ACOs have spent at least $500,000 trying to achieve it, while 26 percent have spent over $1 million.

A Health Affairs study shows a wide range of Meaningful Use attestations amongst rural providers between 2011 and 2014, ranging from 91 percent for podiatrists to just under 10 percent for dentists. The study also revealed that rural providers attested at a higher rate than their urban counterparts, and likely took advantage of technical assistance offered by RECs – assistance that should continue if this group is to keep up with evolving technologies and payment reforms.

Other

An audit of the Nevada Taxicab Authority confirms what we’ve known all along – Las Vegas cabbies are overcharging customers $47 million a year. Big contributors to the total include a $3 credit card processing fee and a fuel surcharge. Auditors recommended disbanding the Authority altogether and reducing the credit card fee to 90 cents. Uber and Lyft couldn’t have asked for better press.

Contacts

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

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5 Questions With Lance Goudzwaard, COO, Panorama Orthopedics & Spine Center

Lance Goudzwaard is COO of Panorama Orthopedics & Spine Center. The Denver-based practice employs 250 staff – 150 of which are clinical – across three facilities to care for between 500 and 600 patients each day. The practice has successfully attested for Stage 2 of Meaningful Use on the NextGen system, and participates in quality-based risk programs such as the Bundled Payments for Care Improvement initiative, in which it receives bundled payments based on episodes of care.

Do orthopedics practices face any special challenges when it comes to selecting, implementing, and using healthcare technology?
Panorama Orthopedics offers five different service lines / sub-specialties, each with unique needs. We had difficulty finding an EHR that met the needs of each sub-specialty, and have done a great deal of customization and template creation in order to accommodate the needs of our physicians.

In addition, we are currently implementing a tool to help supplement our patient portal strategy and help keep our doctors, patients, and caregivers connected between visits. Our goal with this technology is to automate the routine aspects of care while tracking patient progress and monitoring clinical areas of concern.

We also tend to be on the cutting (if not bleeding) edge and are always on the lookout for new technologies to improve processes and our ability to care for our patients. We have a number of technologies in place that were not designed to function as a unit and, as you can imagine, that creates challenges in sharing information across platforms.

What types of health IT have you found to be especially beneficial to your physicians? In what ways?
In our experience, most health IT solutions slow our physicians down. Panorama physicians have largely preserved their patient volume over the past few years, amidst the ever-increasing documentation requirements. We have experienced great variability in the quality of documentation, and many of our providers were completing their charts for two to three hours after clinic. Our physicians were growing very frustrated because they were sacrificing precious family time, and still weren’t meeting our documentation quality goals.

We recently implemented Skywriter MD as a way to help our providers record all the appropriate data in the EHR. Physicians and PAs connect to Skywriters using a secure VPN connection, and communicate with the audio function of tablets and laptops. Providers verbalize the orders, tasks, procedure, and visit notes to the Skywriter, and watch their navigation and data entry in real time. Orders, prescriptions, and follow-up activities are printed and/or managed before the patient leaves the clinic, and the note is complete (and of high quality). Our providers are able to focus on the patient and their care, and by offloading the pointing and clicking activity, they move very quickly from one patient to the next, while also focusing more of their attention on the patient rather than the computer screen.

Have you found any particular patient-facing technologies to be especially beneficial? Have patients commented on the change in practice?
Interestingly, one of the most beneficial technologies for patients has been the use of Skywriter MD. Prior to that, our support staff was completely bogged down in helping our providers complete activities before the patient left the clinic, which prohibited them from returning telephone calls and scheduling procedures during the day. Now that the virtual scribes are helping our providers with those tasks, our support staff are greatly improving the quality and timeliness of communication with our patients, which has improved their satisfaction with our clinic. Additionally, since the new technology has improved the efficiency of our providers, they now have time in their day to see more patients, which has reduced our appointment wait times. Overall, I would say that the addition of virtual scribes has reduced the administrative workload of our providers and staff, which has restored the personal touch that is so valuable to our practice.

We also have high hopes for a new application that we are installing to supplement our patient portal. We anticipate that this mobile app will drive greater patient satisfaction and reduce delays by providing pre-operative schedules and instructions, and creating another convenient way to communicate with our staff.

Is Panorama looking into telemedicine? How will you go about selecting a vendor and introducing the service to patients?
Yes, Panorama is looking into telemedicine strategies, but a significant challenge for us is choosing between the number and variety of options. We plan to introduce telemedicine to our practice through a pilot project with our Physical Medicine and Rehabilitation service line, which includes a group of patients that experience repeat visits.

Given the climate in which practices operate today, what challenges are especially keeping you up at night? How are you tackling them?
The combination of regulatory change and declining reimbursement has forced us to find ways to do more with less. Most sophisticated practices like Panorama have already trimmed the fat, and the only way we can thrive in this environment is to find technology that can help us eliminate waste and become more efficient. Looking back, it made no sense to pay physicians and PA’s to be data entry clerks! With Skywriter MD, everyone is focused on their core competencies, and our patients are reaping the rewards.

Contacts

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

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News 1/20/16

Top News

Under pressure from payers, CMS makes it harder for consumers to sign up for coverage at Healthcare.gov between enrollment periods. Nearly 1 million consumers signed up after open enrollment ended last year, resulting in some dropping coverage after receiving pricey medical procedures. The administration hopes that by eliminating certain special enrollment periods, better clarifying eligibility standards, and enforcing abuse prevention, it will appease payers and motivate the uninsured to enroll by the January 31 deadline.

Webinars

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

Acquisitions, Funding, Business, and Stock

Compliance services and software vendor YEI Healthcare rebrands to Zebu Compliance Solutions, evoking the South Asian animal “known for its strength and dependability.”

Announcements and Implementations

PatientlySpeaking adds multilingual reminders including voice and text to its patient communications platform.

DirectTrust reports a record number of over 44 million Direct transactions between Direct addresses in 2015, with over 13 million messages delivered in the fourth quarter. The nonprofit anticipates the number of transactions will hit 230 million by the end of this year. Over 52,000 organizations used DirectTrust services last year, a nearly 50-percent increase over 2014.

People

Charles Stellar joins WEDI as interim president and CEO.

Rocco Perla (CMS) joins Health Leads as president.

Daniel Elgort (Philips) joins Spreemo as vice president of healthcare analytics.

Telemedicine

Hispanic health platform company ConsejoSano partners with global consulting firm Mercer to offer its Spanish-language telemedicine services to employers.

The National Association of Realtors offers MDlive telemedicine services to members of its insurance marketplace.

The American Academy of Sleep Medicine rebrands its Tell A Sleep Doctor telemedicine service to AASM Sleep. The homegrown service was informally launched last month, and is now available to sleep medicine physicians nationwide.

CareSpan integrates Surescripts-certified e-prescribing technology from DoseSpot into its virtual clinic platform.

Government and Politics

CMS tweaks the Open Payments website, updating its June 30, 2015 dataset and adding the ability to search for physicians by name, a “snapshot” of data, and additional sections from which to download data.

Research and Innovation

New research shows that online patient communities have gained in popularity over the last several years, and have a vital role to play in sharing information between patients, caregivers, and physicians. While the quality of information shared in the forums was considered to be of “low” quality, patient interaction was deemed beneficial in terms of emotional support.

Other

You guessed it: “123456” and “password” remain the most popular passwords according to SplashData’s annual list. Hackers take note: “star wars,” “batman,” and “696969” gained enough popularity to make the list for the first time.

Sponsor Updates

• Health Facilities Management publishes a Field Report detailing how Trinitas Regional Medical Center reduced the severity of injuries due to assault with Versus Staff Assist.

Blog Posts

• 7 Ways to Build a High-Performance Private Practice (AdvancedMD)
• Health IT Shows Up at 2016’s Consumer Electronics Show (Billian’s HealthDATA)

Contacts

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

More news: HIStalk, HIStalk Connect.

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