5 Questions with Chris Romandetti, CEO, First Choice Healthcare Solutions

Chris Romandetti is CEO of First Choice Healthcare Solutions based in Melbourne, FL, which focuses on outpatient orthopedic and spinal care. It employs 128 people across its five facilities, including a dozen physicians and seven PAs, to care for between 425 and 450 patients daily. The organization successfully weathered the effects of Hurricane Matthew in early October.

How did Hurricane Matthew impact FCHS operations? How did your staff prepare, especially with regard to the potential downtime of IT systems?
Thankfully, all of our facilities’ main utilities, including power, air conditioning, and Internet connectivity, remained fully operational throughout and following the storm. Moreover, our buildings sustained no notable damage that would otherwise disrupt the company’s medical or business operations. Consequently, we were back to business as usual on Monday morning immediately following the storm.

Is your IT infrastructure onsite, in the cloud, or a mix of both?
We utilize a mix of both the cloud and redundant servers – our EHR system operates in the cloud, but our day to day business operations are maintained on the server. However, we are considering moving all of our data to the cloud – including any potential new accounting system solution that we may choose to implement in the future. The cloud offers us numerous benefits associated with enhanced care collaboration among our providers, cost considerations, scalability, data security, document control, and disaster recovery, among others.

Does the annual hurricane season prompt your IT team to review its downtime procedures?
Absolutely. Hurricane season is six months long, so we review our unplanned downtown procedures prior to the beginning of the season; and then we reevaluate shortly after the end of the season to determine what things we learned from an unplanned downtown and/or what contingency procedures or communications protocols may need to be refined or modified to further improve our plan.

What advice can you offer other providers who may be thinking it’s time to take a fresh look at their natural disaster preparedness?
It is vital to have a plan in place, because disruption of power, Internet failure, physical property damage, et al could cause you to rely on your downtime procedures to effectively administer patients. The time to review is not when a potential natural disaster is looming, but on a regular basis. This is particularly important when there are changes in staff. Everyone needs to know what to do in the case downtime procedures are activated.

On a side note, how is FCHS and its practices preparing for MACRA. Any other coordinated care initiatives underway?
We are currently evaluating our options for participating in MACRA. When it comes to other programs, we are currently performing outpatient total hip and total knee replacements, as well as minimally invasive spine surgical procedures at our ambulatory surgery center, Crane Creek Surgery Center. In addition, we are planning to submit bids for bundled payment programs on total hip and total knee replacements to CMS, several large insurance payers, and a number of large self-insured employers in our local market (Brevard County, Florida).

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News 12/13/16

Top News

Carequality and CommonWell embark on a data-sharing partnership that will offer CommonWell subscribers HIE capabilities via directed queries with Carequality Interoperability Framework participants. Carequality, in turn, will work with CommonWell to develop its own version of CommonWell’s record-locator service, which it will then make available to its participants. Participants of the two organizations now represent 60 percent of the ambulatory EHR market, and 90 percent of the acute market.

Webinars

December 14 (Wednesday) noon ET. “Three Practices to Minimize Drift Between Audits.” Sponsored by Armor. Presenter: Kurt Hagerman, CISO, Armor. Security and compliance readiness fall to the bottom of the priority lists of many organizations, where they are often treated as periodic events rather than ongoing processes. How can they improve their processes to ensure they remain secure and compliant between audits? This webinar will cover the healthcare threat landscape and provide three practices that healthcare organizations can implement to better defend their environments continuously.

Acquisitions, Funding, Business, and Stock

McKesson Specialty Health will expand when it moves into 13,900 square feet of office space in downtown Evansville, IN early next year. The regional billing office will employ nearly 100 people once fully staffed, and will serve practices affiliated with The US Oncology Network and Vantage Oncology.

Bloomberg releases its annual list of “Best Value” CEOs – those whose larger-than-life salaries seem well worth it given the profits they’ve helped drive at their respective companies. Those with ties to healthcare IT include Larry Page of Alphabet (his last paycheck rang in at $1), Tim Cook of Apple, Lowell McAdam of Verizon, Ginny Rometty of IBM, Randall Stephenson of AT&T, Stephen Hemsley of UnitedHealthcare, and Inge Thulin of 3M.

People

PerfectServe promotes Mary Hatcher to vice president of product development.

Announcements and Implementations

Acentec adds HIPAA compliance and security services to its line of PM products.

Pediatric Associates (MO) implements the Bridge Patient Portal, which it will integrate with its Greenway EHR.

MedicalMine incorporates AAP’s BrightFutures templates into the new pediatrics-specific version of its Charm EHR, PM, and RCM system.

Government and Politics

Aura Labs settles with the FTC over marketing claims that its Instant Blood Pressure app was as accurate as a traditional blood-pressure cuff, and that owner, Ryan Archdeacon, gave the app a five-star review without disclosing his connection to the company. The app was sold between June 2014 and June 2015 for between $4 and $5, and generated over $600,000.

Research and Innovation

A study of 763 IT professionals – including 101 from the healthcare industry – finds that folks are “overconfident” in their ability to collect data needed to identify and remediate a cyberattack. Forty-five percent of respondents admitted that their scanning tools are not capable of fixing or remediating critical vulnerabilities within 30 days. Eighty-three percent believe they can detect changes to a network device within several hours, yet just 54 percent know how long the process actually takes.

Other

Quest Diagnostic notifies 34,000 patients that its MyQuest patient portal was hacked on November 26, exposing test results, names, dates of birth, and some phone numbers. The lab services vendor has not detected any misuse of the information.

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News 12/12/16

Top News

Physician dissatisfaction with EHRs may seem like old hat, but the challenges of implementing and maintaining such systems still pose problems for small and rural practices, according to a new GAO report. These organizations face a harder time transitioning to new value-based care programs thanks to the prohibitive cost of data sharing, which can ring in at $20,000 depending on the vendor and number of physicians available to share the cost. A lack of qualified staff to use such systems for new value-based care and population health management programs also presents a challenge. As one physician interviewed for the report confirmed, “[P]ractices often do not know how to use their EHR system to make a list of all patients with a certain disease, which could help the practice develop population health management strategies for that particular disease, among other activities.”

Webinars

December 14 (Wednesday) noon ET. “Three Practices to Minimize Drift Between Audits.” Sponsored by Armor. Presenter: Kurt Hagerman, CISO, Armor. Security and compliance readiness fall to the bottom of the priority lists of many organizations, where they are often treated as periodic events rather than ongoing processes. How can they improve their processes to ensure they remain secure and compliant between audits? This webinar will cover the healthcare threat landscape and provide three practices that healthcare organizations can implement to better defend their environments continuously.

Here’s the recording of last week’s webinar titled “Get Ready for Blockchain’s Disruption.”

Acquisitions, Funding, Business, and Stock

The local paper details the ups and downs encountered by the three year-old Physician Retraining & Re-entry Program created by family medicine professors at UC San Diego. The program, a 100-hour online course that helps retired specialists with current medical licenses refresh and enhance their primary care skills, has enrolled 225 physicians and found jobs for only about 25 – underwhelming numbers given the impact its founders hoped to have on the predicted physician shortage. Those that have completed the program, however, seem to enjoy getting back into the swing of things. “It felt good to put that white coat on and feel like a doctor again,” says 72 year-old Michael LaRocque, MD who works part time at the Vista Community Clinic. “At this stage in my life, I’m just happy to be in an office without having to run a whole practice. It’s pretty invigorating to have a whole new set of things you’re dealing with. It keeps your mind busy.”

Announcements and Implementations

The Charleston, SC-based Accountable Care Coalition of the Tri-Counties will work with a network of independent pharmacies as part of a pilot project to demonstrate that a care model including pharmacies results in better outcomes and improves preventive care. Physicians and pharmacists will share patient data and evaluations on multi-prescription drug risk and predictive outcomes. “The medical community struggles with managing medication from a cost and patient safety perspective,” says ACC spokesperson Michael Barrett. “We believe these challenges can be addressed through closer collaboration between physicians and pharmacists given the invaluable role pharmacists play in supporting patients’ health.”

Modernizing Medicine introduces two tiers of MIPS-focused consulting services to assist physicians with participation in the value-based care program that begins January 1.

The American Heart Association, AMA, HIMSS, and DHX Group (a consortium of digital health innovators and centers of excellence) form Xcertia, a nonprofit that will develop and disseminate best practices for mobile health apps. It will not establish a certification process for health apps, though DHX does seem to have ties to that space. Its parent company, SocialWellth, acquired failed certification company Happtique in 2014, and has reviewed and certified health apps for payer-based app stores.

Drchrono develops an Ipad-based patient check-in kiosk that can offer relevant educational materials.

South Carolina-based urgent care company Doctors Care leverages ReferWell’s patient referral system across its 53 clinics. The technology sends patients electronic confirmation and reminders of follow-up appointments with specialists.

People

Social media-mined patient insight and prescription drug review company Treato appoints Allen Kamer (OurCrowd Qure) to its Board of Directors.

The Medical Society of Delaware elects Prayus Tailor, MD (Nephrology Associates) president.

Telemedicine

Affiliated Dermatology (AZ) offers teledermatology visits via Iagnosis. The Phoenix-area provider has made 15 of its specialists available for the DermatologistOnCall virtual consults, and will incorporate the technology into its accredited program for dermatology residents.

Research and Innovation

A Walgreens study of 450,000 Balance Rewards members finds that those that entered activities automatically using the incentive program’s support devices or apps remained engaged four times longer than those who entered data manually, averaging 20 weeks of participation. The challenge for Walgreens lies in the fact that a whopping 77 percent of participants entered their data manually.

Other

Commentary trickles out from the Montana Medical Association’s meeting last week, which gathered stakeholders to discuss developing a statewide HIE. MMA will move forward with its explorations thanks to a $50,000 grant from the Montana Healthcare Foundation. Physicians and payers alike are excited by the prospect of digitally sharing information across care settings. "I think even today in 2016, healthcare is the last bastion of the fax machine,” David Kendrick, MD remarks. “It’s going to be the last place somebody pries a dead fax machine out to throw away. And we’ve got to figure out how to improve on that.”

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Population Health Management Weekly Wrap Up 12/11/16

The Los Angeles County Dept. of Health Services selects the Ez-Cap managed care tool from Allscripts to streamline its health benefit administration, claims, and other healthcare transactions.

Bechara Choucair, MD (Trinity Health) joins Kaiser Permanente as its first community health officer and SVP of health and benefit for Kaiser Foundation Health Plan and Kaiser Foundation Hospitals.

Vitreos Health adds CitiusTech’s CQ-IQ clinical rules engine, which includes clinical quality measures computation capabilities. to its predictive and prescriptive analytics product.

Ajdin Camaga (Entrada) joins I2I Population Health as vice president of sales.

Data analytics technology company Advanced Plan for Health adds new predictive modeling capabilities for coronary, neurological, and orthopedic events; and chronic kidney disease to its Poindexter risk engine for population health management. Geared to health benefits plans for self-insured employers, the engine can also predict length of hospital stay and general likelihood of an ER visit for any member of a patient population. 

The Washington, DC-based Population Health Alliance appoints Raymond Fabius, MD (Health Next) Michelle Hart-Guyot (Innovative Healthcare Delivery, Christopher Long (AxisPoint Health), David Nash (Jefferson School of Population Health), and Sunny Ramchandani, MD (Aetna) to its 2017 Board of Directors.

New York City-based payer Healthfirst selects CaseNet’s TruCare population health management technology to better support its transitions of care and readmissions programs.

The Aetna Foundation will work with the Camden Coalition of Healthcare Providers and its National Center for Complex Health and Social Needs to launch the Neighborhood Health Compass initiative. The NHC project will identify and select communities that may benefit from using clinical and non-clinical data to identify the heaviest users of healthcare, and then providing those communities with technical assistance and support to better coordinate care for those super users.

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News 12/8/16

Top News

Employee healthcare provider Crossover Health receives a $92 million investment from Gurnet Point Capital, bringing its total amount raised to $113.5 million since launching in 2010. The Aliso Viejo, California-based company has developed its own Primary Health technology platform, and seems to have made digital health a prominent part of its patient engagement strategies. It operates facilities in the Austin, the Bay Area, and Boston; and plans to expand into Southern California, Dallas, Chicago, and New York. Gurnet Point Managing Partner Christopher Viehbacher and Partner George Montgomery will join Crossover’s Board of Directors.

HIStalk Practice Musings

Organizers of the Health IT Leadership Summit in Atlanta were kind enough to issue me a press pass the morning of the event, which meant I missed Andy Slavitt’s keynote. Though it was literally phoned in, attendees who were brave enough to face the city’s horrendous early-morning traffic told me it was worth the drive. His insight, aided by live commentary from CMS Deputy Chief of Staff Tim Gronniger, IHealth Innovations Chief Growth Officer Justin Barnes, and ONC Chief Health Information Officer Mike McCoy, MD seemed to focus on MACRA and physician adjustment to the Quality Payment Program. Now I know why the CMS press office brushed off my request for an in-person interview.

I was able to catch a very engaging panel on “The Physician’s Perspective on Consumer Engagement” featuring ENT of Georgia Compliance Officer Mike Koriwchak, MD Harken Health Medical Director Hogai Nassery, MD and CompleteMD CEO Sydney Smith. The panelists offered up what I found to be a very refreshing take on wearables in light of HIPAA, with the general consensus being that any sort of gadget that gets patients motived is good. Dr. K, always good for a sound byte, echoed many a user’s opinion of wearables like Fitbit, which he used for a period of time then put in a drawer once he understood his own activity patterns, obstacles, and goals. He added that Fitbit’s sales were down this holiday season compared to last, which makes the company’s decision this week to purchase Pebble seem like a last-ditch effort to maintain market share/relevance.

HIPAA was a touchy subject, with Nassery making the point that, what was once intended to help patients access their data has now turned into a blanket of secrecy providers unintentionally place over that data in an effort to avoid audits and fines. As Dr. K noted, “It’s getting ridiculous when you can’t hang up pictures of your patients and you’re spending thousands of dollars on privacy and security precautions. I don’t trust the government to come in and do the right thing when they audit.” His HIPAA fatigue – and desire to go the extra mile for his patients – has prompted him to tell patients to go ahead and send a picture (yes, an unsecure one) when he can’t stand it anymore.

I wrapped up my half-day attendance watching the inspiring Denise Hines receive the Phoenix Award for Community Leadership from the Metro Atlanta Chamber. Hines is CEO of EHealth Services Group, executive director of the Georgia Health Information Network, past president of Georgia HIMSS, and is gearing up to take over the North American HIMSS board. I’ve known her for several years and she is one of those people who always has a smile on her face and a willingness to help in her heart.

Webinars

December 14 (Wednesday) noon ET. “Three Practices to Minimize Drift Between Audits.” Sponsored by Armor. Presenter: Kurt Hagerman, CISO, Armor. Security and compliance readiness fall to the bottom of the priority lists of many organizations, where they are often treated as periodic events rather than ongoing processes. How can they improve their processes to ensure they remain secure and compliant between audits? This webinar will cover the healthcare threat landscape and provide three practices that healthcare organizations can implement to better defend their environments continuously.

Acquisitions, Funding, Business, and Stock

Despite losing $128 million in the first three quarters of 2016, Oscar Health opens its first clinic. The 6,000 square-foot paperless primary care facility in Brooklyn will operate in partnership with nearby Mt. Sinai Health System – a move that will likely help cushion any operational growing pains. The startup insurance company saw dismal levels of interest in its ACA-induced exchange offerings, and now seems to be looking (or grasping at) for new opportunities. It plans to offer group insurance to employers in February, and hopes to eventually expand its Genius Bar-like clinic concept nationwide.

Announcements and Implementations

TRA Medical Imaging (WA) renews its RCM service agreement with Zotec Partners.

Life management center Get Help Now implements Inteveo’s IMediSuite EHR and PM technology. The organization seems an odd hybrid of personal development programs and business solutions that include practice management services.

IDS releases AbbaDox QuickBox software, which will securely send test results including DICOM images to the desktops of referring physicians.

PMD develops dashboard-based PQRS tools for physician practices, enabling them to add data throughout the year, and receive data validation and progress feedback.

People

Ed Park will join the Athenahealth Board of Directors in January. He will step down from his current position as EVP and COO at the end of this month.

Other

Mississippi-based William Carey University’s College of Osteopathic Medicine partners with the Hinds Community College drone program to develop the Health Integrated Rescue Operation. The program will develop drones that can deliver medical supplies to people in disaster areas. Researchers are also working to equip the drones with smart glass-powered virtual consult capabilities.

Contacts

Jenn, Mr. H, Lorre

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