News 1/5/16

Top News

Doctors Administrative Solutions acquires ConXit Technology Group for an undisclosed sum and rebrands as DAS Health. The newly combined company, now the largest reseller of Aprima Medical Software, will maintain its headquarters in Tampa, FL. ConXit founder and CEO Shawn Miller will join DAS Health as senior vice president of sales. The company has had a bit of a growth spurt over the last six months, acquiring Spectra Healthcare’s RCM product portfolio and doubling its office space with a move to new digs in Tampa.

Webinars

January 13 (Wednesday) 1:00 ET. “Top 5 Benefits of Data as a Service: How Peace Health Is Breathing New Life Into Their Analytics Strategy.” Sponsored by Premier. Presenter: Erez Gordin, director of information management systems, Peace Health. Finding, acquiring, and linking data consumes 50 to 80 percent of an analyst’s time. Peace Health reduced the time analysts were spending on data wrangling, freeing them up to create new actionable insights.

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

Announcements and Implementations

Thousand Oaks, CA-based Compulink Business Systems develops EHR systems for ENT physicians and urologists.

The 14-physician Orthopedic Institute of Wisconsin selects a suite of RCM tools, including business intelligence reporting, from McKesson Business Performance Services.

Acquisitions, Funding, Business, and Stock

Looks like Lyft is finally getting some love (and potentially giving Uber a run for its money): GM invests $500 million in the ride-sharing company, and will work with it to develop a network of self-driving cars. Uber, by contrast, already operates a research center for self-driving cars in Pittsburgh. No word on whether Lyft will also delve into the world of mobile house calls as Uber has attempted to do over the last several years. Both companies will vie for the business of 150,000-plus CES attendees this week, as they legally compete with the Las Vegas taxi industry for the first time. Hopefully they’ll iron out all the wrinkles before HIMSS opens in just under two months.

Government and Politics

HHS issues a final rule modifying HIPAA that allows psychiatrists to report potentially violent patients that should be prevented from purchasing a gun to the National Instant Criminal Background Check system. The rule, part of President Obama’s recent spate of gun legislation, does not allow providers to share diagnostic or clinical information with the NICBC system.

Presidential candidate/Governor Jeb Bush promotes the use of prescription drug-monitoring programs in his just-released drug-control plan, specifically focusing on the not-so-new need for PDMPs to share data between state lines.

Research and Innovation

Yale School of Public Health student Alex Rich develops the PillTracker to help improve medication adherence. The prototype, in use by several of Rich’s family members, lights up, buzzes, and sends users a text message when it’s time to take their meds. If a pill isn’t taken, the device will text message a care team member with a prompt to call and remind the patient. Rich, a former Air Force Major, hopes to market the finished product to ACOs.

A Journal of the American Osteopathic Association study finds that just over 8 percent of 60,722 eligible patients at 14 community health centers were screened for hepatitis C virus according to 2013 guidelines, which call for testing all patients born between 1945 and 1965. Researchers sifted through de-identified EHR data from a national chain of community health centers to identify the screening gaps, and now recommend an assessment of screening guidelines.

Other

Retired chronobiologist Robert Sothern looks back at the last 48 years he has spent quantifying himself on a daily basis. The 69 year-old, who started wearing a step tracker 14 years ago, takes almost obsessive daily measurements of blood pressure, respiration, and air flow, among other things, in hopes of finding patterns that reveal themselves over decades. “We are rhythmic creatures,"he says. "You look at this … data [and] you can see 10-year cycles in it. You can see daily cycles. You can see even men have something approaching a 28-day cycle in their beard growth, which I did measure for three years, too. By having a rhythm, it proves that you are alive.”

Contacts

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

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News 1/4/16

Top News

Healthfinch rings in the new year with a $7.5 million Series A round led by Adams Street Partners. The investment brings the company’s total raised to over $10 million since its founding in 2011. The Madison, WI-based business will use the funds to accelerate development of its practice automation platform beyond prescription refill requests. CEO Jonathan Baran hints that future features may include visit planning and patient communication.

HIStalk Practice Announcements and Requests

Happy New Year! It’s nice to be back in the saddle after the holiday break. I have a feeling that, like me, many of you indulged in a bit of media consumption. My latest streaming obsession includes Fixer Upper – apropos given that I’m looking to change abodes within the next year. I didn’t realize “open-concept floor plan” was such a thing. Other media indulgences included watching the latest Mission Impossible (love Simon Pegg!), Pan (why a Nirvana song was included I’ll never understand), and Jurassic World (how did she run in those heels?); and discovering the comedy of Anjelah Johnson. I don’t watch the scale during the holidays, which is a good thing given that I whipped up several batches of sausage balls and discovered the greatest appetizer ever. Email me for the deliciously simple recipe.

Dr. Gregg was a tad more productive, submitting the timely and humorous “Keeping up with the Tech Joneses” for your reading pleasure over the break. Check it out here.

Thanks to the following sponsors, new and renewing, that have recently supported HIStalk Practice. Click a link for more information.

Webinars

January 13 (Wednesday) 1:00 ET. “Top 5 Benefits of Data as a Service: How Peace Health Is Breathing New Life Into Their Analytics Strategy.” Sponsored by Premier. Presenter: Erez Gordin, director of information management systems, Peace Health. Finding, acquiring, and linking data consumes 50 to 80 percent of an analyst’s time. Peace Health reduced the time analysts were spending on data wrangling, freeing them up to create new actionable insights.

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

Announcements and Implementations

Momentum Physical Therapy (VA) upgrades from Clinicient’s PracticeInsight tool to its TotalInsight clinical, financial, and RCM software.

Acquisitions, Funding, Business, and Stock

Health analytics startup Picwell raises $3 million over the holidays, nearly six months after raising an initial $4 million in equity financing. The Philadelphia-based company, which has developed technology that helps consumers select health plans, was founded four years ago by by a group of University of Pennsylvania professors specializing in healthcare and behavioral economics.

People

Steven Green, MD (Sharp Rees-Stealy Medical Group) J. Stephen Jones, MD (Cleveland Clinic) and Thomas Nantais (Henry Ford Medical Group) join the AMGA Board of Directors. Consultant and podcaster David Introcaso (not pictured) has joined the association as senior director for regulatory and public policy.

Telemedicine

Chicago-based behavioral and mental health telemedicine startup Regroup Therapy raises $500,000 in seed funding led by HBS Angels of Chicago. The five-person company, which calls incubator space Matter home for now, was started last year by Peace Corps alum and former CEB executive David Cohn.

I assume it’s not too late to order DocChat’s virtual visit gift certificates. Publicized as the “first” of their kind, the gift certificates may be just what the post-Christmas, cash-strapped consumer needs to battle back-to-work and –school bugs.

Government and Politics

The Massachusetts Dept. of Public Health awards Appriss a five-year, $6.2 million contract to develop new prescription-monitoring software as part of the state’s (not to mention the nation’s) efforts to crackdown on opioid abuse. The vendor maintains and shares data with similar online tools for 22 other states. Scheduled to go live this summer, the tool will integrate with physician EHRs.

CMS calls for feedback on how to better assess and incorporate quality reporting requirements into EHR certification. Comments are due February 1.

Calling all caped privacy crusaders: The FTC will host its first PrivacyCon January 14 in Washington, DC. The free event seems light on healthcare-related presentations, barring several related to personalized medicine and genetic testing. I’m willing to bet, however, that our industry’s rash of breaches will be a hot topic amongst attendees.

Research and Innovation

Cambridge, MA-based Vecna Technologies looks to streamline the patient intake process with a Vitals Chair that can record blood pressure, body temperature, and weight, ask a series of questions, and transmit the data to the patient’s EHR. The VA is trying out the chair at two locations in hopes of a nationwide rollout. Data/furniture thieves will be disappointed to learn that the chair itself does not harbor any patient information. I had the opportunity to meet Vecna co-founder Deborah Theobald at the company’s headquarters last fall, and was fascinated to learn about the work its nonprofit, Vecna Cares, is doing to help provide better healthcare with “lite” EHRs in impoverished countries.

Rio, eat your heart out: University of Tokyo scientists create a touchable hologram via the Haptoclone machine. The tactile sensation is akin to lightly stroking an object. The scientists are confident the sensation of a handshake or bear hug is not too far off.

ACT, aka The App Association, releases its State of the App Economy Report. Healthcare highlights include top growth areas of chronic conditions, personal fitness, and remote monitoring, plus the overwhelming enthusiasm physicians have for the central role apps will play in patient health by 2020.

Other

President Obama takes a ride with Jerry Seinfeld to promote Healthcare.gov.

CES kicks off in Las Vegas this week, giving HIMSS a run for its money in terms of anticipated attendance and heightened security precautions due to “recent global tragedies.” Dell CMO and CES panelist Nick van Terheyden, MD pens his annual healthcare predictions for the show here.

Contacts

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

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DOCtalk with Dr. Gregg 12/29/15

Keeping up with the Tech Joneses

The Joneses have been around a long time. Heck, I’d wager that Mr. and Mrs. Caveman even had their issues with keeping their boulders as polished and their campfire as bright as the those of the next door rock-dwelling clan. Given that, it probably shouldn’t be any real shocker to notice a sense of envy when a high tech-oriented doc (i.e., me) finds himself feeling the pull to get the latest and greatest gadgetry for his office when confronted with the wow and wonder of another office that has just installed the newest techno-marvel system or device.

It isn’t that we don’t have a pretty gadget-heavy office; we do. But in today’s rapid fire technology advancement world, what once was the best thing since sliced bread pretty quickly becomes crusty and stale, perhaps even a little moldy, when compared with HITland’s most recent baked goods.

Having a cutting-edge office, techno-wise, isn’t easy, especially if you don’t have a multimillion-dollar endowment fund, a clutch of support geeks upon whom to rely, and a research department to keep you up to date on HIT’s breaking trends. Plus, it gets even harder when best laid digital plans don’t deploy as predicted. A few cases in point:

• Hardware: Faster processors, mucho more memory, higher rez monitors, touchscreens, tablets, better scanners, newer printers, higher bandwidth modems and routers, and on and on. (It wasn’t that long ago when “hardware upgrades” mainly involved newer pens, and those were typically free in bulk from drug reps!)
• Operating Systems: Windows Server 2003 and 2005, XP, Vista (yes, we used Vista), Windows 7, Windows 8 – lots of updates in a relatively short time. (Thank goodness that Windows 10 is free.) I remember when, less than two decades ago, “operating system upgrades” were newer charts, nicer paper. and maybe sturdier clipboards. The upgrade costs were oh-so-nominal.
• Associated Software (Server, Security, Productivity, etc.) Versions 1.0 to X.X: Upgrades, upgrades, upgrades. The software does get better, but the verdict is out on whether the seemingly endless cash drain is matched by the “improvements.”
• Patient Portal, Part 1: Back near the beginning of this century, we bought a not-inexpensive EHR that included a patient portal. (This was at a time when very few folks were even talking about such things, when “patient-centered” medical care was mainly the mantra a few “radicals” trying to change the doctor-as-God healthcare model.) That portal wasn’t very pretty – it was actually butt-ugly – but we were promised that it was “on the dev timeline” for improvement. Considering how lovely the rest of the EHR was, we thought it would advance and so also purchased two touchscreen monitors. (This was back in Windows XP days, when touchscreens were relatively uncommon.) These touchscreens were for patients to use at our reception area to log in and access/update their patient data. Fast-forward some years, and that EHR system was acquired-acquired-acquired-sunsetted without one further tweak to the portal. Purchased, but never used.
• Patient Portal, Part 2: After moving onto a new EHR, we found ourselves again with an included patient portal that, despite the beauty and remarkable workflow of the main system, was not very attractive and wasn’t very functional for our use. (I think it was lower priority, mostly built to address MU.) Thus, we set about finding an absolutely beautiful standalone patient portal that was perfect for our families. Only a year or two later and this system was also acquired and sunsetted. More time, money, and energy invested on a very brief, short-term return.

Recently having visited a nice, new large-group practice with all the techno bells and whistles, I’ve felt a real pang to purchase and deploy sleek, new gadgets and find a new system with a really good patient portal. But, beside the immediate financial impact, workflow disruption, and time costs involved with such changes, several nagging thoughts continue to halt my “keeping up with the Joneses” ambitions:

• Does the “latest and greatest” really have a measureable enhancement on patient care? That is, are we not doing something now for those we serve that better tech would then allow?
• Does there ever come a point where the investment in HIT slows, or at least decreases?
• How much of my kids’ college funds (or of my retirement!) am I willing to keep giving away to keep up with the techno-Joneses?
• Having the “most high-tech rural pediatric practice” was great when we started, but just how important is it to maintain the cutting edge …  and is “the cutting edge” cutting anything except my bottom line?

From the trenches…

“Me? Jealous of you? Bless your little delusional heart.” – Rotten eCards

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, and sits on the board of directors of the Ohio Health Information Partnership.

Contacts

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

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Readers Write: Assessing Telehealth Adoption in Physician Practices

Assessing Telehealth Adoption in Physician Practices
By Miranda Moore and Megan Coffman

At a time of rapidly evolving technologies – from Uber to Amazon – more physicians are considering how they can use technology to help their patients access care outside of the traditional, office-based face-to-face visit. One way may be through telehealth services. Exploring how physicians are currently using telehealth services is important in setting the stage for assessing the degree to which telehealth services can improve patient care and outcomes, and reduce the cost of care.

In 2014, the American Academy of Family Physicians (AAFP) surveyed 5,000 family physicians randomly selected from the 2014 AMA Physician Masterfile, receiving 1,557 responses (a 31-percent response rate). The survey asked 30 questions to assess demographics, practice characteristics, their attitude towards telehealth, the barriers they see to using telehealth, how they use telehealth, and their beliefs about telehealth.

The Robert Graham Center analyzed the survey results and produced this report. After adjusting the sample to ensure the estimates computed were representative of family physicians across the US, only 15 percent of surveyed family physicians reported using telehealth services in the last 12 months.

The majority of family physicians expressed positive feelings about telehealth. When asked to agree or disagree with statements regarding telehealth, 78 percent either indicated they strongly agreed or agreed that “telehealth improves access to care for my patients,” while 68 percent agreed that “telehealth improves the continuity of care for my patients.”

Considering family physicians believe telehealth could benefit their patients, it is surprising that there are so few family physicians who used the service in the past year. When asked to identify the barriers to using telehealth in their practice, over half indicated that lack of training (54 percent) was a barrier. Additionally, over half of the family physicians listed the lack of reimbursement by insurers (53 percent) as a barrier. Other financial barriers were the cost of equipment (45 percent) and potential liability issues associated with the use of telehealth (41 percent).

Telehealth represents an important avenue to meet the needs of patients. However, more research is needed to identify and quantify the risks, benefits, and costs of telehealth services.

Miranda Moore is  economic & health services researcher, and Megan Coffman is policy research administrator at the Robert Graham Center for Policy Studies in Family Medicine and Primary Care in Washington, DC.

Contacts

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

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News 12/22/15

Top News

The House and Senate pass S. 2425, a bill that provides blanket hardship exemptions that will allow practices and hospitals attesting to Meaningful Use to avoid 2017 reimbursement penalties.

HIStalk Practice Announcements and Requests

The news cycle has slowed to a crawl as we approach December 25. This will be the last regular update until business resumes on January 4. I hope everyone has a very merry Christmas and happy New Year! Feel free to drop me a note describing the latest technology you find under your tree or in your stocking on Christmas morning.

Announcements and Implementations

Medfusion launches a Spanish-language patient portal.

Government and Politics

GAO recommends that HHS should consider paying the same Medicare rates for evaluation and management office visits at physician practices and hospitals in order to prevent the current shift of services from lower-paid practice settings to higher-paid hospital settings. The recommendation, made at a time when hospitals are gobbling up practices at seemingly unprecedented rates and raising service prices accordingly, comes with the caveat that any savings had as a result of the equalized payment should be poured back into the Medicare program.

Green Spring Internal Medicine (MD) wins the ONC EHR Innovations for Improving Hypertension Challenge, a two-phase competition run in conjunction with the Million Hearts Initiative that honors practices that have successfully used clinical decision support to implement evidence-based blood pressure treatment protocols.

Telemedicine

The Federation of State Medical Boards convenes the second meeting of the Interstate Medical Licensure Compact Commission in Salt Lake City. The group, which now includes 12 states, is working to establish a process that will enable physicians to become licensed quickly and easily in member states.

The local news touts the success of the Southwest Medical Associates (NV) NowClinic, a two year-old telemedicine service set up in partnership with American Well. The medical group has performed 1,300 consults so far via the virtual clinic. 

Research and Innovation

Athenahealth posts the latest flu statistics culled from the diagnoses of over 23,000 primary care physicians. Flu rates remain lower than in years past, with just under 1 percent of office visits resulting in flu-related diagnoses for the week ending December 12. Pediatric visits are also down compared to 2014 and 2013 rates.

Other

The Boston Globe looks at the non-technology side of primary care chain Iora Health, which emphasizes physician eye contact during EHR charting, and exam room layout of side-by-side chairs for face-to-face conversations.

The DoJ looks into the likelihood that Lyft was involved in the May 2014 data breach at Uber. An internal Uber investigation found that an Internet address potentially associated with the breach was traceable to Lyft Engineering Manager Chris Lambert. The federal look-see comes just as Lyft is in talks to raise up to $1 billion. No word yet on whether Lyft will look to enter healthcare as Uber has attempted to do over the last two years.

Contacts

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

More news: HIStalk, HIStalk Connect.

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