News 8/23/12

Walgreens plans to deploy the WellHealth EHR, built upon Greenway Medical Technologies’ EHR platform, to nearly 8,000 stores over the next year. The WellHealth EHR platform, which is already installed at 200 sites, provides pharmacy staff with a single patient view of immunizations, testing history, and prescription history.

CMS selects 500 primary care practices across seven regions to participate in the Comprehensive Primary Care initiative, which will pay primary care practices a care management fee of $20 per month per beneficiary to support enhanced coordinated services on behalf of Medicare FFS beneficiaries. Participating practices were selected based on their use of HIT, ability to demonstrate recognition of advanced primary care delivery, and participation in practice transformation and improvement activities.

CPU Medical Management, a division of MED3OOO, announces a vendor partnership with eBridge to offer a combined PM and document imaging solution.

Quest Diagnostics certifies Meditab Software’s Intelligent Medical Software as a Gold Health IT Quality Solution that provides a streamlined and interoperable solution with Quest’s lab orders and results.

If you are a physician, you are more likely to experience symptoms of burnout than individuals in other professions, according to a study published in the Archives of Internal Medicine. Of 7,299 physicians surveyed, almost half claim to be emotionally exhausted or feeling a high degree of cynicism, or depersonalization toward patients. The specialties with highest burnout rates are emergency medicine, family practice, and internal medicine.

Mobile health app store Happtique pilots mRx, a solution that enables physicians to prescribe medical, health, and fitness apps to their patients. Physicians and licensed health practitioners, such as nurses, dietitians, and therapists can select apps to prescribe and Happtique will track how many times patients clicked the “fill” button after an app prescription is sent. App usage, however, will not be measured, nor will clinical outcomes. My take: sounds fun but it won’t take long for patients to lose interest.

E-mail Inga.

Readers Write 8/21/12

Submit your article of up to 500 words in length, subject to editing for clarity and brevity (please note: I run only original articles that have not appeared on any Web site or in any publication and I can’t use anything that looks like a commercial pitch). I’ll use a phony name for you unless you tell me otherwise. Thanks for sharing!

Note: the views and opinions expressed are those of the authors personally and are not necessarily representative of their current or former employers.

Staying HIPAA Compliant in the Age of Mobile Devices

Healthcare is rapidly increasing its use of electronic devices. A recent survey found that more that 80% of physicians use mobile devices, such as laptops, smart phones (including Blackberrys, iPhones and Androids), and even iPads or tablets in conjunction with their delivery of patient care.

However, smart phones and tablets are particularly vulnerable to a breach of protected health information (PHI) as they are small and can easily be lost or stolen. Also, while laptops or desktop computers are typically property of the medical practice, physicians are more likely to use their personal smart phones or tablets when transmitting electronic PHI. HIPAA permits physicians to use these methods of communication when transmitting PHI so long as they reasonably and appropriately safeguard the information.

So what does this mean for doctors and how can they ensure they are HIPAA compliant? There are several simple ways to provide protection:

• Lock your mobile device and require password protection. Unlike most office computers, smart phones are less likely to be locked when left alone. Any mobile device being used to transmit PHI should be locked when left alone and programmed to automatically lock after timing out. Additionally, the device should only be accessible by a unique password, prohibiting unauthorized access.
• Enable encryption. Encrypting your device can prevent the loss of electronic patient PHI, along with your own personal data.
• Determine if the device can be remotely disabled. Some mobile devices have the capability to be remotely locked in the event they are lost or stolen. This can prevent PHI data breaches if the device ever ends up in the wrong hands.
• Avoid using public Wi-Fi networks and disable file sharing. Public Wi-Fi networks increase the risk of exposing PHI because anyone with the right software could gain access to your device. When using a mobile device, use a secured connection or password- protected Wi-Fi network. Additionally, disable wireless sharing to prevent inadvertently sharing PHI files with others.

This list is certainly not exhaustive, but highlights a few simple means of protecting electronic PHI stored on or transmitted by mobile devices. Implementing these safeguards can help ensure you are HIPAA compliant while still maintaining the ease and convenience of mobile devices.

Jessica Shenfeld, Esq. is the founding partner at The Law Office of Jessica Shenfeld, a boutique law firm that caters to physicians’ legal needs. She is also CEO of EHR Incentive Help, Inc., which helps physicians satisfy the Meaningful Use criteria and apply for the Medicare/Medicaid EHR Incentive benefits.

News 8/21/12

Epocrates announces plans to offer US medical students its Epocrates Essentials drug, disease, and diagnosis reference product for no charge.

Virginia Physicians selects eClinicalWorks EHR for its 58 providers across eight locations.

River Ranch Radiology (TX) implements RadNet’s eRAD RIS.

The Franciscan Hammond Clinic(IN/IL) and Quincy Medical Group (IL/IA/MO) select SA Ignite’s MU Assistant to automate MU reporting. Franciscan’s 47 providers use Allscripts Enterprise EHR; Quincy’s physician utilize McKesson Horizon Ambulatory Care EHR.

For the fifth consecutive year, Hayes Management Consulting earns a spot on INC 5,000’s List of Fastest Growing Companies for 2012.

The number of visits to retail clinics increased fourfold from 2007 to 2009 with an estimated 5.7 million retail clinic visits in 2009. Almost half of all visits were on weekends or during weekday hours when physician offices were typically closed. Retail clinics still represent a small share of the overall visits in outpatient settings, however, as ERs handle 117 million visits annually and physician offices manage 577 million visits.

Sentara Healthcare (VA) partners with telehealth firm MDLIVE to offer virtual medical consults from its network of physicians beginning in October. The deal also gives Sentara an ownership stake in MDLIVE.

Capario launches an integrated patient pay solution in partnership with TransFirst that facilitates the collection of patient payments, including co-pays, deductibles, and balances after insurance has paid.

The amount of money spent on medical practice mergers and acquisitions continues to climb, with $4.2 billion exchanged on 21 practice M&As in Q2. Hospitals in particular are interested in buying practices to control their referral sources and monitor care quality as hospitals begin to be penalized for readmissions.

The top reasons that doctors working in large independent and hospital-owned groups look to change jobs: financial security, dissatisfaction with current environment, and significant lifestyle changes, such as spousal job loss or personal or family financial strife. Physicians say that student loan repayment is their major source of financial stress.

The 12-physician Orthopaedic Associates of Central Maryland contracts with ChartLogic for its EHR suite. I discovered when I went to the practice’s Website that they have a somewhat annoying “jingle” that plays when you enter the site.  Annoying, yet effective, I suppose since I have been humming mdbonedocs.com all afternoon.

PracticeMax, a provider of practice management services for physician practices, announces the retirement of Rick White as president and the promotion of Patrick Lukacs (above) from VP of software services to VP of operations.

E-mail Inga.

DOCtalk by Dr. Gregg 8/17/12

The Gray Lining of the Cloud

The battle rages of cloud versus local host – within the blogosphere, within the EHR sales pitch wars, and within my own little brain. As it does, I came across (or rather, am suffering from) a side of the cloud I have never heard discussed.

We still locally host our EHR. Since we do, I have to keep my Secure Sockets Layer (SSL) license updated (i.e., paid for). If I don’t, our system isn’t accessible and we are back to digging out pens and paper until I pony up the dineros and await the certificate. Fortunately, I have always gotten our SSL renewed on time — though sometimes just barely — and we have remained live.

But what happens when your cloud service provider doesn’t renew their SSL license? Well, we found out about that this week.

Despite my best current local hosting efforts, not all can be maintained within my little realm. For instance, ePrescribing is beyond my control freak domain. I know this because the parent company who now owns my EHR, and who has full dominance over my ePrescribing connectivity, let their SSL license relative to this capability lapse.

Did I get an e-mail or phone call or any notification that ePrescribing was down? I did not. I found out after repeated attempts to send e-scripts were rejected and after calling the VAR who supports me.

Yesterday, our VAR told us that ePrescribing was down system-wide because of said parent company, but would be back up by the evening.

This morning, guess what? Yup. No ePrescribing. And still no e-mail, call, or fax to notify us of what was going on.

Another call to our VAR led me to the inside scoop: our dear EHR vendor had failed to renew their SSL license pertinent to this ePrescribing component in time before the license expired. In fact, so I was told, their SSL license had lapsed three days earlier.

So here we sit with the old prescription pads, penning away prescriptions just like the old days. I’m still paying for my EHR and the support thereof, but one major tool we use every day – many, many times every day – sits idle because someone “out there,” somewhere in the ethereal cloud world, didn’t pony up on time like I always have to do. Something doesn’t seem right about this, does it?

There is definitely a gray lining to the cloud.

From the trenches…

“Behind every cloud is another cloud.” – Judy Garland

Dr. Gregg Alexander, a grunt in the trenches pediatrician at Madison Pediatrics, is Chief Medical Officer for Health Nuts Media, directs the Pediatric Office of Today! exhibit for the American Academy of Pediatrics, and sits on the board of directors of the Ohio Health Information Partnership (OHIP).

News 8/16/12

From DrLyle “ACE 2012. It’s their largest ACE ever with over 4,000 attendees and Mayor Rahm did a special keynote. Glen’s opening address focused on how Allscripts is philosophically and technologically becoming an open system.” Allscripts also unveiled plans for a telehealth solution that integrates the American Well Online Care platform with Allscripts EHR. The announcement was a little unclear as to whether the solution is for the inpatient EHR or ambulatory (or both,) but the integrated product won’t be generally available until early 2013. If you are at ACE, I’d love an email with any updates or cool pictures.

From PairOfAces “Heard that ACE Hardware is having a convention in Chicago at the same place as Allscripts this week.  I’m sure that will present some interesting challenges to Allscripts and the attendees at their conference.” Funny. Both ACE conventions are at Chicago’s ginormous McCormick Convention Center, though in different buildings. The hardware guys, by the way, are being treated to a Rascal Flatts concert, which sounds more much more fun than Allscripts’ trip to Navy Pier.

A Vitera Healthcare Solutions study finds that 91% of doctors want a mobile EHR solution, yet only six percent connect to an EHR through a mobile device. The survey also found that 55% of healthcare professionals used mobile devices to email, phone, text, or send other communications, but only 20% used for medical research on the go.

Fayetteville Medical Associates (TN) selects PatientPoint’s care coordination platform for population management for its PCMH practice.

Harris Corporation will expand Florida’s HIE secure messaging service to 11,000 physician offices that use Care360 solutions from Quest Diagnostics.

We’ll be running a new HIStalk Practice Advisory Board series soon. If you have any burning questions you’d like our expert ambulatory healthcare professionals to answer, please send them my way.

E-mail Inga.