News 4/11/17

Top News

Accounting firm Dean Dorton Allen Ford acquires physician billing and credentialing business Metro Medical Solutions for an undisclosed sum. MMS will be rolled into the Dean Dorton Healthcare Solutions consulting practice. Both companies are based in Louisville, KY.

Reader Comments

From Just the Fax: “Re: ‘A study in the Journal of the American Pharmacists Association finds that pharmacists have a better chance of resolving prescription questions when they reach out to physicians by phone rather than fax.’ In discussing a recent study of pharmacy communications, the fact that they are still using faxes was noted as evidence that e-prescribing is still not sufficient in its adoption. There may be multiple explanations. We use e-prescribing routinely – we are in NY. Yet we still get frequent faxes from pharmacies. Even when I’ve called and pleaded with them to stop, they refuse to do so. Sometimes they send them to the primary care physician for renewal even when the original script was from a specialist. This happened with one of my patients a few weeks ago and the primary care physician submitted it for the wrong dose. Then the managed care company refused to fill it for the right dose because it had already been filled for the month. But that kind of error probably wouldn’t be identified as such. Automatic faxes are also a problem because there is a tendency for people to just sign them and fax them back without calling the patient or looking at the chart. Perhaps some MDs like them but I find them risky.”

Webinars

April 26 (Wednesday) 1:00 ET. “SSM Integrated Health Technologies Clinical Data Migration: Functional and Technical Considerations.” Sponsored by Galen Healthcare Solutions. Presenters: Sandy Winklemann, MHA, RHIA, project manager, SSM Integration Health Technologies; Tyler Mawyer, MHA, managing consultant, Galen Healthcare Solutions; Kavon Kaboli, MPH, senior consultant, Galen Healthcare Solutions. GE Centricity and Meditech to Epic EHR transition. Join us for a complimentary webinar as present the decisions that are important to consider when performing a clinical data migration from the point of view of  the healthcare organization program manager, the clinical analyst, and the technical implementation team. Our expert panel will survey data migration considerations, best practices, and lessons learned. The webinar will present a unique client perspective, offering insight into considerations surrounding staffing, clinical mapping, legacy application support, and validation and testing.

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

Announcements and Implementations

Aprima Medical Software will add ActX’s genomic decision-support technology to its EHR, giving end users drug genomic interaction alerts as part of their prescription workflows. ActX entered into a similar arrangement with CompuGroup Medical earlier this year.

ZyDoc retools its TrackDoc cloud-based transcription technology to include an EHR-integrated smartphone app and enhanced security.

Gateway Homes (VA) selects the AlphaFlex EHR from Mediware Information Systems to help improve its mental health skills-building and psychosocial services rehabilitation services at its three facilities.

The Vascular Experts implements Meridian Medical Management’s VertexDR PM and EHR software, and PrecisionBI analytics tool at its eight outpatient surgical facilities across Connecticut and New York.

Telemedicine

The State of Colorado’s Medicaid program offers members real-time, text-based mental health consults from Ieso Digital Health through a partnership with behavioral health company Beacon Health Options.

The American Telemedicine Association releases guidelines child and adolescent telemental health, plus stroke assessment.

People

Kellie Rice (Together Health Network) joins primary care services and support company ConcertoHealth as executive director of its Michigan market.

Research and Innovation

Researchers determine that hospital-based physicians are more likely than their practice-based counterparts to refer patients complaining of back pain, headaches, or upper respiratory tract infections for CT or MRI scans and X-rays, and for further evaluation by a specialist. The authors of the resultant study, which analyzed data from 31,000 appointments, posit that the unnecessary, or low-value, testing and referrals may be due to the fact that hospital-based MDs have such technology at their fingertips. The study also found that physicians – no matter their location – who did not have a steady relationship with the patient beforehand were more likely to order tests.

Other

Just in time for National Library Week: Researchers develop the Historic Book Odor Wheel, an olfactory identification tool similar to those used to characterize the smells of coffee or wine. The need for such a wheel is part of a greater heritage research project aimed at developing guidelines for characterizing, preserving, and potentially recreating old smells. “When we talk to curators of historic libraries, they point out that smell is the first really important reaction between the visitor and the library itself,” explains researcher Matija Strlič. Colleague Cecilia Bembibre adds that while smell isn’t the whole picture, it “starts a conversation with philosophers, scientists, anthropologists, technologists, and the public itself about what we need to describe a smell.”

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News 4/10/17

Top News

Azalea Health acquires San Diego-based EHR and PM company LeonardoMD for an undisclosed sum. LeonardoMD CEO and pediatric plastic surgeon Ralph Holmes, MD will transition into a physician advisory role at Azalea Health.

Webinars

April 26 (Wednesday) 1:00 ET. “SSM Integrated Health Technologies Clinical Data Migration: Functional and Technical Considerations.” Sponsored by Galen Healthcare Solutions. Presenters: Sandy Winklemann, MHA, RHIA, project manager, SSM Integration Health Technologies; Tyler Mawyer, MHA, managing consultant, Galen Healthcare Solutions; Kavon Kaboli, MPH, senior consultant, Galen Healthcare Solutions. GE Centricity and Meditech to Epic EHR transition. Join us for a complimentary webinar as present the decisions that are important to consider when performing a clinical data migration from the point of view of  the healthcare organization program manager, the clinical analyst, and the technical implementation team. Our expert panel will survey data migration considerations, best practices, and lessons learned. The webinar will present a unique client perspective, offering insight into considerations surrounding staffing, clinical mapping, legacy application support, and validation and testing.

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

Announcements and Implementations

Associates in Diagnostic Radiology and Plaza Radiology – both based in Tennessee – extend their RCM agreements with Zotec Partners.

AthenaHealth adds electronic prior authorization technology from CoverMyMeds to its AthenaClinicals EHR.

Acquisitions, Funding, Business, and Stock

The Pennsylvania Medical Society creates The Care Centered Collaborative, a practice management company aimed at helping Pennsylvania physicians transition to value-based care business models. PAMED has earmarked $15 million for eventual CCC development, including the hiring of 10 FTEs.

New Jersey-based healthcare management company Partners in Care and physician hospital organization CentraState Healthcare Partners form Partners Health Alliance. PHA will provide practice management services focused on help its 700-plus members in The Garden State better leverage value-based contracts with commercial and government payers.

People

Former US Navy Secretary Ray Mabus joins Heal’s Board of Directors. Mabus launched the 21st Century Sailor and Marine health improvement initiative during his eight-year stint as secretary in an effort to reduce sexual assault, suicide, and alcohol and drug abuse.

Michael Ross, MD (Connected Health Strategies) joins Cureatr as a senior clinical advisor.

Government and Politics

New York officials arrest 13 people including physicians, office managers, NPs, and PTs for their alleged roles in a pill-mill ring involving three clinics in Brooklyn. Over the course of five years, the clinics prescribed 6.3 million opioid pills and received over $24 million in fraudulent reimbursements from CMS stemming from unnecessary testing. The investigation kicked off in 2012 (the same year the state’s I-Stop PDMP legislation was passed) when officials noticed a group of “doctor shoppers” becoming extremely active in their medically unnecessary prescription-seeking efforts. No mention has been made thus far of what role New York’s PDMP had in the investigation.

Telemedicine

Crain’s covers the ongoing efforts of Blue Cross Blue Shield of Michigan and Blue Care Network to help 23 physician organizations implement telemedicine services via its physician group incentive program. Seventeen organizations have submitted telemedicine plans that could generate additional reimbursements beginning next month. Six have launched services in some of their practices, while another six are still weighing their options. “The physicians recognize the need to incorporate telehealth into their primary care practices to avoid the fragmentation of care and overuse of antibiotics that could occur if their patients use stand-alone urgent care telehealth centers,” says BCBS consultant Margaret Mason.

Research and Innovation

A study in the Journal of the American Pharmacists Association finds that pharmacists have a better chance of resolving prescription questions when they reach out to physicians by phone rather than fax. The fact that the fax machine is mentioned at all in this study reinforces the fact that there are still many practices that have yet to make the leap to e-prescribing – perhaps with good reason. Of those that have gone digital, researchers found that new prescriptions sent via eRx required clarification four times more than those that were faxed, and twice as often as those that were written. The researchers point out that there is obviously room for improvement when it comes to e-prescribing interfaces.

Other

The IT team at Crystal Clinic Orthopaedic Center (OH) take matters into their own hands when they realize their EHR vendor can’t get them connected to the state PDMP before the end of the year. In six weeks, CIO Gregg Zolton and Gary Pennington, MD led development of an interface “button” that connects their EHR to the Ohio Automated Rx Reporting System. CCOC clinicians can now access OARRS information in less than a second; it previously took seven minutes. “The opioid epidemic could not wait for our vendor to develop the integration software for our EHR system,” says Zolton. “With the professional talent of our IT staff, we were able to integrate the OARRS program in six weeks without the assistance of our vendor.” Google wasn’t much help in my quest to determine what EHR the clinic uses. CCOC uses Medfusion and YourCareUniverse for its patient portals on the clinic and hospital side, respectively.

Sponsor Updates

Blog Posts

• Safer Patients, Better Care: Help with ECRI Institute’s Patient Safety Concerns (Versus Technology)
• [EHR Security Assessments] Your path to optimization (Nordic)

Contacts

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Population Health Management Weekly Wrap Up 4/9/17

Care management tech company Altruista Health hires Jean Prater (General Dynamics IT) as VP of project management, and Tom Joyer (Health Integrated) as VP of sales.

I2I Population Health names Dawn Berg (Assist Consulting Group), Scot McCray (CamCare) (not pictured), and Jay Wilkes (RyMir Consulting) to its sales team. Adam Ackerman (Relatient) joins the company as director of client development.

Netsmart will work with several clients, including Tri-County Mental Health Services (MO), located in states selected to participate in the Certified Community Behavioral Health Clinic program. The CCBHC program requires the use of evidence-based practices, care coordination, integration with physical healthcare, and the provision of 24-hour crisis care, plus participation in a new payment system set up by SAMHSA. The company will deliver care coordination, connectivity, HIE, RCM, and population health management solutions.

CMS awards United Way of Greater Cleveland a $4.51 million grant to help it create a Accountable Health Communities Model. The United Way chapter will use the funds over a five-year period to integrate its community resource navigators into seven Cleveland Clinic, MetroHealth, St. Vincent Charity Medical Center, and Care Alliance Health Center locations. The navigators will work with the providers to assess the health-related social needs of Medicaid and Medicare patients, many of whom live below poverty level. The grant will also help the organizations partner on technology, workflow design, assessment, and planning needs.

Iowa-based Mercy ACO selects Innovaccer’s Datashop data warehouse to aggregate health data from 65 participating facilities including ambulatory sites, hospitals, and payers.

Sponsor Updates

• Intelligent Medical Objects exhibits at the Allscripts Northeast Pro ARUG in Hartford, CT.
• Nordic Consulting presents what employees love most about the company.

Blog Posts

• Non-technical Considerations Before Beginning an Epic Connect Project (Culbert Healthcare Solutions)

Contacts

Jenn, Mr. H, Lorre

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News 4/6/17

Top News

Less than two months after opening a second office, Drchrono closes a $12 million round of Series A funding led by Runa Capital. The Mountain View, CA-based company, which has raised just over $16 million since opening its doors in 2009, will add Runa Capital Partner Andre Bliznyuk and Maxfield Capital Managing Parter Oleg Koujikov to its board.

Webinars

April 26 (Wednesday) 1:00 ET. “SSM Integrated Health Technologies Clinical Data Migration: Functional and Technical Considerations.” Sponsored by Galen Healthcare Solutions. Presenters: Sandy Winklemann, MHA, RHIA, project manager, SSM Integration Health Technologies; Tyler Mawyer, MHA, managing consultant, Galen Healthcare Solutions; Kavon Kaboli, MPH, senior consultant, Galen Healthcare Solutions. GE Centricity and Meditech to Epic EHR transition. Join us for a complimentary webinar as present the decisions that are important to consider when performing a clinical data migration from the point of view of  the healthcare organization program manager, the clinical analyst, and the technical implementation team. Our expert panel will survey data migration considerations, best practices, and lessons learned. The webinar will present a unique client perspective, offering insight into considerations surrounding staffing, clinical mapping, legacy application support, and validation and testing.

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

Announcements and Implementations

Rio Grande Valley Health Alliance will pilot remote patient monitoring, care coordination, and telemedicine technology from Reliq Health Technologies with its primary care patients beginning next month. The alliance is a Texas-based ACO made up of 17 PCPs working in 15 independent practices. Launched in 2013, it now cares for 30,000 Medicare beneficiaries.

People

InSync Healthcare Solutions hires Trent Baker as CISO.

Former Cerner executive (and International Federation of Body Builders competitor) Daphne Bascom, MD becomes the first physician on staff at a YMCA in the US. She joins the YMCA of Greater Kansas City in the new role of SVP of community integrated health.

Telemedicine

PatientClick develops PC Connect, a patient-facing telemedicine app that also features health-record access.

Findings from an American Telemedicine Association survey of 170 member executives echo the results of other, similar studies released thus far in 2017:

• 83 percent will likely invest in telemedicine this year.
• 84 percent feel telemedicine services will “strongly” expand their organization’s coverage and reach.
• 98 percent believe virtual services offer a competitive advantage.
• Reimbursement and licensure are top barriers to greater adoption.

Government and Politics

ONC announces a health data provenance challenge. The office will award up to $180,000 in prizes to teams/entries that can successfully identify available capabilities and methods used by healthcare stakeholders to communicate the provenance of data as it is used to support care. The first round of submissions closes May 22.

Other

The National Quality Forum holds its annual conference in Pentagon City, VA. Data liquidity and outcomes measurement seemed to be hot topics. Aledade CEO Farzad Mostashari, MD lamented that Aledade physicians can’t get data from a third of their EHR vendors.

The wearable that wears you: Dutch industrial designer Daniel de Bruin creates the Neurotransmitter 3000 – a single-person ride that speeds up or slows down based on the rider’s biometric data. High levels of fear or nausea cause the ride to slow down, while more normal vital signs cause it to speed up.

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Jenn, Mr. H, Lorre

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From the Consultant’s Corner 4/6/17

Getting the Lay of the MACRA Land This Year and Next

Despite the change in administration, MACRA, with its Quality Payment Program, is here for at least awhile, having received tremendous bipartisan support in Congress. Because there is significant upside and downside Medicare payment risk, it is essential for all providers to prepare for this new QPP.

Who Participates

If your organization is actively participating in advanced Alternative Payment Models, then the participation in this QPP is covered. However, only 10 percent of providers fall into this category. If there are few Medicare charges or patients, or a new Medicare provider, you do not have to participate. Therefore, most physicians and practice groups will fall under the category of participating under the Merit-based Incentive Payment System program.

Core Components

While MACRA is very similar to the PQRS, Value Modifier, and Meaningful Use programs, it attempts to align all three programs via four components:

• Quality (numerous metrics to choose from)
• Resource Utilization (cost will not be a factor in 2017 and only 10 percent in 2018)
• Advancing Care Information (use of an EHR, with numerous metrics to choose from)
• Clinical Practice Improvement Activities (process improvement – demonstrate core capabilities plus a few additional metrics to choose from)

Performance in these categories is weighted and begins with 60-percent quality, 25-percent advancing care information, and 15-percent process improvement. In two years the weighting will change to 30-percent quality, and 30-percent resource utilization, while advancing care information and process improvement will stay the same at 25 percent and 15 percent, respectively.

Just as with PQRS, there are still multiple ways to report. You can report as an individual provider with an NPI/TIN or as a group of physicians under one TIN. Reporting can take place via claims, registry, CMS website, Qualified Clinical Data Registry or through the EHR system.

There is a significant upside and downside to starting at 4 percent of fee scheduling and ending up at 9 percent over the next four years. This will be based, in large part, on balance budget. Therefore, there will be winners and losers, and providers will essentially be competing against one another. Above all, there is a $500 million pool of money to be shared by the exceptional performers.

What is Important for 2017?

In recognition of the complexity of a new program, many individuals and practices that have not previously reported will begin reporting. CMS has decided that the threshold to avoid a negative penalty should be very low for 2017. As long as one metric – a quality metric, performance improvement project attestation, or the minimum standard of EHR use – is met, the provider/group will not be penalized for their 2017 performance. Because very few will be penalized, there will also be little upside gain. Providers can use 2017 as a year to develop overarching strategy and infrastructure, rather than worry about whole-scale reporting.

Strategy

Typically, many practices put their finance and IT departments in charge of selecting measures that are feasible to report on, reporting, and ensuring accuracy. However, this is a good time for organizations to step back and take a broader look at their organization, which typically includes:

• CIO – Meaningful Use
• CFO – PQRS
• CMO – Quality
• Population Health Lead
• CMIO – EHR Deployment and Optimization

This program provides an opportunity to pull together these leaders and consider organizational strategies. It allows the leadership to then pick metrics and projects that will support their long-term vision, and focus resources on those areas that will most likely help the broader quality goals of the organization. This would create sustainable improvement and optimize performance.

This year is a great one to select a few metrics that are easy to perform to get one’s feet wet and develop a strategy and infrastructure to support MACRA and QPP for the long run.

Nancy Gagliano, MD is CMO at Culbert Healthcare Solutions in Woburn, MA.

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