Readers Write: ICD-10 Optimism Overshadows Lack of Provider Prep

ICD-10 Optimism Overshadows Lack of Provider Prep
By Jim Denny

Some people always see the glass half full and aren’t too worried, despite the circumstance. Keys locked in the car? They say, “It’s such a pretty day, and now I get to enjoy the weather while I wait for the locksmith.” Favorite football team on a losing streak? They think, “Hey, maybe our season tickets will be cheaper next year!”

Within the healthcare industry, many glasses seem more than half full when it comes to ICD-10 preparation. Navicure’s latest ICD-10 readiness survey found that respondents from healthcare organizations are overwhelmingly optimistic about being ready for October 1. While 85 percent are confident they will be ready for the transition, 57 percent indicated their organization is not on track with preparations. Despite their upbeat attitudes, survey respondents did identify specific concerns they need to address in advance of the deadline.

For example, 94 percent anticipate an increase in their denial rate on October 1. Only 30 percent, however, have improved denial-management processes to help cope with this increase. In addition, 56 percent identified cash flow as their greatest concern related to ICD-10, yet a relatively small percent have improved revenue cycle processes to promote better cash flow. Over a third have improved patient collections processes, while 17 percent have improved patient price-estimation processes.

Reading these statistics, it’s easy to wonder how providers are remaining so optimistic despite the fact they’re not completely prepared. Their positive attitudes can likely be attributed to the hard work and dedication they’ve seen from physicians and staff. For instance, survey results show how much progress providers have made with end-to-end testing, an especially critical component of ICD-10 planning. A January 2015 ICD-10 survey found that 38 percent planned to participate in end-to-end testing, but only 11 percent had begun. The most recent survey revealed that 25 percent of respondents had participated in end-to-end testing, and of those, 60 percent also achieved positive results. Progress in perhaps the most challenging aspect of ICD-10 planning shows their degree of hard work and preparation in recent months.

And on another glass-half-full note, the number of providers on track with ICD-10 preparations more than doubled since the previous iteration of the survey. In January 2015, only 21 percent of respondents were on track with their readiness plan, a number that jumped to 43 percent in the most recent results. This amount of progress is promising, and providers will undoubtedly continue to use their remaining time to its fullest.

When you think about it, overwhelming provider optimism about ICD-10 isn’t all that surprising. More than other industries, healthcare requires a perpetually positive outlook. Providers not only treat challenging cases on a daily basis, but also care for an increasingly aging population with higher incidences of multiple chronic conditions. They’re tackling an array of initiatives due to health reform, from Meaningful Use requirements to value-based care. Through all of these challenges, both clinicians and staff remain dedicated to providing the best possible care for each individual patient. Nearly everyone in a provider organization, whether they’re a surgeon or a revenue cycle manager, considers their work a vocation rather than a job. This outlook, along with a healthy dose of optimism, will serve the industry well as we embark on the challenge of adapting to ICD-10.

Jim Denny is president and CEO of Atlanta-based Navicure.

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.

News 9/9/15

Top News

Apple unveils the iPhone 6s and 6s Plus, iPad Pro (it’s biggest tablet to date), updates to the Apple Watch, and new accessories like the Pencil. (I’m surprised they didn’t call it the iPencil.) The biggest healthcare technology tie-in came at the beginning of the event, when AirStrip Technologies co-founder Cameron Powell, MD demonstrated the company’s app for the Apple Watch, which enables physicians to monitor the health of pregnant women and their babies.

HIStalk Practice Announcements and Requests

The lazy days of summer are behind us, which means the healthcare IT news will be flying fast and furiously between now and the holidays. Take advantage of special rates on HIStalk Practice sponsorships (HIStalk sponsors get an extra discount) to make sure your message stands out. Contact Lorre for details.

Pandora celebrates its 10th anniversary with an ad-free day of listening, which is always music to my ears. The realization that I’ve been listening to the streaming-music website for that long makes me stop and think about the last time I bought an actual CD. I honestly can’t remember, though I’ll never forget the day I bought my first – Duran Duran’s The Wedding Album. Current favorite Pandora stations include Rend Collective, Laid Back Beach Music, and Early Jazz. Am I missing anything by not jumping over to Spotify or Apple? Share your two cents and favorite music sources in the comments below.

Webinars

September 22 (Thursday) 12:00 ET. "Just Step on the Scale: Measure Ongoing EHR Success and Focus Improvements Using Simple but Predictive Adoption Metrics." Gene Thomas, CIO of Memorial Hospital of Gulfport, will share how his organization used an EHR adoption assessment to quickly target priorities in gaining value from its large Cerner implementation. Thomas and Heather Haugen, CEO of the Breakaway Group, will also share real-life results that prove the need for a disciplined approach to setting and measuring key success factors. Commit to taking that scary first step and step onto the scale, knowing that it will get measurably better every day.

Telemedicine

This article points out the strong “bite” telemedicine is taking out of primary care thanks to a shortage of PCPs and an expanding pool of vendors. The bite may turn into a mouthful once Anthem, UnitedHealth, and retail clinics like Walgreens expand their telemedicine programs in the coming months.

And speaking of the growing telemedicine market … Greenville, SC-based Arcpoint Labs launches Arcpoint MD, a telemedicine subscription service geared to employers and individuals. The company, which seems to be best known as a franchisor of medical screening businesses, offers consumers unlimited usage for $18 a month, well below the typical $40-$50 charged per consultation by bigger name telemedicine vendors.

TeleCommunications Systems releases the VirtuMedix mobile telemedicine app.

Announcements and Implementations

Hallmark Healthcare Solutions partners with ECG Management Consultants to develop cloud-based software that assists providers in developing, managing, and evaluating physician compensation plans.

Zotec Partners launches an ICD-10 educational microsite for physicians.

People

Neil Solomon, MD (Blue Shield of California) joins MedZed as co-founder, chief strategist, and CMO.

Jacque Sokolov, MD (SSB Solutions) and Conrad Prusak (Vistage International) join GlobalMed’s new Board of Directors. CEO Joel Barthelemy will also take a seat on the BoD.

Athenahealth promotes Tim O’Brien to chief marketing officer, Dan Haley to general counsel, and Kyle Armbrester to chief product officer. Former CMO Rob Cosinuke will move to a new role with the company’s Leadership Institute.

Government and Politics

CDC releases a 2014 snapshot of EHR utilization by office-based physicians, finding that half of those surveyed had installed at least a basic system. Iowa, Minnesota, Montana, North Carolina, North and South Dakota, Utah, and Wisconsin had higher utilization rates than the national average, while New Jersey and Tennessee had the lowest. It would be interesting to correlate these findings with the presence and assistance of the 62 government-funded RECs in each state.

ONC’s Health IT Policy Committee focuses its last meeting of the year on draft recommendations for interoperability goals, and the EHR-switching habits of EPs and hospitals. You can’t argue with the data: The rate at which physicians changed all their vendors quadrupled from 2 percent in 2013 to 8 percent in 2014, proving the rip-and-replace market is alive and well.

Research and Innovation

An EHealth Initiative study finds that the inability of ACOs to access data outside of their own networks is their biggest challenge, followed by a lack of data integration and issues around change management. Nearly half of the 69 ACOs surveyed reported difficulty in engaging patients despite having the bells and whistles associated with EHRs and care-management software. One-fifth of the respondents reported having telemedicine programs in place – a percentage that will likely rise as providers attempt to keep patients out of retail clinics and off of consumer-friendly telemedicine apps.

Other

Savannah, GA-based Mercer Medical College debuts its Culinary Medicine program this fall in an effort to help future physicians better understand and communicate the benefits of healthy eating to patients. The program combines cooking classes, research, and community engagement, including providing free health screenings at local farmers markets. “In medical school, there’s the concept of ‘see one, do one, teach one,’” says second-year medical student Kevin Jiles. “They’re talking about procedures, but we’re using it to take what we learn in the kitchen and bring it to others.”

Australian oncologist Ranjana Srivastava shines a troubling spotlight on the role health illiteracy plays in misunderstood diagnoses, treatment directives, and overall patient engagement:

“[A]s medical advances reward us with ever more sophisticated drugs and interventions, there is little to suggest that patients are any more engaged about what it means for them. Evidence abounds as to how little our patients understand of what we tell them. Many don’t know what it means to take pills on an empty stomach or have a fasting cholesterol test. Health illiteracy is associated with poor surveillance, delayed diagnosis, problematic compliance and worse outcomes. Health-illiterate patients ask fewer questions, visit doctors less, and rely more on anecdotes and myths. These patients are poor at self-care and they make for poor carers. Culturally and linguistically diverse groups fare worse in every way.

“Health education must start in school. We need to teach children the importance of understanding how the body works. When a woman is health literate the whole family benefits. But simply producing more material won’t do if it’s not well thought out or presented in a way that fails to engage diverse groups.”

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.

News 9/8/15

Top News

CMS unveils its first plan to address health equity in Medicare, focusing on patient populations that experience disproportionately high rates of disease, barriers to accessing care, and lower quality of care. The program, which aims to reduce these disparities over the next four years, will prioritize efforts according to six specific areas:

• Expanding the collection, reporting, and analysis of standardized data.
• Evaluating disparity impact and integrating equity solutions across CMS programs.
• Developing and disseminating promising approaches to reduce disparities.
• Increasing the ability of the healthcare workforce to meet the needs of vulnerable  populations.
• Improving communication and language access for individuals with limited English proficiency and persons with disabilities.
• Increasing physical accessibility of healthcare facilities.

The announcement follows last week’s news of a HHS proposed rule, Nondiscrimination in Health Programs and Activities, that the agency hopes will hopes will promote equal access to healthcare and coverage across its services and affiliated programs.

HIStalk Practice Announcements and Requests

The summer doldrums are behind us, which means the healthcare IT news will be flying fast and furiously between now and the holidays. Take advantage of special rates on HIStalk Practice sponsorships (HIStalk sponsors get an extra discount) to make sure your message stands out. Contact Lorre for details.

Fall fundraisers are in progress, with local schools looking to raise money through the usual assortment of holiday giftwrap, frozen cookie dough, and magazine subscriptions. I had to chuckle when I came across this $8 family medical journal. Paper is definitely dying a slow death in the world of healthcare record-keeping.

Webinars

September 9 (Wednesday) 2:00 ET. “Need to cleanse, unify and manage the provider data in your EMR master file and other IT systems?” Phynd’s Unified Provider Management platform allows healthcare organizations to maintain a single, verified, customized profile for each provider across legacy IT systems. This 30-minute presentation will explain how Phynd’s system can help synchronize internal provider information in real time; create provider interoperability among systems; and manage, update, and analyze provider information with workflow tools to improve revenue cycle and clinical communication.

September 22 (Thursday) 12:00 ET. "Just Step on the Scale: Measure Ongoing EHR Success and Focus Improvements Using Simple but Predictive Adoption Metrics." Gene Thomas, CIO of Memorial Hospital of Gulfport, will share how his organization used an EHR adoption assessment to quickly target priorities in gaining value from its large Cerner implementation. Thomas and Heather Haugen, CEO of the Breakaway Group, will also share real-life results that prove the need for a disciplined approach to setting and measuring key success factors. Commit to taking that scary first step and step onto the scale, knowing that it will get measurably better every day.

Announcements and Implementations

MacPractice offers Updox integrated fax and document management services.

Acquisitions, Funding, Business, and Stock

Los Angeles-based ZendyHealth looks to bring Priceline’s business model to healthcare. The startup has created a platform that allows users to pitch their prices for diagnostic services and treatments (Botox injections, teeth cleaning, CT scans, etc.) that participating providers can either accept or reject. Company founders believe it will give providers a way to fill empty appointment slots, and consumers a chance to find affordable care.

In other healthcare price transparency news, the local business paper profiles OkCoPay, a Seattle-based startup that has rolled out its up-front healthcare pricing app in 16 cities. The company, which is looking to raise its first seed round, offers premium listings and marketing tools to physicians and dentists for a monthly fee, and is in the process of developing online tools providers can use to manage their own listings.

Government and Politics

OCR selects FCI Federal to conduct its second round of HIPAA audits, which will include covered entities and business associates. OCR noted earlier this year that it will audit 150 of the 350 selected covered entities and 50 of the selected business associates for compliance with the Security Standards, 100 covered entities for compliance with the Privacy Standards, and 100 covered entities for compliance with the Breach Notification Standards.

The Pennsylvania eHealth Partnership Authority makes available up to $10 million in grant funding to Pennsylvania HIOs interested in helping connect practices and hospitals to its statewide P3N HIE. The application period runs through June 30, 2016.

Research and Innovation

University of Illinois scientists develop a temporary “tattoo” (patch would be more accurate) that measures blood flow rates and skin hydration by responding to temperature changes in the wearer’s body. Users can upload pictures of their tattoos to an accompanying smartphone app that then translates the temperature data into a health report.

People

Ann Fisher-Jackson (March of Dimes) joins Keystone IT as director of marketing.

The Greater Houston Healthconnect names Deepak Chaudhry (Nexus Health Systems) CTO. 

Founding Rochester RHIO Executive Director Ted Kremer announces he will step down effective October 16. Associate Director Jill Eisenstein will serve as interim ED while the nonprofit works to fill the vacancy by early 2016.

Kerryanne Shuler (Athenahealth) joins MedEvolve as SVP of RCM and analytics.

Telemedicine

Mount Pleasant Retirement Village implements TripleCare’s telemedicine solution for after-hours care across its multi-facility campus in Monroe, OH.

Houston Clinics implements the Aeon Clinical Laboratory and Authentidate telehealth platform to deliver remote mental health and rehab treatment to up to 10,000 patients at eight facilities. It is the first roll out of the combined solution since the two companies announced their intent to merge late last month. Houston Clinics hopes to roll the technologies out to 160 clinics in the near future.

Other

The Washington Post takes an intimate look at the growing role medical actors play in training future physicians in the art of conducting gynecological and urological exams. Retired salesman and US Army veteran Jim Sandloop, who has subjected himself to 1,000 such experiences, jokes that,“If this is their first examination, they’re going to be trying to stare a hole through the wall over here, because their world’s about to end as they know it.”

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.

HIStalk Practice Interviews Clive Fields, MD Co-Founder, VillageMD

Clive Fields, MD is co-founder of VillageMD, a Deerfield, IL-based consulting firm that specializes in assisting primary care practices with business development, value-based contracting, and analytics-driven decision-making.

What prompted you to help found the company?
The past few years, and as far as the eye can see, will pose both challenges and opportunities for primary care physicians. The move to value-based payment and the increasing focus on wellness, prevention, and management of chronic illness is exactly what PCPs have been trained for. Success in those areas will not be easy. It will require organizational changes, the adaptation of technology, and access to capital that most physicians have no experience with. VillageMD was founded to help physicians meet those needs. Our goal is to provide PCPs with all the tools necessary to drive improved quality and cost efficiencies through the healthcare system.

What type of practices seem most attracted to the VillageMD model?
We are currently in discussions with physicians in every type of model you can imagine – independent groups seeking to remain independent, small groups looking to grow, and hospital-employed groups interested in accelerating their change to value-based contracting. We originally focused on independent physician groups interested in growing in a local market. For those we offer a complete PM solution including a robust population health infrastructure. Allowing physicians the time to do what they do best – taking care of patients – is driving this type of group to VillageMD. Large hospital groups are struggling with change just as are independent physicians. Those groups are interested in technology, work flow and our payer experience as they move towards population-based change. On the surface, the hospital-based and independent physicians seem completely different, but similar clinical goals in managing a population successfully are attracting them to VillageMD.

Our initial client was an independent group in Houston. Over the last two years we have seen that group move almost all of their commercial and Medicare patients into value-based arrangements, while at the same time growing the group size and adding two additional locations. We have also helped the Houston group grow a citywide, affiliated primary care network. In August, we announced a relationship in the Indiana market with a large hospital system providing a population health infrastructure to a large group of employed physicians. We will work to help this group move to successful implementation of value-based contracts, while at the same time helping them grow a larger geographic footprint for both their employed and affiliated physicians. We have an executive team in the Illinois and New Hampshire markets, and anticipate announcing new relationships in the near future.

How are physician practices using analytics to improve outcomes and increase access?
For physicians to be successful in this new payment model, clinical pathways will have to be focused on populations not individual patients. These should all be informed and measured with data. Nothing will ever replace the value of a physician-patient relationship, but to extend reach beyond the traditional exam room will require the use of analytics. We currently use analytics to identify utilization trends, improve quality metrics, and increase patient attribution. Physicians need to know who their patients are, what contacts they are having with the healthcare system, and what opportunities can be reasonably predicted that will improve their clinical outcomes.

How does this utilization differ from what was done just five years ago? Where do you see analytics taking primary care in the future?
For most of my career, patient contacts were limited to scheduled clinical appointments. The use and availability of data lets me identify quality gaps and clinical opportunities, and reach out proactively to help them meet their needs. Being able to identify a group of patients with poorly controlled diabetes and reach out to them with education and support, not one at a time but as a group to improve their diabetic metrics, is both clinically effective and administratively efficient.

The future in medical technology and analytics is really exciting. I believe we will see disease management and population-based data completely integrated into the EHR. The processes we use now to identify and contact high risk-patients will become automated, driving improved and efficient outcomes. This is the advance that needs to happen to move from the electronic documentation of a medical record to truly using an EHR to manage a population of patients. At VillageMD, we are moving in that direction, integrating a risk stratification tool into the EHR so that it is available at the point of contact between a physician and patient.

It seems the industry is looking to hospitals and health systems to lead the way in population health management, but I’m convinced primary care has an integral role to play. What are your thoughts?
In America we all benefit from the finest hospitals and specialty care in the world, and no change in our healthcare system should diminish that. Unfortunately, the focus on specialty care has created a fragmented and expensive system that is not economically sustainable. I believe a similar focus on improved outpatient care, in the areas of wellness, prevention, and chronic-disease management, is where the next evolution of our healthcare system will occur. No one is better suited for that role than PCPs. Controlling a patient’s diabetes and avoiding renal disease blindness and other complications should be our clinical goal. Unfortunately, the system has been focused on managing rather than avoiding those outcomes. Successful value-based contacting and population management will drive resources to those physicians skilled in the prevention of disease complications, not only in the treatment of them.

Some would argue that primary care is hard put to dig itself out of the fee-for-service trenches. How do you see healthcare technology propelling the shift towards value-based care?
The healthcare system is struggling with the move away from fee-for-service medicine, including primary care. Those physician groups that are able to make decisions quickly and use data to pivot away from failures and towards success are in the best position. Organizations with streamlined administrative structures that allow physician voices to be heard in every aspect of the organization will do well in the future. The increasing use of technology continues to identify areas where PCPs can make an impact. Utilization, quality, and patient satisfaction metrics continue to identify the PCP as the lever that can most impact all three areas.

What’s next on your clients’ plates with regards to healthcare IT projects now that Meaningful Use is winding down and ICD-10 will soon be upon us?
Our clients continue to use IT to identify areas physicians can use data to improve clinical outcomes. The integration of utilization and risk stratification data into chronic care management and transition care management program is high priority. A consistent focus is moving information out of the IT department and to the place a physician can best use it – an office visit, telephone encounter, or e-visit.

What will the next five years hold for VillageMD?
The future is incredibly bright. The move to value-based reimbursement requires skillsets not currently present in most physician groups. We believe our experience, management team, and track record of success can provide those skills for many groups in the future.

Do you have any final thoughts?
Change is hard, and anyone who says otherwise hasn’t been through it. Now is the time for PCPs to use their unique position in the healthcare system to drive the kind of results we all strive for, across populations, insurance status, and disease states. The future has never been better for PCPs.

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.

Population Health Management Weekly Wrap Up 9/4/15

Top News

Essentia Health is one of 11 Minnesota-based providers that will use State Innovation Model grant funding to ramp up data analytics efforts. The health system will use $313,000 to hire a data analyst who will focus solely on population health. The funds will also pay for Epic’s Healthy Planet software, which the new analyst will use to identify needs and trends found in Essentia’s Epic EHR.

Webinars

September 9 (Wednesday) 2:00 ET. “Need to cleanse, unify and manage the provider data in your EMR master file and other IT systems?” Phynd’s Unified Provider Management platform allows healthcare organizations to maintain a single, verified, customized profile for each provider across legacy IT systems. This 30-minute presentation will explain how Phynd’s system can help synchronize internal provider information in real time; create provider interoperability among systems; and manage, update, and analyze provider information with workflow tools to improve revenue cycle and clinical communication.

September 22 (Thursday) 12:00 ET. "Just Step on the Scale: Measure Ongoing EHR Success and Focus Improvements Using Simple but Predictive Adoption Metrics." Gene Thomas, CIO of Memorial Hospital of Gulfport, will share how his organization used an EHR adoption assessment to quickly target priorities in gaining value from its large Cerner implementation. Thomas and Heather Haugen, CEO of the Breakaway Group, will also share real-life results that prove the need for a disciplined approach to setting and measuring key success factors. Commit to taking that scary first step and step onto the scale, knowing that it will get measurably better every day.

Acquisitions, Funding, Business, and Stock

Dexter, MI-based consulting firm Tactical Strategies expands its healthcare IT services to include clinical analytics, and risk management and measures for population health management initiatives.

Analytics vendor MedeAnalytics sells a majority interest in the company to Thoma Bravo, a private equity firm that includes GHX, Hyland Software, SRS Software among its healthcare investments.

Announcements and Implementations

Western Connecticut Health Network chooses Cerner’s Millennium EHR, will upgrade its Soarian revenue cycle applications, and implement Cerner’s HealtheIntent population health management system.

ZeOmega announces that a managed Medicaid plan has expanded its use of the company’s Jiva population health management tool as part of its roll out of a new dual-eligibles program for its underserved members in 16 states and Washington, D.C.

People

Medecision promotes Kathy D’Amario to SVP/CTO.

Government and Politics

The Virginia Hospital and Healthcare Association develops the Community Health Dashboard to give users insight into key population and health statistics for each of the state’s 40 Senate districts or 100 House of Delegates districts. “Starting in September, we are meeting with all the delegates, senators and challengers,” explains Riverside Health System spokesman Peter Glagola. Riverside is one of six hospitals represented in the dashboard. “Our goal is to educate the legislators about Riverside Health System and what we do to keep our communities healthy and how legislation influences our business. We will be using the dashboards in our meetings with the legislators.”

Research and Innovation

The Institute for Family Health and HealthAlliance of the Hudson Valley partner to create the Kingston, NY-based Center for Health Information Technology Research to Promote Population Health in Primary Care. The new center will use a two-year, $1.26 million grant from the Empire Clinical Research Investigator Program to train six primary care-focused researchers in identifying effective methods for using healthcare IT to improve outcomes and reduce health disparities.

I don’t think it’s too much of a stretch to think that Epic has been in the population health management business for some time. CEO Judy Faulkner sustained the idea when she told attendees at this year’s Epic UGM that customers had exchanged 18 million patient records in July alone. Faulkner stressed the importance of “huge” data in announcing Epic’s new Cosmos Research Network, which will enable users to contribute de-identified patient data for research purposes.

Black Book Rankings notes in its latest study that 84 percent of primary care practices in the midst of replacing their EHR are giving preference to vendors with population health tools and analytics.

Other

Fun Friday Fact (just in time for game-day weekend): Googling “fun fact” will result in just that, with a link to the original content.

Sponsor Updates

• AdvancedMD announces the six winners of its video contest.
• Nordic brews up an EHR IPA to raise funds for veterans and the unemployed during Epic’s UGM in Madison.
• PerfectServe releases a new case study featuring IPC Healthcare’s Memorial City practice.

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.