5 Questions with Alyson Tiedeman, Director of Practice Management, South Florida Medicine

Alyson Tiedeman is the director of practice management at South Florida Medicine, a large multispecialty group of over 100 physicians in urology, oncology, surgery, surgical oncology, thoracic surgery, and radiation. Tiedman oversees contracting and credentialing, implementations and on-boarding, integration and training, billing and revenue cycle management, practice management, financial infrastructure, accounting, banking and cash management, as well as the operations and administration of SFM’s 70 locations.

What sort of IT challenges arise with a medical group of SFM’s size? How do you ensure everyone is on the same page when it comes to moving forward with healthcare IT projects, and improving patient experience and clinical outcomes?
Some of our practices are still on paper. Even though we encourage them, we do not mandate that a practice leverages our IT infrastructure. This can present challenges as we look to implement greater connectivity strategies. Today, the majority of our practices have an EHR (there are currently seven different systems in use), and all of our practices are required to use our centralized billing services. SFM has also implemented a best practice in which we measure the success of both our central billing office and CareCloud PM system against a set of core billing and collections metrics. Monthly tracking of first-pass pay rates with payers and days in accounts receivables are not just critical for the overall success of the practice, but for the successful retention and recruitment of member physicians.

How much control does SFM give its physician members in terms of selecting healthcare IT systems?
SFM has embraced a flexible business model that allows physician members to leverage a common administrative and IT infrastructure. SFM’s hybrid IT model has allowed our group to expand rapidly, while negotiating better payer contracts for our members and gaining predictability around administrative costs along the way.

To be a successful group, you need to be able to offer choices to member physicians, especially when you support as many specialties as we do. Meaningful Use has been one of the key drivers of this for our group and getting our members to adopt IT and use it successfully.

Why did SFM decide to move to a centralized cloud-based PM system? Was each location using its own system prior to adopting CareCloud?
SFM has found that one size may not fit all when it comes to IT infrastructure; however, there are certain aspects of the business that need to be standardized, especially for compliance purposes. Given the diversity of our member practices and the speed with which they have joined, SFM offers a flexible model by which members can still choose to use their existing EHR system. At the same time, members can opt to have SFM handle revenue cycle management or stick with their current billing and collections staff. With CareCloud’s technology at the heart, disparate solutions can be integrated into the common platform so all parts work together seamlessly.

What’s next in terms of technology implementations for the practice?
Currently, we want to have all of our practices using an EHR as that lends to stronger clinical outcomes and overall operational benefits. All of our practices are required to use CareCloud’s PM system as we bill under one tax ID, and this helps facilitate that for our group.

It seems that a medical group of this size might be able to tell a compelling story for health information exchange. How are your physicians sharing information amongst each other, local hospitals, and beyond? Is SFM formally plugged into a HIE in Florida at the moment?
Although we encourage HIE for our group, we are not formally involved on the multispecialty side. However, our member physicians do exchange clinical information with outside clinicians and care delivery organizations, and are therefore very much involved in HIE.

Bonus Question: What benefits have you seen result from smaller physician groups joining SFM, especially with regard to healthcare IT?
With the direction that healthcare is going, the trends have changed and a small, one-to-five physician practice can find it very difficult to thrive in this environment, especially with ongoing Medicare cuts. Combining forces leads to many benefits, such as increased profitability by way of reduced overhead costs (IT and otherwise), higher payer contacts, better supply rates, increased referral sources, and the overall support and expertise of a bigger organization, just to name a few.

Contacts

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

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HIStalk Practice Interviews Baha Zeidan, CEO of Azalea Health

Baha Zeidan is co-founder and CEO of Azalea Health.

Describe how Azalea Health came to be, its current target market, and your role at the company.
Azalea was started by three founders, including myself, who worked at a regional medical laboratory company. In this role, I had the opportunity to work with many EHRs during the process of interfacing lab results and orders with physician EHRs. We noticed that most EHRs in the industry were clunky, and physicians had a hard time understanding how to use them because they did now follow their workflow.

In 2007, we recognized the opportunity to build a healthcare IT solution that would be truly cloud-based and as simple to use as an email tool. We offer a complete solution that integrates easily with existing systems.

Our target market has been focused on physician offices in small towns and rural areas. Our clients typically don’t have the resources or expertise to implement EHR and billing technologies that are now required by the Affordable Care Act. We help them with their workflow, revenue cycle, and compliance with government regulations like Meaningful Use and ICD-10.

I am the CEO and co-founder, and in this role I am responsible for driving the strategic direction of the company. With my team, I ensure Azalea Health is on track to meet its product development, customer service, and performance goals, as well as community goals. I have also, in many ways, become an ambassador for Azalea Health in our local community and in the healthcare IT community. Although I am the CEO and the visionary, every single person on the team has a say and contributes to our direction and success.

What is the status of the Azalea Health / simplifyMD partnership? Isn’t it really more of an acquisition on the part of Azalea Health?
Azalea Health has acquired and merged the simplifyMD team with our team. We are thrilled that simplifyMD customers are joining the Azalea family. simplifyMD customers will now benefit from an even greater variety of solutions and expanded capacity to support their needs. Azalea Health benefits from the addition of the highly talented simplifyMD team. It’s been a smooth transition and we are all excited about our future opportunities.

The current simplifyMD Atlanta office will continue to be in the Atlanta area. Azalea Health has its main office in Valdosta, Georgia, with satellite offices in Macon, Georgia and Gainesville, Florida. simplifyMD staff will not have to re-locate to Valdosta. We see the company as strengthening sales operations out of Atlanta with support and product development mostly in Valdosta. 

One of the great benefits of this merger is how well the products complement each other. The product teams are working to interface products immediately and to determine the combined product road map.

Mike Brozino, simplifyMD’s former president and CEO, will continue to provide guidance and input in an advisory capacity. As the transition occurs, management team and roles will be determined and announced. We will continue to use Azalea Health and simplifyMD names and branding during the transition.

It seems that the EHR market, especially vendors that serve smaller practices, is living up to predictions of consolidation. What do you foresee your part of the market doing over the next three to five years? Are additional acquisitions in the company’s future?
You are absolutely right on your consolidation view. Actually, the recent transaction of Azalea and simplifyMD is a testament of that consolidation. The market is still highly fragmented, and companies with simple/scalable end-to-end solutions and with excellent customer service will continue to win.

I also foresee that physicians will start to work more with a vendor that can help them not only with the EHR software, but also with how to navigate the complexity of the financial side of our healthcare system.

We see ourselves as a leader in the industry, and we will continue to focus on growing our customer base organically and through mergers and acquisitions.

When do you think the replacement market will settle down? What do you think Azalea Health’s role will be once this happens?
Healthcare software is going through a major revolution, likely accelerated by healthcare reform. We see customers that are on a third replacement of their EHR. This trend will likely continue through the next decade as vendors attempt to keep up with the constant changes in ICD-10 and Meaningful Use.

Some vendors have not prepared their solutions to keep up with rapidly evolving payment changes, and many will have difficulty in providing mobile applications for the providers and their patients. Also, as healthcare is becoming more and more interconnected, you will see some vendors not able keep up with the interoperability needed between systems – mobile, wearables, and clinical devices.

What are your customers’ biggest challenges at the moment with regards to healthcare technology?
Innovation and government regulation are causing healthcare technology to be in a constant state of flux. Navigating through the regulatory environment while simultaneously taking advantage of the most recent advancements from cutting-edge solutions is a daunting task for physicians and hospitals.

Providers are challenged by increasing costs, reduced reimbursements, escalation of regulatory oversight, and a need to ensure that their patient’s private health information remains private, all while providing the best quality of care possible. Our philosophy is to reduce the complexity of operating a medical practice by streamlining clinical and financial workflows, and providing services that assist with maintaining compliance and ensuring that the practice is adequately reimbursed for the services provided.

Have you seen any of your customers drop out of Meaningful Use, or avoid it altogether? Why have they done so, and has this been the best business decision in the long run?
We do see physicians dropping out of Meaningful Use, and we still see some that are avoiding it altogether. Some of them have avoided it because they see it as another layer of complexity in accommodating Stage 2, and they don’t see the advantage in doing more for less incentive.

Some are still on the fence thinking that they have a few more years to practice and maybe they’ll be able to dodge Meaningful Use altogether. This has not been a good decision for them for many reasons. More patients want to be engaged with their healthcare, and they are demanding that their clinical information be available electronically. Second, more providers are wanting to electronically send referrals and clinical data between health systems to different providers. Third, the healthcare payment system is going through changes (ICD-10, pay for performance, pay for outcome, pay for reporting). Those changes can be much easier to adopt if the provider is using a certified EHR and participating in Meaningful Use.

What are the company’s plans for next-generation product features? How will you ensure Azalea Health’s products stand out from the rest?
Azalea has a patent pending on “collaborative charting.” We are excited about this concept, which allows healthcare providers to collaborate in real time on a patient chart and see what each healthcare provider is documenting about the patient.

Also, we are very thrilled about our future mobile development. The next generation EHR is lightweight and mobile-focused. I can go on and on about our future development, including more tools for telemedicine – a key differentiator for us, as well as enabling device makers, patients, and other systems to easily and securely connect with the Azalea platform.

What is the company doing to foster innovation in your area of healthcare IT? Any future hackathons planned?
We had great success earlier this year with our first Azalea-sponsored hackathon in cooperation with local colleges and universities. We are making this an annual tradition. Also, we are planning this year on hosting an internal hackathon within the Azalea Research and Development Team!

Our VP of Technology, Duncan Kabinu, is starting a continuous learning and collaboration program within our R&D team that will look at potential innovations in new technologies, and not just those in healthcare. We’ll look to see how other industries have solved problems, and how we can learn from and apply those solutions in healthcare.

How do you see your customers responding to increased industry interest in telemedicine? Do you anticipate Azalea Health making a play in that area in the near future?
Telemedicine has been part of our strategy for several years. We have a project underway in which we are implementing the Azalea EHR in 40 schools in South Georgia in collaboration with the Georgia Partnership for Telehealth. This effort will help those schools use telemedicine in the school rather than taking the student patient out of school to see a provider or specialist.

We are also working on providing real time video chat within our platform to enable telemedicine and patient engagement. 2015 will be very exciting year for us, as we will continue to provide innovative tools for telemedicine and help connect rural patients with specialists from anywhere in the country.

It seems the company has a number of community service endeavors. Is there one service project in particular that has left a lasting impression?
Azalea Health has its roots in rural Georgia (Valdosta). We have been a huge supporter of United Way local projects. However, the most interesting and longest lasting projects we are involved in are related to helping our local schools, technical colleges, and state universities. We mentor interested students in programs designed to educate them about healthcare IT to help build and foster a local workforce that will fill our need for future innovators in the healthcare IT industry.

Any concluding thoughts?
The healthcare IT industry is going through a lot of change. It’s been very exciting to be able to help providers navigate those changes, and provide them with solutions that encourage them to focus more on patient care. Also, it is an honor for Azalea to be a company that helps patients learn more about their condition, while engaging them with their providers, and ultimately improving their overall healthcare.

Contacts

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

More news: HIStalk, HIStalk Connect.

Get HIStalk Practice  updates.
Contact us online.

News 8/21/14

Top News

After some industry speculation and a trade group letter-writing campaign, CMS confirms it will withhold until next June nearly one-third of submitted records on drug and device industry payments to physicians and teaching hospitals because of suspected inaccuracies with data included on its Open Payments website. The agency will move forward with plans to make the site accessible to the general public by September 30, and has extended the review period to September 8.

HIStalk Practice Announcements and Requests

Don’t miss the following HIStalk webinars:

August 27 (Wednesday) 1:00 p.m. ET. Enterprise Data – Tapping Your Most Critical Asset for Survival. Presented by Encore, A Quintiles Company. Presenters: Jonathan Velez, MD, FACEP, CMIO, Hartford Healthcare; Randy Thomas, Associate Partner, Encore, A Quintiles Company. This webinar will describe the capabilities provider organizations need to become data driven. The presenters will provide an overview of the critical role of an enterprise data strategy, creating the right data from source systems beginning with implementation, real-world data governance, how to avoid “boiling the ocean” with an enterprise data warehouse, and the role of performance feedback to transform analytics insights into improved outcomes and efficiencies.

September 4 (Thursday) 2:00 p.m. ET. MU2 Veterans Speak Out: Implementing Direct Secure Messaging for Success. Presented by DataMotion. Moderator: Mr. HIStalk. Panelists: Darby Buroker, executive director of health information exchange, Steward Health Care; Anne Lara, EdD, RN, CIO, Union Hospital of Cecil County, MD; Andy Nieto, health IT strategist, DataMotion; Mat Osmanski, senior application analyst, Steward Health Care; Bill Winn, PhD, Meaningful Use service line executive, Navin, Haffty & Associates. Panelists will discuss the strategy and tactics of meeting the transitions of care requirements for MU2, including assembling the team, implementing Direct Secure Messaging, getting providers on board, and reporting results. 

Acquisitions, Funding, Business, and Stock

Telemedicine Solutions company Avizia closes an equity funding round led by NextGen Angels, Blu Venture Investors, and Middleland Capital. The company will use the investment to further expand its sales channels, extend its product line, and grow market awareness. The company also announced that Edward Kennedy (Tollgrade Communications) has joined its Board of Directors.

Private equity firm Apax Partners LLP is looking for a buyer for payer and revenue cycle vendor TriZetto, according to rumors. Apax took TriZetto private in 2008 for $1.4 billion and hopes to sell it for up to $3 billion. TriZetto made $190 million in profit in the most recent fiscal year.

Investment company HealthQuest Capital closes its debut fund to the tune of $110 million, more than double its original target. The company is looking to invest in such target sectors as healthcare IT, mobile health, patient care products, consumer health, diagnostics, and medical devices.

A Baltimore technology site profiles Maven Medical, an eight-employee startup that offers a medical procedure price transparency app to help doctors choose cost-effective tests based on average Medicare reimbursement rates.

Cerner comes in at number 22 out of 100 on the Forbes list of the World’s Most Innovative Companies. Salesforce claimed the number-one spot for the fourth year in a row. It will be interesting to see whether the Siemens acquisition will help or harm Cerner in next year’s rankings.

Announcements and Implementations

Denton County, Texas commissioners approve a new $95,000 EHR system from eClinicalWorks that will consolidate and enable easier access to records from all of the county’s health services. The county expects to go live on the new system in a few months.

CDC selects Dell Services to provide it with IT infrastructure, application, and user-support services as part of a five-year, $120 million Information Technology Infrastructure Support Services contract. Dell has worked with the federal agency in a similar capacity for the last 11 years.

Government and Politics

A judge rules that Iowa regulators were within their authority when they voted to ban a first-in-the-nation videoconferencing system that allows urban doctors to dispense abortion drugs to women in rural clinics. Planned Parenthood of the Heartland (IA) started using the system in 2008. More than 6,400 women have used it to obtain abortion pills at outlying clinics, mainly in rural areas. Planned Parenthood has announced it will likely file an appeal.

Registration is now open for ONC’s 4th Annual Consumer Health IT Summit, taking place September 15 in Washington, D.C. Confirmed speakers that caught my eye include Mark Heaney of Get Real Health, Laura McCrary of the Kansas Health Information Network, and patient Alexis Barries.

Research and Innovation

Greenway Health is granted a patent for billing and claims generation in clinically driven revenue cycle management. The patent applies to “location-driven bill coding,” and will enable the company’s PrimeSUITE EHR to automatically assign an allowed service cost consistent with the payer fee schedule for that physician’s location.

Apple is granted a curved touch display patent, which it originally filed for in 2010. Industry insiders expect the patent pertains to development of the iWatch, or a similar wearable or fitness-tracking device.

People

Duke Reilly (Pfizer) joins Amazing Charts as director of industry business development.

Tom Skelton (Foundation Radiology Group) joins Surescripts as CEO.

Other

Alaska Public Media reports on the regulatory burdens facing many small practices in the state. Independent physician Oliver Korshin, MD attempted to apply for an exemption out of the Meaningful Use program due to the financial hardship his practice would face. When selecting an exemption category, the 71 year-old said, “The only one that possibly applied to me was disaster. So I picked disaster and I described my disaster as old age and I submitted as my supporting document a copy of my passport.”

Practice Fusion responds to recent media coverage of its two-day outage, telling Politico that, “Last week, Practice Fusion’s platform was never down, but its third-party data center provider, QTS, experienced 512K issues with their primary and secondary networking equipment.” Two days without access to digital patient records left many of the company’s 112,000 customers understandably frustrated, as evinced by comments culled by Mr. H and this story on affected physician practices.

Sponsor Updates

• Billian’s HealthDATA discusses five hospital hiring trends in the C-suite.
• South County Radiologists (MO) selects McKesson Business Performance Services for its 14-physician practice.

Contacts

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

More news: HIStalk, HIStalk Connect.

Get HIStalk Practice  updates.
Contact us online.

Pretzel Logic 8/20/14

EHR Musical Chairs

As EHR use grows across the market, we see the replacement market starting to grow, too. Depending on whom you believe, the EHR replacement market could range from 40 to 80-plus percent of existing users. (The latter seems like a stretch, but to paraphrase John Maynard Keynes, in the long run we’re all dead, which I suppose applies to EHRs as well as people.) There is obviously a large and looming replacement market in front of us, and one characteristic that separates replacement customers from first-time buyers is that they are more seasoned (embittered?) and are usually adamant about not repeating the youthful indiscretions of their past.

Until recently, it’s been hard to find hard industry data on trends like EHR replacement. There are plenty of places to go for advice on how to manage EHR replacements, but the pickings are pretty sparse (OK, barren) when it comes to real data on the buying behavior of seasoned EHR users. It’s worth noting that the one thing the Meaningful Use program has given us is better industry data than we’ve ever had before. Jamie Stockton’s excellent analyst reports for Wells Fargo Securities offer some really fresh insights on industry dynamics using CMS data (a testament to the benefits of opendata.gov and crowd-sourcing). A professor of mine used to say that there is no Geneva Convention for data, and it’s fair to say that Jamie and his colleagues have sadistically extracted a lot of confessions from the CMS Public Use Files on MU attestation.

The Wells Fargo EHR replacement report (referenced in HIStalk) looks at the results of 6,000 physicians using over 500 EHR systems who attested to MU in 2011 or 2012 and then switched to a different vendor in 2013. These 6,000 physicians represent about 4 percent of the total physicians who attested during that time period and represent an early view of the choices being made in replacing one EHR with another.

One of the most interesting pieces of information in the report is head-to-head analyses between different EHR vendors – which systems are people running from and which systems are they running to? The data is in the report, but it takes a little work to calculate, and I’m guessing that few people have the time to drill into the data to this level. Luckily, I’ve done the work for you, and here are my conclusions:

There is growing consolidation in a smaller set of vendors.

• Physicians used over 500 vendors for MU in 2011/2012. Yet, relatively few of these vendors had net gains among physicians switching vendors, with the biggest gainers being Epic, Cerner, athenahealth, eClinicalWorks, and Aprima.
• Over 50 percent of all physicians who changed vendors switched to these five vendors.
• The number of certified EHR systems has dropped almost 60 percent from MU Stage 1 (about 3,800) to MU Stage 2 (about 1,600). (I got this from the ONC CHPL site, not from the Wells Fargo report.)

Physicians fled from small vendors.

• Over 2,000 of the physicians who switched EHRs went from a small vendor to a larger, established vendor

Everyone except Cerner lost customers to Epic.

• Cerner was the only vendor to have a net gain against Epic.
• The biggest losers to Epic were NextGen, GE, and Allscripts.

Athenahealth and eCW both lost to Epic. They fought each other to a draw, and both made significant gains against smaller vendors.

• Athenahealth and eCW each lost two physicians for every one they gained from Epic.
• Athenahealth and eCW lost as many as they gained against each other.
• Athenahealth and eCW took more customers from small vendors than any other vendors, even Epic.

Physicians left Allscripts more than any other vendor.

• Allscripts had the biggest net loss of physicians among all 500+ EHR vendors.
• Allscripts lost head-to-head against every major vendor except McKesson.

I should note that there are limitations to this data. It covers only physicians participating in Meaningful Use, and it addresses only the market for replacement EHRs, not the entire market. And, while 6,000 physicians sounds like a big number, once you slice and dice the data down to the EHR-vs-EHR level, the numbers can get pretty small and thus less statistically reliable. I don’t want to make too much of this data, but to ignore it would be to make too little of it.

Is this data consistent with broader trends we’re seeing in the market? Darned if I know, but I’ll give it a shot.

1. The industry is slowly starting to consolidate on a smaller number of vendors. The financial injection of Meaningful Use Stage 1 put the market on steroids for a while, with lots of new EHR companies forming overnight to meet surging demand, but the inevitable industry shakeout now seems well underway. It’s unclear whether this is mostly a supply-side phenomenon (i.e., failures of startup vendors whose flaws were masked by MU dollars) or a demand-side phenomenon (i.e., physicians choosing to move to a smaller set of vendors, or hospital consolidation driving physicians to their enterprise vendor). Regardless, technology life cycles in every industry follow similar patterns. There is lots of product innovation at the outset, but the market eventually settles on a smaller set of dominant models that narrows market choices but enables more industry standardization. Process innovation starts to dominate over product innovation as users feel confident about investing in new organization processes that embed these new technologies. Which brings me to point #2.

2. There is growing separation between the enterprise EHR segment and the retail, small-practice EHR segment. With growing consolidation in ambulatory healthcare delivery from hospital acquisition of physician practices, as well as ACO formation, EHRs are increasingly being run by hospitals and ACO-like organizations who are trying to engineer fundamental process innovation for accountable care and patient-centric care. Are these still mostly just buzzwords? Yes, definitely. But an EHR vendor who doesn’t have management, products, and services to meet the needs of a complex array of enterprise users – such as IT, care and quality management, revenue cycle, security and compliance, and C-suite – doesn’t stand a chance in the enterprise space and may as well just focus on the market for small, independent physician practices. I got to peek over someone’s shoulder at a recent KLAS report on EHRs in the large practice space (11-75 physicians) that rated products not only according to what clinicians think, but also according to what IT and C-suite personnel think. More often than not, vendors that did well with clinical users did not do so well with IT and C-suite personnel, and vice versa. Athenahealth, Epic, and Greenway stood out as the only vendors who scored solid cross-enterprise ratings. Increasingly, EHR purchasers are in enterprises, and they value staff maturity and accountability, project management, product stability, and user support at least as much as nice user interfaces. In addition, clinicians within these enterprises seem to be gaining more respect for their IT and administrative counterparts as they become aware that those nice user interfaces are really ugly when they’re slow or unreliable.

3. Epic and Cerner seem to be moving ahead of the pack in reaching down into the enterprise ambulatory segment, while athenahealth and eCW seem to be battling it out in reaching up into the enterprise ambulatory segment. It’s unclear whether it’s better to start with a hospital product and step it down into the large ambulatory space, or start with a small office product and scale it up into the large ambulatory space. Deeper integration with hospitals than just lab results delivery is a fundamental requirement in this space, so the larger hospital vendors have a leg up there, as well as in their experience working with professional IT and administrative staff. The ambulatory vendors have the hearts of many clinicians though, which is important, but as noted above, will only go so far if they can’t scale their management and technology to work in higher-level settings.

4. If you’re an enterprise purchaser, your choices are mostly limited to a relatively small set of mature vendors. There are hundreds of EHR systems out there, but how many of them are backed by mature and robust implementation processes, deep technical bench-strength, strong support teams, and administrative features to centrally manage multiple practice EHRs? That takes more than a few Ruby programmers and a year’s supply of Mountain Dew. In looking to buy or replace an EHR, put a lot of emphasis on testing the vendor staff’s depth, experience, maturity, and professionalism. They will support you in the face of the unexpected, which in healthcare these days is just around the next bend.

5. If you’re a small-practice purchaser, you have more choices, but buyer beware. The small practice space is where a lot of product innovation will still take place for some time to come, but that comes at a price – lots of small vendors who are incredibly creative on the technology side don’t have the scale or backing to provide a lot of development and user support. That may be fine, because as a small practice your needs are easier to support because you don’t need complex interoperability, or population health, or IT administrative control, or high-powered analytics. You still want a vendor who will come running when you’re down and who will be around in the years to come, so don’t get too dazzled by shiny screens with no real people behind them.

It’s amazing what conclusions one can draw from a little data and a lot of artistic license! As more data is released by CMS, I’ll be sure to steal more insights from Wells Fargo Securities’ data analyses and share them with all of you.

Micky Tripathi is president and CEO of the Massachusetts eHealth Collaborative. The views expressed are his own.

Contacts

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

More news: HIStalk, HIStalk Connect.

Get HIStalk Practice  updates.
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News 8/19/15

Top News

Federal finger-pointing continues as recovered correspondence from CMS Administrator Marilyn Tavenner shows she asked a staffer to delete email related to the troubled launch of Healthcare.gov. “Time and again, the self-proclaimed ‘most transparent administration’ has been anything but,” House Energy and Commerce Committee Chairman Fred Upton, R-Mich., said in a statement. “And now we know that when HealthCare.gov was crashing, those in charge were hitting the delete button behind the scenes.” Adding to the drama is CMS’ refusal to hand over requested documents to the Associated Press about the kinds of security software and computer systems behind the federally funded website. CMS has told the AP that disclosing them could violate health-privacy laws because it might give hackers enough information to break into the service.

HIStalk Practice Announcements and Requests

Thanks to all of the readers who filled out the annual reader survey. I’ll have an overview of the results, plus a gift card winner, in my next post later this week.

If enterprise data is your thing, then be sure to register for the next HIStalk webinar – Enterprise Data – Tapping Your Most Critical Asset for Survival, presented by Encore, a Quintiles Company, happening on August 27 at 1 pm ET. This first in a webinar series called “It’s All About the Data” will describe the capabilities provider organizations need to become data driven. The presenters will provide an overview of the critical role of an enterprise data strategy, creating the right data from source systems beginning with implementation, real-world data governance, how to avoid “boiling the ocean” with an enterprise data warehouse, and the role of performance feedback to transform analytics insights into improved outcomes and efficiencies. Presenters include Jonathan Velez, MD, FACEP, CMIO at Hartford Healthcare; and Randy Thomas, Associate Partner at Encore, A Quintiles Company.

If business intelligence is your thing, don’t miss “For Small Practices, the Time is Right for Business Intelligence.” Matt Barron of ADP AdvancedMD was kind enough to share his take on the topic in a recent HIStalk Readers Write piece.

Speaking of reader contributions, I am looking for guest authors who work in the world of physician practices to regularly write about their experiences with HIT. Do you work at a practice that has seen the writing on the wall and dropped out of Meaningful Use? Are you an Epic ambulatory user with a story to tell? Email me with your ideas for one-time or regular contributions.

Acquisitions, Funding, Business, and Stocks

Walmart trims its earnings forecast due to rising medical costs and increased spending on healthcare for its employees. The news comes just as the company begins to roll out 12 primary Care Clinics across the U.S. I wonder how Walmart will control its own clinic costs and service pricing, not to mention how likely its employees – many of them newly insured – will be to use them. I have little doubt the $4 employee rate for office visits will entice many. Perhaps it will take notice of what Cerner is doing to attract staffers to its on-site clinics and pharmacies, such as using push notifications to alert employees to “ways to save” and highly targeted educational messages and reminders that support specific health and wellness initiatives. No mention has been made yet as to whether the big-box retailer will follow in the Epic EHR footsteps of CVS MinuteClinics.

Speaking of Walmart, I had the opportunity to hear the opinions of several industry representatives on its entry into primary care at the recent Health Care Summit. Two panelists were painfully hesitant in providing their less-than-enthusiastic opinions of the impact retail clinics will have on the ambulatory space. Matt Portch, team leader of Commercial Effectiveness at Pfizer, said, “I’d hate to see an OR in the back of a Walmart,” adding that he’s concerned about retail businesses pushing the limits of healthcare business models. Laura Beaty, MD of concierge medical practice PartnerMD (GA), provided the best sound bite of the event when she said, “If we equate cheap with excellence, it doesn’t work. Value is a different story.” Walmart might have some work to do convincing its new peer group of the value of its services. Cost-conscious Walmart shoppers probably won’t need as much.

Private equity firm GTCR will invest up to $200 million in Cedar Gate Technologies, which it will form with former Medco CEO David Snow, who will add $20 million of his own money and serve as CEO. The company plans to “build a transformative company in the healthcare information technology industry by acquiring outstanding healthcare data and analytics businesses and accelerating their growth.”

InnovaHealth Innovations opens up shop in Portland to help physician practices comply with ACA regulations via audit and compliance reviews. The consulting firm will also offer performance improvement analyses and educational seminars on implementing innovative practice strategies. Roberta Kaplan (Oregon Health Authority) will lead the new company.

National medical group Mednax agrees to acquire medical practice revenue cycle management company MedData for an undisclosed sum. The acquisition will help Mednax expand its relationships with hospitals where its physicians work and build new relationships with MedData’s client base of 3,000 physicians in 43 states.

Announcements and Implementations

Origin Healthcare Solutions and MDS Medical partner to offer mdsAnalytics – a customized version of Origin Analytics – to users of Greenway Health’s PrimeSUITE EHR. The companies report the partnership will enable even the smallest of practices to take advantage of sophisticated reporting, dashboard, and visualization tools.

Navicure launches the Navicure Payments software platform to help providers collect co-pays or balances due before service, estimate patient financial responsibility and secure commitment to pay at the time of service, and collect balances after insurance adjudication.

Azalea Health signs up the physician groups of Georgia-based Dorminy Medical Center and Irwin County Hospital for its EHR and RCM systems.

AMD Global Telemedicine integrates video conferencing software from Vidyo into its Agnes Interactive software to simplify Web-based telemedicine workflow.

National physician specialty services company Sheridan Healthcare chooses VitalWare’s iDocuMint ICD-10 code assignment and bill preparation tool for its 2,800 providers.

Urology Centers of Alabama adds Greenway’s PrimeRCM revenue cycle solution, joining its PrimeSUITE EHR/PM system.

Co-creators of a new behavior health screening kiosk – the first to be installed in a retail clinic in the U.S. – tell me they are developing privacy modifications to the kiosk for future iterations.  These will likely include a curtain (like a voting booth), “blinders” built up around the sides of the device, or use of a flat-screen monitor. As I mentioned when I first wrote about the kiosk, privacy and mental health should go hand in hand when it comes to screening tools in retail spaces, so it’s nice to see the developers take that into consideration. While I agree with the need to more openly discuss mental health issues, I’m not so sure the average patient that suffers from one is ready to shout about it from the rooftops (or from the floor of their local retail clinic).

People

MModal announces that CEO Duncan James will resign from the company, which recently exited Chapter 11. MModal has also brought in a new board.

Family physician Jack Pinney, MD (MidMichigan Health Medical Center) joins the Optimizerx Board of Directors.

Divya Nag, founder of StartX Med, an accelerator to commercialize Stanford research, joins Apple to lead its healthcare initiatives.

People Magazine profiles the family of MedAptus employee Jennifer Crowley, whose six-year-old son Padraig has been diagnosed with stage 4 neuroblastoma, the same rare childhood cancer that killed her infant son in 2006. Friends have started a fundraising page to help cover the family’s medical bills. Padraig was started immediately on chemotherapy and will have a long stay at Memorial Sloan Kettering. 

Government and Politics

Newly released 2013 data from CMS show that 96 percent of federally funded health centers have implemented an EHR, and nearly 85 percent of their providers are receiving Meaningful Use payments. Over 54 percent of the centers have achieved recognition as Patient Centered Medical Homes.

Former House Speaker Newt Gingrich makes the case for smartphones and veterans healthcare at a recent American Enterprise Institute event. He cited applications from ZocDoc and Wello as innovations that will help deliver high-quality, accessible healthcare to veterans. “We have the opportunity to create a 21st century veterans service system empowering veterans to use their smartphones to re-center services on their lives at their convenience,” Gingrich added.

The Texas Health and Human Services Commission awards network security and fraud detection company 21 CT a $19.8 million contract to develop software that is already helping the state detect Medicaid fraud. The new Torch technology pulls data in from the state’s healthcare system, as well as federal data, physician data, business records, background checks, and Google maps. It then links it together and displays it in an easy to understand format, allowing investigators to spot trends in Medicaid reimbursement.

Research and Innovation

Harvard’s Forum on Healthcare Innovation launches the Healthcare Acceleration Challenge, a competition that aims to identify and promote proven innovations that if widely disseminated could lower the cost and increase the quality and access of healthcare delivery in the U.S. Finalists will share $150,000 and the opportunity to present their ideas at the Forum’s invitation-only conference in April 2015. The winner will be awarded an additional $50,000. Applications are being accepted through September 29.

Other

The Major William Adams Veterans TeleHealth Clinic (CO) receives the Caregivers of the Year award from the Colorado American Legion. Formed in 2007, the clinic was one of the first in the nation to utilize video conferencing equipment to connect veterans in rural and remote areas to doctors.

Urgent care and emergency medicine practice Legacy ER (TX) makes the Web pages of Architectural Digest as part of the magazine’s coverage of the American Institute of Architects’ National Healthcare Design Awards. 5G Studio Collaborative has won numerous awards for its design.

In Canada, B.C. Emergency Health Services drops its $2.8 million ambulance electronic patient care record a year after it was supposed to go live, saying that, ”the vendor was unable to meet our business requirements.” The vendor was Interdev Technology.

Local news correspondent Bruce Hensel, MD profiles the use of 3-D printing to create plastic models of bones to practice on before surgery. The report notes that 3-D printing technology is now fast enough and cheap enough for individual doctors to afford, and that some insurance companies are considering covering the cost of making the plastic models.

The local paper profiles nonprofit Community Health IT Inc., which is leading a project aimed at helping small practices connect to the Florida HIE via its MyHealthStory record-sharing service. The service, powered by Relay Health and free to patients, is intended to give clinics and medical offices, especially those in rural areas, a lower-cost alternative for sharing patient information.

Sponsor Updates

• NextGen describes the three tiers of the Patient Centered Medical Home.
• Kareo CMIO Tom Giannulli will present a session on “The Essential Role for Technology in Improving Patient Care” at UBM Medica’s Practice Rx Conference in Philadelphia, September 18-19.