News 7/28/11

Michigan Eye Institute chooses SRS ERH for its eight provider, five-location practice.

MGMA calls on HHS to withdraw its proposed HIPAA accounting of disclosures rule, which would require practices that maintain an EMR to have the capability to produce a detailed report of every instance a patient’s information is accessed by any staff member for any reason, including claims submittal.  MGMA notes that because over 90% of surveyed members believe the proposed rule would be “very” or “extremely” burdensome, an unintended consequence could be that practices avoid implementing EMRs.

Ampla Health chooses MED3OOO’s InteGreat EHR for its eleven FQHC and community health centers.

Telemedicine and telehealth technologies may address an increased need for quality healthcare in rural locations, according to a report by the UnitedHealth Center for Health Reform & Modernization. The report calls for the expansion of broadband connectivity to facilitate telemedicine adoption, a reduction of regulatory barriers for using telemedicine technologies, and improving and aligning reimbursement to encourage greater telemedicine use across rural settings.

Five providers from Aquidneck Medical Associates (RI) are among the first in the state to receive an $18,000 check for their Meaningful Use of eClinicalWorks’ EHR.

Kremer Eye Center (PA) selects NexTech’s EMR/PM and marketing software for its 11 surgeons and eight optometrists.

DrFirst introduces EPCS Gold version 2.0, which support electronic prescribing of controlled substances, based on individual state laws and the ability of the receiving pharmacy to meet DEA’s requirements to process the prescriptions.

HITEC-LA, the REC for Los Angeles, adds Greenway Medical to its list of preferred EHR vendors.

Epocrates announces first phase availability of its Epocrates EHR mobile and Web-based EHR, which is designed for primary care practices with 10 or fewer physicians. Epocrates will also offer a license to a native Apple iPhone app that supports remote patient look-patient look-up, schedule access, and e-prescribing capabilities.

Physician offices added 5,000 new jobs in June; the healthcare sector as a whole added 13,500 jobs.

Almost half of physicians who use digital tools to access prescription drug information would like to view the information on their smartphones or iPads, according to a Manhattan Research report.

Please join me in welcoming Preceptor Consulting as HIStalk Practice’s newest Platinum sponsor. Preceptor provides HIT training and support services and over the last five years has provided system design, building, testing, and go-live support for over 500 facilities. Preceptor specializes in EMR support and resources for multiple systems, including Epic, Cerner, McKesson, Allscripts, Napochi, and NextGen. Mr. H and I are very thankful for Preceptor’s support of both HIStalk Practice and HIStalk.

The AMA and 91 other medical associations send a letter to Dr. Donald Berwick expressing concern that healthcare providers will not have enough time to react to CMS’s newly proposed changes to the e-prescribing program.  Specifically, the medical associations contend that providers won’t have time to apply for exemptions and are concerned that CMS has not provided an additional reporting period in 2012 for physicians who don’t comply with the 2011 e-prescribing requirements. The medical groups assert there should be no penalties applied until 2013 against a physician facing a 2012 e-prescribing penalty.

E-mail Inga.

News 7/26/11

The local press highlights Western Wisconsin Medical Group and its success implementing Cerner Ambulatory EMR. The paper notes the 55-physician practice is the “first medical group in Wisconsin – and perhaps the entire United States – to have all its doctors using electronic medical records.”  I am sure plenty of practices across the country would beg to differ.

Speaking of Cerner, I notice that Saint Barnabas Health Care Systems (NJ) is promoting its Physician Community Connect Program, which extends discounted pricing  for Cerner EMR. Saint Barnabas is subsidizing the purchase of Cerner EHR by the lower of 85% of implementation-related fees or $5,000 per physician.

e-MDs joins eClinicalWorks, Greenway, NextGen and Sages as Preferred EHR Partners for the New York eHealth Collaborative (NYeC) REC. The preferred partners offer special pricing and contract terms for REC participants. NYeC  also recognizes another dozen EMR vendors who have completed a vetting process and are designated as  “Meaningful Use Partners.”

The American Academy of Ophthalmology (AAO) develops a list of EHR requirements for ophthalmologists seeking to achieve Meaningful Use incentives. The recommendations address how EHRs should accommodate certain areas of ophthalmic practice, including supporting documentation between the office and operating room; capturing and displaying vital signs of the eye; and incorporating hand-drawn sketches or annotations into records.

The AAFP partners with Avatar International to launch an online patient survey portal for gathering and analyzing patient feedback. The survey gathers information required for medical home recognition, including data on patient satisfaction, timeliness of providers, and provider accessibility and communication. Aggregated data is shared with AAFP. Price tag: $150/year for AAFP members.

The 50-physician St. Joseph’s Clinic (AR) adds MedQuist’s clinical technology and transcription services

The Tampa Bay Business Journal names Doctors Administrative Solutions, an ambulatory EMR implementation firm, to the region’s list of 50 fastest growing private companies.

UT Physicians, the 900-provider faculty practice for The University of Texas Health Science Center at Houston, expands its agreement with McKesson’s Revenue Management Solutions to include coding for the anesthesia and radiology departments.

The median compensation for practice managers remained relatively flat from 2009-2010, according to MGMA. Administrators in practices with six or fewer FTE physicians earned median compensation of $86,459, a slight decrease from 2009. Median compensation for administrators in seven- to 25-physician groups earned an average of  $115,000, which is 0.28% increase from 2009.  Large group administrators earned an average of $150,756.

E-mail Inga.

News 7/21/11

Beacon Partners announces the expansion of its Allscripts service lines to include consulting for Allscripts MyWay, Professional EHR, Enterprise EHR, and Practice Management.

The Reading Hospital (PA) selects PivotHealth to provide physician practice management services for its affiliated physicians. The hospital also names Gregory Lutz executive director of The Reading Hospital Medical Group. Interestingly, Lutz was most recently was a SVP with PivotHealth.

Cardio Pulmonary Diagnostic (NJ) and Hudson County Cardiovascular Care (NJ) contract for McKesson’s Practice Complete EHR and PM system.

AdvancedMD announces the release of its ONC ATCB-certified EHR 2011 solution that includes an enhanced patient portal, new Meaningful Use reporting tools, and utilities for submitting immunization and health surveillance data.

The seven provider Premier Medical Clinic (FL) chooses MedicsDocAssistant EHR from Advanced Data Systems.

For practices implementing EHRs, perhaps it’s mildly comforting to know the process is not any easier for physicians in Canada. The Canadian Medical Associates Journal (CMAJ) highlights some of the more common complaints from physicians adopting EMRs (most sound mighty familiar):

• Vendors give hard sales pitches and will try to sell items that aren’t necessarily required
• Software often comes with glitches
• Training is not always up to standard
• Practice administrators do not sufficiently involve physicians when selecting an EMR
• Government certification programs for EMRs don’t  address software usability or clinical needs
• Clinical data is not easily shared between systems.

The 13-physician Kootenai Imaging (ID) chooses McKesson Revenue Management Solutions, including preparation for ICD-10 coding changes and PQRI tracking.

DrChrono.com incorporates M*Modal’s Speech Understanding technology into its EHR application, making it the first medical speech-to-text functionality for the iPad. Check it out above.

Findings from an MGMA survey indicate that almost 70% of practices are in the process of becoming a patient-centered medical home and 20% are already accredited. The top challenges for PCMHs include establishing care coordination and modifying or adopting an EHR to support PCMH functions.

Surescripts recognizes Allscripts as one of seven Gold Solution Providers for e-Prescribing. Surescripts also awards e-MDs its White Coat of Quality.

The AMA introduces AMA Coding Online, a website that offers coding, billing, and compliance resources. Pricing for the tools range from $185 to $800 for a one-user, one-year subscription.

E-mail Inga.

Joel Diamond 7/19/11

Technology Reflections of the Past Decade

Ahhh, the dog days of summer. Hot afternoons followed by soothing evening breezes, with care-free children chasing fireflies.

The recent summer solstice sadly reminds me that 2011 is halfway gone, and I reflect on the past decade. So much has changed. The fear of Y2K was quickly overshadowed by 9/11. Technology seems to be no longer an accessory, but an intrinsic part of our day-to-day (rather, second-to-second) frenzied lives, deeply woven into our culture.

So with the first half of the first year of the second decade of the second millennium nearly over, let us look back on the incredible changes that have taken place in the past ten years—as well as the amazing transformation of physicians’ attitude towards information technology.

• Over the past decade, heart disease deaths have decreased dramatically by 40%. The routine use of cardiac stents and statin drugs have much to do with this.
• 10 years ago, cardiologist actually wrote illegible progress notes on paper. A decade later, the quality of ink in pens has markedly improved, making these records appear more vibrant and “easier to read.”

• The rise in information technology has shown a fascinating trend over the past 10 years. Some estimate that the use of CPOE has approached the remarkable 10% level.
• A decade ago, most physicians obtained pornography by looking in magazines or renting VCRs. This has vastly disappeared today, as doctor compliance with Internet pornography approaches 98%.

• Speaking of VCRs, the last 10 years has resulted in their eradication, much like dracunculiasis (also known as the Guinea worm.) Even the DVD has largely been replaced by newer technologies. The soon-starting medical student class of 2016 is completely unfamiliar with the phrase, “Programming my VCR is so difficult that only a brain surgeon could do it,”
• Despite loss of financial incentives and eventual penalties looming in 2016, the majority of neurosurgeons do not have current plans to adopt EMR technology. However, most report greater job satisfaction in 2011 despite long work hours since they seldom miss their favorite shows now that they can “TiVo them.”

• In 2011, a fascinated audience watched a computer named Watson successfully compete on the game show Jeopardy, reflecting a new era of Natural Language Processing and the prospect of vital data mining from spoken and written word. In parallel, health care analytics attained new heights as more discrete EMR data became available.
• While other industries have moved from a quaint vision of subservient secretaries “taking dictation,” doctors in 2011 have maintained this charming tradition with an unrelenting grip on their olde worlde “Dictaphone.” Some icons are worth holding onto in this gadget-crazed world of ours.

• In the year 2000, the Human Genome Project finalized the mapping of our entire DNA, leading to exciting advances in targeted gene therapy and personalized medicine.
• Today, 90% of doctors use Google Maps. Advances in Global Positioning Satellite technology have allowed many of these practitioners to use these digital maps to guide them through the complicated route from home to hospital. Interestingly, less than 1% of these clinicians report the similar use of handheld devices to routinely access vital patient data. By contrast, gene technology is beginning to see clinical benefits in 2011, although the wearing of jean shorts (or as couture designers refer to them, “jorts”) has been largely confined to clinicians in rural Kentucky.

As summer fades and days get shorter, don’t forget to raise a frosty mug to the next decade. Let’s hope that our industry, which is ranked lower in productivity than the US Post Office, will change its perspective and just try a little harder to keep pace with the rest of the world.

Joel Diamond, MD is chief medical officer at dbMotion, adjunct associate professor at the Department of Biomedical Informatics at the University of Pittsburgh, and a practicing physician at UPMC and of the Handelsman Family Practice in Pittsburgh, PA. He also blogs on interoperability.

News 7/19/11

Greenway Medical Technologies will raise up to $100 million in a planned IPO. The company’s financial performance has been improving: a $926,000 loss on $38.8 million in revenue in fiscal 2008; $955,000 net income on $48.7 million in revenue in 2009; and $2.9 million net income on $64.6 million in revenue in 2010.

Speaking of Greenway, despite sporting a Greenway logo on his shirt, PGA golfer Jason Dufner failed to make the cut  following the second round of the British Open.

A reader forwarded me a copy of the results of AAFP’s 2011 EHR User Satisfaction survey, which includes the opinions of 2,719 family physicians. AAFP is careful to point out the limitations of the survey (it did not consider software release levels, participants were self-selected, sample sizes were small for some products) and notes that its goal was not to identify “winners.” Still, there are a few interesting nuggets to consider:

• The highest overall levels of satisfaction came from users of MEDENT, Amazing Charts, e-MDs, Praxis, and EpicCare Ambulatory.
• The lowest satisfaction ratings came from users of MediNotes (formerly Charting Plus), Misys EMR, Horizon Ambulatory Care, and Medinformatix.
• Praxis, Practice Fusion, and Amazing Charts had the highest scores for training and support; MediNotes, MPM, and Misys EMR had the lowest.
• EHR vendor support was the area in which users were least satisfied.
• About 14% of the respondents had switched EHR systems at least once because of system dissatisfaction.

Holy Name Medical Center (NJ) will offer Aprima EHR, PM, and RCM software to its 800 hospital-affiliated physicians.

The British Medical Association recommends that healthcare professionals and medical students “politely refuse” Facebook friend requests from patients. The AMA, by the way does not explicitly recommend refusing social networking requests from patients, but advises physicians to maintain boundaries “appropriate” for the patient-physician relationship.

Phil Suiter, the new president and CEO of EMR vendor digiChart, says he was hired to perform a “strategic repositioning” of the company. The Nashville Medical News profiles Suiter, who has founded or led multiple healthcare businesses over the years. He notes that digiChart’s revenue has been stuck at the $10 million level for some time. The company is now rolling out PracticeSmart, a combined EHR/PM solution, and will continue its focus on the OB/GYN market. With the industry consolidation trend, Suiter is no doubt positioning the company for potential acquisition:

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