HIStalk Practice Winners Circle: Baqar Naqvi, Practice Manager, Progressive Medical Care

Editor’s Note: This is the first installment of the HIStalk Practice Winners Circle, an interview series featuring physician practice professionals that have been recognized for their health IT-related expertise.

Baqar Naqvi is the practice manager for Progressive Medical Care in Montgomery Village, MD. EHR vendor MTBC named him Office Manager of the Year for 2016.

Tell me about yourself and the practice.

I am, by training, a pharmacist. I have 30 years of experience at different director-level positions within the DoD, VA, and other healthcare systems. I have worked for Progressive as practice manager since 2011. I work part-time to help out my wife, Tesheen Naqvi, MD who is one of three physicians at the practice. It seems like it is going very well.

Given that you’ve been with Progressive since 2011, how have you seen healthcare technology impact the staff’s ability to care for patients?

I have very positive feedback as far as technology is concerned, because I think the healthcare industry was way behind and now they are catching up. We can now capture things like immunizations, patient physicals, or other follow-up issues – even making appointments has become easier. We now have a clearer picture than we did before. There’s no longer a need to have so many personnel attached to administrative tasks like filing and retrieving charts. We can now get that information in just a couple of keystrokes. Healthcare technology has saved us a lot of time.

Our patients are very happy because, when they sign up for the patient portal, they can easily see all their health information – their prescriptions, balances, appointments – and even update their own contact information. It prevents headaches all around.

Why did you receive the Office Manager of the Year Award? How have you used the practice’s healthcare technology to benefit staff and patients?

For two reasons. The first being that I educated my staff – physicians, front desk, medical assistants – on why health IT is important. It is human nature to resist change, after all. We still have challenges. At the highest level, my job is to convince my staff that this can help patients, save us time, make us more efficient. Though it has definitely resonated with staff and patients, I find that it is a continuous battle. I have to help them understand that there are consequences to not using this technology appropriately. If we don’t update patient information and we need to get in touch during an emergency, what is going to happen? If we don’t sign up patients for the portal, guess what? We’ll get more phone calls.

This is the way I approach explaining the value to them, which brings me to my second reason. I make the front desk staff sign up every new patient for the portal before he or she leaves. There’s a certain amount of education involved. You have to walk them through it; there are no if, ands, or buts allowed. We are trying to strongly encourage our patients to sign up. That effort is the reason our practice has high portal enrollment numbers.

Is the practice looking at implementing any new healthcare technologies in 2017?

We’re thinking about doing telemedicine. I’m working on it – looking at different vendors, and at the related legal issues. I’m investigating that at this point.

What is your number-one consideration when vetting telemedicine vendors?

There are three factors involved – safety, what legal challenges I have to deal with, and cost.

I understand that several of your physicians have attested for Meaningful Use. Now that it seems to be winding down, what consideration are you giving to MACRA?

This is going to be a moving target, to be very honest. I don’t expect MACRA is going to be the last step. In two years we’ll be using some other term as we learn more and things continue change. We do plan on participating. The only thing I’m worried about is that the changes will penalize us. It’s really difficult to break even. Cost is one of our major concerns, and so anytime I look at those changes or rules coming from CMS, I worry. I have not done a deep dive on it yet.

Do you think you’ll need to adopt new technologies or use what you have in different ways as you transition to value-based payment programs? Or, will things stay the same?

I hope I don’t have to look for another vendor. MTBC has been very good at implementing my suggested changes. If telemedicine factored into MTBC, I’m confident that would be the easiest way for us to transition. Going to other vendors for just one component – telemedicine – is going to be expensive and cumbersome for us. We may have to upgrade our computers. If we have to do it, we have to do it.

What are your goals for 2017 when it comes to helping the practice use healthcare technology more efficiently and effectively?

I think I will stay on the course that I am on to educate our patients. The biggest concern patients have is security. They want to know “Is my information safe?” We have some information about HIPAA, and we are educating patients on the the safest way to communicate with us which is through messaging. Don’t send us emails, don’t call us. The best way is to send us messages. Our challenge is to educate patients so they feel comfortable communicating with us using technology.

For doctors and staff, I think we are doing a pretty good job and we will keep doing it so everybody starts using technology more and more. My goal is to have almost 50 percent of my patients signed up to the portal by the end of this year. We are close to 30 percent. It is a stretch, but achievable.

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News 1/23/17

Top News

GetWellNetwork acquires patient intake technology company Seamless Medical Systems (and the 150 clinics it serves) for an undisclosed sum. It is GetWellNetwork’s third acquisition in nearly as many years, and seems to be its strongest in the outpatient market.

Webinars

January 26 (Thursday) 1:00 ET. “Jump Start Your Care Coordination Program: 6 Strategies for Delivering Efficient, Effective Care.” Sponsored by Healthwise. Presenters: Jim Rogers, RN, RPSGT, director of healthcare solutions, Persistent Systems; Jason Burum, chief client officer, Healthwise. This webinar will explain how to implement a patient-centered care coordination program that will increase quality as well as margins. It will provide real-world examples of how organizations used care coordination to decrease readmission rates, ED visits, and costs.

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

Surgical Notes formally launches a set of RCM services for ambulatory surgery centers.

Indianapolis-based OurHealth will implement EHR and PM technology from Athenahealth across the 40 employer-based clinics it manages in five states.

New West Physicians (CO) selects Health Dialog’s shared decision-making tools for patients suffering from spinal stenosis, and knee and hip osteoarthritis.

Northwest Vein & Aesthetic Center (WA) offers patients calming virtual reality experiences from Oncomfort to help alleviate stress and anxiety during vein procedures. The clinic notes that it’s hoping to increase patient satisfaction and improve outcomes with the add-on service. Anyone want to wager this will soon be offered during labor and delivery?

Digital health coaching company Welkin Health partners with health IT startup Common Sensing to create a diabetes management program aimed at improving insulin adherence. The program will provide a real-time look at blood glucose data via dosing data wirelessly transmitted from Common Sensing’s smart Gocap and supporting information from Welkin Health coaches.

Acquisitions, Funding, Business, and Stock

The Core Institute raises an undisclosed amount of equity financing from Frazier Healthcare Partners and Princeton Ventures. The company, which provides management, IT, and care coordination services for musculoskeletal medical practices, will use the investment to grow its payer partnerships. The Phoenix, AZ-based company recently established a Physician Hospital Organization with Banner Health (AZ).

Telemedicine

An American Well survey of over 4,000 consumers confirms what I’ve heard anecdotally from friends and family members over the last six months – consumers are increasingly clamoring for virtual consults, and are looking at availability of such services when shopping around for physicians. Some interesting stats:

• 66 percent are willing to see a physician via video
• 69 percent believe diagnosis via video is more accurate than that given via phone or email.
• 20 percent would be willing to switch to a PCP that offers video visits. That number climbs to 34 percent when taking only parents of the under-18 set into account.

Based on these stats, it seems that physician practices would want to consider adding virtual visits as a way of increasing patient satisfaction and loyalty, though that’s easier said than done in today’s world of legal red tape and reimbursement uncertainties.

Government and Politics

Andy Slavitt, now a private-sector citizen, tells Politico that he will remain in Washington, DC (albeit on a part-time basis) to serve in bipartisan efforts to save as much of the ACA as possible.

Editor’s Note: The Trump administration is settling in and thus a number of personnel moves at HHS/CMS/ONC are in motion. Mr. H covered the more prominent transitions, plus President Trump’s executive order to initiate repeal and replacement of the ACA, in his most recent post. I try not to repeat news he’s already covered, given some of the overlap in our readerships.

Other

HIStalk Practice readers know I’m a book lover, and now I’ve found the perfect vacation to accommodate my bookwormish ways. Gladstone’s Library in Wales offers tourists the chance to lodge in former Prime Minister William Gladstone’s residential library. For a bit less than $200 a night (en suite), tourists can immerse themselves in the library’s 250,000 books – 32,000 of which are part of Gladstone’s private collection. The building comes equipped with everything a voracious bibliophile needs – cozy armchairs and sofas, puzzles, newspapers, picturesque views, and roaring fires in the wintertime. If only they’d advertise on Groupon …

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Jenn, Mr. H, Lorre

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Population Health Management Weekly Wrap Up 1/22/17

Franklin, TN-based Healthways, which sold off its self-described population health management Sharecare business summer, changes its name to Tivity Health in an effort to better align with its fitness and health improvement offerings targeted to seniors via payer and employer programs.

Geisinger Health System (PA) launches Springboard Health, a community-focused program that looks like it will incorporate social determinants of health into efforts that it hopes will help improve the health and wellness of local populations. The program will launch in Scranton, PA to help its residents deal with high levels of diabetes and obesity, as well as behavioral health issues and economic challenges related to income and access to fresh foods. “We are going to introduce innovative programs and foster robust community collaborations, and back it all up with data to make sure Scranton is the healthiest place to be in the country,” says Geisinger President and CEO David Feinberg, MD. “Once we successfully implement Springboard Healthy Scranton, we’ll take the program on the road to communities with similar socioeconomic health challenges.”

The Robert Wood Johnson Foundation partners with NYU’s School of Medicine’s Dept. of Population Health and Robert F. Wagner School of Public Service to develop the City Health Dashboard. The tool will offer city leaders and public health officials a visual snapshot of a local population’s health across five areas – outcomes, behaviors, clinical care, socioeconomic factors, and physical environment.

Hill Physicians Medical Group (CA), the largest IPA in the northern part of the state, enlists the services of Evolent Health as it prepares to participate in the Next Generation ACO program. The group will initially tap into Evolent’s risk-adjustment services, network strategy development, and deploy its Identifi care coordination and population health management platform.

Kern Health Systems selects ZeOmega’s Jiva 6.1 population health management technology to better manage care for its 240,000 members in California.

The North Country Initiative rolls out population health management technology from Lightbeam Health Solutions to the 150 physician members of its healthcare partnership, which includes six hospitals and dozens of independent practices.

NTT Data Services adds Vitreos Health’s predictive analytics to its healthcare product line in an effort to bolster its population health management offerings.

MCG Health and Milliman MedInsight develop MedInsight Guideline Analytics to assist providers with benchmarking, provider profiling, care management reporting, and marketing.

Sponsor Updates

• Intelligent Medical Objects will exhibit at the Allscripts 2017 South ARUG January 21-22 in Raleigh, NC.

Blog Posts

• Optimize rapid response team efforts with automated, real-time communication (PerfectServe)

Contacts

Jenn, Mr. H, Lorre

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News 1/19/17

Top News

Teladoc shares climb nearly 14 percent on the news that the company will price nearly 9.5 million shares at $16.75 apiece. Analysts anticipate that, if fully subscribed, the move will help the company bring in $159 million for further development. The company claimed $77 million in 2015 revenue, $123 million in 2016, and expects to bring in $185 million this year. It has raised close to $173 million since launching in 2002.

Webinars

January 26 (Thursday) 1:00 ET. “Jump Start Your Care Coordination Program: 6 Strategies for Delivering Efficient, Effective Care.” Sponsored by Healthwise. Presenters: Jim Rogers, RN, RPSGT, director of healthcare solutions, Persistent Systems; Jason Burum, chief client officer, Healthwise. This webinar will explain how to implement a patient-centered care coordination program that will increase quality as well as margins. It will provide real-world examples of how organizations used care coordination to decrease readmission rates, ED visits, and costs.

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.

Telemedicine

SnapMD announces another round of upgrades to its Virtual Care Management technology including configurable pricing and stand-alone documentation.

Announcements and Implementations

Hill Physicians Medical Group (CA), the largest IPA in the northern part of the state, enlists the services of Evolent Health as it prepares to participate in the Next Generation ACO program. The group will initially tap into Evolent’s risk-adjustment services, network strategy development, and deploy its Identifi care coordination and population health management platform.

EclinicalWorks integrates Qardio’s smart blood pressure monitor, and wireless scale and analyzer with its EHR and patient-facing Healow app, giving patients the ability to send physicians personal health data in between appointments. It seems like an interesting development, but I wonder how physicians plan to compensate themselves for keeping up with such a steady stream of information, and where they’ll find the time to analyze and react to the data.

Government and Politics

On the eve of inauguration day, Athenahealth CEO Jonathan Bush points out three areas that President-elect Trump should focus on as he continues efforts to repeal and replace Obamacare: 

• Let the cost and quality data of government-provided healthcare services flow so that consumers and physicians can make more informed decisions.
• Encourage innovation by reducing regulatory overreach.
• Get out of the business of designing healthcare technology. “[ONC] is a small agency causing tremendous ripple effects in healthcare by dictating the specific features, functionality, and design elements of electronic health records that clinicians are required to use,” Bush explains. “This is akin to a government agency telling Apple exactly what the next iPhone should look like.”

STAT offers up an analysis of everyone’s favorite CMS tweeter, inadvertently presenting an interesting case study on the power of social media and the ways in which government officials can use it during times of extreme change. Slavitt, who has tweeted 3,200 times since December 6, stresses that his forthrightness shouldn’t be surprising given that, “The terms I agreed to were to speak my mind and do what I think is right. I’m not going to be right every time. If people want to criticize, I’m willing to take that.”

Research and Innovation

A two-part, longitudinal study of 566 primary care groups with eight or fewer physicians finds that, not surprisingly, their extent of healthcare technology adoption depended on the size of the practice, ownership, and external financial incentives. While research showed increased adoption of EHRs, e-prescribing, and patient portals across the board, it also showed that hospital-owned practices were the highest adopters, followed by practices with three to eight physicians, and then those with one or two. Higher adoption was also tied to greater participation in public reporting of quality data and in pay-for-performance programs, and a larger chunk of revenue from Medicare. Only 20 percent of all the practices had adopted use of email or online medical records as a means of patient engagement.

Other

UPMC Chief Innovation Officer Rasu Shrestha, MD shares the news that members of the Japan Sanitary Equipment Industry Association have agreed to standardize the images used on Japanese toilet control panels. (Yes, you read that correctly.) The move was made in an effort to accommodate Western tourists, who have had trouble understanding the controls, which operate features like warm air drying and the bidet.

Epithelioid sarcoma patient Kirsti Loyall hasn’t let losing her right foot keep her from going places. She kept the amputated foot and has begun documenting their adventures via her “onefootwander” Instagram account, which she hopes will prove to her followers that there is life after cancer.

Contacts

Jenn, Mr. H, Lorre

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Readers Write: MIPS is Here – Don’t Be Afraid

MIPS is Here – Don’t Be Afraid
By Mandy Long

Some feel that the Merit-Based Incentive Payment System, part of the Quality Payment Program intended to improve the healthcare continuum by advancing quality-based care, has created new risk and uncertainty for a main industry pillar – providers. On the one hand, physicians who have been participating for years in the Physician Quality Reporting System and Meaningful Use state they feel ready for MIPS reporting. On the other hand, some have voiced concerns over needing more time to understand the program and prepare their practices due to a lack of resources, including staff and funding.

MIPS presents opportunities and challenges, and practices should stay educated regarding value-based reimbursement. As the chair of the Electronic Health Record Association’s Clinician Experience Workgroup, I’ve spoken with numerous clinicians, stakeholders, and industry experts about the concerns physicians have over the new reporting requirements and potential pitfalls.

While another mandate may seem daunting, many of today’s modern technologies can help address these changes and aid in the clinical, financial, and operational success of physicians. Here are four common MIPS-related concerns I’ve heard and accompanying reasons why the right technology and EHR vendor can help alleviate those stressors:

1) Concern: Practices are concerned about the lack of resources and time needed to help staff understand the new requirements.

Why? Understanding the complex requirements of MIPS can be difficult and overwhelming, especially for practices that feel they have less time and inadequate resources to develop the necessary knowledge.

Resolution: Work with a vendor that doubles as a responsive training and support team. Not only should they supply a modern solution that is intuitive and easy to use, but they should also offer services such as concierge coaching, education, and advisory services for practices that may not have the necessary in-house talent (or time). With limited resources, it is important to have an expert available to keep your staff well-informed as legislation evolves in our industry.

2) Concern: Practices are concerned that their staff doesn’t have the right experience with EHR systems and skills to leverage data needed for participation.

Why? Most physician practices have limited time to devote to additional administrative duties, including collecting and reporting data on quality measures and completing required documentation needed for participation in the new payment models.

Resolution: Select a vendor that has a proven track record in MU attestations and PQRS reporting, and offers an EHR system with structured data that automates the process. The right system should not increase overhead, but rather make your current team more efficient by streamlining data entry and reporting for each patient visit.

3) Concern: Practices that fight joining larger organizations are concerned that they lack the data needed to compare their performance to that of other practices or benchmarks.

Why? Some industry thought leaders have said that MIPS was a Congressional effort to push doctors to join larger organizations, which many consider better equipped to manage and coordinate care across the continuum. It is believed that practices that do so are more likely to participate in quality monitoring or clinical benchmarking than practices that do not share resources.

Resolution: Implement a solution with native analytical capabilities that documents near real-time comparative benchmarking of quality and cost. Your system should not only track individual physician performance and practice performance, but should also show you where you stand when compared to other physicians in your specialty.

4) Concern: Practices are concerned that they lack financial resources needed to make initial investments.

Why? Practices may not have a budget that can absorb the investments and resources necessary to keep up-to-date on and purchase solutions that meet regulatory requirements, especially when it comes to dedicated headcount to focus on quality programs.

Resolution: Avoid headaches by investing intelligently now with a partner offering services and solutions to help you avoid the end-to-end burden yourself. Your vendor should offer a specialty-specific, all-in-one suite of solutions and help develop a roadmap supporting your practice’s evolving needs. Your system should have MIPS success embedded in its technology, and shouldn’t require you to re-enter data already being collected during the clinical visit. It should offer services to educate and train your staff on how to appropriately document to succeed in the new MIPS landscape, and keep you knowledgeable as requirements evolve.

While CMS recognizes some difficulties that practices will face with new legislation, successfully navigating MIPS ultimately falls to the provider in selecting a partner who will best support their long-term goals. If you’re experiencing concerns similar to those listed above, don’t wait and see how these measures will impact your operations and finances. Find a great partner and adopt the right solution to prepare for the volume to value transition.

Mandy Long is VP of product management at Modernizing Medicine in Boca Raton, FL. 

Contacts

Jenn, Mr. H, Lorre

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