News 1/12/12

CMS releases a Meaningful Use Attestation report from November 2011 that provides insight into which EHRs have the most attestations. I played with the numbers a bit and created this chart showing the top ambulatory EHR products in terms of attestations. EpicCare Ambulatory tops the list with 28% of the 21,318 attestations; eClinicalWorks follows with less than 9%, Allscripts Professional at 5.6%, and athenaClinicals is at 5%. And if you combine all of Allscripts’ ambulatory EHR products, they have 7% of the ambulatory EHR attestations. Fascinating stuff that raises questions, such as what percentage of vendor users does each attestation number represent? For example, eClinicalWorks reports having 60,000 physicians on their combined PM/EHR product, meaning only 3% of their providers have attested. That compares to athenahealth, which claims to have 6,000 athenaclinical providers, meaning 20% of the EHR providers have attested. It will take some time to find more facts and figures, but I’m hoping to dig deeper. [Update from Inga: Based on the vast differences in practice demographics and reasons for buying a particular EMR product, comparing  each vendors’ percentage of attesting providers may have limited value. For example, though eCW has 60,000 physician users, a significant number are CHC providers who are ineligible to qualify for MU incentives. A vendor offering a free solution, such as Practice Fusion, may attract more providers who are more interested in basic EMR functionality than in qualifying for MU incentives. Regardless of how you crunch the numbers, however, the overall number of EPs attesting through November (21,318) seems quite low.]

By the way, CMS says that as of December, 35,515 EP had successfully attested for Medicare Meaningful Use incentives. while another 355 were unsuccessful. Medicare paid EPs $275 million.

Practice Fusion announces it has raised an additional $2 million in funding. The company has now raised over $38 million from Band of Angels, Felicis Ventures, and others.

Adventist Health will implement Cerner Ambulatory EHR across its 130 outpatient clinics.

Winchester Radiologists (VA) contracts with HealthPro Medical Billing to provide billing services for its 17 physicians.

Massachusetts Eye and Ear Associates selects PatientKeeper Charge Capture and PatientKeeper P4P for its 250 clinicians.

Billing service provider MedData acquires MedDirect, a provider of RCM management and patient communication services.

Idaho Health Data Exchange (IHDE) signs an agreement with Greenway Medical to provide interoperability between Greenway’s PrimeSUITE EHR and IHDE’s HIE.

The American Podiatric Medical Association partners with HealthFusion to promote the use of HealthFusions’s MediTouch EHR.

The number of retail clinics grew 11.2% last year to 1,355 and is predicted to continue growing into 2012. One reason: the forecasted increase in demand for medical care, fueled by health reform and more access to medical coverage. CVS, one of the country’s largest retail clinic, plans to open 500 new MinuteClinics over the next five years.

Age makes a difference when it comes to physicians perceiving benefits of HIT. The majority of US doctors believe that technology does not improve diagnostic decisions, improve health outcomes, or improve the quality of treatment decisions. Most doctors under the age of 50, however, believe HIT offers numerous benefits, including a positive impact on outcomes, faster access to health services, reduced medical errors, and improved care coordination.

E-mail Inga.

News 1/10/12

The Miami paper profiles CareCloud, an up-and-coming provider of a cloud-based PM solution. The company has hired 30 people in the last five months (110 total employees) and raised $20 million in new VC funding. CEO Albert Santalo says the company is not yet profitable, though it grew revenues about 600% in 2011. The basic solution is $499 a month. It also offers an RCM option based on a percentage of collections and just rolled out an EHR.

US health spending grew 3.9% in 2010, which was only .01 percentage points faster than the 2009 rate and the second-slowest rate in 51 years. The slower growth is blamed on high unemployment, loss of private health insurance coverage, lower median incomes, and higher patient deductibles and co-pay. Total 2010 spending was $2.6 trillion, or $8,402 per person.

At the same time healthcare spending is falling, payer reimbursements are declining. The average commercial payer reimbursements for new and established office visits fell 2.86% in 2011, though Medicare paid more than commercial payers for almost all office visits.

Physician RCM provider MDeverywhere partners with collection agency Transworld Systems to jointly promote their services.

Pediatric Orthopaedic Associates (GA) selects SRS for its 12 providers.

Wayne Physical Medicine (NY) and LC Internal Medicine Clinic (LA) choose Waiting Room Solutions’ PM/EMR solution. Waiting Room Solutions also just partnered with UnityFax to offer its clients integrated inbound fax service.

The 46-provider Northeast Georgia Diagnostic Clinic contracts with MediRevv for AR management.

The American Academy of Pediatrics and Sanofi Pasteur introduce vaccine packaging technology that includes a 2D scan for tracking lot numbers and expiration dates. Pediatricians will no doubt be sending enhancement requests to their software vendors to integrate 2D scanning with their EMR application.

The number of physicians employed by hospitals has grown by 32% since 2000. Hospitals employ 212,000 physicians, or about 20% of all physicians.

E-mail Inga.

DOCtalk by Dr. Gregg 1/7/12

“No Soup for You!”

The Soup Nazi. Another Seinfeld expression that has penetrated modern cultural phraseology.

I’m guessing there are very few folks unfamiliar with the Seinfeld phenomenon whereby so many turns of phrase have eked into our communal awareness and lingo from just one TV show, albeit one very cleverly written TV show.

Thus, due to this social phenomenon, I could not help but conjure up the Soup Nazi’s “No soup for you!” when discussing the upcoming HIMSS Annual Conference & Exhibition with a friend the other day.

“What in the heck do soup and HIMSS have in common?” you might wonder.

Well, remember when Elaine thought she was ordering from the Soup Nazi? She commented that he looked “exactly like Al Pacino, you know, Scent of a Woman, hoo-ahh, hoo-ahh!” only to have her order for some yummy soup rebuffed with a Gestapo-esque, “No soup for you!”

Similarly, my desire to attend this year’s conference has been “no soup for you-ed” by HIMSS and its schedule change. There’s just no way that I could afford to pay both the costs of attending AND the costs for being away from the office during the majority of a work week. Not unless I use HIMSS as my vacation. (Uh… no… I don’t think so.)

Previously, it was hard enough to attend on the weekend and a Monday or Tuesday. Time away from the office is time when no income is being generated, losing thousands of dollars as bills pile up and still paying staff to man the fort. But, it was doable and worthwhile, especially to be able to attend all the HIStalk fun – i.e., HIStalkapalooza, et al.

I get that HIMSS is more and more oriented toward the vendor world and the large provider institutions, despite the fact that over half of healthcare is still delivered in smaller communities by smaller practices. It makes more sense for them to have their salaried folks come during their regular work week than to pay their people extra to travel/work on the weekend. But for me and, I’m suspecting, most of my small trench ilk, that is the exact opposite logic for our needs.

Then, on top of being “no soup for you-ed” on the event timing, the HIMSS meetings seem to me to have pretty much taken on a “big boys” focus. (No gender discrimination intended.) It makes me sort of miss TEPR – Toward the Electronic Patient Record – Conferences that, while not as well run as HIMSS, had a much greater end user focus with a nice blend of vendor “ooo” and “ahhh” mixed in with meetings and talks that were more useful for us onesy-twosies.

I’m still a HIMSS member, but I feel my membership has been a bit rebuffed just as were Elaine’s comments to the Soup Nazi.

Realizing how late it is to be whining about this and realizing , too, how little effect my whine will have, I nevertheless felt compelled to throw this out into the Internet air, just a mini-bitch on behalf of us little guys who so often get left out of the “soup.”

From the trenches…

“Do you ever get down on your knees and thank God you know me and have access to my dementia?” – George Costanza

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 the Future exhibit for the American Academy of Pediatrics, and sits on the board of directors of the Ohio Health Information Partnership (OHIP).

News 1/5/12

From WatchDog “Re: Appeals. Thought you might want to remind your readers that the Affordable Care Act included a new provision for appealing the PQRS and e-prescribing programs. The informal process goes into effect now for the 2011 year.”  Good to know. Finding details on the appeals process on CMS Website  isn’t exactly easy, but I think I finally found the right link. If you think a mistake was made on your PQRS or e-prescribing data, you can contact the QualityNet Help Desk to request a review.

Doctor’s Medical Center (FL) selects Vitera Healthcare Solutions’ Intergy Meaningful Use Edition for its 23-physician practice.

The local paper reports that more than 28,500 patients have access to Buffalo Medical Group’s (NY) patient portal, which is based on Epic’s MyChart. The 100 physician practice recently announced the availability of MyBMGChart from iPhones and Android-based smartphones.

Pacific Eye Specialists (CA) picks SRS EHR for its 10 provider group.

Practice Fusion updates its e-prescribing software, including changes to improve the overall workflow, make medication searches easier,and  simplify drug and allergy interaction alerts

iPractice Group achieves Gold Status as a partner in Greenway Medical’s Business Alliance program.

CareFirst BCBS is offering a free version of Medical Home Builder 2.0 software from the American College of Physicians for practices participating in its PCMH program.

NCQA approves  the use of Phytel solutions to meet certain NCQA requirements for PCMH recognition.

Welch Allyn CEO Julie Shimer announces she will retire at the end for 2012.

The American Academy of Urgent Care Medicine partners with Quest National Services to offer its members Quest’s billing and EMR solutions.

A local paper profiles Dr. Kurt Frederick (TX) and his extensive use of Twitter and other social media tools. Frederick contends that more providers will use social media tools in the future as compensation becomes more closely tied to keeping patients well. In addition to engaging patients on Facebook with fun posts, such as his “Are You Smarter Than a Medical Student?” series, Frederick also shares personal details of his life, which he believes creates a bond with patients.  Frederick’s philosophy:

Patients want to know what we read; what we think about things. They want to know about our families.

E-mail Inga.

News 1/3/12

ZirMed will offer its RCM solutions to the outpatient surgery and ambulatory care provider customers of  AmkaiSolutions.

The 21 providers at Rockford Orthopedic (IL) receive checks totaling $378,000 from CMS for their meaningful use of eClinicalWorks EHR.

ManagementPlus donates $140,000 in software to the People’s Health Clinic (UT), giving providers access to its EHR 5.0 software.

Emdeon appoints Rich Amico VP of information technology and IT principal for its Institutional Provider Services unit. He was previously SVP of business technology for Healthways.

EMR/PM provider CareCloud hires pediatrician Juan J. Reyes, MD, MBA as director of clinical technologies.

ProHealth Care (WI) will add several hundred physicians to its Epic system by the end of 2012 as part of a lease program for area independent physicians.

Solid advice for practices considering a cloud-base system: include both pre- and post-implementation expenses when calculating the total cost of ownership. Some extras to consider include implementation and consulting fees, Internet connectivity, network requirements, ongoing maintenance, technical support, conversion fees, and replacement costs for outdated hardware.

I am back from that slower-paced part of the world that Mr. H labeled the “Land Without Broadband.” After the first day in the 3G-less world, I gave up on everything but the most basic e-mail and quit trying to scour the Internet for HIT news. Instead, I read a couple of books, got a little sunshine, and drank a bit of wine (ok, more than a bit, but that’s what vacations are for, right?) I’m happy to be back at it and contemplating what 2012 will bring. My insights for HIT in the New Year are not particularly unique, but I predict we’ll continue to see practices merge with larger practices or health systems as providers look for ways to reduce overhead and align themselves in preparation for ACOs and similar care models. Also, as smaller practices disappear, so will several of the smaller niche vendors who realize that the continued development of their product is economically unfeasible in light of shrinking customer bases and new government requirements. Finally, more cash-strapped providers will embrace cloud-based, hosted, and/or “free” EMRs in hopes of achieving Meaningful Use objectives.

The other big New Year’s tradition is, of course, resolutions. Many of mine are the same as last year, including 1) lose five pounds, 2) exercise at least three times a week, and 3) eat healthily. I’m thinking this should be the year I add, “keep off the five pounds all year long,” but then I might be forced to give up my secret indulgence: dark chocolate espresso beans.

E-mail Inga.