News 10/22/13

From Helen Reddy: “Female doctors are better. These findings don’t surprise me a bit.”  A Canadian study finds that female doctors provide higher quality of care than male doctors, though men are more productive. Researchers looked at billing information for 870 providers relating to procedures with elderly diabetic patients and determined that women practitioners were “significantly “ more likely to follow clinical guidelines for required medications and to plan required examinations. Male physicians, however, had almost 1,000 more procedures per year than female doctors. Assuming the findings hold true for US physicians, perhaps we’ll see a boost in compensation for female doctors as payment models shift from production-based to outcomes-based.

Medical management and staffing firm Hospital Physician Partners will implement athenaCollector, athenaCommunicator, and athenaClarity. Shares of athenahealth, by the way, reached a lifetime high of $141.38 Monday, five days after reporting its Q3 results: revenue up 43 percent, adjusted EPS $0.29 vs. $0.30.

The Drummond Group certifies SRS EHR as a 2014 Complete EHR.

Vitera Healthcare Solutions connects to the Surescripts network to provide EHR users integrated Direct secure messaging capabilities.

Cardiac Consultants (TX) selects the VersaSuite EHR/PM platform.

Navicure reports a 31 percent increase in its third quarter results from a year ago and announces several new clients including Care New England Health System, Sumner Medical Group (TN), and Tanner Clinic (UT).

Miami Children’s Hospital (FL) will offer area physicians a private-labeled version of HealthFusion’s MediTouch EHR that will interface with the hospital’s IT systems.

Curious: a North Carolina doctor is accused of breaking into a neighboring practice where she was seeing patients and now faces charges of breaking and entering and felony larceny. The power had apparently been turned off in Felicia Brabham, MD’s office so she moved her medical records, lab supplies, and cat into an office that another physician used about once a month. Earlier this year Dr. Brabham was charged with insurance fraud and writing bad checks; she has now voluntarily surrendered her medical license.

Email Inga.

News 10/17/13

CMS extends the registration period for the PQRS administrative claims-based reporting option and the PQRS Group Reporting Option from October 15 to October 18, 2013 to give providers additional time to register. Failure to participate in PQRS for 2013 triggers a 1.5 percent reduction in Medicare reimbursements in 2015.

e-MDs will integrate Phreesia’s point-of-care check-in solution into its EHR platform.

CareCloud CEO Albert Santalo tells the Boston Business Journal that his company may launch an IPO next year. The company also just announced the hiring of R. Scott Lentz as CFO, who was the CFO for Picis when it registered for its IPO and who has been involved in fund raising activities for other organizations throughout his career. Lentz also served as CFO for Aprima Medical and PracticeOne.

Waiting Room Solutions changes its name to WRS Health “to reflect its major expansion of service offerings.” Reading between the lines I take this to mean that in addition to its PM/EMR platform, WRS has expanded its offerings to include  transcription, bookkeeping, practice marketing, and other services. The company also announced the integration of PDR Network into its EMR.

Medfusion rebrands its recently reacquired Inuit Health patient portal technology back to its original name and adds Vern Davenport (formerly of MModal) and Buck Goldstein (UNC Chapel Hill) to its board.

A North Texas publication profiles two physicians in the same practice who have differing views on EMRs. Calvin Simmons, MD has used paper for 40 years and believes that using an EMR makes a physician less focused on the patient and more attentive to the computer; he also believes an EMR would slow him down. Meanwhile Edward Kremer, MD uses Practice Fusion and claims he “couldn’t function” without an EMR. Interestingly, both doctors claim to have patients that have left their care because they don’t like their approach to technology: some have dropped Simmons because they wanted digital records while others have left Kremer because “they didn’t like his faced glued to the screen.” Proof that there’s no pleasing everyone.

Riverside Medical Group (VA) selects athenaCollector for billing and practice management for its 300+ physicians.

Email Inga.

News 10/15/13

From Colonel Henry: “Re: MGMA. I wanted to pass on word that I enjoyed reading your impressions of the recent national MGMA show.  My company was prepared to bring our entire expo team to San Diego but decided against it when we saw the shortened exhibit hours. There are just so many shows to go to (we got to many state MGMA shows this year) and you have to weigh the overall value at all times. The shortened hours at the national show were the main reason for us not going. Thanks again for the always lively commentary.” Thanks for the kind words. It will be interesting to see whether MGMA opts for longer exhibit hours next year.

From Elise St. John: “Re: Souvenirs. I made it home from MGMA and thought I’d snap a quick pic of my collected treasures. The sports cream was for my aching feet.” I didn’t buy any sports cream (though that doesn’t sound like a bad idea) but I did pay $5 for  packet of eight band-aids to soothe my blisters. Maybe I’ll expense them to Mr. H.

eClinicalWorks reports a sold out crowd at last weekend’s 2013 National Users Conference in San Antonio, which featured demonstrations of the eClinicalWorks V10 EHR release, eClinicalWorks’ population health management and patient engagement tools, and over 100 educational sessions.

A local paper profiles the EMR implementations at three Kearney, NE clinics and apparently finds few providers who are happy with the new technology. A 26-doctor practice reports that staff resignations are at an all time high since starting its $1.5 million implementation, and at least one physician claims the system has added 150 minutes to his day. Another practice says the transition from paper to electronic records has required the temporary hiring of 12 workers and physicians don’t expect to recoup the cost of the investment. The manager of one clinic, however, says all his physicians are on board and they’d “never go back.”

ADP AdvancedMD says that over 1,000 users have downloaded its iPhone app since it debuted two months ago.

Aprima Medical offers its customers an option for offsite hosting services through Technology Solutions Providers, Inc.

Virginia Hospital Center Physician Group selects eClinicalWorks EHR for its 100 employed physicians and Washington Health System (PA) chooses eClinicalWorks EHR for the 87 physicians and 21 residents in its family practice residency program.

A RAND study finds that the primary driver of job satisfaction for physicians is being able to provide high-quality healthcare. EHR use impacts doctor job satisfaction because of worries that EHRs interfere with face-to-face patient interaction and increase clerical work by doctors. Physicians also have concerns that medical record accuracy may be negatively impacted when templates are used.

SRS hosts its annual User Summit this week in Greenwich, CT.

ZirMed says that so far in 2013  it has added over 900 clients, recorded 30 percent growth, and processed more than 2.2 billion transactions.

Capario launches CaparioOne, a redesigned web portal application for RCM.

More than 80 percent of medical practices participating in an MGMA survey express concern that the ACA insurance exchanges will increase patient collection burdens and offer low reimbursement rates. Still, the majority of medical practices see the  potential for exchanges to provide care to underserved patient populations. Forty percent of practices are still deciding whether or not to participate with new exchange insurance products.

Epocrates introduces Provider Directory to help members easily identify other clinicians for consultations and patient referrals.

ADP AdvancedMD debuts AdvancedInsight, a business intelligence reporting suite that provides a dashboard view of a practice’s finances.

Athenahealth earns the #3 spot on the list of 2013 Best Places to Work in Maine in the large employer category.

Practice Fusion guarantees it will be 2014 MU-ready by the end of 2013 and will pay up to $5,000 in EHR costs for any new customer who switches to a different EHR if Practice Fusion’s certification timing is not met.

Emdeon will pay its former CEO George Lazenby $2.4 million over the next two years, following his September 30th resignation. Breaking up may be hard to do, but I bet a couple of million bucks softens the blow.

EClinicalWorks adds Elsevier’s ExitCare technology for evidence-based patient education and discharge instructions into its EHR.

The children of parents who use a PHR are 2.5 times more likely to be compliant with well-child visits, according to a Kaiser Permanente study. The same children were also more likely to receive all their immunizations.

During the MGMA conference last week, several sessions were filled to capacity, leading a number of attendees to voice their displeasure. MGMA did the right thing and responded with a discount code for one free on-demand session.

The 122-provider Elmhurst Clinic (IL) deploys Phytel’s population health management suite to help clinic case managers and nurses manage recently discharged patients and ensure appropriate follow-up care.

3M Health Information Systems introduces the 3M Outpatient CDI Program, which offers consulting services for outpatient facilities and physician practices needing to improve the documentation and coding process.

Nuance Communications announces the Clinic 360 suite, an outsourced transcription service and application for physician practices that manages the dictation, review, editing, and sign-off of patient documents. Nuance also introduces a new version of Dragon Dictate Medical for Mac.

Email Inga.

MGMA13 Wrap-Up 10/9/13

I departed San Diego bright and early Wednesday morning and thanks to Wi-Fi on the plane I only have about 400 emails left to read (if I owe you a reply, please give me a day or two.)

I covered a fair amount of ground in my previous posts but here are a few random, if rambling musings. Hold on for the ride.

I had noticed a particular vendor posted several Tweets encouraging attendees to stop by their booth at specific times for a demo of their latest software. I headed to their booth at the specified time and had a conversation with an employee that went something like this:

Me: Is the demo of the new EMR version just for existing customers or would it be helpful for someone who just wants to see your EMR?

Vendor: It’s really for existing customers. Are you looking to buy a new EMR?

Me: Actually I am not with a practice.

Vendor: Oh, well you might just want to come back in a couple of hours and see our presentation on ICD-10 because that will include information applicable to anyone.

Me: Hmm. Okay.

So, I went away in frustration, wondering why I was not offered some sort of EMR demo, not to mention why Vendor would think a presentation on ICD-10 would be a good substitute for a look at their latest EMR software. Could it be because my badge did not say “practice administrator?” Maybe they were thinking I only wanted a demo to get in the drawing for their tablet giveaway. Maybe next year.

On the other hand, I had an amazing experience with the folks at CompuGroup Medical. The staff was wearing the t-shirts above, which I thought were quite clever. I told a couple of the ladies I really loved the shirts, and they mentioned they had been giving them away but had just run out. I expressed my disappointment, continued chatting a bit, and then the CEO Norbert Fischl walked over and told me he’d give me his t-shirt if I I took a few minutes to hear about their disease management platform. To clarify he did not give me the shirt off his back – just an extra one he was taking home. It was more than a fair trade and I learned about their offering that integrates patient data from EMRs, claims, labs, pharmacies and other sources to identify at-risk patients based on evidence-based clinical standards. Providers can then create personalized health goals for individual patients and track their progress. Their target market includes ACOs and payers that need tools for automating the chronic disease management process and for proactively identifying at-risk patients. CompuGroup also offers several EHR, PM, RCM, and portal solutions and internationally sells products for clinicians, hospitals, pharmacies, insurers, and the government. If there were an award for Best Effort to Draw Someone Into Your Booth and Look at Your Product, CompuGroup and Norbert would win hands down.

I chatted with one of the Practice Fusion reps for a while. They seem like a young and enthusiastic bunch, which gives me some insight into the company’s culture. I asked him how the company made money if the EMR was free, and he told me about the ads that display in the software. I tried to get him to tell me what the company was doing in terms of selling de-identified PHI but he claimed he didn’t know much about that. I’m pretty sure he was telling me the truth since he was primarily involved with getting providers signed up on the EMR. I believe he said that the company currently has 30,000 active physician users.

Speaking of Practice Fusion, I had a few conversations with folks about their recent $70 million round of funding. It seems to have a number of smart people scratching their heads, though one person did tell me he believes the company is well-run and does good job continually enhancing the product.

Julie at Clinicspectrum stopped me and told me a little bit about her company, which provides back office services for practices, hospitals, and billing services at a set rate of $6.50 per hour. They off-shore their services but you have to love the simplicity of the model.

I asked several vendors how the show was and the general consensus was very positive. Several expressed disappointment, however, with the limited amount of time the exhibit hall was open. One person shared MGMA’s explanation that they had studied trends from previous years and determined that most leads came in during the particular hours the hall was open this year. Perhaps, but if a vendor is investing thousands of dollars at a trade show and has flown in staff from across the country, I would think most rather have the exhibits open more than three hours a day. Not to mention that lunchtime overlapped the exhibit hall hours, meaning that attendees who wanted to eat had that much less time to check out the exhibits. It will be interesting to see if MGMA decides to keep the same schedule next year.

A friend told me I should check out PatientPoint and it was a good recommendation. Their platform includes a patient check-in/care coordination component that integrates with a practice’s EHR and scheduling system; an exam room piece that takes the place of traditional paper brochures so patients can read up on different conditions while waiting for the physician; an internal communication system for the practice; and, a waiting room monitor to display educational content. They also offer a platform for hospitals and for consumers. It’s all about coordinated care and patient engagement.

Speaking of engagement, it’s amusing to hear the different ways vendors attempt to engage people. As I strolled the aisles, I had eager sales reps ask if I wanted to save money on billing; if I was looking for new options to handle after-hours phone calls; if I had considered using automated patient reminders, etc.  Amy at Patient Prompt even offered me a 20 discount on her company’s appointment reminder services if I signed up at the show (I declined.)

I wanted to chat with the Aprima folks but I never could get anyone’s attention. I was happy to see they had their HIStalk Sponsor sign displayed, as did Wolters Kluwer, IMO, Allscripts, PatientKeper, Vitera, and about 20 others.

I bet we’ll see more and more companies like Ellkay, which offers data migration and conversion services for EHRs. They told me business is booming.

I noticed Allscripts was showing the FollowMyHealth portal, which they purchased from JarDogs earlier this year. The rep told me they have been selling more of the FollowMyHealth product than the Intuit/Medfusion platform because customers say it offers more functionality. Allscripts is selling FollowMyHealth to their own customers, as well as non-Allscripts practices.

MGMA’s Jeb Shepard and Jennifer Gasperini led a session offering updates on healthcare-related happenings in Washington. It covered a lot of ground and was informative but also pretty depressing. Jeb also gave an excellent and non-political explanation of the ACA and the insurance marketplace. The speakers offered their email addresses in case attendees have questions in the future. Duly noted.

In terms of booth traffic, athenahealth seemed to be buzzing every time I walked by. I also listened in on a demo and overheard one of the execs being drilled by a CIO-type on data security, connectivity guarantees, redundancy and similar topics. The answers were solid, giving me insight into some of athena’s success.

Sunday afternoon, while waiting for the exhibits to open, I chatted with an administrator from a large practice that uses Vitera. He had experience with a number of other products, including Greenway. He felt strongly that once the Vitera/Greenway merger was complete, the Greenway management team would be taking over because their product, reputation, and company culture was superior. I disagreed but shared this conversation with a few other folks over the next couple of days. The general consensus: Vista and the Vitera team will end up calling the shots, though the Greenway leaders may stay on for a while.

I may need to reflect on this a couple more days, but if I could pick a single word to summarize attendees’ general state of mind it would be “anxious.” Anxious, as in they see many changes looming in terms of payment models, practice ownership, and government regulations. Maximizing revenues and cutting costs remain the top priorities, meaning practices must figure out the most painless path to ICD-10, evaluate whether the benefits of later MU stages are worth the effort, and whether their physicians (and patients) would be better served if they consolidated with a health system or another group, or participated in an ACO, or converted to a PCMH model. HIT tools are available to ease some of the pains, but it’s no doubt overwhelming to find, implement, and pay for new products, especially as more vendors consolidate and products are sunset. Gosh, do I sound like the oft-pessimistic Mr. H with all this doom and gloom?

Thanks MGMA for a well-run, informative, and fun conference. See you next year in Vegas!

Email Inga.

From MGMA 10/8/13 Afternoon Update

I’m a little weary from my day so this update will be brief. I’ll have a complete wrap-up tomorrow.

I have an important announcement to make: I’ve decided to stay in San Diego and open a hair salon.

Dear Emdeon: please send me a pair of the lime green shoes.

Thanks Capario for displaying your HIStalk sign!

Sadly I missed out on NextGen’s chair massage.

My favorite booth. Cool couches, open, and welcoming.

If I hadn’t just had my picture taken in a boa at Greenway’s party I would have donned a fun get-up and taken advantage of Trizetto’s photo booth.

I don’t recall what Emdeon was giving away but a crowd of folks were hoping to win something big.

Nothing draws more people than a drawing for $1,000, courtesy of MGMA and their sponsors.

I intentionally went light on swag, but I am optimistic I will get an email from someone saying I won an iPad mini.

I have the best story to go with this tee shirt, and I will share it tomorrow. For now let’s just say that the CEO of CompuGroup Medical rocks.

Happy travels if you are heading home Tuesday. If you are still in San Diego tonight, I’ll be the one with swollen feet and flats.

Email Inga.