News 7/2/13

As rumored on HIStalk this weekend, Intuit announces plans to divest its health group, including the patient portal business it acquired from Medfusion in 2010 for $91 million. I wouldn’t be surprised if Intuit tried to find a buyer among its pool of resellers, which includes Allscripts, GE, and Greenway. I realize Allscripts recently purchased Jardogs’ patient portal technology, but Allscripts could still be a potential suitor given its large number of customers using the Intuit product.

Allscripts, eClinicalWorks, and Epic lead all vendors in ambulatory EMR adoption, with just over 10 percent of the market each. Almost three-quarters of all practices using EMRs are supported by the top 20 vendors; over half of practices with more than 41 physicians use Epic.

CareCloud hires Paul Henry (ADP/AdvancedMD) as VP of small group sales.

Women’s Healthcare Associates (LA) selects the Vitera PM/EHR platform.

The ONC Beacon-EHR Vendor Affinity Group names Adele Allison, national director of government affairs for SuccessEHR, as co-chair, along with Chuck Tryon of MyHealth Access Network.

ZirMed announces that its first claims acceptance rate is averaging 98 percent or higher.

A Nebraska practice warns patients of the possibility of identity theft after a physician loses a thumb drive containing 2,125 patient records. The office says the lost records included patient demographic information but no social security numbers.

Thanks to SRSsoft CEO Evan Steele who did some number crunching and found that 17 percent of EPs earning an $18,000 EHR incentive in 2011 did not earn the $12,000 incentive in 2012. To earn the incentive in 2011, EPs had to demonstrate MU for 90 days. A full year’s demonstration was required for the follow-up year. As Evan states, “a 17 percent loss rate in any business is wholly unacceptable, and this failure does not portend well for the future of the EHR Incentive Program.”

Porter Research looks at ICD-10 readiness among physician practices and finds that most are concerned with disruptions in cash flows when the new code set goes into effect. Of practices that have not yet started preparing for the transition, more than a third believe they have adequate time to prepare. The rest either don’t know where to begin or lack time, staff, or training resources.

Administrators at two Phoenix children’s clinics claim the use of scribes for EMR documentation has improved physician workflow, eliminated transcription costs, and improved revenue cycle. One orthopedic surgeons says the scribes “may have very well saved the clinic by helping with the implementation of the new EMR.”

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News 6/27/13

Humana earns the top spot in athenahealth’s 2013 PayerView Report, which ranks health insurers based on claims-payment data. Other highlights from the report:

• Medicaid continues to underperform on key metrics, such as days in A/R
• Many payers performed worse than the 95 percent benefit accuracy, including six payers that returned correct co-pay information less than 50 percent of the time
• Payers still require enrollment by fax or mail for 65 percent of transactions.

The seven-provider Athens Bone and Joint Orthopedic Clinic (GA) selects simplifyMD’s EHR.

Financial management issues are the most challenging difficulties facing group practice executives, according to an MGMA member survey. Specific concerns include managing rising operating costs, preparing for potential cuts in reimbursement rates, and navigating transformative federal policies. Implementing an EHR is considered less of a challenge than a year ago, but optimizing an existing EHR has become a more pressing concern.

Orion Healthcorp., a provider of medical billing and coding for physician offices, names Dale Brinkman (Western Skies Billing Service) CEO and promotes Joseph Seale from COO to president.

UCSF Dermatopathology and Oral Pathology Service selects McKesson to provide revenue management services for its eight-physician group.

Kareo reports that one-third of the 4,000 providers signed up for its EHR have moved from another EHR system.

Consumer Reports publishes an excellent overview of the PCMH model that should be a must-read for anyone wanting to understand the why and how of this emerging care model. The article outlines what a PCMH is, how it is run, how it can reduce costs, and how it benefits patients. The use of “smart medical records” is recommended to facilitate preventative care,  improve provider-patient and provider-provider communications, and manage the coordinated care process. If you work for a vendor serving the ambulatory physician market, it’s worth the read. If nothing else, you will seem really smart at your next company cocktail party.

A Maine newspaper profiles Michael Clark, MD, owner of Lifespan Family Healthcare Center, which is part of the PCMH Pilot Program. Clark believes the success of the PCMH is dependent on modern technology, including EMRs that are available to both providers and patients:

Electronic medical records allow for easier tracking of complex medical problems, help to prevent medication prescription errors, provide automatic reminders for overdue care, flag critical lab values and improve coordination among different specialists and healthcare facilities. Equally important, patients have the same access to all of their records as providers.

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News 6/25/13

From Sleepless: “Re: Priorities. The customer should be the priority, but you know how people are programmed to cater to doctors’ schedules and timelines. It is as though we are living in the 1950’s. I also find it offensive when I call the doc office or pharmacy and get the recording that says doctors press 1 and the rest of you press 2.” Apparently I am not the only one who is annoyed by office staff that seem to believe their doctor’s time is more valuable than mine. As another reader pointed out, the staff’s priority should be to assist, “the one with cash in their hand.”

eClinicalWorks has signed up 1,000 providers to its RCM during the first six months of 2013 and is projected to reach $100 million in revenues by 2015. eCW offers the service for 2.9 percent of monthly collected revenues and includes EHR.

Georgia Governor Nathan Deal announces that athenahealth will expand into Atlanta, bring 500 new jobs, and make an $10.8 million investment in the Ponce City Market area.

An American Medical News article discusses ways that practices can use patient data from EHRs to  impact the way care is delivered and identify improvements on the business side. For example, EHRs help practices identify patients in need of preventative care, facilitate the management of chronic care cases, and monitor outcomes. To improve population health, experts recommend using Meaningful Use measurements as a guide and selecting target measures from the 64 included in Stage 2.

The AMA votes to lobby CMS for a two-year grace period to avoid complying with the ICD-10 transition, despite the announcement last week by ONC head Farzad Mostashari, MD that there will be no additional ICD-10 delays.

A CMS study concludes that adoption of EHRs in community practices doesn’t necessarily decrease costs, but can facilitate either increases or decreases in costs depending on how the EHR is used and the context in which it is used.

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News 6/20/13

From Guppy: “Re: KLAS scores. KLAS always seems to hand-pick the largest vendors as winners. It was interesting to look at the data you reported because it would appear that a number of the small, specialty-specific vendors do a much better job at usability than the big fish – shocking!”  “Usability” is not necessarily the same thing as customer satisfaction, which is the metric KLAS is measuring. Regardless, the KLAS scores always stir up plenty of controversy. At least in the ambulatory EMR segment, several of the smaller vendors did quite well, including PCC, SRS, and Sevocity.

The 110-provider Oregon Medical Group will implement Phytel’s Outreach, Insight, and Coordinate modules for population health management.

Technology could improve treatment outcomes for children with chronic illnesses, according to a report from Boston Children’s Hospital and the Verizon Foundation. The white paper stresses the need for technology that improves coordination among members of the care team; improves care management by providing appropriate data required for decision-making; facilitates the education of care team members on available resources; and incents providers to adopt technology that focuses on the patient and family rather than a traditional physician-centric model.

CMS publishes updated 2014 clinical quality measures for EPs, which are categorized based on the agency’s priorities for patient and family engagement, patient safety, care coordination, population health, efficient use of resources, and clinical effectiveness.

Yesterday I stopped by my optometrist’s office to pick up some contacts. While the tech was hunting for my order, he took a phone call. As I became increasingly impatient for him to get off the phone and finish helping me, another employee explained that the tech was talking to the doctor. When I finally walked out the door, I wondered to myself who should have been the tech’s priority: the customer/patient or the doctor?  Anyone?

Robert M. Wah, MD, the ONC’s first deputy national coordinator and a retired Navy captain, is named president-elect of the AMA.

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News 6/18/13

From RyanS: “Re: KLAS Mid-Term Report. Physician’s Computer Company earned the top customer satisfaction scores in both the ambulatory PM and EHR software categories.” The Mid-Term report is based on performance scores gathered over the previous 12 months. RyanS provided a few other highlights, including:

• PCC Partner PM (1-10 physicians) blew away the practice management competition with a score of 95; Epic Resolute/Prelude/Cadence (> 75 physicians) was next with a score of 88.7;  Greenway PrimeSuite Practice (11-75 physicians) was third at  88.6.
• Top performers in the ambulatory EMR segment were PCC EHR (1-10 physicians) with a score of 95.5; EpicCare Ambulatory (over 75 physicians) at 88.3; and SRSsoft EHR (11-75 physicians) at 86.7.
• Top clearinghouse providers were Navicure (92.3), ZirMed (92.5), Office Alley (91.1), and Practice Insight (90.1).
• KLAS recognized McKesson Practice Partner (11-75 physicians) as the product demonstrating the biggest improvement since its December, 2012 awards, jumping 13 percent to 56.7. AdvancedMD EHR (1-10 physicians) gained 12 percent to 76.2.

Vitera Healthcare Solutions announces that it has acquired Birmingham, AL-based SuccessEHS, which offers PM/EHR, electronic dental record, dental imaging, and revenue cycle solutions. SuccessEHS, which has doubled in size in the past two years, will be operated as a division of Vitera and expand Vitera’s user base to  10,500 organizations, 415,000 medical professionals, and 85,000 physicians.

CureMD offers discounted subscription rates, and free implementation, training, and data migration for the 4,400 users of the Mitochon Systems EHR platform. Last month Mitochon announced it was exiting the physician EHR market and would no longer market its free EHR product.

The office manager for Summersville Pediatrics (SC) shares her practice’s experience migrating from MyWay to Aprima Medical’s EMR with assistance from Aprima dealer ConXit Technology Group.

CareCloud hires Tom Cady (athenahealth) as VP of professional services.

Nature Coast ACO (FL) expands its relationship with eClinicalWorks to include eCW’s Care Coordination Medical Record.

Nuance releases a new version of Dragon Medical Practice designed for smaller practices that includes voice shortcuts to aid searches for medical information and more than 90 specialized medical vocabularies.

A computer outage in the Canadian province of Alberta caused about 202 medical clinics to lose access to patients’ health information for more than five hours last week. “Thousands” of patients were affected and many practices turned patients away. One physician told a local paper, “When this happens it cripples you. We didn’t even have Internet access. This is also a financial loss for physicians.” The EHR vendor blames the outage on a faulty network device that routes data to the clinics.

e-MDs relocates and expands its headquarters and will operate out of a 30,000 square foot administrative campus in Cedar Park, TX, a 40,600 square foot technology campus in Austin, TX, and a separate data center providing business continuity and disaster recovery services.

Vitera Healthcare releases Vitera Medical Manager EHR, a Web-based EHR, analytics, and transaction platform for current Vitera Medical Manager customs.

The primary motivator for becoming an ACO or PCMH is to improve patient outcomes, according to a survey by eClinicalWorks. Almost all respondents believe that an integrated EHR would be the most valuable HIT feature for an ACO or PCMH.

An MGMA report provides more evidence that ICD-10 readiness is moving slowly. The greatest concern is the lack of communication and critical coordination between physician practices and their EHR/PM/clearinghouse vendors  regarding software updates and testing. Less than five percent of practices report they have made significant progress when rating their overall readiness for ICD-10 implementation.

Emdeon acquires Goold Health Systems, a provider of pharmacy benefits and related services to state Medicaid agencies.

Forty-two percent of practicing physicians are dissatisfied with their jobs, leading many to consider leaving medicine and taking early retirement. Decreasing autonomy, low reimbursement, and administrative hassles were the key drivers of dissatisfaction.

The number of retail medical clinics is predicted to climb from 1,418 at the end of 2012 to 2,868 in 2015.

In an AAFP News interview, Farzad Mostashari, MD discusses EHRs, ROIs, productivity, improved patient care, and more. Regarding productivity:

If physicians just replicate the existing paper-based processes in a digital way, they probably are not going to get huge productivity gains. But if they redesign the care flow to designate what things are done by people versus what’s done through the EHR technology, then that really adds to productivity. That’s how I would summarize the experience of folks who have made EHR implementation a wonderful business decision.

E-mail Inga.