News 2/1/17

Top News

Republican members of the Senate Finance Committee vote to move Rep. Tom Price’s (R-GA) confirmation for HHS secretary forward to a full Senate vote after deciding this morning to suspend rules requiring the presence of at least one member of each party. Their Democratic counterparts, who boycotted yesterday’s vote, were once again absent.

Webinars

February 8 (Wednesday) 1:00 ET. “Machine Learning Using Healthcare.ai: a Hands-on Learning Session.” Sponsored by Health Catalyst. Presenter: Levi Thatcher, director of data science, Health Catalyst. This webinar offers a tour of Healthcare.ai, a free predictive analytics platform for healthcare, with a live demo of using it to implement a healthcare-specific machine learning model from data source to patient impact. The presenter will go through a hands-on coding example while sharing his insights on the value of predictive analytics, the best path towards implementation, and avoiding common pitfalls.

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

Acquisitions, Funding, Business, and Stock

CompuVision, a managed IT services company based in Santa Barbara, CA, merges with health IT consulting and services firm Sagewood Systems. The newly combined company will operate under the CompuVision name. Sagewood CEO Bill Wood will transition to CompuVision’s SVP of Engineering. Alberto Kywi (Cottage Health) has joined the combined company as senior healthcare management consultant.

E-prescribing software vendor DrFirst acquires clinical trial recruitment services company VisibilityRx. Terms of the deal were not disclosed. VisibilityRx apparently mines retail pharmacy data to match patients clinical trials. DrFirst President G. Cameron Deemer believes the platform “will enhance the value of our partners’ EHR and pharmacy products, while also helping providers deliver the newest and most applicable clinical trial information to their patients.”

Speaking of DrFirst, its team has put together HIStalkapalooza recap videos over the last several years. Check this one out to get yourself pumped up for health IT’s night out at HIMSS.

Just a few weeks after CEO Tim Cook takes a pay cut due to sluggish sales, Apple reports record-setting Iphone sales and $78.4 billion in first-quarter revenue. The Apple Watch also had its best quarter ever – a stat that surprises me given the general malaise consumers seem to have sunk into when it comes to wearables.

People

Jeff Lew (Cerner) joins Nextech Systems as VP of product management.

Telemedicine

Ganjapreneur reports that NuggMD will expand its online evaluation services for medical marijuana patients beyond its home state of California to include Nevada and Alaska. The company helps patients apply for and receive medical marijuana cards, and connect with a partner dispensary that provides home delivery.

Announcements and Implementations

DAS Health makes its AssessURhealth mental health assessment tool available via online portal. Assessment categories include anxiety, alcohol misuse, depression, opioid risk, and somatic symptoms.

Government and Politics

I tuned into the CMS MIPS overview webinar held earlier today to educate myself about the program and to see if any physician pain points jumped out at me. The biggest, by far, has to be the complexity of participation. “I know this can get a little confusing” was uttered quite a few times by MIPS Program Lead Molly MacHarris, who helped take attendees through over 60 high-level slides. It seems to me that, in an effort to attract as many MDs to the program as possible, CMS has inadvertently added a level of participation complexity that will likely leave most physicians wondering where in the world to begin. That being said, the program also has an incredible amount of flexibility when it comes to picking your own pace, and the measurements and categories that best suit individual practices. The slide deck should be available on the CMS website soon. For those who still have questions, feel free to email qpp@cms.hhs.gov or call 866-288-8292.

Other

I wonder how many baristas will be serving this on the HIMSS exhibit floor: The Finnish “Funguys” at Four Sigmatic attempt to cash in on the superfoods craze with the introduction of mushroom-infused coffee. The company’s green coffee mix includes maitake and chaga mushrooms, which may help to lower blood glucose levels and support digestive health. 

Sponsor Updates

• Healthwise exhibits at EClinicalWorks Day in New Orleans.

Blog Posts

• Prepping for Go Live (Culbert Healthcare Solutions)

Contacts

Jenn, Mr. H, Lorre

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News 1/31/17

Top News

Senate Finance Committee plans to vote on Rep. Tom Price’s (R-GA) confirmation as HHS secretary stall when Democratic members decide to boycott the vote in light of, among other things, a Wall Street Journal report that claims Price “got a privileged offer to buy a biomedical stock at a discount.” The finding contradicts Price’s testimony during last week’s confirmation hearing, in which he said the discounted Innate Immunotherapeutics shares were “available to every single individual that was an investor at the time.” The boycott also delayed the confirmation of Treasury Department head nominee Steven Mnuchin. The vote will likely be rescheduled for tomorrow.

Webinars

February 1 (Wednesday) 1:00 ET. “Get your data ready for MACRA: Leveraging technology to achieve PHM goals.” Sponsored by Medicity. Presenters: Brian Ahier, director of standards and government affairs, Medicity; Eric Crawford, project manager, Medicity; Adam Bell, RN, senior clinical consultant, Medicity. Earning performance incentives under MACRA/MIPS requires a rich, complete data asset. Use the 2017 transition year to identify technology tools that can address gaps in care, transform data into actionable information, and support population health goals and prepare your organization for 2018 reporting requirements.

Announcements and Implementations

North Broward Radiologists (FL) renews its RCM and PM agreement with Zotec Partners.

MediSys will offer Alpha II’s PQRS registry to help its EHR and PM customers collect and report Quality Payment Program data.

People

Thomas Parry (NorthPage) joins healthcare analytics firm Practical Data Solutions as national sales director.

MedEvolve hires Jenny O’Pry (MedSynergies) as SVP, RCM and Matt Seefeld (NantHealth) as SVP, business development.

Telemedicine

San Diego-based PatientClick adds telepsychiatry to its line of telemedicine services.

The Indiana Rural Health Association’s Upper Midwest Telehealth Resource Center enlists the services of telemedicine consulting firm TeleHealth Solutions to help it provide resources and expertise to physicians across Illinois, Indiana, Michigan, and Ohio.

Government and Politics

CMS will host a webinar tomorrow (February 1) to help small, rural, and underserved practices become better acquainted with MIPS.

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Jenn, Mr. H, Lorre

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News 1/30/16

Top News

Former HHS Secretary Sylvia Burwell encourages folks to sign up for healthcare coverage by tomorrow’s deadline. While her tone isn’t quite as funny as those taken by the #PullThisAd contingent, her tweet does dovetail with the surge in grassroots advertising for Healthcare.gov seen in the wake of President Trump’s decision to pull $5 million in weekend ads for the exchange.

Several former Obama staffers have even started a GoFundMe campaign to bring back digital advertising that was cancelled – a move seen by former Healthcare.gov CEO Kevin Counihan as “outrageous” given the last-minute nature of much of humanity. “We know that more young people enroll during the final days of open enrollment,” he explains, “but they need to be reminded of the Jan. 31 deadline.”

HIStalk Practice Announcements and Requests

Invites for HIStalkapalooza went out today. Please do us both a favor and click the “Attend Event” button in your invitation, and then follow the steps to register for your ticket. As Mr. H mentioned in today’s Monday Morning Update, if you don’t click the link and register, our check-in system won’t recognize you and you’ll be denied entry. We’d both be disappointed. You wouldn’t have the chance to dance the night away, and I would miss out on an opportunity to thank you for reading.

Webinars

February 1 (Wednesday) 1:00 ET. “Get your data ready for MACRA: Leveraging technology to achieve PHM goals.” Sponsored by Medicity. Presenters: Brian Ahier, director of standards and government affairs, Medicity; Eric Crawford, project manager, Medicity; Adam Bell, RN, senior clinical consultant, Medicity. Earning performance incentives under MACRA/MIPS requires a rich, complete data asset. Use the 2017 transition year to identify technology tools that can address gaps in care, transform data into actionable information, and support population health goals and prepare your organization for 2018 reporting requirements.

Here’s the recording of last Wednesday’s webinar, “Jump Start Your Care Coordination Program: 6 Strategies for Delivering Efficient, Effective Care.”

Announcements and Implementations

Cleveland-based Chronic Care Management adds support for clinical quality measures programs to its CCM offering, which includes care planning and coordination, medication management, and patient assessments.

Surgoinsville Pharmacy (TN) goes live with UpDox’s Pharmacy Connect care coordination technology, giving it the ability to securely share patient records with local physicians via their EHRs.

Family Choice Urgent Care (OR) selects Practice Velocity’s VelociDoc EHR software and services, including billing and online scheduling. The Machesney Park, IL-based company’s EHR received top category-leader rankings from KLAS in its most recent software and services report.

Acquisitions, Funding, Business, and Stock

San Francisco-based Fitbit lays off 110 employees – 6 percent of its global workforce – in an attempt to stay on track after a disappointing fourth quarter that included poor holiday sales. The company, which acquired competitor Pebble in December, estimates earnings of between $572 million to $580 million – a far cry from its projected $750 million.

People

Chip Porter (Virtual Radiologic) joins Medical Billing Experts as CEO.

OptimizeRx names Jim Lang (Water Street Healthcare Partners) to its Board of Directors.

Cureatr board member William Winkenwerder Jr., MD (Highmark), becomes interim CEO following founder Joseph Mayer, MD’s decision to transition out of the role to become vice chairman of the board. Winkenwerder, who has been on the board since 2015, plans to expand the real-time patient alert company’s current provider partnerships, and expand into long-term and post-acute care.

Angela Mattioda (Abeo) joins Surgical Notes as VP of the company’s new RCM services.

Telemedicine

The American Telemedicine Association releases practice guidelines for mental health, pediatrics, and stroke. Public comments are due February 17.

Research and Innovation

An observational study published in JAMA Ophthalmology finds that patients are more likely to report their symptoms on an Eye Symptom Questionnaire than they are via EHR, prompting researchers to question whether patient data in the EHR is comprehensive enough for use in clinical research. They point out that the difference in symptom reporting may be due to errors of omission on the part of the physician, including forgetting or choosing not to report a symptom. As a patient, I also wonder if the encounter itself was part of the problem. Did the patient feel rushed, and thus forgot to bring up what they considered to be minor concerns? Was the physician in a hurry? Did they wind up documenting after hours, and thus forgot a few details? I can imagine any of the above ringing true given the frantic pace some practices are trying to keep in order to keep the doors open.

Sponsor Updates

• EClinicalWorks will exhibit at Arab Health 2017 January 30-February 2 in Dubai.
• Nordic will host a meetup in Chicago February 3.

Blog Posts

• Six Ways the World is Closer to Closing the Healthcare Skills Gap (GE Healthcare)
• 5 critical steps within a successful Epic upgrade project (Nordic)

Contacts

Jenn, Mr. H, Lorre

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News 1/26/17

Top News

Former HHS Secretary Sylvia Burwell will take over as CEO of American University in Washington, DC on June 1. She will become the first woman in the school’s history to hold the position. It seems to be her first foray into the professional world of academia. Aside from her government gigs (including stints during the Clinton administration), Burwell has also lent her expertise to the Walmart Foundation and the Bill & Melinda Gates Foundation. For context, her predecessor at HHS, Kathleen Sebelius, went on to form her own consulting and leadership development firm.

Webinars

February 1 (Wednesday) 1:00 ET. “Get your data ready for MACRA: Leveraging technology to achieve PHM goals.” Sponsored by Medicity. Presenters: Brian Ahier, director of standards and government affairs, Medicity; Eric Crawford, project manager, Medicity; Adam Bell, RN, senior clinical consultant, Medicity. Earning performance incentives under MACRA/MIPS requires a rich, complete data asset. Use the 2017 transition year to identify technology tools that can address gaps in care, transform data into actionable information, and support population health goals and prepare your organization for 2018 reporting requirements.

Acquisitions, Funding, Business, and Stock

Less than two weeks after dissolving its Coordinated Care Oklahoma HIE, Yeaman and Associates taps its relationship with Nuance to create the Coordinated Care Health Network – a subscription-based, radiology image-sharing service for HIEs that relies on the Nuance PowerShare Network. Yeaman and Associates CEO Brian Yeaman, MD has hinted that an accompanying patient-matching service is also in the works.

Atlanta-based healthcare software and app development company Pointclear Solutions will relocate and expand its Nashville office this spring. The company, which currently employs 20 Music City staffers, plans to hire an additional 30 over the next two years. The new office space will become Pointclear’s primary development hub.

Announcements and Implementations

Universal Research Solutions develops a MIPS-specific qualified clinical data registry and real-time performance scores dashboard to help reduce the administrative reporting burdens already associated with the new program.

HealtHIE Georgia, an HIE serving rural providers in southern part of the state, connects to the statewide Georgia Health Information Network. Phase one of the project has already connected two hospitals and 20 clinics to GaHIN. A second phase will add six hospitals and a yet-to-be-determined number of clinics.

The McKesson Specialty Health-supported US Oncology Network adds 50 Vantage Oncology practices and their 350 affiliated physicians as part of an acquisition announced nearly a year ago. McKesson acquired the oncology-focused practice management company plus Biologics, an oncology pharmacy services company for a combined $1.2 billion.

People

Christie Lawrence (KPN Health) joins consulting firm ARDX as VP of commercial services.

Research and Innovation

McKesson’s IKnowMed EHR for oncologists comes out on top in a six-month Black Book survey of 733 physician practices. The software came McKesson’s way through its acquisition of US Oncology (now US Oncology Network) for $2.16 billion in 2010.

A New England Journal of Medicine survey of 426 PCPs finds just 15 percent are in favor of totally repealing the ACA. Of those that voted for President Trump, only 38 percent would like to see the ACA repealed in its entirety. An overwhelming majority are in favor of keeping the provisions related to pre-existing conditions, allowing young adults to remain on parental policies, and tax subsidies to consumers. Nearly half are in favor of penalizing those that don’t sign up for insurance. Nearly 74 percent are in favor of making changes to the law, though there doesn’t seem to be a general consensus on what those changes should be. Many of those surveyed responded most favorably to proposals that would increase consumer choice of health plans and greater use of health savings accounts.

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Jenn, Mr. H, Lorre

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Readers Write: The Need for Pediatric-Specific Functionality in EHRs

The Need for Pediatric-Specific Functionality in EHRs
By Sue Kressly, MD

Pediatricians repeat this message often: Children are not just little adults. This sentiment rings true in both how we practice medicine and in what we need from our EHR technology. Despite our unique challenges in treating children and adolescents, according to a recent AHRQ Technical Brief, only 8 percent of pediatricians are using a fully functional EHR with pediatric functionality.

As healthcare providers have transitioned from paper to electronic records, we will soon see the first generation of patients who have never had a paper record. For these patients, their entire lifespan will be captured in electronic format. However, if pediatricians are using an adult-based model to capture, support, and record the information of young patients, how can they possibly trust its accuracy? Quite frankly, it’s akin to building a skyscraper knowing the first 21 floors were built with faulty materials.

While much work went into developing the Model Children’s EHR format, the majority of physicians who care for children are still waiting for basic functionality that keeps children safe and supports pediatric evidence-based guidelines. Accurate and useable pediatric growth charts, alerts for abnormal pediatric vital signs according to normative values (120/80 is not a normal blood pressure for a three year-old), and accurate and useable weight-based medication prescribing and liquid dose calculations should be ubiquitous by now – but they aren’t. Unfortunately, pediatricians are still pulling out their smartphones to calculate medication doses.

Incorporating recall systems for annual preventive care is easy and available. However, children are seen, at varying intervals, 12 times in the first three years of life, according to the Bright Futures periodicity schedule. This is the foundation of pediatric medical care, yet very few EHRs provide the ability to recall patients for caring, according to this well-established guideline. Further, recording details of an examination is fraught with its own difficulties. Many adult-based EHRs are delivered with templates including a neurologic exam that reports “alert and oriented x 3.” This is completely inappropriate for an infant, and there is often no easy way to document the subtleties of the physical exam for children, because of their dynamic nature change over time. For example, documentation about an anterior fontanelle and infant hip exam are of crucial importance in the first year of life, as is scoliosis screening and Tanner staging during adolescence. However, these templates for documentation are not available in one-size-fits-all EHRs.

Support for vaccine inventory and clinical decision support surrounding immunization forecasting are integral to pediatric care. Yet, most EHRs do not support and update immunization information in a meaningful way. In addition, adolescent privacy presents its own challenges. What demographic is more poised to want to interact with their physician via electronic technology than teens and young adults? However, most portal technology lacks the ability to tackle the unique challenges of communication with both parents/guardians and teens on sensitive matters, such as such as communicating directly with a teen about her chlamydia screening test or a parent about the results of a parental ADHD survey.

Pediatricians want robust health IT for both their patients and their practices. It’s time for the industry to step up and deliver what the future of our community deserves as pointed out by the American Academy of Pediatrics’ Blueprint for Children – Pediatric functionality to support and promote the health of children and the pediatricians who care for them.

Sue Kressly, MD is owner and a practicing pediatrician at Kressly Pediatrics in Warrington, PA. She is also medical director of Office Practicum.

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