Senate Republicans break through the Democratic attempt to stall final voting on Seema Verma’s nomination to head up CMS by passing a cloture vote – a move HIStalk Practice readers may recall from the will-they-or-won’t-they voting process for HHS Secretary Tom Price, MD. It looks like the final confirmation vote will happen within the next several days. As with Price, Verma’s eventual confirmation is expected along party lines.
Webinars
None scheduled in the coming weeks. Contact Lorre for information on webinar services.
Acquisitions, Funding, Business, and Stock
Global skincare company LEO Pharma’s Innovation Lab invests $5.5 million in five startups, two of which are based in the US. San Francisco-based Pacific has developed an app to help consumers manage stress, anxiety, and depression; and a corresponding dashboard tool for providers. Remedly, also based in San Francisco, has developed an EHR and PM system for dermatologists.
Announcements and Implementations
Austin-based startup WeInfuse develops cloud-based infusion center management software that includes patient scheduling, insurance pre-authorization, and medication inventory and delivery capabilities.
Casamba adds MedBridge’s patient engagement technology, including home therapy programs, to its TherapySource EHR and PM solution for post-acute therapy providers.
People
CareCloud brings on Greg Shorten (Validic) as chief revenue officer.
Meghan Hendricks (SSM Health) joins prescription drug pricing software company Doc and I as CIO.
Mordechai Raskas, MD (Children’s National Medical Center) joins specialized pediatric urgent care provider PM Pediatrics as director of telemedicine and clinical informatics.
Telemedicine
Akos launches its virtual consult business for consumers and employers in Arizona, with plans to expand to 10 more locations within the next few months. The company, formed last year by InstaMed Health Center Chairman Kishlay Anand, MD and neurologist Swaraj Singh, MD has raised $1 million in seed funding thus far. Its preferred brick-and-mortar provider network for patients that need in-person care seems to be the only thing setting it apart from the many other telemedicine companies popping up with increasing frequency.
Greenway Health software reseller and consulting company MDS Medical will add Otto Health’s telemedicine platform to its service line.
Government and Politics
Athenahealth CEO Jonathan Bush makes the media rounds this week to weigh in on the release of the GOP’s American Health Care Act, which he admits offers a “glimmer of hope” when it comes to prompting consumers to shop around for their care. He believes three things need to happen to make healthcare “shoppable:”
1. Arm patients and providers with cost/quality information to make better decisions, and reward them financially for doing so.
2. Connect our various care settings so when people do go in and out of certain settings, their health information will follow them.
3. Put all of health care on a national network. The industry can build all the software it wants, but without the connected tissue of a network innovation and knowledge-sharing can only happen in silos. One of many missed opportunities in healthcare that could be resolved with a national network is around scheduling; today only 16% of providers have at least some of their appointments available for web scheduling. A two-sided national network would allow patients to book appointments more conveniently, as well as for providers to fill appointments more conveniently. On the clinical side, with a national network doctors could share and access like-clinical scenarios and outcomes in real-time vs. once a year at an annual conference.
March 9, 2017Guest articlesComments Off on Readers Write: 5 Tips for HIPs to Help Jumpstart MIPS Readiness
5 Tips for HIPs to Help Jumpstart MIPS Readiness By Chris Gluhak
Despite rumblings among the new administration and some members of Congress about dismantling the ACA, one thing remains certain: The move toward a performance- and outcome-based healthcare economy is critical to ensuring affordable access to quality care. MACRA is designed to do just that by establishing baseline performance requirements aimed at improving both the quality and cost effectiveness of care to benefit patients, providers, and payers.
As part of MACRA compliance, the MIPS Quality Payment Program kicks off this year, requiring healthcare providers to start collecting and reporting on quality metrics to CMS. With the first clinician scores set to be published in 2019, the stakes are high for providers in demonstrating that they meet performance and outcome expectations.
Not only is MIPS required for successful population health management and adequate reimbursement under CMS guidelines, but the trend toward healthcare consumerism will also force providers to compete for market share on the basis of their performance. Consumers care about ease of access, transparency of care and costs, affordability, and outcomes. These factors are driving patients to select providers more carefully. With these kinds of metrics soon to be publicly available, clinicians are under increasing scrutiny to maximize their performance scores to maintain market share.
As a result, Health Information Professionals (HIPs) are in a powerful position to help providers implement accurate, efficient data collection and reporting processes to meet these new standards for reimbursement and market satisfaction. Here’s where your expertise is needed most:
1) Determining performance measures. Clinicians can choose what types of data they will submit to CMS in order to measure performance. Several scoring criteria relate directly to the work of HIPs including the use of end-to-end electronic reporting through certified EHR technology; heavily weighted activities like member outreach and engagement, care coordination and population management; and IT-related requirements, such as establishing reporting structures for measures on individual and group levels, and planning for including Part D cost data into cost reporting. Choosing the right scoring criteria can make a substantial difference in the reportable success of the practice, and HIPs can help practitioners understand which metrics make the most sense for their practice.
2) Implementing MIPS systems. One of the most critical aspects of MACRA will be implementing the necessary infrastructure to support timely and accurate submissions. That means IT systems must provide for efficiency and accuracy in collection, documentation, reporting, tracking, and submission of clinical metrics. One of the biggest obstacles in this process is often the inability to use unstructured data in clinical charts. Manual analysis is exceptionally expensive and time-consuming, and frequently prone to error. To resolve that problem, HIPs should investigate and lobby for a MIPS solution that uses an advanced natural language processing engine to automate the extraction of all data from clinical charts.
3) Integrating data across reimbursement processes. In addition to required MIPS reporting systems, practices may also find that integrating data collection and analysis across all of their reimbursement processes, including clinical data collection, analysis, and tracking, will provide for additional efficiencies, as well as reveal insights into practice management. Again, implementing the right technology can enable this integration. Solutions that provide a versatile data acquisition and integration suite that supports a wide range of interfaces, with the ability to ingest and integrate data from even the most complex and disparate sources are ideal. HIPs can assist in this process by collaborating with payers and other partners to ensure congruency across data fields, ensuring all data fields and patient records are complete and accurate, and monitoring data entry processes for data cleanliness and efficiency.
4) Educating providers. Providers must be made aware that the performance scores for all participating clinicians (or groups of clinicians) will be made public by CMS in 2019. It’s imperative that they understand the implications of this publication, in terms of both reimbursement and competitive positioning. As stewards of the information, HIPs can play a primary role in articulating the importance of positive performance metrics in maintaining a strong CMS relationship, and a successful practice overall.
5) Continuous evaluation. Along with emphasizing the importance of the initial score publication, HIPs can also play a critical role in establishing internal monitoring mechanisms that keep clinicians informed of their performance status relative to others in the organization, and relative to themselves on an ongoing basis. This type of continuous evaluation not only provides benchmarking data to improve practice performance and care quality overall, but also to help maintain a strong position in the marketplace as consumers begin to gravitate toward practices that demonstrate top-notch performance.
With the initial MACRA/MIPS reporting period already underway, HIPs must act quickly to ensure their practices are in compliance both operationally and technologically. In order to earn the maximum benefit through CMS, clinicians must submit a full year of data by March 31, 2018. Implementing the most effective IT systems and processes now will ensure accurate data collection throughout the year, for the most thorough and efficient reporting now and into the future.
Chris Gluhak is director of risk adjustment – solutions consultant at Health Fidelity in San Mateo, CA.
Scottsdale, AZ-based telemedicine hardware, software, and medical device company GlobalMed acquires Miami-based TreatMD, a telemedicine company with global providers that also offers billing, EHR, remote monitoring, and wearable integration, plus white-labeling capabilities. Terms of the deal were not disclosed. TreatMD was launched by Lennick Holdings Managing Partner Bryan Lenett last August.
Webinars
March 9 (Thursday) 1:00 ET. “PAMA: The 2017 MPFS Final Rule.” Sponsored by National Decision Support Company. Presenter: Erin Lane, senior analyst, The Advisory Board Company. The Protecting Access to Medicare Act of 2014 instructed CMS to require physicians to consult with a qualified clinical decision support (CDS) mechanism that relies on established appropriate use criteria (AUC) when ordering certain imaging exams. Providers must report AUC interactions beginning January 1, 2018 to receive payment for Medicare Advanced Imaging studies, with the CDS recording a unique number. Outliers will be measured against a set of Priority Clinical Areas and interaction with the AUC. This webinar will review the requirements for Medicare Advanced Imaging compliance and will review how to ensure that CDS tools submit the information needed for reimbursement.
Previous webinars are on our YouTube channel. Contact Lorre for information on webinar services.
Announcements and Implementations
Parasail Health offers an open API to help developers integrate its patient financing app, which includes tools to help patients comparison shop for loans, into their respective website or payment portal.
Modernizing Medicine will add e-commerce capabilities to its EHR through a partnership with skincare company Galderma Laboratories, giving dermatologists and their patients the ability to more easily order OTC products in tandem with prescription drugs.
Alternative Family Services will replace six IT systems in use at its eight facilities in California with the Cx360 EHR from Core Solutions.
Medical Oncology Hematology Consultants (DE) joins The US Oncology Network, a McKesson Specialty Health-supported company that provides PM tech and services to independent oncologists across the country.
Mental health and substance abuse outpatient provider A Helping Hand of Wilmington (NC) adopts Mediware’s AlphaFlex EHR.
People
Navicure hires Kermit Randa (PeopleAdmin) as its first chief growth officer.
Todd Unger (Daily Racing Form) joins AMA as chief experience officer and SVP of physician engagement.
Government and Politics
The Delmarva Foundation joins 11 other CMS-funded organizations in helping small practices participate in MACRA’s Quality Payment Program. The foundation will specifically provide technical assistance to 5,500 MIPS-eligible practices with 15 physicians or less in Maryland and Washington, DC.
Sponsor Updates
EClinicalWorks releases a new podcast, “Tips from a Superuser – How to Improve Functionality.”
A study conducted by RAND Corp. and Harvard Medical School researchers uses commercial claims data from 300,000 patients with acute respiratory illnesses to determine that, while telemedicine may increase access to care, it also has the potential to increase utilization and resultant healthcare spending. Their analysis found that 12 percent of direct-to-consumer virtual visits replaced in-person visits to other providers, 88 percent were new users, and annual spending increased by $45 per user. “If you make something easier to access, people will use it,” says co-author Lori Uscher-Pines. “That lower threshold means that people are using this as an add-on service.”
HIStalk Practice Announcements and Requests
Don’t miss the second installment of the HIStalk Practice Winners Circle, an interview series featuring physician practice professionals that have been recognized for their health IT-related expertise. This month features Kids Plus Pediatrics owners Albert Wolf, MD and Todd Wolynn, MD. They entered the Ernst & Young Entrepreneur of the Year competition not once, but three times, finally winning in the healthcare category. I’d ideally like to run at least one of these interviews a month. (February got away from me thanks to HIMSS.) I’m already looking to line up April’s interview. Feel free to email me with suggestions of award-winning physician to reach out to.
Webinar
March 9 (Thursday) 1:00 ET. “PAMA: The 2017 MPFS Final Rule.” Sponsored by National Decision Support Company. Presenter: Erin Lane, senior analyst, The Advisory Board Company. The Protecting Access to Medicare Act of 2014 instructed CMS to require physicians to consult with a qualified clinical decision support (CDS) mechanism that relies on established appropriate use criteria (AUC) when ordering certain imaging exams. Providers must report AUC interactions beginning January 1, 2018 to receive payment for Medicare Advanced Imaging studies, with the CDS recording a unique number. Outliers will be measured against a set of Priority Clinical Areas and interaction with the AUC. This webinar will review the requirements for Medicare Advanced Imaging compliance and will review how to ensure that CDS tools submit the information needed for reimbursement.
Previous webinars are on our YouTube channel. Contact Lorre for information on webinar services.
Announcements and Implementations
Over 120 primary care providers in Maryland partner with management services company Collaborative Health Systems to form the Chesapeake Independent Physician Association. “This new IPA fills a need and offers independent physicians the means to provide better care while transforming their practices as healthcare changes from ‘volume to value,’ notes Gene Ransom, president of The Maryland State Medical Society. “The association prepares physicians to take advantage of value-based contracts with commercial and public payers.”
Acquisitions, Funding, Business, and Stock
India-based Omega Healthcare Management Services acquires healthcare analytics company WhiteSpace Health for an undisclosed sum. The deal adds Research Triangle Park, NC-based WhiteSpace’s development facility in Hyderabad, India to the Omega fold, bringing its India-based facilities to five.
People
Family HealthCare Network (CA) promotes Paramvir Sidhu, MD to CMO.
Peter Spitzer (Spitzer & Associates) joins Innovaccer’s Board of Directors.
Research and Innovation
Researchers develop technology that enables a human to correct a robot with their mind using an electroencephalography monitor cap, which measures brain waves, algorithms to monitor those brain waves, and output capabilities that can send the brain wave analysis to the robot before it makes a mistake. The scientists have even programmed the robot to blush after being corrected.
Fitbit introduces a new, slimmer wristband with continuous heart-rate monitoring, plus new sleep-tracking capabilities to help users monitor the duration and intensity of their sleep cycles. The product developments come alongside the company’s announcement that two founding employees – Chief Business Officer Woody Scal and Interactive EVP Tim Roberts – are on their way out, and that it will “formally align” around consumer health and fitness, and enterprise health. “2017 is a transition year,” says co-founder and CEO James Park, “and while we continue to lead the connected health and fitness market, we must take important steps to chart our return to profitability and growth. It is essential that we are organized properly so that we can successfully execute our strategy.”
Other
Web application security blogger Anand Prakash shares a payment method entry bug that could have allowed cash-strapped hackers to take Uber rides for free. Prakash alerted Uber about the bug, after which they apparently gave him several free rides in the US and India.
Editor’s Note: The HIStalk Practice Winners Circle is an interview series featuring physician practice professionals that have been recognized for their health IT-related expertise.
Albert Wolf, MD is CFO and Todd Wolynn, MD is president and CEO of Kids Plus Pediatrics in Pittsburgh. The pair won the 2016 Ernst & Young Entrepreneur of the Year Award in the healthcare category.
Tell me about yourselves and the practice.
TW: The practice was actually started in the 70s by two of our teachers from residency. We basically took it into a new evolution in 2010, and made it Kids Plus. The five current owners are physicians. Al is an MD/MBA and I am an MD/MMM, which is a Masters of Medical Management. I was just telling the guys today about an NPR story on physician dual degrees and how that is the next wave of the future – looking at predictive analysis and leveraging business analytics. It’s now about the business of medicine, rather than the art of medicine, which we’ve always emphasized. It takes great business to deliver great medicine.
When you took over in 2010, was the innovative use of technology a part of your vision for the practice?
AW: Yes, it was. That’s actually written into our mission statement, which is "Meet, Learn, Grow." "Meet" is really just meeting our patients where they are. The use of technology is vital for that. It allows us to meet patients and their families in their home, at work, in their backpacks, on their phones, on their laptops, and on their tablets. Wherever they are, whatever means of communication works best for them, we want to be there for them. Again, our goal is always, how can we best serve them? It’s not let’s make them adapt to the way we do things. We adapt to the way they want to do things. That was integral when we formed Kids Plus.
What technology did you start with and how has that evolved as the practice has grown?
TW: When we formed Kids Plus, we were using an EHR, but it was, in our opinion, not great. It was an adult-based EHR that did pediatrics on the side. When we formed Kids Plus, we changed EHR companies to a pediatric-specific EHR that we felt better enabled us to do outpatient pediatrics. Since then, we’ve changed EHR companies again. We’re currently with Physician’s Computer Company. We’re always looking for how we can best leverage technology to serve our patients.
What about portals, branded apps, and telemedicine?
TW: With each EHR – with any kind of technology, really – we’ve tried to enhance the patient engagement with technology. That certainly has included the EHR and patient portals, which we’ve had for over six years. We really try and take technology back to the mission, to meet, learn, and grow with people. As that goes, technology has been heavily leveraged in terms of not just a Web presence, but a very deep and meaningful social media presence through several different venues, whether it’s Facebook, Twitter, Instagram, or Pinterest. That’s undersold, often times underappreciated, and honestly met with fear by the healthcare community.
We take our patient engagement/technology show on the road. We’ve been invited to the Children’s National pediatric business meeting in DC over the last several years, and were invited to the nationwide Children’s meeting last year so that they can better understand how we leverage technology as part of the patient engagement experience. We’ve really recreated a new footprint for what we envision the pediatric practice of the future looks like. It’s physically different. We have a multi-purpose engagement space, which we call The Well. We have a physical play and fitness space, which we call the Fitness Through Play Space. We then take that layer of really unique physical engagement and then layer on top of that a really unique virtual engagement. Part of what differentiates us, and definitely part of what got us to win the Ernst and Young award, was this different experience that families have at Kids Plus because of this marriage of physical and virtual immersion.
With regard to apps, we haven’t found that killer app that provides the kind of functionality that would make it Kids Plus worthy at this point.
You mentioned that the healthcare community has traditionally shied away from using social media as part of patient engagement initiatives. In what ways has Kids Plus moved beyond that fear you referred to earlier?
TW: Our standing charge is to know our audience, which is millennials. They’re the people that are having kids right now. This is a generation that really does not have the same kind of connectedness to the rule books their parents had, like Dr. Spock. They’re on their phones and their kids are on their phones. Their social peer groups are often times much stronger in some ways than their limited network of physical friends. Recognizing that, and really having some vision as to where people were going and what they needed … we realized they needed somebody to be there with them in a virtual manner. That’s not to say we want to take away from that physical engagement, because we know how important it is, but there’s only so much you can do in a 10- or 15-minute visit. It’s part of the reason we reimagined what the physical space looks like.
We have moms groups here, which is actually a really compelling group called New Moms Coffee that meets in the Well. When they age out, they now go into Not-So-New Moms Coffee, which is for mothers of seven- to twelve-month-olds. There’s Toddler Time, which is from 12 to 36 months. On top of that, we’ve layered a closed Facebook group for each of those groups, which has now been scaled out to all three of our offices, both physically and virtually. The Facebook group is about to exceed 1,000 moms. It’s now spurred off multiple Facebook groups, based on interest. They all have a common interest of raising these new children within our community. On top of that, they’ll break off into running groups, academic groups, knitting groups, whatever their interest is. It’s been pretty neat. On top of that, we never rested on our laurels and said, "Well, this is going great." We then said, "How do we make this even more meaningful?" which is part of why we’ve gone even more heavily into videos.
Our biggest move in the last two years has been the creation of our production studio, right on site. People gave us weird looks when we told them we have a communications director! Matter of fact, the group out of DC Children’s National pretty much told us they don’t invite us every year because we scare the audience too much. They give us a year of recovery time. The last time we presented, they gave explicit directions to me and our director to not scare their docs too much, and give them something they can easily do. The last time we were there, in 2015, we revealed our very first video segment that came out of the production studio.
We use videos now for human interest stories and community engagement, plus health-oriented segments called The Daily Dose. Those particular videos, which are between 45 and 75 seconds, are built off an e-book our providers created on various health topics. We keep building on that platform, which definitely leverages technology, but is really about connectivity and community at its philosophic end. That’s what we really want to do.
AW: I’ll add that it all goes back to knowing our audience. Maybe two generations ago, when we needed to communicate with a parent about something, we could provide them a handout. We could give them a piece of paper with something on it. The last generation of parents, they don’t want paper. They just want to go online and read it. The current generation of parents don’t even want to go online and read it. They just want to watch a video on it. We’ve evolved how we communicate with parents and technology has definitely helped us do that.
How have these videos and your social media presence impacted patient care and staff productivity?
Our communications director, Chad Hermann, has fielded over 6,000 questions through Facebook and through those e-book-formatted Doctor’s Notes. People now tell us that’s their go-to. Maybe in the 50s, you went to your Dr. Spock book, but now you go to your Kids Plus Doctor’s Notes to look up what you want to find.
We’re actually on our third website. Our second website was really very well received, and was event placed into a textbook on healthcare Web presence. That was only two years ago, but we already trashed that site because it didn’t meet where we felt we needed to be in 2017, 18, and 19. It’s now incredibly searchable. It really fits the mold of the millennial website, as they are much more comfortable with scrolling. You’ll see the links work, and it’s fairly intuitive, but it’s also a lot of resources right at your fingertips.
Let’s talk a little bit about your Ernst and Young journey. What prompted you to enter – and keep entering – and what feedback did you receive after the win? How has that impacted Kids Plus?
AW: We’ve entered the competition three times – 2013, 2014, and 2016. A friend of Todd’s – someone who had nothing to do with healthcare but knew about the innovative things we were doing – convinced us to throw our hat in the ring. We were the only medical people there that first year. When we didn’t win that first year, we came back a second and a third time because we felt that we were doing better at getting our story across. One of the big problems that we had was that we’re not a flashy 3-D printer company. We’re not a multimillion dollar international corporation. We’re just doing outpatient pediatrics, and you can’t get much less glamorous than that.
Each year, we refined our storytelling, and I think finally, after three rounds of practicing at it, we were a little bit more successful in getting our story across as to what we do, what makes us unique, and what makes us innovative and entrepreneurial. That’s what ended up leading to success, I think.
TW: We’re innovating in the very conservative and slow-to-adapt field of healthcare. That part of our story, as Al said, we were really able to put some punch behind it. The other thing is, we were in front of Ernst and Young. This is a company that focuses on your finances. They’re looking at companies that have venture capital money and are looking at 20- and 30-fold growth in a year or two. We said that’s not how medicine works. I think that was one of our proudest moments – seeing the recognition and getting to that national stage with companies that rely on that kind of growth, and seeing that here’s a primary care pediatric practice being recognized for innovation. That was really pretty cool.
What’s next in terms of technology for Kids Plus?
I would say video or virtual engagement. We’ve done a project on that in a research capacity to see how it would fit into our practice. We still are looking for what the right fit is down the road. I know some groups do that. Some big health systems do that, as well. What we do is different. The reason why it’s different is that it’s really driven from the ground up. This is not top-down technology, as in, "Hey, here’s this new system. Here’s how you’re going to use it."
We’re nimble enough and we are, I believe, business-oriented enough to see where the opportunities are and to adapt, as Al pointed out, to what our patients and their parents need and want. What we have is a very ground-up approach. It rests on the notion that it really takes a village to raise a child. We want to be absolutely part of that village – a place to meet, a place to learn together and to really help the entire community grow as we focus on our children and families in the practice.
The article about Pediatric Associates in CA has a nugget with a potentially outsized impact: the implication that VFC vaccines…