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News 8/22/17

August 22, 2017 News Comments Off on News 8/22/17

Top News

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On his way to China, HHS Secretary Tom Price, MD tours several tribal health facilities in Alaska to better understand the successes and challenges involved in delivering care to Alaska Natives. Price lauded the delivery model of the Southcentral Foundation, which provides integrated primary and mental health care on one campus via a unique model that sees providers moving from patient to patient, rather than the other way around. The region’s remote terrain prompted discussion of the struggles many patients find in accessing care. Telemedicine – and the money necessary to implement it and offer reimbursement for it – must have surely come up. Alaska is no stranger to the promise of virtual visits. It has passed telemedicine-friendly legislation over the last several years, and is home to the National Telehealth Technology Assessment Resource Center. Housed within the Alaska Native Tribal Health Consortium, the center is one of several set up across the country to help local providers understand and implement telemedicine services.


HIStalk Practice Musings

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The nearly two-and-a-half minutes of eclipse totality I experienced yesterday were indeed amazing. I traveled a bit further north than originally planned, owing to a friend who extended an invite to hunker down the night before at a cabin in North Georgia. Watching a crescent sun transform into what for me will likely be a once-in-a-lifetime total solar eclipse experience was breathtaking. I enjoyed experiencing it with other people in a public viewing area. That the area was on the shores of Lake Chatuge, on a nearly cloudless day, made it even more memorable. Other than the extra 20 minutes of traffic I faced driving home, my only regret is not snagging a commemorative T-shirt.


Webinars

September 13 (Wednesday) 1:30 ET. “How Data Democratization Drives Enterprise-wide Clinical Process Improvement.” Sponsored by: LogicStream Health. Presenter: Katy Jones, program director of clinical support, Providence Health & Services. Providence is demonstrating positive measurable results in quality, outcomes, and efficiency by implementing clinical process improvement solutions in arming operational and clinical stakeholders with unlocked EHR data. Providence’s army of process engineers use their self-service access to answer questions immediately instead of waiting for reports to be written and double checked for possibly inaccurate information. The presenter will describe practical applications that include antibiotic stewardship, hospital-acquired infections, and comprehensive knowledge management.

Check out Vince and Frank’s brutally honest presentation on “Allscripts’ ‘Repeal and Replace’ of McKesson’s EIS.” It’s been viewed nearly 500 times since we posted it late last week.


Announcements and Implementations

Allscripts launches eParticipate, a service that enables eligible providers to conduct clinical research trials within their own four walls through a partnership with Elligo Health Research. Professional, TouchWorks, and Sunrise EHR customers will have access to trials in the areas of gastroenterology, neurology, pain, urology, pulmonology, and women’s health.

Higi will combine health screening data from its retail health kiosks with clinical, claims, and genomic data synchronized by Interpreta to give providers and payers deeper insight as they move forward with patient care plans.


Acquisitions, Funding, Business, and Stock

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SilverVue looks to expand beyond the world of post-acute care search technology with the acquisition of Ergo Sum Health. The Sandy, UT-based company has rebranded ESH’s MACRA software, consulting, and compliance services as Check. Terms of the deal were not disclosed.


People

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David Schloss (Caladrius Biosciences) joins Teladoc in the new role of chief human resources officer.

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Pivot Point Consulting hires Zack Tisch (Nordic) to take on the role of consulting services executive.


Government and Politics

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The Washington Health Benefit Exchange selects San Francisco-based BetterDoctor to collect and verify provider data listed on its Healthplanfinder insurance marketplace, which will launch with a new look and easer to use interface when open enrollment kicks off this November.


Telemedicine

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The CDC approves Fruit Street Health to offer its Diabetes Prevention Program to patients via group video calls with registered dieticians. Fruit Street will also issue DPP participants Fitbits, wireless scales, and an accompanying app to help users share and track their progress.

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Daniel McDyer, MD offers EpicMD’s telemedicine services to his patients at Florida Woman Care of Jacksonville (FL).


Other

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The Institute for Women’s Health (TX) notifies patients of a keylogger virus that was installed June 5, discovered July 6 and removed July 11. The virus apparently tracks and records every click made within a computer system, potentially giving hackers access to passwords, financial information, health data, and other personal details. IWH is jumping through all of the necessary hoops – reporting the incident to HHS, offering identity theft protection services, etc. All this despite the fact that the practice had installed network filtering and security monitoring, firewalls, antivirus software, and password protection before the virus hit.     


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Jenn, Mr. H, Lorre

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5 Questions With Mark Lewinsohn, Vice President of Clinical Services, LifeWorks NW

August 20, 2017 5 Questions With Comments Off on 5 Questions With Mark Lewinsohn, Vice President of Clinical Services, LifeWorks NW

Mark Lewinsohn is vice president of clinical services at LifeWorks NW, a behavioral health and addiction treatment nonprofit with 15 locations in and around Portland, OR. The organization recently implemented population health management technology from Enli Health Intelligence to better enable its participation in the federal Certified Community Behavioral Health Clinics demonstration project.

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How has LifeWorks NW used healthcare technology in the past to serve its patients? How have you seen health IT improve access to services and treatment outcomes?

LifeWorks NW was an early adopter of the EHR. Implementing electronic records allowed us to build the infrastructure to monitor and track client and service data, and to then support a data decision-making system. Thus, we already had the foundation in place to move forward with the population health solution to address issues that impact a consumer’s outcome (no show, engagement, access to treatment, etc.)

Health IT enables us to use data to determine the root causes of barriers to accessing care, which is critical to improving outcomes. For instance, with such insight we may discover we are not offering enough new patient times or scheduling at times/days that are not desirable. In addition, we can readily identify strategies to engage clients who may be missing appointments or who are disconnected from our services.

What prompted you to begin looking at population health management solutions?

LifeWorks NW has been a pioneer in integrating mental health and primary care. We have had mental health staff embedded in primary care clinics for more than a decade. That integrated care model has proven successful, so now we are focusing on reverse engineering integration: Through a better understanding of an individual’s overall physical health, we will have improved insight into how it may be impacted by their behavioral health condition or vice versa. We know that people with serious mental illness do not access preventative care and have a shorter lifespan than those without. We want to impact
that statistic. Plus, our involvement in the national demonstration project for Certified Community Behavioral Health Clinics has provided additional resources and requirements for increasing our tracking of health metrics and improving coordination of care with primary care providers.

What impact will Enli’s technology have on your participation in the CCBHC demonstration project?

We hope to develop specific protocols that look at the whole health of the individual rather than the siloed approach historically taken in healthcare. Enli will allow LifeWorks NW to efficiently track clients who are receiving CCBHC services and identify those with high health risks due to their chronic medical condition(s). In line with the CCBHC model, we can then more readily identify how their co-morbid condition impacts both physical and mental wellbeing. In addition, through data automation, staff will be able to devote more time to client support because they no longer have to manually track information or look through charts to figure out which clients need outreach/support.

What advice do you have for other behavioral health organizations looking to implement population health management technology?

Population health is new to behavioral health providers. We had a good foundation through our EHR system, and were able to build on that as we moved to implement technology for population health management. To ensure that effort is successful, we believe it is critical to find a partner, like Enli, that has a solid foundation, but is nimble and willing to blaze a new trail and work together to learn what will result for the best outcomes and achieved objectives.

Is LifeWorks NW looking at other types of health IT? What’s on your wish list?

In sum, yes! We believe that there is so much opportunity to make a positive impact on client outcomes and improve community health. We are currently exploring a host of solutions that will improve care coordination between behavioral health and other healthcare and non-healthcare entities. We really see the value of – and great need for – HIEs that will be the pipeline for mobilization of information across our region. That kind of technology will greatly enhance our ability to support the people we serve – and the larger community – with more effective care and treatment.


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Readers Write: The Promise (and Pitfalls) of Greater Consumer Expectations

August 20, 2017 Guest articles Comments Off on Readers Write: The Promise (and Pitfalls) of Greater Consumer Expectations

The Promise (and Pitfalls) of Greater Consumer Expectations
By Anne Weiler

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Consumer expectations are finally hitting healthcare. We’ve long become accustomed to having anything we want delivered to our homes at any time, in minutes. This level of 24/7 convenience is driving an expectation that all service delivery should be that good. And healthcare is no exception in the eyes of increasingly cost-conscious consumers. After all, rising deductibles, premiums, and copays are causing people to examine where they spend their healthcare dollars, leading them to evaluate care based on outcomes, convenience, and overall experience. We first saw indications of this on highway billboards advertising emergency room wait-times. It’s now spilling over into other areas of healthcare, like concierge medicine and direct primary care, both business models that give patients almost unlimited access to their care team. Healthcare technology is certainly aiding and abetting these expectations, with telemedicine perhaps offering the most promise in meeting expectations around convenience and up-front costs.

Virtual assistants and interactive mobile treatment plans also show huge promise. But for these burgeoning healthcare concepts to take off, their popularity with patients and physicians alike hinges on some basic tenets. First, patients need to feel supported and confident. Once they do, they can start to self-manage outside the clinic. The old way of delivering care instruction – be it verbally or on paper – is seriously lacking in providing this support and confidence. Patients forget between 40 and 80 percent of what is said to them in a face-to-face visit, while paper instructions are often lost. Virtual assistants and apps are always available, and can deliver tailored information when and how patients need it. They can alert both the patient and care team when something requires greater attention. This ability to provide actionable, personalized, and real-time care shows great promise in improving patient experience and outcomes.

However, the challenge in creating this always-connected world of healthcare – whether that’s through consumer health apps, wearables, or even those apps prescribed by healthcare organizations – is that they generate more data than physicians know what to do with. Though this data can provide extremely valuable insights to manage populations, there’s often no place for it in the medical record, which is not designed for patient-generated data.

Data without context is meaningless, which is why physicians initially balked about having device data in the EHR. While understanding how much a healthy person is active is interesting, you don’t need Fitbit data for that when there are other clinical indicators like BMI and resting heart rate. Understanding how much someone recovering from knee surgery is walking is interesting, but only if you understand other things about that person’s situation and care, such as how much they walked before surgery, pain levels, and side effects.

However, if you ignore the patient experience outside the clinic, decisions are being made with only some of the data. In Kleiner-Perkin’s State of the Internet Report, Mary Meeker estimates that the EHR collects a mere 26 data points per year on each patient. That’s not enough to make decisions about a single patient, let alone expect that AI will auto-magically find insights from aggregated information.

How do you marry this patient-generated data with current healthcare IT systems? The value of patient engagement and self-management through virtual assistants and applications is real. Current systems, however, aren’t designed for this data. To the patient, every single one of those Fitbit steps or recorded symptoms is interesting. To the physician, it’s noise. To make sense of these two worlds, we need a few things. First, we need to leverage machine-learning and big data tools to make sense of the terabytes being collected directly from patients. Next, we need to identify indicators of adverse events or negative trends. Then, we need to be able to react to and act on those indicators for patients, either with alerts and instructions delivered by an app, or by direct outreach from a clinician.

Finally, this data needs to make its way back into the patient’s medical record – but not all of it. Scores from patient-reported outcome surveys, important recorded symptoms, and trend data should be attached to the EHR. The rest should be available directly to the patient, and to clinicians and analysts to work with in BI and other tools. To make this new world a reality, patient engagement systems must be interoperable and open, and sit side-by-side with the EHR. There’s a whole world of data and learning out there to improve patient experiences and outcomes, but to capitalize on it, we need openness and interoperability.

Consumer expectations are indeed hitting healthcare – hard. Patients are no longer shy about telling physicians and payers what they want and how much they’re willing to pay for it. While these expectations can seem overwhelming to those insiders who have long become accustomed to healthcare’s glacial pace, we shouldn’t be discouraged. These greater expectations can indeed be met, provided we take the time to develop and offer physicians and patients tools that meet their needs and fit their workflows.

Anne Weiler is co-founder and CEO of Wellpepper in Seattle.


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News 8/17/17

August 17, 2017 News Comments Off on News 8/17/17

Top News

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Phil, a San Francisco-based prescription delivery service, raises $10 million in a Series A round of funding led by Crosslink Capital. Phil has developed technology that automates communication between patients, physicians, pharmacists, and payers to ensure timely deliver of medications and improve adherence. The company, which partnered with telemedicine vendor Lemonaid Health earlier this year, will use the investment to expand its pharmacy network and double its staff by 2018.


HIStalk Practice Musings

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Eclipse fever seems to be skyrocketing as everyone prepares for Monday’s event. Case in point: Supply of protective eyeglasses has dwindled, and prices have commensurately skyrocketed. Thankfully, I know a guy who knows a guy. Now, I just need to check and see if the manufacturer of the lenses I bought on the black market are indeed approved by the American Astronomical Society. (You can find their list of approved vendors here.) I’ll be venturing about an hour and a half from home in an attempt to immerse myself in the path of totality. I’ll be interested to see if I do indeed encounter the traffic nightmare many seem to think will occur. Hopefully the atmosphere of wherever I end up will be festive rather than frustrated. How will you view the eclipse in your area? Feel free to share your eclipse party plans in the comments below.


Webinars

None scheduled in the coming weeks. Previous webinars are on our YouTube channel. Contact Lorre for information on webinar services.


Announcements and Implementations

Rio Grande Valley Health Alliance (TX) goes live on care coordination, remote patient monitoring, and telemedicine software from Reliq Health Technologies across its ACO, which includes 15 independent primary care practices and 17 physicians.


Telemedicine

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A study of 195 Parkinson’s patients finds virtual consults to be just as effective as in-office visits with regard to quality of care, quality of life, caregiver burden, and patient and neurologist satisfaction. Fifty-five percent of patients preferred the virtual consults over office visits, likely due to the fact that, on average, they saved an average of 169 minutes and 100 miles of driving. The study’s authors note that the biggest barrier to offering telemedicine visits to Parkinson’s patients is a lack of Medicare reimbursement – a situation they hope will change as the telemedicine component of the 21st Century Cures Act evolves.

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Des Moines, IA-based Certintell receives the final installment of an $850,000 seed round of funding from Prairie Crest Capital. Founded and led by former Genentech sales and marketing rep Ben Lefever, the telemedicine company is focused on providing its services to FQHCs and other providers that care for Medicaid patients. It plans to next focus on developing a mobile app.


People

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The Strategic Health Information Exchange Collaborative hires Kelly Hoover Thompson (Pennsylvania Dept. of Health) as CEO.


Research and Innovation

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Aurora, IL, Madison, WI, and Grand Rapids, MI take the top spots in the latest Vitals Access to Pediatric Care report, which looked at pediatrician availability and patient-reported metrics like provider ratings, ease of getting an appointment, and wait times. Practices in the highest-ranking cities reported wait times of under 13 minutes, well below the national average of nearly 19 minutes. Bottom-performing cities (predominantly found in Texas and California) make their patients wait upwards of 30 minutes.


Other

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New Jersey Academy of Family Physicians President Peter Carrazzone, MD takes umbrage at the amount of blame being heaped on physicians’ shoulders for the opioid epidemic. In the local paper, he points to physician willingness to check the state’s PDMP, but a lack of follow-up when physicians report suspected “doctor shopping.” “You can download a form,” he says, “you fill it in, you send it to a faceless computer and time passes. You don’t know what’s happening. I really think there should be a more proactive support, maybe some sort of hotline where you could … have a direct person to talk to. Doctors in today’s world have layers and layers of protocols being added to our normal work, and it becomes a little overwhelming. The doctor is not the enemy here. It’s the patients that have addiction problems that are abusing the system.”

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The New York Times paints an interesting picture of the progress Aledade is helping independent physicians make in the areas of preventive care and hospital readmissions. Though the Bethesda, MD-based company, formed by former National Coordinator Farzad Mostashari, MD in 2014, prides itself on helping practices transform with technology, its software is “the least interesting thing it does.” It’s the way in which it helps practices implement and use that technology in unobtrusive and workflow-friendly ways that seems to really win the company customers (which as of late has also included payers interested in its ACO services). “We’re very comfortable in our model,” Mostashari says.


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Jenn, Mr. H, Lorre

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HIStalk Practice Interviews AMA President David Barbe, MD

August 17, 2017 Interviews Comments Off on HIStalk Practice Interviews AMA President David Barbe, MD

Family physician David Barbe, MD is president of the American Medical Association. After 15 years in independent practice, he merged his practice with the 650-physician Mercy health system in Springfield, MO, where he is now VP of regional operations.

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Tell me about yourself and the organization.

It’s really an exciting time to be president of the AMA with all that is going on in healthcare. The AMA is the largest and oldest national physician organization. We have over 220,000 members including students and residents – practicing physicians from all over the country in every specialty. It’s a way that we can bring the voice of physicians together so that we can, in fact, speak with one voice and articulate those issues that are most important for physicians and our patients.

You spent a good part of your early career as an independent physician before moving to hospital employment. How have you seen technology improve medicine? And on the flip side, how have you seen it take away from the art of medicine?

Once upon a time, when I first entered practice 34 years ago, everything was paper – prescriptions were paper and the chart was paper. Some physicians made pretty good paper charts and others didn’t. The EHR came into being really barely more than 10 years ago. I think most people think it’s been with us forever, but widespread adoption of the EHR is only about 10 years old. There were EHRs before that, but very few physicians in the country were using them. I think most of us looked at the EHR with great hope and anticipation. We understood the potential and the promise of the EHR, but for many physicians, and I would say even most physicians, the EHR has become a very significant source of frustration. It is the first or the second thing that physicians list when they talk about dissatisfaction with the way their practices are going and what stresses them.

While the EHR does continue to show promise, we are a long way from being in the perfect world with our EHRs. The AMA issued a white paper a couple of years ago. The authoring task force brought in practicing physicians from all over the country to talk about what it would take to make the EHR better. We came up with things that range from doing a better job of supporting team-based care to doing a better job of promoting care coordination. Reducing workload in terms of providing more effective decision support at the time of care, data liquidity, and interoperability continue to be a big problem. If a patient sees another physician and they’re on a different EHR than I am, that information just doesn’t transfer back and forth smoothly. We have a lot of opportunity for improvement.

The AMA believes that getting a practicing physician’s voice into that development and refinement process is critical. We work really hard with the vendors to try to encourage them to talk to practicing physicians to take to heart what we’re telling them about what does not work for us, and design that into the next update and next generation of the EHR.

Speaking of physician frustrations with EHRs, how do you plan on helping the AMA work to reduce physician burnout?

Most of the studies on this show that burnout comes from external factors. It’s things like the stresses of the EHR, workload and productivity, uncertainty regarding payment methods, the challenges of documenting and reporting the various quality metrics and Meaningful Use metrics that we are being asked now to report on. All of those things interfere with the doctor-patient relationship at some level. We did a study just last year that shows physicians spend twice as much time during their work day on the EHR and what I’ll call paperwork-related activities as they spend with their patients. The AMA has devoted a lot of resources to this. Physicians consider themselves evidence-based. The AMA has taken a lot of effort to gather information about what would really help.

We write that down into three big categories. One is, how do we change the external environment? How do we then give physicians tools to better cope with what we have to deal with? There’s still going to be that part of us that has to strive for more satisfaction, a better work-life balance, and adapting better to those external stressors. AMA has put together a suite of products called Steps Forward that contains 40 modules ranging from how to be more efficient at reauthorizing prescriptions to how to conduct a better meeting within your group practice, and everything in between. We have a lot of information in there about how to prepare your practice for quality reporting that has come down the pike under MACRA. It’s a broad suite of products.

We also want to change the practice environment. We want to reduce the burden, for instance, of prior authorizations. The AMA has put together a white paper with 21 recommendations of how the paperwork burden and a pre-authorization burden can be reduced and yet not compromise some of the things, if you will, that the insurance companies feel like they need to accomplish with their prior authorization forms. We have been successful. We’re seeing insurance companies discontinue requirements for prior authorizations in different markets. That will have a very meaningful improvement in a physician’s life. We found that it takes an average physician, or his or her staff, 16 hours a week to do prior authorizations. That’s two full work days for someone to do prior authorizations that add very little, if any, value to the care we give. In fact, they often delay care. Ninety percent of physicians said that care has been delayed due to the time it takes to process and get approval on a prior authorization.

The AMA also seems to focusing its resources on the opioid epidemic and educating physicians about best prescribing practices. What role do you see technology playing in stemming this tide?

We believe that the PDMP – a good, well-functioning PDMP – is critical to helping physicians help their patients through this very difficult issue of opioid misuse and what it often leads to, which is substance abuse. The good PDMPs, and I’ll define what I mean by that, they have clearly shown that they reduce prescribing. We see evidence of this in fewer overdoses and fewer deaths as opioid prescribing goes down.

Good PDMPs are products that have real-time information. If I see a patient on a given day and PDMP data is a month old, then I don’t know if they went to two other doctors over the course of that past month. It needs to be in near real-time. It needs to be easy to access as part of the physician’s natural workflow. If you have to get out of your EHR, log in to a PDMP, and go through several security steps – and all that takes five minutes to get there – that physician is just not going to use that. That is not an efficient use of their time even though when they get there, the information may be good. It needs to be a natural part of the workflow, easily incorporated and accessed through their EHR, and contain timely information. If you make it easy, physicians want this information. They know how important it is. We need to continue to work toward making each of these as easy as possible to use. That is a huge step.

In terms of other technologies, there are some that are developing out there that will help patients more closely regulate their own use. If I prescribe a bottle of 100 pills to a patient, I don’t know if they take them in one week or two weeks, or if it really lasted the whole month that it was intended to. There are dispensing systems out there in which the medication is dispensed out on a daily basis so that it makes it less possible for a patient to misuse the medication that they’re given. Things like that are also on the rise. I expect that some innovative physician developers will come up with other easy to use, effective apps that would help patients and physicians do a better job at monitoring and tracking medication use.

Let’s back up to PDMPs for just a second. Are there any states that you’ve heard of that are using them in really effective ways?

In terms of good examples, there is some sharing of information between state PDMPs, but quite honestly, these things often end up getting hung up in state legislatures. That slows down our ability to be nimble and to make rapid cycle improvements in PDMP effectiveness. That also requires state-to-state collaboration, the sharing of information across state lines. In my home state of Missouri, we have two large metropolitan areas that are right on the state line – St. Louis on the east and Kansas City on the west. If you live in Illinois and you come to Missouri to see a doctor, the doctor can’t access the Illinois PDMP; same thing on the other side of the state. Again, opening these up, making the information available across state lines, certainly in regional areas, would really be a giant step forward.

What are your thoughts on the black eye Missouri has created for itself in terms of standing up a statewide PDMP?

The fact that we haven’t been able to get a PDMP approved has been a real sore spot for physicians in the state. Again, sometimes the problem rests with the state legislature. That has been the case in Missouri. It demonstrates, however, how determined physicians and other governmental agencies are at getting this information into the hands of prescribers. You may be aware that in St. Louis, St. Louis County has actually developed a PDMP that they are willing to share with other counties around the state. That is really gaining traction as a workaround to a statewide PDMP. I think it will actually not only help us in this intermediate term, but will actually move the discussion at the state level forward in a more effective way.

Speaking of state legislation, how are you seeing the political climate in Washington affect AMA members? Are they heartened that HHS Secretary Tom Price, MD comes from a physician background? Happy that the ACA is still in place?

We always think it is important that a physician leads agencies like HHS and even CMS. We would prefer to see physicians in all of those roles, especially physicians that have had practice experience. Someone who has been in the trenches and understands what it’s like to work in an EHR, what the burden and the hassle of prior authorizations is like. A physician that has that background is in a better position to understand and address those problems. We hope the current administration will address regulatory relief, making it easier to practice medicine, taking less time away from our patients, and giving us more time for the highest and best use of a physician’s training. We do believe that the current administration is more interested in that. We have begun to see movement in that.

We also know that the Republican Congress seems to be a little more favorable toward regulatory relief. It was just a couple of weeks ago that I met with Chairman Brady of the House Ways and Means Committee to discuss regulatory relief and how could they change things to make it easier for physicians to do their job. I am cautiously optimistic that we are going to see improvement.

The other big area, of course, is health system reform and where we stand with regard to potential changes in the ACA. The AMA believes that significant gains were made under it, including Medicaid expansion, and insurance exchanges and subsidies to help patients with low and moderate incomes purchase insurance were very beneficial. We saw 20 million people get insurance that did not have it prior to the ACA. That is a good thing.

We also believe that there are some areas in which the ACA is falling short or not working. Affordability is one of those. Even with the subsidies, there are some low-income individuals that have difficulty affording coverage. The other thing is the high deductibles in some of those plans. If you’re low income, even if you’ve been able to afford the premium, you still may not really have access to care because of the high deductible.

The stabilization of the insurance markets also needs urgent attention. You may know that over a third of the counties in this country have only one offering in the insurance exchange. That’s really no choice at all if you value patient choice, which the AMA does. One insurance company is not choice. There are many counties that now have no offerings in the exchange. If we were to have this conversation six months ago, 97 out of 114 counties in Missouri had only one offering on the exchange. I’m sad to say that a couple of months ago, an insurance company pulled out of the Kansas City area and has left 24 Missouri counties now with no insurance offering. This action is by the insurance company. I’m not defending them. They have simply not found the insurance exchanges to be profitable. They have been losing money in many areas of the country.

In order to get the insurance companies back in, the AMA would like to see the cost sharing reduction program stabilized and effectively reinstituted so that insurance companies can offset some of the premium cost to low-income individuals. We’d also like to see a reinsurance-type program such that if insurance company losses are excessive, there is a reinsurance to limit their losses. It’s through those types of programs that we can entice some of the insurance companies back into these markets where there’s no offering in the exchanges. We believe that competition will actually help bring down premium prices, and certainly improve choice and availability for patients.

What health technology has you most excited in terms of its ability to help improve access and outcomes?

The AMA is very interested in what I’ll generically call telehealth. It’s often referred to as telemedicine, but I think it is much broader than that. It improves the ability to link physicians and patients in ways that we’ve not been able to do before. We now have the technology available to link up, let’s say, a specialist in an urban area or an academic center with patients in a more rural area. For me, in Missouri, that really makes a difference. In my day job as a physician executive with my health system, I oversee five small hospitals and 75 physician practices – some of which are 100 miles away from urban or tertiary care centers. We are already employing technologies like e-hospitalist where we have a hospitalist or an intensivist in an urban area that can provide backup and assistance to both nurses and physicians in a smaller rural hospital. It allows us to sometimes keep patients in a rural hospital that would otherwise have to have been transferred, sometimes hours away to a tertiary care center. Things like that really make a difference in patient care.

We believe that we’ve just scratched the surface. To that end, the AMA is involved in many activities to help accelerate the development of and adoption of new technologies – all the way from simple limited scope technologies like apps on a mobile device all the way up to how we make the EHR better. As I said earlier, we really want to insert the voice and the experience of the practicing physician into this development process earlier. To that end, for instance, the AMA participates in innovation center in Chicago called Matter, where we have the opportunity for practicing physicians to come in and meet with innovators and discuss their ideas. We have a mock exam room in which we can actually try to see how these innovations would play out in a real-world practice. We believe doing that will help make the final products more usable.

What frustrates physicians as much as anything is that these new technologies may be developed in a vacuum with regard to practicing physician input. They’re developed and rolled out to doctors with the promise of being the next best thing. But I look at it and say, “What practicing physician ever thought this would work for them?" In many cases, in spite of best efforts, they just haven’t engaged with practicing physicians. We really think that there’s a lot of opportunity out there for new technology and physicians are eager to adapt. We’re ready to do things that will help patient care. It’s just that much of technology at this point has been as much of a curse as a blessing.

Do you have any final thoughts?

I think it is important for physicians to be involved and engaged. We talked about physician burnout. When physicians get burned out, they tend to disengage. This is the wrong time for that. We need every physician to be in there, to be active in their groups, to be active in their hospitals if they have a hospital part of their practice. To be active in physician organizations like their county and state medical societies. That’s how we change difficult practice environments – through physician involvement and engagement. The AMA wants to help that happen. I encourage physicians to stay connected and engaged, and to not withdraw. That’s how we’re going to make things better.


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Recent Comments

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