News 7/27/17

Top News

FDA Commissioner Scott Gottlieb, MD announces the voluntary Pre-Cert for Software Pilot Program, which seems to be a “fast lane” assessment and vetting process for digital health apps that, unlike more traditional medical devices, require updates and upgrades. Pre-certified companies will eventually be able to submit less information (some none at all) than is typically required before marketing their product. Companies interested in participating in the program can begin submitting statements of interest August 1.

Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre for information on webinar services.

Acquisitions, Funding, Business, and Stock

Amazon seems to be assembling a team devoted to formally upping its presence in the health IT space; one that, for now, seems to be separate from the health and life sciences efforts of AWS. Dubbed “1492,” CNBC reports the Seattle-based group will initially focus on products and services related to EHR data and telemedicine, as well as creating apps for existing products like Echo.

Remote cardiac monitoring startup Signature Medical closes a $2.5 million Series A round led by Riot Ventures, Bose, and parent company Allied Minds. The company is working to refine its flagship AcoustiCare wearable, which uses proprietary acoustic and AI technology.

Announcements and Implementations

Privia Health doubles the size of its network in Georgia, increasing to 150 physicians since Privia Medical Group – Georgia launched in 2015. The Arlington, VA-based clinically integrated practice management company operates in six states, and has signed up 1,600 physicians since opening for business 10 years ago.

MyMipsScore adds a MIPS score simulation tool to its MIPS calculation app. Simulations can be run based on target performance rates for any of the program’s 217 quality measures.

Specialdocs Consultants helps PCPs in Connecticut transition to concierge practice models. Matrix Personalized Medicine, Darien Signature Health, and Glenville Medical Concierge Care make up the 6,000-plus such practices operating in the US today.

Research and Innovation

A WebPT survey of 5,200 rehabilitation therapists finds efficient documentation to be the most important feature of the 56.5 percent of those that use medical record software. Perhaps it’s because I live in a health IT bubble, but I find it surprising that 16 percent of surveyed therapists still document only on paper. Top overall challenges include burdensome documentation, declining reimbursement, and payer and government regulations.

Other

The local paper looks at educational outreach programs led by companies like Alosa Health and Axial Healthcare that help physicians and pharmacists better understand their opioid prescribing habits and rates recommended by the CDC. “We’re not out there to chastise them,” says Melissa Jones, RN of Alosa Health. “It’s a discussion. We’re a sounding board.” Reps like Jones may visit three to five practices a day, all in the name of promoting safe opioid prescribing practices, including alternatives.

HITRUST debuts the Community Extension Program to help providers all of types and sizes improve cybersecurity practices via the alliance’s assessments and programs. The free program will offer collaborative town hall events in 50 cities over the next year.

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Readers Write: Guiding Principles for Designing a Useful Healthcare Mobile App

Guiding Principles for Designing a Useful Healthcare Mobile App
By Calvin Chock

Healthcare mobile apps can provide many benefits to busy physicians. Roughly 80 percent of healthcare providers use smartphones and medical apps, and more than 25 percent rely on mobile apps to provide patient care. In discussing mobile app usage, physicians strongly voice the need for quicker and easier access to patient data. If a mobile app is well designed, enables efficient access to patient data, and is easy to use, it can serve as a powerful companion to an EHR. By following some basic guidelines during the concept and development process, a robust, user-friendly mobile app can be built that meets a physician’s need for quick and easy data access.

The methodology outlined here is specifically targeted towards large applications with hundreds of features, complex workflows, and a vast number of users interacting in different ways. For these complex applications, the challenge is to design a solution that is useful but that will also fit into a much smaller form factor. Often, the trade-off involves realizing the full application cannot be fully converted into a mobile app, and instead making a version that is less complex, sequestering a subset of valuable features that are not meant to replace the full application but instead complement it.

Guidelines for Developing Critical Elements Help Ensure Success

There are several basic elements that require much thought and consideration when building a mobile app from a complicated application such as an EHR. This includes the overall design and layout, the types of user interfaces, and user experience.

Follow Design Principles and Build a Strong Foundation

First and foremost, realize that it is unlikely that all the information in the application can be crammed into a tiny screen. Distil the information down by breaking it into smaller subsets using a few logical steps:

Build an inventory of workflows.

Physicians, nurses, pharmacists, and other key staff all have different screen sets. Take an inventory of the workflows for various users to find out what they do during the day. Watch, observe, study, and write down each user’s role and their distinct user pattern.

Determine which items on the list are a good fit for a mobile app.

Look at the subset list closely and decide which workflows make sense to put in a mobile app and which will be challenging or cumbersome due to the limited size. Also, review each one and ask yourself, “Was the user able to fully complete a useful task?” If the answer is yes, keep it on the list. If not, then consider whether that specific workflow is a good candidate for a mobile app.

For example, during office visits, physicians document a wide range of a patient’s medical details. This function is probably not the best candidate for an app due to the large number of data entry fields and content. Phones are not great data entry vehicles, so trying to type a lot of information in can be cumbersome and frustrating. In contrast, physicians spend a tremendous amount of time reviewing patient data and acknowledging this review was done.

An example of a typical day would include a review of hundreds of lab results, dozens of notes, and several new orders. Lists of data that require limited data entry lends itself well to a mobile app. This tedious and time consuming work can now be done outside of the office, which now gives physicians the flexibility to do this work on the go.

Rank each item’s value.

Of those workflows that you determine will work well on a phone, rank the value of each subset based on potential user utilization of the app or other factors.

Once the subsets have been ranked, establish one theme for the app’s purpose. Too many different themes are confusing. For example, if the main goal is to empower the user to perform tedious work on the go, then define that as the primary goal and rank the features based on achieving that goal.

Utilize the Minimum Loveable Product (MLP) concept. In many applications, there is a choice between speed of delivery versus quality. If the mobile app is meant to be a compliment to the main application versus a full replacement, then designing an MLP will allow you do deliver a solution quickly and with high quality. Start the design work of just the most valuable workflows first, building one highly usable feature at a time. As users rally around that one feature, they get eager for the next one. You won’t sacrifice quality, and will still deliver new features at a good pace.

Lastly, use smart phone features to your advantage. Incorporating Location Based Services can save the user time in filling out location-related data entry fields, notifications can provide important alerts to users while the app is not in focus, and the camera phone can be used to take photos of documents or patients for immediate upload.

Create a Great User Experience with a Simple Layout and User Interfaces

Once the main theme is selected and an initial set of features has been identified, the last step is to take the time to think about how the app will look and how the user will interact with it. Going from a wide screen to a tiny one is challenging, so screen element choices are critical to maintaining a high level of usability. Only essential information can be shown, and creative ways must be utilized to display information. For instance, instead of showing the full directory of a file system, a hierarchy can be represented by descending shades of a color, saving time and real estate.

Be consistent with elements used throughout the app. If a field is accepted by clicking a button or swiping left to right, the same method should be used on every single page. Having a consistent user interface is key to the learnability of an application.

Employ user-friendly interface elements, such as big toggle switches, buttons, swipes, or gestures. Entering a lot of data using a phone is frustrating, so limiting free text entry when possible is important.

Make the app look simple and easy to use so practice staff can absorb the view quickly. Avoid too many user interfaces, text, and other details, or the screen will look cluttered and confusing.

Finally, verify that the user interface design will work on the majority of phones users have. While phones today are standardizing, it is still important to check. Time and expense can be saved by building the app to support only the top two or three phones potential users have.

Calvin Chock is VP of product management and engineering at McKesson Specialty Health in The Woodlands, Texas.

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News 7/26/17

Top News

The House Ways and Means Committee announces the Medicare Red Tape Relief Project, which will work to reduce legislative and regulatory burdens on Medicare providers. The three-stage project (the name of which is eerily similar to AMA’s Break the Red Tape campaign) is initially seeking feedback from stakeholders on how Congress can deliver statutory relief from current mandates, and how it can work with HHS Secretary Tom Price, MD and CMS Administrator Seema Verma to provide that relief. Feedback is due August 25.

HIStalk Practice Musings

I added a landline several days ago in an effort to take back my cell phone from certain members of my household whose friends love to call and chat for extended periods of time. It’s been about 10 years since I’ve had a home phone, and I had forgotten how many telemarketing calls they attract. It didn’t take me long to look up the particulars of adding my new number to the National Do Not Call List. The CDC, which tracks mobile phone and landline use in households as part of its focus on the health habits of American domiciles, reports that cell phone-only homes are now in the majority. Fun/sobering fact: Nearly 30 percent of wireless-only adults are binge drinkers, while “only” 18 percent of adults living in landline households drink heavily.

Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre for information on webinar services.

Announcements and Implementations

ATI Physical Therapy (IL) develops an app to give its physical therapy patients access to their treatment plans and related content while on the go.

Digital health company Livongo Health will make its high blood pressure- and diabetes-related educational resources available to patients through its new membership in the American Heart Association’s Center for Health Technology and Innovation Tech Collaborative.

Radiology Associates (AR) selects enterprise imaging software from Mach7 Technologies.

People

Therapy Source hires Tracy Sippl (Cross Country Staffing) to head up its TheraWeb virtual therapy staffing services.

Telemedicine

The Memphis, TN-based Southern College of Optometry’s new paperless FocalPoint clinic rolls out telemedicine services from EyecareLive.

Telemedicine startup OmniaMD – founded by cardiologist Jorge Castellanos, MD and Lauren Timpe, RN opens for business in California.

Abundant Life Social Services (UT) will offer remote mental health therapy through white-label telemedicine services from Doxy.Me

Government and Politics

CMS adds new APIs and Github Repositories for developers working on QPP reporting.

Other

The majority of Wisconsin tech company Three Square Market’s 80 employees have agreed to embed RFID chips in their fingers to free up time when accessing the building and purchasing things at the on-site cafeteria. CEO Todd Westby has downplayed any concerns around privacy by pointing out that cell phones report “100 times” more data than do RFID chips.

The Onion publishes a funny piece on the damage Dr. Mario is doing to the practice of medicine:

“You see, unlike Dr. Mario, I’m constantly forced to make nuanced, complicated decisions. There are more than three germs out there. And there’s more to medicine than spinning pills in the air and lining them up according to color in columns of four or more. In my practice, I write prescriptions, conduct examinations, order diagnostic tests and scans, and break the bad news to terminally ill patients about how long they have to live. It really is an extremely difficult job.

Just yesterday I picked up my forceps and—being ever so careful not to touch the sides of the incision and get shocked—removed an ice cream cone from a man’s skull, successfully treating his brain freeze. For real doctors, it’s all in a day’s work.”

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News 7/25/17

Top News

Maven Clinic secures a $10.8 million Series A round led by Spring Mountain Capital, bringing its total funding to $15.8 million. The company, which offers its virtual maternity services to employers and directly to consumers, launched in 2015 and now boasts 25 employees and 100,000 users. Lauren Breuggen (Spring Mountain Capital) and Rachel Winokur (Bright Health) will join Maven’s Board of Directors.

Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre for information on webinar services.

Acquisitions, Funding, Business, and Stock

PhysIQ will use $8 million raised in a Series B funding round led by 4490 Ventures to ramp up commercialization of its VitaLink remote-monitoring and analytics technology. The AI-powered software is geared towards ambulatory patients and clinical trial researchers from the worlds of pharma and medical devices. Dan Malven (4490 Ventures) and Zafrira Avnur (Quark Venture) have taken seats on the company’s board. The company has raised nearly $20 million since opening its doors four years ago.

People

Daniel McCarter, MD (University of Virginia Health System) joins ChenMed as Richmond CMO at its JenCare Senior Medical Center in Virginia.

Telemedicine company HealthPoint Plus hires Justin Holtzman, MD (South Shore Hospital) as CMO.

CNBC reports that Amazon has hired Box healthcare and life sciences VP Missy Krasner in an unnamed role.

Announcements and Implementations

Aprima teams with Patient identification Platform to help physicians more efficiently match eligible patients with clinical trials.

Idaho and Utah will connect their HIEs to share patient admission, discharge, and transfer notifications with PCPs. Both are part of the Strategic HIE Collaborative’s Patient Centered Data Home hub that connects HIEs in Arizona, Nevada, Nebraska, and parts of Colorado.

ChiroTouch develops tablet-based self check-in technology for patients.

Government and Politics

The HHS Office on Women’s Health disseminates $1,600,000 to 16 organizations – including community clinics, health centers and health departments – to fund projects that will seek to prevent opioid abuse by women and girls. The awards – $100,000 to each organization – comes on the heels of a OWH report that focused on the impact such abuse has on females.

The FDA will hold the inaugural meeting of its Patient Engagement Advisory Committee October 11-12 in Washington, DC. The gathering, which will focus on the patient-identified challenges associated with clinical trials, will mark the first time the agency has focused on patient-related issues related to medical devices.

Senators vote along party lines to continue efforts to repeal the ACA. The “motion to proceed” enables them to begin debating the ins and outs of formal legislation.

Research and Innovation

A look at 200,000 patient satisfaction surveys finds that personal interaction with physicians trumps online tools, customer service, and waiting room amenities when it comes to customer loyalty and recommendations to friends and family. The data also showed a direct correlation between provider and overall practice satisfaction rankings.

Other

Remember when?: Microsoft clears up confusion around reports that its 32 year-old Paint app will be scrapped once Windows 10 updates go live. The art app will be available for free via the Windows App store – a move the company made after the “incredible outpouring of support and nostalgia around MS Paint.” The news takes me back to when our family installed our first PC. We quickly became accustomed to the static-y noise of dial-up, and the accumulation of AOL CDs brimming with free access to a social media-free Web.

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News 7/24/17

Top News

Private equity firm KKR will acquire WebMD for $2.8 billion. Founded in 1996, WebMD began looking at possible suitors early last year as its revenue from pharmaceutical ads began to dry up. Analysts at the time gave it a $2 billion valuation. Its websites include WebMD.com, Medscape.com, and MedicineNet.com – all of which will now live under the same umbrella as KKR’s DentalPlans.com and AllAboutCounseling.com sites.  

Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre for information on webinar services.

Announcements and Implementations

Commonwealth Primary Care ACO taps Sonora Quest Laboratories to be its diagnostic testing provider of choice. (SQL is a joint venture between Banner Health system (AZ) and Quest Diagnostics.) The ACO, made up of 130 independent physicians in Arizona, will use SQL’s population health analytics to better identify high-risk patients and close gaps in care.

In an effort to better assess and improve quality, Orthopaedic Associates of Michigan will use Code Technology’s benchmarking reports to help it develop a patient-reported outcomes program.

Child and family services provider KidsTLC (KS) selects NetSmart’s EHR.

Acquisitions, Funding, Business, and Stock

Portland, ME-based healthcare financial and advisory firms BerryDunn and Compass Health Analytics decide to merge.

People

Primary Care Development Corp., a nonprofit dedicated to investments and policy initiatives around primary care, appoints Altruista Health CMO Munish Khaneja, MD to its development committee.

Casey Liakos (Huron Consulting) joins Carex Consulting as president.

The Vermont Medical Society promotes Jessa Barnard to EVP. She’ll take over leadership of the 2,000 physician organization when current EVP Paul Harrington retires this December. 

Telemedicine

Birmingham, AL-based AlternaVisit – best, if not widely, known for its white-label telemedicine solutions – begins offering website development and management services to physician practices. It’s a logical step, according to CEO Tom McDougal, given that a professional, easy-to-navigate website is a practice’s first step in adding telemedicine services.

In a move that I predict will become increasingly common amongst physician practices, Keady Family Practice rolls out virtual consults in an effort to make accessing healthcare easier for their patients, many of whom live in rural areas. “It’s just the convenience of having that face-to-face virtual appointment with your provider,” says Krista Wilson, a KFP medical support staff member. “It’s not that we don’t want our patients to come here, but we want to add benefits for patients without added stress to their schedules.”

New Benefits adds telemedicine services from MDLive to its line of healthcare discount plans for employers.

Other

@Rachel_LEAD and Politico pick up on a new trend in health IT marketing – enticing potential customers with high-tech gadgets that become operational once a demo is scheduled.

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Jenn, Mr. H, Lorre

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