News 10/15/18

Top News

HealthRight President Scott Roix pleads guilty to felony conspiracy charges related to a telemedicine scheme that bilked payers like Blue Cross Blue Shield of Tennessee out of nearly $1 billion. The three year-long crime involved HealthRight filing fraudulent claims for incorrectly prescribed pain creams and related products that it illegally marked up. Four other people – each associated with a compounding pharmacy – have also been charged. 

Webinars

October 30 (Tuesday) 2:00 ET. “How One Pediatric CIN Aligned Culture, Technology and the Community to Transform Care.” Presenters: Lisa Henderson, executive director, Dayton Children’s Health Partners; Shehzad Saeed, MD, associate chief medical officer, Dayton Children’s Health Partners; Mason Beard, solutions strategy leader, Philips PHM; Gabe Orthous, value-based care consultant, Himformatics. Sponsor: Philips PHM. Dayton Children’s Health Partners, a pediatric clinically integrated network, will describe how it aligned its internal culture, technology partners, and the community around its goal of streamlining care delivery and improving outcomes. Presenters will describe how it recruited network members, negotiated value-based contracts, and implemented a data-driven care management process.

Previous webinars are on our YouTube channel. Contact Lorre for information.

Announcements and Implementations

Greater Houston Healthconnect goes live on PrognoCIS healthcare technology from Bizmatics. The HIE services providers in 24 counties across Southeast Texas.

Therap adds a health-tracking dashboard to its EHR for providers of community-based services, and intellectual and developmental disability service organizations.

People

The AAFP elects associate professor of family medicine and East Dayton Health Clinic (OH) staff physician Gary LeRoy, MD president-elect.

Lygeia Ricciardi (Clear Voice Consulting) joins digital health startup Carium as chief transformation officer.

Government and Politics

The City of South Bend, Indiana signs a three-year contract with Michiana Health Information Network to develop a database of homes at risk of lead exposure and a system that will alert physicians about at-risk patients. Local physicians believe the arrangement is a step in the right direction given that only 8 percent of the city’s children have received lead screenings in the last 15 years, but worry that not enough resources are going towards follow-up care for lead exposure.

Submissions are due today for ONC’s Easy EHR Issue Reporting Challenge. First announced in late May, the contest hopes to showcase entries that demonstrate easy ways to report usability problems to IT departments, vendors, and patient safety organizations. Up to $80,000 in prizes are available.

Other

A 13-month workplace study on the health effects of treadmill workstations versus sit-stand desks finds that the treadmills helped to improve the overall health of overweight users, but didn’t do much for those who were already fit. One commentator called the study “costly,” which makes me question how worthwhile it is to spend money on that type of attempt to improve health and boost productivity.

The trend of on-demand medical office space strengthens with the launch of Alma Health, a New York City-based startup that offers therapists access to stylish, co-working space for sessions. Patients are afforded well-appointed waiting rooms designed to heighten privacy. The company was founded by former Oscar Insurance VP Harry Ritter, MD.

This is a dangerous idea: Basis launches to offer patients a cheaper alternative to therapy with licensed professionals. For $35, patients sit and chat virtually with an unlicensed “specialist” for 45 minutes. The company requires its specialists to have 15 hours of online training. It does not require them to have experience in healthcare or psychology. I’m saddened by the fact that investors have already poured over $3 million into this phone-a-friend company, which is perpetuating the idea that cheap and convenient equal effective.

Delaware Public Media highlights the value-based care success Southern Delaware Medical Group and other area practices have had with ACO management company Aledade. The company’s services, which include in-person and digital resources, have helped several Delaware-based practices reduce hospitalizations by 13 percent, save Medicare over $5.5 million dollars, and earn a quality score of 96 percent. Providers like Beshara Helou, MD of Georgetown Medical Associates point out that value-based care success comes with a cost: “From a financial point in the beginning, it was not a very good investment—I’ll tell you that. It was a big learning curve. For the first six months in 2014 everybody was just volunteering their time and effort and energy.” Helou finally saw an ROI in 2017. “It’s not about the money,” he adds. “It’s about the quality of care, but you want to be rewarded for doing a good job.”

Sponsor Updates

• Intelligent Medical Objects chairman, chief innovator, and co-founder Frank Naeymi-Rad, PhD, MS, MBA will be inducted into the American College of Medical Informatics at AMIA’s annual symposium in San Francisco November 3-7.
• Nordic will exhibit at the Georgia HIMSS Annual Conference October 16 in Atlanta.

Blog Posts

• Celebrating Health IT, Industry Collaboration and EHR Optimization (Medicomp Systems)
• Expanding Access to Quality Home Healthcare Through Mobile Innovation (NVoq)

Contacts

Jenn, Mr. H, Lorre

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News 10/10/18

Top News

CVS Health receives DoJ clearance to proceed with its $69 billion acquisition of Aetna, which will operate as a standalone business once the deal closes at the end of Q4. The arrangement is contingent on Aetna selling off its Medicare Part D business.

CVS Health President and CEO Larry Merlo says the companies will have the combined capabilities in “technology, data, and analytics to develop new ways to engage patients in their total health and wellness. Our focus will be at the local and community level, taking advantage of our thousands of locations and touch points throughout the country to intervene with consumers to help predict and prevent potential health problems before they occur.”

Aetna CEO Mark Bertolini told Fortune earlier this year that, “The insurance company isn’t going to be about making money anymore. It’s [going to be] about facilitating the financing of affordable and convenient care,” pointing out that CVS has 10,000 stores within five miles of 80 percent of US consumers. Bertolini will resign once the deal is done and then join CVS Health’s Board of Directors. Aetna President Karen Lynch will take over his executive role and become a CVS EVP.

Webinars

October 30 (Tuesday) 2:00 ET. “How One Pediatric CIN Aligned Culture, Technology and the Community to Transform Care.” Presenters: Lisa Henderson, executive director, Dayton Children’s Health Partners; Shehzad Saeed, MD, associate chief medical officer, Dayton Children’s Health Partners; Mason Beard, solutions strategy leader, Philips PHM; Gabe Orthous, value-based care consultant, Himformatics. Sponsor: Philips PHM. Dayton Children’s Health Partners, a pediatric clinically integrated network, will describe how it aligned its internal culture, technology partners, and the community around its goal of streamlining care delivery and improving outcomes. Presenters will describe how it recruited network members, negotiated value-based contracts, and implemented a data-driven care management process.

Previous webinars are on our YouTube channel. Contact Lorre for information.

Announcements and Implementations

Houston MRI & Diagnostic Imaging selects ERAD’s RIS and PACS software including patient and physician portals.

Acquisitions, Funding, Business, and Stock

AMA’s business development and commercialization company Health2047 launches its second venture, First Mile Care, which aims to support pre-diabetic patients through health coaching and related resources. FMC founder and CEO Karl Ronn comes to the company from P&G.

Telemedicine

CVS Health’s MinuteClinic rolls out Teladoc-powered Video Visits in Kentucky. Now offered in 16 states, the retail clinic’s telemedicine service will be made available nationwide by the end of the year.

Other

Beth Friedman of Agency Ten22 was kind enough to send over her physician practice-related insights from AHIMA, which took place late last month in Miami Beach:

Protecting patient information across all settings of care and business operations was consistently emphasized as fundamental to ensuring patient trust. Attendees were encouraged to align privacy, security, and data management best practices. Lessons learned from organizations experiencing cyberattacks drove home the need to:

• Maintain backups of PHI.
• Secure systems and protect data.
• Never underestimate the malicious nature of cybersecurity attacks.
• Assess your business associates or outsource this task to a third party.

In sessions covering security certifications and frameworks like NIST, HITRUST and GDPR, HIM professionals — in conjunction with their IT counterparts — can play an important role in helping practices promote stronger privacy, security, and data governance. Their expertise should not be underestimated or ignored. Project management and denial management are two additional technology areas where HIM experts can lend a helping hand.

Providers were encouraged to use IT systems as a first line of defense against payer denials. Intersect Healthcare CEO Brian McGraw suggested the following strategies in his session:

• Track your practice’s top encounters and diagnoses denied.
• Educate staff on clinical documentation and coding guidelines for common denials.
• Upload knowledge into your IT systems for easy access and denial disputes.
• Know payer rules, include them in your IT systems, and build awareness across all staff.
• Move toward payer collaboration and conduct clinical conversations about denials.

According to McGraw, “Providers should adopt a proactive approach to pursue every avenue under their contract.” Another practical tactic for physician practices to consider is the use of HIM professionals for IT and centralization projects.

Coding focus is shifting to a long-term, holistic view of the patient versus individual office or hospital encounters. Chronic care management programs are part of that shift. For physician practices setting up a CCM program, the first few steps are most important. TrustHCS Director of Coding Quality and Professional Development Nena Scott provided four takeaways for CCM success:

• Take your time during initial program setup to achieve better patient outcomes
• Focus on managing chronic conditions so they don’t reoccur
• Work to avoid hospital readmissions—acute exacerbations of chronic disease
• Strengthen communication and patient management between hospital, physician and post-acute care providers—nurses, physician assistants, care managers, etc.

Sponsor Updates

• AdvancedMD will exhibit at the American Society of Dermatologic Surgeons Annual Meeting October 11-14 in Phoenix, AZ.
• Aprima will exhibit at the AAFP Annual Meeting October 10-12 in New Orleans.

Contacts

Jenn, Mr. H, Lorre

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From the PRM Pro 10/10/18

What does HIPAA Mean for the Future of Patient Relationship Management?
By Jim Higgins

Jim Higgins is the CEO and founder of Solutionreach in Lehi, UT.

Technology that was the stuff of science fiction just 50 years ago has now become commonplace. Nowhere is this more evident than in healthcare. From mobile communication to wearable devices to remote visits to AI-directed care, technology is rapidly evolving to meet the needs of a consumer-oriented patient base. As Tom Martin, director of healthcare information systems at HIMSS, put it, "The healthcare ecosystem is increasingly converging on patient-centric technology solutions. The role of the provider is to expand far beyond the walls of the exam room, especially as our healthcare system transitions towards value-based purchasing.”

Effective patient relationship management is defined by its ability to create meaningful connections with patients. This ensures that patients will not only return, but also refer friends and family to their provider’s practice. Implementing new technology is a big part of that — and has been shown to have significant benefits for practices. Beyond a jump in patient satisfaction and loyalty, medical facilities that take advantage of new health technology are more profitable, efficient, and productive. The future of strong patient relationships lies in the adoption and integration of a variety of different technologies.

Preparing for the Future

Whether we are ready or not, these technological advancements are here to stay. While exciting, they have also left many scrambling to understand how to take advantage of their benefits while staying compliant with regulations like HIPAA. By preparing now, you can better ensure a smooth transition when your practice does adopt PRM technology. One key to being ready is to stay abreast of the latest technologies and assess which might eventually be a good fit for your particular specialty and individual practice.

To get you started, here are just few examples of cutting-edge technology currently being used by medical facilities to improve patient relationships.

Chatbots

In 2017, UCLA unveiled their Virtual Interventional Radiologist. Using the power of artificial intelligence, they have created a virtual radiologist in the form of a chatbot. The VIR is able to quickly provide evidence-based answers to frequently asked medical questions. Chatbots are also being considered for use in triage, research, patient engagement, and care coordination.

Robotic Care

In February 2018, Humber River Hospital introduced Pepper, their four-foot-tall, humanoid robot. The robot is used to interact and engage with patients and visitors at the reception desk. A second Pepper robot is programmed to work specifically as a part of the hospital’s Child Life Program. In Japan, robots are doing even more. Terapio the Robot makes hospital rounds, delivers medications, and retrieves records. The use of robots in healthcare is expected to explode in coming years. In fact, in anticipation of the predicted nurse shortage, the National Science Foundation has allocated $1 million to the development of robotic nurses.

Virtual Care and MHealth

Another recent addition to the healthcare world — virtual care — is already upon us. In 2018, one in four US adults received some kind of virtual care, and there are four times more who say they would like to give it a try. Nearly half would select an immediate virtual appointment over a delayed in-person one.

Virtual access to health information and communication has also soared. The use of mobile health apps has tripled since 2014, and wearable health monitor use has quadrupled. And the vast majority of users say they’re interested in sharing that health data with their provider. Add to that the widespread use of patient texting and email use, and it’s easy to see why around 76 percent of practices say they use mobile health on a regular basis — with the main use being communication.

Organizations are Working Towards Compliance

These PRM advances bring up a lot of questions about compliance. Fortunately, many organizations are working to find solutions now — before the technologies have completely taken off. One popular idea is implementing the use of biometric data (like fingerprints, heartbeat, or even brain waves) to verify identity before sending sensitive information remotely. In addition, vendors like Fitbit, Samsung, and Apple are all working to create HIPAA-compliant options for healthcare organizations. And just this year, the AMA set new standards for the physician use of AI.

However, you cannot solely rely on outside organizations to do all of the legwork. To be ready for the future, you should start considering what you can do now to make the transition to more high-tech PRM solutions easier. Begin by creating a model of your current patient experience and identify where it would make sense to someday implement these new technologies. Once you’ve identified your anticipated additions, consider how they would be impacted by HIPAA. That way, when that technology becomes more widely available, its implementation will be much easier and more secure.

HIPAA Review Best Practices

Here are a few compliance best practices for the future of healthcare PRM technology … as well as for today:

Regular Security Risk Assessments – It’s easy to become complacent about security, but cyber-attacks get more sophisticated every day. Make sure to institute regular security risk assessments, including IT-specific assessments. Getting into the habit of conducting quarterly risk analyses (not just yearly) will keep security top of mind as you move into the future.

Thorough Vetting of Vendors – Taking a hard look at the vendors you work with is critical — especially as patients demand the latest tech. Choose carefully. Do your research before signing on — look at each individual component of a new technology to ensure it is not vulnerable to attacks. Consider having a specialist on standby for instances when you are unsure about the security of a particular technology.

Up-to-Date Business Associate Agreements – It is very important that you require all vendors to follow proper security protocols to reduce compliance risks. These agreements should clearly outline the vendor’s responsibility and compliance protocols.

Employee Training – One of the most common causes of HIPAA breaches is employee behavior. Make sure that every person who may come in contact with Protected Health Information (PHI), from your cleaning crew to your executives, is trained on HIPAA compliance on a regular basis. You can never do too much training.

Technological advances are coming to your PRM and it’s up to each individual practice to be prepared. As you take the time to review new technologies and actively pursue regular HIPAA compliance activities, you will be prepared to meet the future head-on.

Contacts

Jenn, Mr. H, Lorre

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News 10/8/18

Top News

EClinicalWorks makes several announcements at its annual user conference:

• Palmer College of Chiropractic Clinics implement its EHR.
• CMS approves its integration with the Blue Button 2.0 API, giving patients easier access to their health data through the Consumer-Directed Exchange.
• The company adds search engine functionality to its EHR, enabling physicians to pull health data from digital access points supported by CommonWell, Carequality, and Blue Button.

HIStalk Practice Announcements and Requests

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Webinars

October 30 (Tuesday) 2:00 ET. “How One Pediatric CIN Aligned Culture, Technology and the Community to Transform Care.” Presenters: Lisa Henderson, executive director, Dayton Children’s Health Partners; Shehzad Saeed, MD, associate chief medical officer, Dayton Children’s Health Partners; Mason Beard, solutions strategy leader, Philips PHM; Gabe Orthous, value-based care consultant, Himformatics. Sponsor: Philips PHM. Dayton Children’s Health Partners, a pediatric clinically integrated network, will describe how it aligned its internal culture, technology partners, and the community around its goal of streamlining care delivery and improving outcomes. Presenters will describe how it recruited network members, negotiated value-based contracts, and implemented a data-driven care management process.

Previous webinars are on our YouTube channel. Contact Lorre for information.

Announcements and Implementations

Arizona Arthritis & Rheumatology Associates selects TSI Healthcare to help implement and manage its NextGen EHR and practice management software across eight locations.

New York-based HIEs HealtheConnections and HealthlinkNY partner to expand their combined services to 43 percent of the state, including 7,518 physicians in 24 counties.

Child Guidance Center implements TenEleven Group’s EHR to enhance its behavioral health services for families in Jacksonville, FL.

Los Alamitos Orthopaedic Medical & Surgical Group (CA) deploys email encryption services from Identillect Technologies.

Telemedicine

PlushCare expands its direct-to-consumer telemedicine services to all 50 states.

Research and Innovation

Physicians are eagerly awaiting virtual assistant tools that can help improve dictation, documentation, communication with staff, and responding to patient questions, according to a survey on patient engagement technology. Results also indicate that, in the nearer term, physicians are actively looking at purchasing interactive touchscreens or tablets to digitize their exam rooms – features they believe improve their interactions with patients.

Other

The Washington Post looks at the generational shift in the time-honored tradition of retaining a primary care doc. Younger patients prefer quicker alternatives like urgent and retail care clinics and telemedicine to waiting weeks to see a brick-and-mortar PCP. A patient’s propensity to have a PCP on hand increases with age, according to a Kaiser Family Foundation study mentioned in the article. To keep up with Millenial expectations of instant accessibility, smaller practices like that run by family physician Mott Blair, MD in rural North Carolina have taken to increasing same-day appointments and digital messaging.

Sponsor Updates

• Frost & Sullivan honors Medicomp Systems with the EHR Optimization Technology Leadership Award for its Quippe suite of solutions.
• Healthwise will exhibit at the Cerner Health Conference October 8-11 in Kansas City, MO.
• EClinicalWorks will exhibit at the AAFP Family Medicine Experience October 10-12 in New Orleans.

Contacts

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News 10/3/18

Top News

A California law goes into effect requiring physicians to check the Controlled Substance Utilization Review and Evaluation System (CURES) before writing prescriptions for controlled substances. The idea for the database, which physicians had previously been accessing voluntarily, came from Bob Pack after his two children were killed by an opioid-addicted driver who had obtained prescriptions from six different doctors at the same hospital.

Webinars

October 30 (Tuesday) 2:00 ET. “How one pediatric CIN aligned culture, technology and the community to transform care.” Presenters: Lisa Henderson, executive director, Dayton Children’s Health Partners; Shehzad Saeed, MD, associate chief medical officer, Dayton Children’s Health Partners; Mason Beard, solutions strategy leader, Philips PHM; Gabe Orthous, value-based care consultant, Himformatics. Dayton Children’s Health Partners, a pediatric clinically integrated network, will describe how it aligned its internal culture, technology partners, and the community around its goal of streamlining care delivery and improving outcomes. Presenters will describe how it recruited network members, negotiated value-based contracts, and implemented a data-driven care management process.

Previous webinars are on our YouTube channel. Contact Lorre for information.

Acquisitions, Funding, Business, and Stock

EWellness Healthcare CEO Darwin Fogt sells off his Evolution Physical Therapy clinics to “focus on becoming the industry thought leader in the new realm of digital telehealth physical therapy.” While thought leadership might inadvertently help pay the bills, I presume his goal is to focus solely on the company’s virtual rehab technology for employees, which offers patients app-based recovery exercises, virtual consults with physical therapists, wearables integration, and nutritional and wellness programs.

Post-acute care technology vendor Optima Healthcare Solutions expands its software and services for outpatient clinics with the acquisition of Vantage Clinical Solutions, which offers RCM and digital marketing and consulting services to physical therapy practices.

Announcements and Implementations

Orthopedic Associates of Dutchess County (NY) implements Compulink’s Orthopaedic Advantage EHR and practice management technology.

DocuTap integrates InstaMed’s Auto Payment Collect tool with its EHR and practice management software for urgent care clinics.

CareCloud updates its Breeze patient engagement and physician review software to include mobile patient feedback surveys, deeper integration with social media and physician review websites, and dashboards that deliver real-time insight into a patient’s care experience.

App-based house call provider Heal joins Apple’s Health Record ecosystem, giving patients the ability to share their phone-based medical records with its OnCall app.

HRSA contracts with AAFP for use of its Uniform Data System Mapping and Data Analysis Services, which helps users pinpoint neighborhoods in need of additional healthcare services.

Research and Innovation

Researchers find that smaller, hospital-owned practices in wealthier neighborhoods have been more apt to participate in the Comprehensive Primary Care Plus program, a model of healthcare delivery that offers performance-based incentives and prospective care management payments. Non-participating practices in CPC+ areas were found to serve less affluent and educated patients, many who are Medicare and/or Medicaid beneficiaries, and who were admitted to the hospital more often for avoidable reasons. Researchers believe the program’s parameters should be adjusted so that resource-strapped practices that serve vulnerable populations can keep up with the transformation activities the program’s model requires.

Other

This is an interesting trend: In an effort to make it easier for physicians to operate small practices on their terms, R2 Medical Group offers scalable (almost on-demand) medical office space for rent that includes support staff if needed. Physicians can opt to utilize the space based on hourly rates. WeShareMD has opened a similar business on the West Coast.

Sponsor Updates

• Nordic wins a work-life balance award based on anonymous employee submissions in the large-employer category.
• AdvancedMD will host its annual user conference, Evo18, October 3-5 in Salt Lake City.
• Aprima will exhibit at AAFP’s annual meeting October 10-12 in New Orleans.
• Culbert Healthcare Solutions will exhibit at the Cerner Health Conference October 8-12 in Kansas City, MO.

Contacts

Jenn, Mr. H, Lorre

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