News 9/17/13

The ONC releases models for Notices of Privacy Practices for healthcare providers, which reflect the Omnibus Rule regulatory changes that go into effect September 23.

Quality Insights of Delaware REC becomes the nation’s first REC to have 1,000 primary care providers demonstrate Stage 1 MU.

Here’s a figure that surprised me: 41 percent of US consumers would be willing to switch doctors to gain online access to their own EMR. As much as I love the idea of having full access to my personal health records, it would take more than the prospect of EMR access to motivate me to switch physicians. I do agree with the 84 percent of consumers who believe they should have full access to their EMR, and, mildly annoyed that only a third of physician think it’s a good idea. Currently only a third of Americans have full online access to their EMR, but  more than half track some aspect of their health history online, including physical activity, weight, and/or blood pressure.

The AMA releases the 2014 CPT code set, which includes 335 code changes

Washington Orthopaedics & Sports Medicine (DC/MD) selects SRS EHR for its 11 providers and three locations.

The eight-provider Tustin Irvine Medical Group (CA) selects iSALUS Healthcare’s OfficeEMR.

Kansas Nephrology Physicians is implementing Benchmark Systems’ billing platform for its seven-physician practice.

Hayes Management Technology adds its go-live support and legacy support services to its website.

GMed adds LDM Group’s messaging programs for patient medication compliance to its EHR platform for gastroenterology.

Mann Ear, Nose & Throat (NC) provides its 10,000 patients mobile access to their medical information using echoBase’s Resonate software platform.

Frost & Sullivan presents Vitera Healthcare Solutions its 2013 North American Customer Value Enhancement Award for outstanding performance and success, which recognizes the company’s focus on implementing strategies to create customer value.

Nuance Communications announces an Epic-optimized version of its Dragon Medical 360 | Network Edition.

The American College of Physicians is the latest industry group to suggest changes for the EHR incentive program. In a letter to CMS, the ACP says that the current Meaningful Use timeline is “aggressive” and warns that  the program’s success may be limited when combined with overly ambitious objectives. The ACP recommends that requirements become less prescriptive to allow EPs of all specialties to be creative in applying technology to the unique characteristics of their practice, specialty, and patient population.

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News 9/12/13

Health IT expenditures are rising as physician offices continue to adopt and optimize EHRs, according to an MGMA cost survey report. Annual IT expenditures per FTE physicians were $19,439 in 2012, a 28 percent increase since 2008. Offices also report increases in median staffing costs as additional personnel are hired to manage operations and provide clinical, and ancillary support. MGMA theorizes the increased staff costs may be the result of initiatives to improve patient satisfaction and provide more patient-centric care. The full report must be purchased so it’s unclear if MGMA proposes options for cutting costs, such as migrating to a cloud-based EHR to reduce IT expenses or merging with a larger practice/selling out to a hospital to leverage IT and staffing resources.

A couple of recent studies indicate the use of EMRs in physician offices can positively impact care. In a JAMA-published study, researchers found that switching from paper to EMRs led to “modest reductions” in the number of ED visits by diabetics (519 vs. 490 visits per 1,000 patients) and hospitalizations (251 vs. 239 per 1,000 patients). Also in JAMA:. a research letter reported that using an EMR that included automated growth monitoring helped doctors pick up on cases of possible growth disorders among kids.

And from another JAMA article: small EHR-enabled clinics that participated in an P4P incentive program showed slightly more improvements in cardiovascular care processes and outcomes.

Twin Fountains Primary Care Clinic (TX) implements simplifyMD’s EHR/PM platform.

MGMA-ACMPE names Garth Jordan (EDUCAUSE) COO.

ZirMed will offer tools to help providers transition to ICD-10.

Athenahealth releases the Demandforce automated marketing and communication service created by Intuit. Demandforce will be available on the athenahealth Marketplace for providers using athenaCommunicator and is designed to increase patient engagement, attract new patients, and measure the impact of marketing and social media efforts.

I just received my first MGMA party invite and it looks to be a fun one. Interestingly the invite highlights the host company’s RCM solutions, and makes no mention of the fact that it is a leading provider of ambulatory EHR solutions. Could this be a foreshadowing of what vendors will be highlighting this year?

eClinicalWorks and NextGen reseller PracticeMax acquires Chicago-based Medi-Data Service, a provider of billing and PM services.

Every year US consumers spend 52 hours researching  health information online, but only make three visits to the doctor. Americans are most likely to search a pharma-sponsored website after being given a diagnosis from a physician, but also jump to the web before filling a prescription and after experiencing new symptoms. WebMD is the online resource most often accessed by physicians.

Ophthalmology EMR provider Medflow will use DataMotion Direct to enable the secure exchange of PHI for its 2,800 physician customers.

The 110-provider Prima CARE (MA/RI) selects Ingenious Med’s mobile revenue capture technology.

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News 9/10/13

I was drawn to this headline, which suggests that the implementation of a cloud-based integrated EHR/PM solution will save independent physicians from acquisition. The press release covers the results of a survey of CFOs, CIOs, administrators, and support staff from hospitals and physician practices and finds that the majority of practices believe their billing and collection systems/processes need upgrading. Almost half the practices report they are considering an upgrade to RCM software within the next six to 12 months, which is not surprising given the looming ICD-10 deadline. Also not surprising: most practices would prefer a single source vendor for their RCM/PM/EHR solution. I found this result a big more confounding:

88 percent of business managers fear that the ramifications of their outdated and/or auto-piloted RCM systems, particularly those not integrated to EHRs, will force their physician to sell out to a larger physician group or hospital within 12 months or face practice dissolution.

My guess is that practices realize they need to get an ICD-10-ready solution in place or else they won’t be able to get paid. Instead of offering reasons for this high level of fear, Black Book suggests that practices can save themselves from acquisition if  they migrate to a cloud-based solution. What about those practices that have a perfectly satisfactory non-cloud-based PM solution that simply requires an updated version in advance of ICD-10? I am not anti-new technology and maybe I am overlooking something, but the way this information is presented leaves me wondering what kind of funding Black Book may get from some of these cloud-based vendors.

NextGen Healthcare’s parent company Quality Systems acquires Mirth Corporation, which offers the Mirth Connect open source integration engine. The company says the acquisition will allow NextGen to better offer data exchange capabilities, including participation in HIEs. Strategically its appears similar to Allscripts’ dbMotion acquisition in that it provides the company with diversification beyond its core EHR products. NextGen likely hopes the Mirth offering will give the company an edge when competing for a health system’s ambulatory EHR/PM business.

Capario announces it is ready to begin ICD-10 testing with its submitter customers and vendor partners and is offering customers an online ICD-10 submitter testing tool at no charge.

Patients of Advocate Medical Group (IL) file a class-action lawsuit against the practice, charging the group did not do enough to protect their private data. The suit follows the July 15 theft of four unencrypted computers that contained information on more than four million patients.

In the same neck of the woods, a debt collection agency that had contracted with the University of Chicago Physicians Group notifies 1,400 patients that their PHI and financial information had been openly viewable on the collection agency’s website.

The AMA publishes a toolkit to help physicians navigate the HIPAA changes that go into effect September 23. While the 25-page document looks quite comprehensive, practices would probably found it handier a few months ago when most started ramping up for the changes.

Most physicians report being satisfied with their career choice, although 40 percent would choose a different career, given a chance to rethink their career path. I wonder how that compares to the general public, especially since physicians seem to switch careers less frequently  than teachers, EMR sales reps, or even attorneys.

Aprima Medical integrates NoteSwift into its EHR system.

Memorial Health Hermann Health System (TX) takes almost 600 providers live on eClinicalWorks EHR and adds an additional 200 user licenses.

The Rhode Island Quality Institute and BCBS Rhode Island will pay primary care practices up to $10,000 in incentives to use the state’s HIE.

WellStar Cobb Family Medical (GA) goes live on Epic across five of its offices as part of WellStar Health System’s $125 million EHR initiative.

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News 9/5/13

NextGen Healthcare client Williamette Valley Providers Health Authority (OR) deploys a clinical decision support tool developed by the Clinical Decision Support Consortium that takes a request for CDS from NextGen Ambulatory EHR, delivers it to an enterprise clinical rules service at Partners HealthCare for analysis, and immediately returns recommendations within the NextGen application. The Consortium is composed of several provider organizations and EHR vendors, including Partners HealthCare and NextGen, and aims to establish nationwide consistencies for CDS recommendations. The “cool” factor here: community-based physicians have access to CDS data from a large academic medical center across the county and have recommendations available at the point of care.

ZirMed partners with EHR Integration Services to provide Allscripts PM and GE Centricity Group Management customers integration with ZirMed’s RCM, clinical communications, and analytics solutions.

Family physicians top the list of the most highly recruited doctors, followed by internal medicine specialists, according to a report by physician research firm Merritt Hawkins. Also of note: hospital employment of physicians continues to grow, increasing from 11 percent of physicians in 2004 to 64 percent in 2013, and, quality based incentives are included in 39 percent of new physician assignments, up from seven percent in 2011.

NYC REACH, the REC for New York City, assigns Aprima Medical Meaningful Use Champion status in its Vendor Recognition Program.

The majority of medical students use a tablet, smartphone, and computer routinely in a professional or academic capacity, according to an Epocrates survey of future physicians. Fifty-four percent use a tablet as part of their medical training, up from 23 percent a year ago.

HIMSS names eClinicalWorks customer White River Family Practice (VT) winner of the 2013 Ambulatory HIMSS Davies Award of Excellence for its success in improving quality of care and patient safety while achieving a demonstrated ROI. Since its EMR implementation, the practice has documented improvements in several of its quality of care objectives, including the percentage of patients receiving smoking cessation intervention, screened for alcohol use, receiving pneumococcal vaccines, and seen weekly with IVD or diabetes receiving AntiThrombic treatment.

Allscripts announces the GA of Allscripts Professional EHR 13.0, which is ONC 2014-certified and supports both Stage 1 and 2 MU requirements.

Kristi Syling (Vanguard Health Systems) joins PerfectServe as compliance officer.

NextGen Healthcare releases an updated version of its Patient Portal, which incorporates Spanish and two dialects of Chinese.

Kareo tops Black Book’s list of Top 20 Seamless Software Vendors for EHR, Practice Management, and RCM, earning a number one ranking in nine of 18 evaluation criteria and achieving a top five ranking in all categories.

Horizon Eye Care (NC) adopts InteliChart Patient Portal.

Visitors to this year’s Minnesota State Fair can leave with more than oversized stuff animals and fried food hangovers, thanks to BCBS of Minnesota. BCBS is handing out  vouchers for free e-visits through its Online Care Anywhere website.

EMR/PM provider Visualutions will resell Wellcentive’s population health management and data analytics solutions to FQHCs.

California lawmakers reject a law that would allow nurse practitioners to work autonomously. Nurse practitioners are allowed to practice independently in 17 states and the District of Columbia, but California physician groups lobbied against the proposed legislation in their state.

Athenahealth unveils its plan to transform its newly purchased Arsenal on the Charles complex to include 150,000 square feet of office space, walking and biking paths connecting to the nearby Charles River, outdoor meeting spaces, a museum, parks, a farmers market, an accelerator space to incubate small HIT start-ups, restaurants, and, my personal favorite, a beer garden. No doubt the planned improvements will be a draw for prospective employees, especially those considering competing opportunities in Silicon Valley or Verona, WI.

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News 9/3/13

Select Walgreens Healthcare Clinic locations in Indiana will fully integrate their EHR with Community CareConnect, the EMR platform owned by Community Health Network. Healthcare Clinic patients will also have the ability to schedule follow-up appointments with Community Health Network physicians.

EyeMD EMR Health Systems expands its marketing efforts in Canada through a partnership with Winnipeg-based Max Systems, a healthcare billing and scheduling provider.

The IT administrator for a New York orthopedic practice is charged with forgery, criminal possession of a forged instrument, and grand larceny after it was discovered he used a physician’s electronic signature to create a prescription for Percocet.

A Nashville newspaper profiles Urology Associates and Heritage Medical Associates, two of the region’s oldest and largest physician groups, and highlights some of the ways the groups have managed to stay independent and profitable. Heritage’s CEO notes his organization scales its technology and infrastructure to support physicians, while Urology Associates attributes long-range planning and foresight for its decision to implement EMR long before MU legislation. Interestingly, back in my vendor days several years ago, I actually visited both of these practices and even then each was well ahead of their peers in terms technology adoption.

The latest MU numbers from CMS as of July 31: $15.9 billion paid since the program’s inception, including $6.4 billion to 312,000 EPs.

In case you missed it, Dr. Gregg had a great post over the weekend entitled, “Take the Cannoli,” which touches on a darker side of vendor/provider relationships and includes a mention of Practice Fusion’s opt-out approach to sending emails to patients and asking them to rate their physician. Basically, unless a physician opts out of the program, each time a progress note is created in the EHR, the patient is forwarded an email that appears to have come from the doctor and includes a survey. In the last 17 months, patients have submitted almost two million reviews. As Dr. Gregg points out, this wealth of data benefits Practice Fusion far more than its customers.

Like Dr. Gregg, I was a annoyed when I heard about the program. It’s quite likely that no HIPAA or privacy rules are being violated,  but it’s troubling that so many Practice Fusion physicians were apparently unaware that the company was sending emails in their name. Practice Fusion contends it communicated details of the program through various channels when it was first initiated and it mentions the program in its current end-user agreement.

At a minimum Practice Fusion has done a poor job of communicating. Because of poor communication, the company now has a number of customers and prospects who view the organization with some degree of mistrust. Perhaps the company will recognize the program needs to be restructured to be opt-in versus opt-out. After all, who wants emails sent in their name without their knowledge?

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