News 11/19/13

From Bob Christgau: “Re: NextGen User meeting. I thought the meeting itself was great, though the bands were terrible.The opener was the Brian Setzer Orchestra (and I actually like them) but it was so loud and distorted it was not enjoyable. The second act was Big and Rich who were clearly already drunk before they started the performance, which forced me to retire to the bar.” I wonder if vendors would be better off spending their money on a great cover band like Vitera did at MGMA. I recall a few great entertainers (Zac Brown and Colbie Caille come to mind) during HIMSS parties, but I also remember looking for the nearest exits during a couple user group meetings featuring pathetic performances by Kasey and the Sunshine Band and a tired Loretta Lynn.

An IDC Health Insights report highlights disturbingly high levels of physician dissatisfaction with their ambulatory EHRs. In a relatively small survey of 212 providers, 58 percent said they were very dissatisfied, dissatisfied, or neutral about their EHR. The providers, which included both PCPs and specialists, used over 25 different EHR products and cited lost productivity as the biggest problem with the technology. The top reasons for EHR satisfaction were a reduction in lost or missing charts, the ability to access charts remotely, and incentive payments.

Also disturbing: this essay by an Alabama physician who describes the inefficient and cumbersome EMR she uses to document a visit with a dementia patient suffering knee pain. Based on the results from the above survey, there must be plenty of EMR users with similarly clunky systems; however, I know of plenty of products that sound far more user-friendly than the one she is using. If you are a provider or a vendor, please assure me your product is more efficient.

Greenway Medical releases Intergy v9.00, which includes a dashboard to track the progress of a practice’s transition to ICD-10 or MU attestation. It may take me awhile to get used to the new Greenway/Intergy name combination.

ONC announces an interoperability project to enhance data exchange between EHRs, prescription drug monitoring programs, and pharmacies to help prescribers identify potential abusers directly from order entry. The initiative would establish common technical standards and a standard vocabulary to allow EHRs and HIEs to integrate data from state-run prescription drug abuse databases.

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News 11/14/13

A Pennsylvania physician sues his billing company for more than $100,000 in lost revenue after thousand of patient records were wiped from the billing company’s computer. Bholo Roy, MD claims that more than 100 clients lost data after the billing service’s computer failed with no usable backup. Roy concludes, “It is all in the cloud, and if the cloud disappears someday, we are all in trouble.”

MGMA finds that almost 80 percent of medical practices deemed “better performers” use patient-satisfaction surveys to evaluate and improve practice operations. About 10 percent of the better-performing practices use patient-satisfaction survey results as part of their physician compensation formula.

Kareo launches Kareo Marketplace, a solution center to help private practices identify cloud-based applications and services to optimize their operations. All offerings integrate with Kareo’s medical office software platform and include solutions for practice marketing, EMRs, document management, billing services, and consulting.

CareCloud names Kevin Brown (athenahealth) VP of west coast sales.

Join me in giving a big shout out to ESD, HIStalk Practice’s newest Platinum sponsor. ESD has been a HIStalk sponsor since 2009 and recently opted to extend their support to both HIStalk Practice and HIStalk Connect. ESD is one of the country’s largest HIT consulting firms and works with organizations to implement new or upgraded systems or just make existing systems work better. Their clinical professionals know all facets of HIT and can help with EMR implementations, staff augmentation and training, ICD-10 readiness, project management, physician help desk, and more. Solutions expertise includes Allscripts, NextGen, and  Epic. For the last three years ESD has been named a Best Place to Work in Healthcare based on employee retention, employee benefits, and economic success. I also happen to know they a fun bunch since they hosted a very lively HIStalkapalooza in 2012 and brought a top-notch bowling team to this year’s event. Thanks to the ESD folks for supporting HIStalk Practice.

NextGen announces NextPen Voice, a pen that accepts either voice or written input depending on user preferences and activities.

E-MDs recognizes its customer Jennifer Brull, MD (KS) for being named an 2013 EHR All-Star for her use of EHR to improve quality care and increase practice profitability.

Beacon Medical Group (IN) will deploy Phytel’s population health management and enterprise care management products for its 145-physician practice.

DrFirst launches Patient Advisor Report Card, which advices physicians of prescription fill rates at the point of care and sends alerts patients of unfilled prescriptions.

Doctors blame EMRs for slowing them down and reducing productive face-time with patients, according to a physician practice preference survey. Physicians point to declining reimbursements and administrative hassles as the top reasons for income dissatisfaction and express frustration with the limits of hospital contracts and pay structures. A third of the 1,474 physicians and staff survey say a portion of their compensation is tied to quality and cost of care provided.

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From the NextGen Healthcare UGM 11/12/13

Special Report from Dr. Jayne

My personal physician is attending the NextGen User Group this week in Las Vegas and agreed to send her impressions of the meeting. I’m always begging for people to report in from various user group meetings so was glad to have a dedicated roving reporter I can live vicariously through while I sit in the office addressing provider quality initiatives. It’s her first trip to a vendor user group so I’ll be looking forward to her insights:

The NextGen User Group Meeting kicked off Sunday night in Las Vegas with a poolside cocktail reception at the MGM Grand sponsored by Itentive. Monday featured keynote speaker Jeffrey Hayzlett from Bloomberg Television. The NextGen leadership team presented as well, showcasing some new products such as NextPen Voice which allows dictation and transcription into the EHR on top of the existing pen functionality that allows capture of discrete data using the pen.

In addition to the Mirth-based NextGen Share product that Inga mentioned on HIStalk Practice, they also announced the new NextGen Patient Portal mobile solution. Attendees were given the opportunity to test drive it using a personalized patient account on their demo system. I have to say it’s a very slick solution and you have to admire the fact that they staffed a mock practice to respond to “patient” requests for appointment, refills, and other services. I thought the fact that available providers included Elvis Presley and Wayne Newton was a nice touch. Also clients who tested it out had the opportunity to win poker chips at a daily drawing. I guess that’s one way to beta test!

Monday night featured customer appreciation events from clearinghouses Navicure and Gateway EDI (TriZetto) as well as HIStalk sponsor IMO. Tuesday features the NextGen client event which I’ve been told is always over the top. I hope I make it that long because my feet already hurt. This convention center is huge.

The way she was gushing about it, I didn’t want to wait until HIMSS to see it (plus I needed a diversion from the above mentioned quality reports) so the folks at NextGen were happy to set me up with a demo account. I wasn’t too happy to see that I already owe a patient balance of $205 for my recent visit with The King but I enjoyed the opportunity to check it out. Apparently I have an appointment pending with Wayne Newton next month.

Email Dr. Jayne.

News 11/12/13

From Caymus: “Re: Patient portals. I know a number of practices who already charge patients to access their portal and have for years. Some actually want to have different charges based on tiered portal service. Note that the portal is often wrapped into other concierge-style options.” CMS agrees with me that it’s not “appropriate” for providers to charge patients a fee to access their portal or online PHR. If patients are willing to pay, however, then good for the providers that are successfully collecting fees. I’ll mention that there was a time I paid about $40 a month for home phone service, $15 a month for AOL so I’d have browser and email access, and $5 for movie rentals at the neighborhood Blockbuster store. Perhaps we should re-visit this fee issue in another year or two and see if there are still patients willing to stick with providers that charge for online record access.

NextGen Healthcare hosts 5,000 attendees at this week’s annual User Group Meeting in Las Vegas. During the opening session on Monday, Nextgen introduced NextGen Share, an interoperability solution based on the Mirth HIE platform that facilitates clinical data exchange and referrals from within the NextGen EHR.

The 11-provider Ocean Eye Institute (NJ) selects SRS EHR.

CMS tells MGMA and other stakeholders it might reconsider performing external, end-to-end ICD-10 testing with physician offices following recent problems with its Healthcare.gov site. Previously CMS has said it would not offer external testing and that it was confident with its current internal testing procedures.

Epic, Allscripts, eClinicalWorks, and NextGen customers represent almost half of all EPs that have attested to Stage 1 MU with a 2014 edition base EHR product. CMS reports that through the end of September 47 percent of all EPs (over 325,000) have attested for MU and been paid $2.4 billion.

Medical Radiologists (OH) deploys RadNet’s eRAD technology for its 14-physician group.

Emdeon reports Q3 results: revenues up nine percent, net loss of $16.2 million vs. $15.2 million.

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News 11/7/13

Full implementation of HIT in 30 percent of community-based physician offices would reduce the demand for physicians by four to nine percent, according to researchers from the Johns Hopkins Bloomberg School of Public Health and The Commonwealth Fund. Other predictions, based on a review of previous studies include:

• Physician demand could decline an additional four to seven percent if care was delegated to NPs and PAs and supported by HIT.
• The use of HIT could reduce regional shortages of physicians by enabling as much as 12 percent of care to be delivered remotely or asynchronously.
• If HIT systems were adopted by 70 percent of practices, the estimated impact could more than double.

Kareo hires David Mitzenmacher (Volusion) as VP of customer success and Nitin Somalwar (Flurry) as VP of engineering.

Epocrates’ Bugs + Drugs app reaches 100,000 downloads in less than a month of its release. Epocrates, whose parent company is athenahealth, pulls clinical and billing  information from athenahealth’s data warehouse to track antibiotic resistant bacteria.

A CMS email this week included this FAQ about the EHR incentive program:

Can an eligible professional (EP) or hospital charge patients a fee to have access to the certified EHR technology (CEHRT) solution that is used to meet the meaningful use objective of providing patients the ability to view online, download and transmit their health information?

My initial thought was that if my EP tired to charge me to view or download my records, I would fire him/her. My second thought was that if this is truly a “frequently” asked question, then there are probably providers already charging patients these fees.

Here is what CMS had to say:

We do not believe it would be appropriate for the EP or hospital to charge the patient a fee to access the Certified EHR Technology solution regardless of whether the solution is in the form of a provider-specific portal, an online personal health record, community portal or some other solution.This is consistent with the position taken in the Stage 1 final rule (75 FR 44358) and reiterated in the Stage 2 final rule (77 FR 53999) with regard to the meaningful use objective to provide patients with clinical summaries of office visits. Access to the Certified EHR Technology solution would be provided to satisfy the requirements of the “view online, download and transmit” objective, rather than in response to a request from a patient. We note that the charging of fees for health information provided in response to a patient’s request is governed by the HIPAA Privacy Rule.

HIMSS Analytics recognizes 50 of Truman Medical Centers (MO) ambulatory clinics with its Stage 7 Ambulatory Award.

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