Population Health Management Weekly Wrap Up 12/20/15

Kaiser Permanente announces plans to open a medical school in Southern California. Classes will begin in 2019, and will likely accommodate up to 50 students. “We have the opportunity to help train future physicians on 21st century medicine and be on the cutting edge of all the changes we are experiencing,” says CEO Bernard Tyson. “Our model of care is best for the current and future diverse populations in this country.” The organization has noted there will be a strong focus on population health management, team-based approaches to patient care, and patient engagement.

Health analytics company Pulse8 licenses population health management tech vendor Altruista Health’s Chronic Illness and Disability Payment System to better calculate its risk adjustment analytics for Medicaid, Medicare Advantage, and private payers.

KLAS Research ranks Atlanta-based Wellcentive as one of the top five vendors of population health management technology.

Greenway Health embarks on the second phase of its population health project with Vanderbilt University Medical Center (TN). Funded by the Patient-Centered Outcomes Research Institute, the next phase builds on the data warehouse development and clinical trials recruitment conducted in 2014. Patient recruitment is expected to increase to 3,000 by October 1, 2016 and to 5,000 the following year. The project will also aim to increase the number of Greenway Health provider sites connected to the data warehouse, growing to nearly 2,000 by 2017.

Pennsylvania-based Pocono Health System and Lehigh Valley Health Network agree to a full-asset merger that will take effect in the first half of 2016. The new entity will develop a “hospital of the future” tentatively named Pocono Medical Center, as well as open additional ambulatory health centers. LVHN representatives see the merger as LVHN part of its commitment to providing more integrated care to the Pocono region through population health management, including sharing a common EHR. LVHN announced it will spend $200 million on Epic over the next four to six years. PHS seems to be an EClinicalWorks shop, so it seems likely the Epic assets played a part in merger talks.

Contacts

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

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News 12/17/15

Top News

Kaiser Permanente announces plans to open a medical school in Southern California. Classes will begin in 2019, and will likely accommodate up to 50 students. “We have the opportunity to help train future physicians on 21st century medicine and be on the cutting edge of all the changes we are experiencing,” says CEO Bernard Tyson. “Our model of care is best for the current and future diverse populations in this country.” The organization is also putting out feelers for a dean, who will hopefully embed healthcare IT into the curriculum.

Reader Comments

From Greg Chittim: “Re: The FlowingData “Day in the Life” of Americans. I am a huge fan of FlowingData (we have both of his posters up in our office) and read Nathan’s stuff regularly. I thought you’d appreciate our “Day in the Life of Dr. Jones,” which is an artistic representation of what exists in our core Analytics platform. We are able to mine data from the HIPAA audit trail required in all EHRs to visualize the minute-by-minute lives of physicians and care teams as they interact with their EHR and PM systems. From that, we can make very detailed inferences about when/how they get behind schedule, the effect of same-day appointments, and if the care teams are working to the ‘top of their license.’”

Announcements and Implementations

ProHealth Physicians  (CT) partners with OptumCare for administrative and clinical support. Optum will provide ProHealth’s 370 clinicians with data, analytics, connectivity, and population health management tools plus front-office services.

IPatientCare signs on with Area 51 Data Solutions to improve data security, support, and backup services for its EHR customers.

MedAllies, a Direct Reference implementation vendor, will leverage Merge Healthcare’s vendor-neutral referral management platform to simplify image ordering and results delivery for its nearly 300,000 connected users.

Acquisitions, Funding, Business, and Stock

CVS Health completes its acquisition of Target’s pharmacy and clinic businesses for $1.9 billion. Included in the buy-out are 1,672 pharmacies and 79 clinics, which will be rebranded as MinuteClinics. CVS expects to open up to 20 new clinics in Target stores within the next three years. CVS Health Executive Vice President and Associate CMO Andrew Sussman, MD alluded to the Target clinic integration during my interview with him earlier this month.

Government and Politics

The Syracuse, NY-based HealthEConnections HIE and Fort Drum Regional Health Planning Organization sign an agreement with the DoD making the digital medical records of nearly 20,000 local soldiers and military families shareable with physicians outside of the VA. “What’s been missing all these years has been the military,” explains FDRHPO CIO Corey Zeigler. “Now, when soldiers and their family get care in our area, all of that information goes back to their primary physician on post.”

Medicare will provide physician-level data to Amino, a San Francisco-based startup that is the first for-profit company to earn access to the full range of Medicare data for providers. Amino will initially use the data to help patients, particularly women, find physicians whose practice patterns and skills meet their needs, and plans to roll out services related to procedures, treatment options, and costs in the near future.

Other

Missouri’s St. Louis County conducts a feasibility study on the idea of opening health clinics at MetroLink stops. The Bi-State Development agency, which runs the county’s public transportation, is conducting the $42,000 study, scheduled for completion early next summer. The clinics would be the first of their kind in the country. “This will bring healthcare closer to the community, particularly for those who are transit dependent,” says Project Manager John Wagner.

Brazil shuts down WhatsApp for 48 hours after the Facebook-owned messaging app fails to comply with a court order related to criminal gang activity. As I mentioned last week, 80 percent of the country’s physicians use the app to communicate with patients. No word yet on how treatment plans or appointment scheduling were affected.

Contacts

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

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DOCtalk with Dr. Gregg 12/17/15

E-Prescribing in the Dark

I don’t know about anybody else’s experiences, but my relationship with e-prescribing reminds me of Helen Keller’s quote about “walking with a friend in the dark.”

Not having seen much posted about this topic may be more a result of my ignorance than anything, but a quick search didn’t lead to many practical perspectives that I could find. Thus, maybe adding one to the blogosphere wouldn’t be just a rehash.

First, we’ve used e-prescribing for years. Love it. Period. When it works.

And it mostly does work, and typically works quite well. It makes it easy to prescribe, reduces the risk of error from illegible handwriting, lowers the chances of lost prescriptions to almost null, and makes tracking of prescribed meds MUCH easier.

But, all of that’s true only when it works. As mentioned, it doesn’t always work, and that’s when the dark creeps in.

(The e-prescribing solution that our EHR employs has been called the “giant” of the industry. There are others, and they may work differently, but my experience is limited to our little giant.)

The two main times I’ve noted when it doesn’t work:

1. When something is amiss in the patient demographics
2. When an “Unknown Drug” gets pulled into the patient record

The first issue is really problematic. If our system sends an inquiry to the e-prescribing solution and there’s some kind of glitch in the demographics, here’s one of the responses we receive:

I ask you: What do you do with that? There are no instructions, no next steps. You’re only told that this person, who you know for a fact exists and whose insurance eligibility you’ve verified, can’t be found. And you’re not allowed to do anything about it. (“Resubmission not allowed.”)

There are some similar rejection notices as I recall, but they all have the same thing in common – no info on what exactly is wrong, no way to correct whatever errors there are, and no option to do anything about it.

The second problem isn’t always quite as vexing, but still should have some improved address. Here’s an example from one of my patient’s charts (patient and prescribing doctor de-identified):

With this one, I can at least call the pharmacy and try to determine which of the medications this patient was dispensed on that day might be the elusive “DRUG UNKNOWN.” This involves figuring out which CVS pharmacy is “#1691,” finding their phone number, calling them to ask them to look up prescribed Rx from that day for that patient, and then manually charting the now known drug into the patient’s chart. As I said, problematic, but at least it has a resolution, even if it isn’t simple or one automated by the e-prescribing solution.

My personal ask for our (or any) e-prescribing solution is this: You’re good to have as a friend. I appreciate you. Walking with you even though it’s sometimes in the dark is far better than walking without you. But, please … please … add transparency and end user-friendly info and advice. Cryptic messages that provide no value or direction may make some programmer on your end feel as though they’re doing something, but it isn’t something that’s at all helpful to us provider grunts – be they us little trench grunts or those in the bigger trenches. We would all benefit from a little more light.

From the trenches…

“Walking with a friend in the dark is better than walking alone in the light.” – Helen Keller

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: Get a Handle on HIPAA

A Renewed Emphasis on HIPAA Compliance
By Lyn Triffletti

As the Office for Civil Rights prepares to launch phase two of its HIPAA auditing program next year, healthcare organizations should be turning their attention to this area of compliance. The upcoming audits will target covered entities and business associates, assessing whether they are consistently meeting HIPAA privacy, security, and breach notification rules, even if they haven’t experienced a recent breach.

The government’s main interest in performing these audits is to ensure that healthcare providers are sufficiently self-policing when it comes to health information security. In other words, the agency wants to make sure that organizations across the care continuum are committed to maintaining patient privacy and have processes and procedures in place to accomplish that goal.

Audits happen…are you ready?
Even though only a portion of physician practices will be audited in the next year, it would be a mistake to assume that such a review can never happen. OCR is dedicated to verifying compliance in all types of facilities regardless of size, so every organization should be prepared to demonstrate its commitment by making a financially reasonable effort to deal with potential risks and adequately preserve patient privacy. Especially because the forthcoming audits are designed to focus on Evaluation & Management coding, there has never been a better time for physician practices to get a handle on HIPAA.

Marrying obligation with affordability
Unfortunately, many smaller practices do not have the internal resources to effectively self-police for compliance. Addressing this issue internally requires dedicated personnel who have the expertise to develop policies, provide education, assess compliance, shore up weaknesses, and so forth. This level of proficiency is not only expensive, but also can be hard to find.

A more cost-effective option involves partnering with a third party that offers the necessary resources to achieve and sustain compliance. These types of organizations often provide technology that automates and streamlines the compliance effort. For example, a physician practice can leverage third-party software to generate a comprehensive and appropriate HIPAA policy — just by answering a few questions. Similarly, the practice can use an online tool to offer meaningful staff education, allowing employees to get up to speed on HIPAA anywhere and at any time. These tools help an organization quickly spin up its compliance program without having to hire new staff or re-task existing personnel.

Bottom line: By working with an external partner or expert, a smaller practice can demonstrate its commitment to following HIPAA regulations without blowing its budget.

All partners are not the same
When seeking a HIPAA compliance partner, organizations should take a careful look to make sure they join forces with an entity that provides value and delivers on expectations. Following are a few questions to ask as you proceed in reviewing different options.

• What is the partner’s degree of experience? The primary reason to partner with an outside resource is to take advantage of the company’s level of familiarity with and understanding of HIPAA’s rules and regulations, filling in the gaps at the particular practice. A partner should be able to demonstrate it is a subject matter expert with a proven track record.
• Are they familiar with your specialty? HIPAA compliance looks different depending on the area of practice, and you want to double check that the expert can appropriately address your organization’s specific needs.
• Has the company ever audited for the government? One way to gauge a potential partner’s know-how is to see if they have performed audits for the OCR. This experience would give them a first-hand view of what the agency requires and what compliance looks like.
• How robust is the technology? Practices shouldn’t select a partner that has a less-than-comprehensive solution. Organizations need to know what content the product includes and how close that is to what the government requires. Also, ask about how many users currently work with the software and how different organizations interact with the technology. Training is also key. Practices should gain an appreciation of how intuitive the software is and what training the partner provides.
• How do they promote retention of information? To achieve compliance, an organization has to do more than offer education and hope for the best. Practices must make sure staff participate in the training and retain the information. To that end, technology solutions should present a way of monitoring which staff have taken the course so you can follow up with those who have not engaged. Furthermore, the solution should offer a method for assessing whether staff understand and can apply the information to their day-to-day work.

Although meeting HIPAA regulations may seem overwhelming, it does not have to be. Organizations that take a fiscally responsible approach to compliance and leverage the resources of an outside expert can ensure they meet the government’s expectations while remaining in budget.

Lyn Triffletti, CCSP, CPCO, CPC, PCS is a vice president of compliance at Stericycle Inc.

Contacts

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

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News 12/16/15

Top News

Consumers get an extra two days to apply for January 1 coverage at Healthcare.gov. The site has seen its highest traffic ever over the last several days, with users facing digital queue wait times of 10-minutes plus. The Obama administration has already let it be known that it will no longer extend the January 31 deadline to coincide with April 15 tax deadlines.

Webinars

Check out the always entertaining and extremely knowledgeable Vince Ciotti and Frank Poggio presenting Tuesday’s webinar, “CPSI Takeover of Healthland, Are You Ready?” You can check out my Twitter recap here.

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

Acquisitions, Funding, Business, and Stock

Digital healthcare marketing startup Clariture Health raises a $3.5 million Series A. The bicoastal startup is looking to ramp up product development and quadruple its workforce.

People

Practice Fusion appoints Steve Filler (Oliver Wyman) COO and promotes Octavia Petrovici to senior vice president of product management.

Announcements and Implementations

The Delaware Center for Health Innovation selects The New Jersey Academy of Family Physicians as its vendor of choice for its Practice Transformation Services project. NJAFP will work with the Delaware Academy of Family Physicians to help primary care practices transition to value-based payment models.

SouthCoast Health (GA) implements a revenue cycle rules engine from RCXRules to automate business processes across 18 locations.

AxiaMed and VersaSuite develop an integrated payment processing and portal solution for specialty clinics and hospitals.

Greenway Health offers its EHR customers access to Merge Healthcare’s vendor-neutral IConnect Network Services referral management platform.

Government and Politics

The House Appropriations Committee releases the 2016 Omnibus spending bill without one reference to Meaningful Use. Healthcare IT-related items of interest include a budget of $60.3 million for ONC, and an AHRQ budget cut of $34 million. It also focuses on healthcare cyber security, instructing HHS to report on the industry’s preparedness to respond to threats and to organize yet another task force for the development of cyber security best practices.

CMS releases an updated version of the DocGraph teaming data set. Originally introduced in October, the update offers improved documentation on how physicians work together.

Telemedicine

Kaiser Permanente Northwest (OR and WA) offers urgent care video visits to members with no copay.

The local business paper points out the secret to Santa’s spotless sick-day record: “Once the stuff of sugar plum-fueled visions, today telehealth is a vital part of keeping North Pole operations running on time. [Options for timely healthcare can be difficult to come by. Even quick trips to medical hubs in Anchorage or Iceland are time away from the office that Santa and his elves cannot afford if they’re to meet their December 25 guaranteed delivery date. How else do you think he prevents an itch in Ireland from becoming a horrible head cold by Hustisford?”

Research and Innovation

A Verizon analysis of 1,900 breaches over the last 20 years finds that 90 percent of industries have suffered a data breach affecting personal health information.

Other

FlowingData plots microdata from the 2014 American Time Use Survey to get a closer look at what Americans are doing at any given hour. I’d love to see an even more micro-level look at physicians as they go about their daily practice routines. It seems likely that the computer, rather than the patient, would form the epicenter of activity.

STAT News dives into the big business of consumer data mining by health insurance companies. Payers are looking at everything from the car you drive to your shopping patterns to establish more tailored outreach efforts that will help steer consumers away from unhealthy habits. “I think I could better predict someone’s risk of a heart attack based upon their Visa bill than their genome,” explains Deloitte data-mining team lead Harry Greenspun, MD. The Big Brother aspect of this business practice makes a strong case for cash and carry.

Sponsor Updates

• EClinicalWorks client HealthNet is awarded the 2015 HIMSS Ambulatory Davies Award of Excellence.
• Healthwise’s Catherine Serio publishes “Alone, Adrift, and Hoping for Health.”

Blog Post

• Meaningful Use Modified Stage 2 (AdvancedMD)

Contacts

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

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