News 3/4/14

From Hometown Girl: “Re: HIMSS. I couldn’t make it this year but loved your updates. Did you see anything cool for the ambulatory world?” Thanks to everyone who followed along from home. As I mentioned in one of my updates on HIStalk, I wasn’t wowed by any particular offering that I saw. Overall I would say there seems to be more of a blurring of offerings from both the traditional inpatient and ambulatory vendors with both promoting different flavors of products for care coordination and connecting with patients and other providers. One person I chatted with suggested providers are increasingly concerned with what’s going on outside their own walls and the products and services seemed to reflect that.

As usual, almost every vendor believes that HIMSS week is a great time to send out a press release or three. I still have several hundred unread emails in my inbox and fear it will take me all week to catch up on all the news. Hopefully I have caught most of the big stuff.

WEDI, in partnership with EHNAC, will create a Practice Management Accreditation Program to review PM vendors in the areas of privacy, security, mandated standards and operating rules, and operational functions. While I am all for having vendors meet minimum performance standards, is this really the best time to ask vendors to jump through one more hoop to remain competitive in the marketplace? It’s no surprise that we are seeing limited advances in product usability and innovation.

CMS Administrator Marilyn Tavenner told a HIMSS audience last week the October 1 ICD-10 transition will not be pushed back, though some providers may be giving case-by-case exemptions for meeting Stage 2 MU targets. The AMA was quick to issue a statement expressing deep concern “that Medicare does not have a back-up plan if last minute testing demonstrates anticipated problems with this massive coding transition” and warned that “disruptions in medical claims processing will hurt doctors and their patients.”

The ONC issues a proposed rule for voluntary certification criteria for EHRs in 2015, which would be separate from MU regulations. The 2015 edition certification criteria would offer a way for non-MU EHR systems to become certified; would enhance interoperability efforts; would include functionality criteria for patient population filtering of clinical quality measures; and, improve alignment with other HHS programs.

GetWellNetwork debuts GetWellNetwork Ambulatory, which is available on mobile and stationary devices and integrates with EHRs to provide personalized information, healthcare tools, and patient pathways to help patients and their caregivers participate in the patient’s care.

Practice Fusion offers integration between its EHR and AliveCor Heart Monitors and between the Diasend System for glucose/insulin reporting.

Speaking of Practice Fusion, I discussed the company with a couple of different industry insiders at HIIMSS last week and got differing opinions on the companies long term viability. One EMR executive suggested that the company could be a dark horse in the market and noted its KLAS scores were respectable. He believed the free platform would continue to appeal to smaller, independent providers. Another seasoned industry expert was not as confident about Practice Fusion’s viability, noting that neither its advertising model nor the sale of data would provide adequate revenue to sustain the company long term. It’s possible that both could be right, which would leave thousands of “happy” users looking for a replacement system.

Greenway acquires PeopleLynk, which sends patient relationship messages based on EHR events.

Greenway Medical names Phreesia its Marketplace Partner of the Year.

Greenway will integrate DrFirst’s controlled substance e-prescribing software into its Intergy, PrimeSUITE, and SuccessEHS systems

Greenway, by the way, had a good size booth at HIMSS, though maybe not as large as what they brought to MGMA and definitely in a less prominent location.

ADP AdvancedMD announces general availability of its reporting suite AdvancedInsight, which provides physician offices with financial insight into their practices.

ADP AdvancedMD offers an ICD-10 transition program in partnership with Alleon Healthcare Capital to provide preparation resources, product enhancements, and a revenue cycle financing program. The financing program aims to minimize the impact of  revenue delays and helps clients withstand up to 90 days of  nonpayment.

ICD-10 was definitely one of the hotter topics at HIMSS, both on the exhibit floor and in the educational sessions. 3M in particular had a huge booth promoting its ICD-10 readiness tools.

Interestingly ADP AdvancedMD was not an exhibitor this year. Perhaps the expense is too much considering not too many attendees are in their sweet spot in the smaller private physician practice segment.

Nuance integrates its multi-functioning printer scanning solution eCopy ShareScan with NextGen Ambulatory EMR.

Cerner and NextGen achieve bilateral data interoperability between the NextGen Ambulatory Solution Suite and the Cerner Network.

Physician First ACO (FL) selects eClinicalWorks Care Coordination Medical Record (CCMR) to advance its care coordination, population health, and quality health initiatives. West Florida ACO will also implement eCW’s CCMR platform.

The 200-provider Northeast Georgia Physicians Group, an Allscripts TouchWorks EMR customer, achieves Stage 7 on the HIMSS Analytics Ambulatory EMR adoption model.

Allscripts had a big HIMSS presence and was displaying its new tag line,  “The Power of All.” I thought it was a pretty clever play on words and emphasizes their intent to provide solutions across the full HIT spectrum.

DrFirst estimates that its Patient Advisor medication adherence platform delivered  $21 million in prescription savings opportunities in its first three months of operations.

Etransmedia acquires Medigistics, a provider of RCM and A/R management services for healthcare providers.

The AHRQ offers a toolkit to help physicians and their staff prevent problems associated with managing lab tests and results, including suggested processes for tracking, reporting, and following up with patients and avoiding diagnostic errors.

E-MDs introduces e-MDs Cloud RCM services.

PerfectServe introduces automatic electronic PHI filtering capabilities that remove ePHI from the body of messages sent to non-secure mobile devices.

Aprima Medical announces that over 1,500 former Allscripts MyWay customers have migrated to the Aprima platform. A friend told me she was at a reception last week and overheard an Aprima employee joke that Allscripts’ decision to stop supporting MyWay was the best thing to ever happen to Aprima’s business.

More than one-third of physicians have prescribed an app to their patients, according to a QuantiaMD member poll. Almost half of physicians participating say they would never prescribe an app because of the lack of regulatory oversight.

A three-year study of a PCMH demonstration project reveals the model did little to reduce costs and utilization or to improve the quality of care. The JAMA-published study found the PCMH model didn’t reduce hospitalizations, ED use, ambulance services, or costs.

CMS launches eHealth University to help providers navigate various federal eHealth programs, including EHR, ICD-10, administrative simplification, and quality.

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News 2/20/14

CMS announces it will offer end-to-end ICD-10 testing in summer 2014 to a small group of providers. The testing will include providers sending test claims using ICD-10 codes and CMS returning remittance advice to outline any claims adjudication.

Meanwhile, more confirmation that most providers are not ready for ICD-10: Aloft Group finds that 50 percent of providers are a quarter of the way or less complete with the ICD-10 implementation process with physician buy-in the top conversion obstacle.

University of Michigan Medical School researchers report that most people find physician-rating sites at least “somewhat important” when choosing a doctor and that usage of such sites is “substantially higher” than just a few years ago. I happen to be in that majority, having recently searched various sites before selecting a new primary care provider. I also admit that the only times I have ever left a online review on any site for any product or service has been when the experiences were negative (I bet I am in the majority for this behavior as well.)

The US Patent and Trade Office awards Greenway three patents related to the automation of medical research designed to improve population by coordinating the collection, analysis, and reporting of relevant patient data contained in EHRs.

More work must be done to mitigate inappropriate access of patient data by employees, according to a HIMSS Security Security survey conducting with funding from MGMA and Experian Data Breach Resolution. Despite federal initiatives,19 percent of health systems and physician practices surveyed report having a security breach within the last 12 months and 12 percent have had at least one known case of medical identity theft reported by a patient.

Nordic Consulting moves into expanded space in Madison, WI. The four-year-old company reported $81 million in revenue in 2013 and has 400 employees, 350 of them Epic consultants and two-thirds of those being former Epic employees. Most of them live in areas other than Madison. It also took in $38 million of investment funds.

Aprima makes available its EHR/PM platform to run on the three pound, touchscreen Toshiba KIRAbook Ultrabook computer.

CureMD announces the death of its president, CEO, and co-founder Kamal Hashmat, MD following a “tragic accident.” Co-founder and CIO Bilal Hashmat will take over as president and CEO. Condolences to his family and co-workers.

The Northwest Area Health Education Center REC (NC) helps 399 providers from 102 practices meet the first stage requirements for MU, which surpasses the agency’s goal of 393 providers.

If you have any suggestions for ambulatory HIT technology or sessions during HIMSS next week, please let me know. In between fun parties and trinket hunting, I do plan to check out as much as possible so please send me your recommendations.

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News 2/18/14

The Colorado Health Institute analyzes the state’s looming shortage of primary care providers, which mirrors deficits across the country. The CHI offers several recommendations to address the estimated shortfall of 258 providers, including the use of emerging technology to increase patient self-care of common ailments and to advance options for self-diagnostic testing. The CHI also encourages streamlined policies to increase the use of telemedicine.

ONC reports that RECs have “far exceeded” their goal to support the adoption and use of HIT by 100,000 small practices, CHCs, and rural and public hospitals, while continuing to support providers to reach MU. I found the ONC’s announcement a little confusing since only 85,000 PCPs had met the MU milestone by the end of November, which is clearly short of the 100,000 goal.

The Worcester Business Journal looks at EHR adoption in the state of Massachusetts, which is requiring all providers to sign onto the Mass HIway HIE by 2017. Small practices and certain specialized providers are most resistant to automation, largely due to cost concerns and skepticism over potential benefits. Girish Navani, CEO for the Worcester-based eClinicalWorks, notes that it will be “only a matter of time before providers everywhere will convert” to meet regulatory requirements and to recognize the benefits of sharing patient records electronically.

I was looking at the latest MU Workgroup Stage 3 recommendations and noted a few new items that could potentially impact EPs, should these requirements be included in the final rule. Recommendation requirements include:

• The EHR would assist with follow-up on orders, including the return of results from specialty consults to the ordering provider.
• The EHR would provide EPs with access to medication fill information from pharmacy benefit manager
• Patients would have an easy way to request an amendment to their record online to offer corrections, updates, or additions.
• Patient-generated health information could be added electronically through a questionnaire, survey, or intake form, or, through secure messaging.

The National Testing Program for ICD-10 readiness of HIPAA transactions extends certification to Greenway’s SuccessEHS solution.

Benchmark Systems will offer its customers electronic statements and online pay solutions from PatientPay. Benchmark also announces several new customers including Comprehensive Pediatrics of Brooklyn (NY) for EHR and PM, Advent Medical Group (MO) for EHR, and, Dawn’s Medical Billing (VA) and American Self (VA) for PM.

SimplifyMD version 14.0 achieves 2014 Edition Complete EHR Ambulatory ONC HIT Certification from ICSA Labs.

Researchers from the University of Pennsylvania find that dermatologists that evaluated hospitalized patients using teledermatology provided nearly identical assessments as doctors examining the conditions in person.

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News 2/13/14

ICD-10 implementation costs for physician practices could be almost three times higher than estimated five years ago according to an AMA report that considered such factors as training materials, consulting fees, software upgrades, testing, payment disruptions, and physician productivity losses. The study predicts that small practice costs will range from $56,639 to more than $226,000; medium practices will pay between $213,364 and $824,735; and, large practices could spend between $2 and $8 million. Vendor/software upgrade costs represent a major cost variable that most, though not all,  practices will face. Meanwhile, the AMA “strongly urges CMS to reconsider the ICD-10 mandate,” which the organization believes is financially disastrous for physicians, impedes progress to a performance-based environment, and is unlikely to improve the care physicians provide their patients.

Sobering: a survey of 1,000  (seemingly self-selected) physicians finds that 70 percent don’t think the HITECH program was worth its cost. Other key findings:

• 65 percent say their EHR implementation has led to financial losses.
• 45 percent believe care has become worse since implementing EHR.
• 73 percent of the largest practices would not purchase their current EHR system again.
• 67 percent dislike the functionality of their EHR systems.
• Nearly half believe the cost of these systems is too high.
• More than two-thirds say that coordination of care with hospitals has not improved.
• Nearly 38 percent doubt their system will be viable in five years.
• 26 percent doubt their vendor will be in business in five years.

RelayHealth Financial achieves full EHNAC HNAC accreditation for the 14th consecutive year.

Privia Medical Group (VA) will implement athenahealth’s PM, EHR, patient communication, and care coordination services for its 154 providers and affiliated ACO.

Also from athenahealth: the company  announces that it has integrated drug monographs from its Epocrates acquisition into athenaClinicals.

Four Ellis Medicine (NY) primary care locations deploy PCMH transformation management and analytics tools from Arcadia Healthcare Solutions to earn Level 3 NCQA PCMH recognition.

HIMSS Analytics recognizes 51 clinics of Northeast Georgia Physicians Group with its Stage 7 Ambulatory Award.

CMS and ONC introduce Randomizer, a tool that allows providers to exchange data with a test EHR in order to meet measure #3 of the Stage 2 transitions of care requirement.

Kareo launches a new MU resource center that includes links to articles, websites, and white papers, as well as FAQs that cover basics about MU and attestation.

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News 2/11/14

Lawmakers propose legislation that repeals the SGR formula and introduces a Medicare physician payment system that rewards merit over quantity of services and incentivizes physicians to participate in alternative payment models. Some specifics include:

• Medicare would eliminate the scheduled three percent reductions in reimbursements for failing to comply with MU criteria, as well as the escalating penalties of up to five percent in 2019
• Medicare would drop the two percent penalty scheduled for 2017 for failing to report PQRS measures
• Physician payments would increase 0.5 percent a year for five years
• EHRs would be required to be interoperable by 2017 and providers would be prohibited from deliberately blocking information sharing with other EHR vendor products
• Technical assistance funding would double for small practices with 15 or fewer professionals
• Beginning in 2017, HHS would monitor clinicians for the appropriate use of advanced diagnostic imaging based on appropriate use criteria. Physicians deemed “outliers” for non-use or non-compliance of appropriate use would be subject to prior authorization for applicable imaging services.

CMS announces a one month extension of the deadline for EPs to attest for MU for the Medicare 2013 reporting period. In its email announcement CMS did not provide an explanation for moving the deadline to March 31.

Georgia Physicians for Accountable Care selects eClinicalWorks Care Coordination Medical Record to advance its ACO objectives.

A screening program for abdominal aortic aneurysms integrated into an EHR reduced the number of unscreened at-risk men by more than 50 percent within 15 months, according to a Kaiser Permanente study.

The NCQA recognizes the 180-provider HealthPoint Medical Group (FL) as the first practice to earn NCQA Patient-Centered Specialty Practice Recognition for its efforts collaborating with patients to improve quality.

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