News 8/29/16

Top News

Athenahealth acquires Techstars graduate Filament Labs and its Patient IO care coordination technology for an undisclosed sum. Athenahealth has already added Patient IO to its AthenaWell app for patients, and will add it to its Population Health service  for providers in the fall. The two companies developed a relationship last fall when Athenahealth invested in Patient IO via its More Disruption Please Accelerator program. This acquisition marks the second time Athenahealth has bought an MDP Accelerator company; it acquired Arsenal Health in April. CEO Jason Bornhorst (who developed apps for Expedia prior to his gig with Patient IO) will join Athenahealth as executive director of product strategy, with the rest of the Patient IO staff joining Athenahealth in Austin.

Webinars

None scheduled soon. Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.

Sensato CEO John Gomez always puts on an excellent webinar and his HIStalk-sponsored one from last week was no exception. I chuckled when he moved to the “Enforcement Fun Facts” slide. Did you know that private practices are number-one when it comes to the most common type of covered entity that has been required to take corrective action to achieve voluntary compliance? Gomez explained that this is due to a number of reasons including budget, and a general lack of security know-how. As Gomez put it during the Q&A, “they just don’t understand that they need to be doing these things.”

Above is the recording of “Surviving the OCR Cybersecurity & Privacy Pre-Audit.” For those with shorter attention spans, a tweet recap is available here.

People

Kumar Parakala (Technova) joins Agnity Healthcare’s advisory board.

Announcements and Implementations

NorthStar Anesthesia implements Plexus Technology Group’s Anesthesia Touch anesthesia EHR at 11 facilities, including ambulatory surgery centers, in Texas, Ohio, and Pennsylvania.

Calgary-based Brightsquid launches the Secure Health Exchange messaging service. The company is no doubt hoping physicians in its native Alberta will use the new service to take advantage of the province’s new billing codes for using approved secure-communication channels.

Government and Politics

ONC announces the winners of its blockchain research challenge, which sought to uncover ways that blockchain technology could protect, manage, and exchange digital health data. Fifteen winners were chosen, including teams from MIT; Accenture; Deloitte; IBM, which has been working on blockchain concepts for some time; and several hospitals.

Pennsylvania becomes the 49th state to implement a prescription drug monitoring program, which is being rolled out alongside new prescribing guidelines and $20 million in the state budget to fund 20 centers of excellence for addiction treatment. Legislation creating the Achieving Better Care by Monitoring All Prescriptions PDMP was passed in 2014, but its development was delayed by a lack of funding. Governor Tom Wolf has introduced additional legislation that would require physicians to check the PDMP each time they prescribe controlled substances, an idea that has some physicians worried about the strain on their workload.

Telemedicine

The US Patent and Trademark Office declares certain elements of an American Well patent invalid based on its belief that the company didn’t invent them and so can’t patent them. The action, taken at the behest of competitor Teladoc, is similar to a ruling by a Massachusetts federal court earlier this year over the same patent elements.

Other

I had no idea this was a thing (but it makes total sense): HR executives looking for their next fun employee outing may want to consider a visit to their local Rage Room (aka Anger Rooms), where participants can smash items like printers, sofas, and glass to their heart’s content. Prices at the Anger Room in Dallas range from $25 for five minutes of destruction to $75 for 45 minutes of ultimate demolition. (And yes, gift cards are available.)

Sponsor Updates

• The local business paper covers GE Healthcare’s donation of medical equipment to the Olympic and Paralympic games in Rio.

Blog Posts

• 100% dictation accuracy with speech recognition? (NVoq)

Contacts

Jenn,  Mr. H, Lorre, Dr. Jayne, Dr. Gregg

More news: HIStalk, HIStalk Connect.

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Population Health Management Weekly Wrap Up 8/28/16

Washington Regional Medical System promotes Mark Thomas, MD to vice president, population management.

William Gillespie, MD (Gillespie Health Strategies) joins Medecision as executive vice president, population health management, and CMO.

Bob Vernon (The Advisory Board Company) joins Lumeris as managing principal.

Community Health Centers of Arkansas rolls out population health management technology and reporting capabilities from I2I Population Health across its 76 locations.

Thomas Health System (WV) will work with Aegis Health Group to engage local employers in population health management programs using resources such as its OneCommunity portal, and an embedded employer relations specialist.

The state of Kansas awards a $215 million Medicaid claims system contract to HP Enterprise, which will bring in Cerner’s HealtheEDW data warehouse and population health management tool to allow care managers to optimize the treatment of Medicaid patients in near real time.

A Commonwealth Fund brief on the assessment of patient self-management skills in population health management risk stratification stresses the correlation between low skill levels and risk of chronic-disease development.

Contacts

Jenn,  Mr. H, Lorre, Dr. Jayne, Dr. Gregg

More news: HIStalk, HIStalk Connect.

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News 8/25/16

Top News

CMS announces that MSSP and Pioneer ACOs have saved Medicare over $1.29 billion since launching in 2012. Medicare ACOs – 392 MSSPs and 12 Pioneers – realized combined total program savings of $466 million last year. Also noteworthy is the fact that average quality performance have improved over the last two years by more than 15 percent on preventive care measures that include depression screening and follow-up, blood pressure screening and follow-up, and providing pneumonia vaccinations.

Webinars

None scheduled in the coming weeks. Contact Lorre for webinar services, including produced and promoted options. Past webinars are on our HIStalk webinars YouTube channel.

Acquisitions, Funding, Business, and Stock

Los Angeles-based MedBill-IQ launches its billing review and negotiation service. Users can email or upload their bills for free review, and then opt to pay a fee to use the company’s appeals and negotiations service. Co-founder Peter Yeh seems to have a solid background in the billing review business, having served as COO of Qualified Billing & Collections.

Call center and health IT consulting company Maximus goes on a hiring spree to fill 2,000 jobs at its call center in Gates, NY, which will serve members of public health programs. The company has filled 600 positions since opening the center in July, and anticipates filling the remaining positions by October.

Announcements and Implementations

Vivacare releases the latest version of its InfoRx patient engagement app.

NVoq announces GA of its SayIt speech recognition technology in Canada.

Portland-based OCHIN will offer Acuere’s real-time EHR and claims data aggregation technology to the 170 healthcare organizations it serves across the country.

Community Health Centers of Arkansas rolls out population health management technology and reporting capabilities from I2I Population Health across its 76 locations.

People

Piyanun Yenjit (Paknampo Hospital) joins Medicomp Systems as director of operations for Thailand.

Telemedicine

A Texas Business Association survey of registered voters finds that 70 percent favor the use of telemedicine, 51 percent believe access to physicians has gotten more difficult, and of those that can get an appointment, 24 percent have to drive 30 minutes-plus to take advantage of it. A smaller TAB survey of employers finds enthusiasm for telemedicine to be even higher, at 77 percent, and yet only 18 percent offer it as part of benefits packages. Texans seem to love telemedicine, which makes the ongoing battle between the state’s medical board and companies like Teladoc all the more absurd – at least from the consumer perspective. (Since 2011, the board has disputed the right of telemedicine companies to treat Texans without an initial in-person visit.)

Research and Innovation

Wired looks at the latest research on “passive digital diagnosis,” in which smartphone features like GPS and microphones help track mood and potential mental health problems. Though still in development, location-based tracking seems to have the most potential. “People whose movement through geographic space seemed to be more rhythmic had lower anxiety and depression levels,” says researcher Stephen Schueller, adding that normal routines start to slip as depression creeps in.

Government and Politics

AMGA asks CMS to provide the methodology it plans to use in paying out providers that enroll in the Comprehensive Primary Care Plus program. “We contacted the CPC+ Help Desk two weeks ago and were told that they are unaware of both the paper and its publication date,” the association notes in a letter to CMS Deputy Administrator for Innovation & Quality and CMO Patrick Conway, MD adding that, “Obviously, it is difficult, if not impossible, for provider practices to decide responsibly whether or not they can or should participate in the CPC+ demonstration as either a Track 1 or Track 2 when they do not know to what extent they will be at risk for repaying all or a portion of their prepaid amounts to CMS.” AMGA members seem to still be smarting from extremely short Next Generation ACO application timelines.

ONC publishes a draft version of its 2017 Interoperability Standards Advisory, which improves upon the 2016 version by establishing it as a web-based resource, rather than a text document, and embedding links to ongoing ONC Interoperability Proving Ground projects. Comments on the proposed standards are due October 24.

Meanwhile, amidst the glad ACO tidings, CMS Acting Administrator Andy Slavitt continues his MACRA listening tour …

Other

Fifth grader Evan Robertson makes cybersecurity headlines for an award-winning school project that proves most people value free WiFi over privacy. As part of a fourth-grade science project, Robertson developed a mobile WiFi hot spot with a somewhat unusual list of terms and conditions (see above). During testing at local retail outlets, he found that 76 people connected, and 40 percent accepted the terms and conditions, confirming his hypothesis that at least 50 percent would accept. 

Contacts

Jenn,  Mr. H, Lorre, Dr. Jayne, Dr. Gregg

More news: HIStalk, HIStalk Connect.

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From the Consultant’s Corner 8/25/16

Mitigating Revenue Risk During IT Implementation

From small practices to large integrated delivery networks, the ability to evaluate and select the appropriate IT applications is increasingly important. A number of drivers are pushing healthcare organizations to look critically at their IT vendor mix, especially their revenue cycle applications, including clinical integration initiatives (and the need to extend clinical and business applications to affiliates), the shift to value-based reimbursement, competitive merger and acquisition activity, and vendor market consolidation.

No matter the reason, developing a strategy to mitigate disruption to cash flow is a crucial component of any billing system or EHR implementation. The potential risk to revenue is no less an issue for private practices than for IDNs, yet, too often organizations devise their plans to protect revenue after the vendor selection has been completed and contracted. A better option is to address your Risk to Revenue Mitigation Strategy as part of the vendor selection and contract negotiation processes.

For example, practices should include both implementation staffing needs and ongoing staffing demands (i.e., for application maintenance and user support) in their “total cost of ownership” analysis. Keep in mind that, although most vendors have pre-defined implementation approaches that include helpful standard workflows and staffing structures, these vendor-defined best practices may not adequately address an individual practice’s unique workflow or business requirements. Organizations with a single billing office, for instance, will have vastly different workflows and training requirements than those with decentralized hospital/professional billing and customer service.

To mitigate risk to revenue during revenue cycle or EHR implementations, consider adopting a comprehensive strategy inclusive of these seven elements:

1. Create a business intelligence blueprint prior to go-live. This is the number-one mechanism for mitigating revenue risk, but it’s often overlooked. While most vendors offer robust reporting and BI tools, during the sales process, these same vendors often do not set realistic expectations as to the work effort required to build them before go-live.

2. Don’t skimp on training. In fact, training should be the last place to look for cost savings. In reality, IT implementations always involve changes to workflows, policies and procedures, user roles, application navigation, and personalization tools. Practices must balance vendor recommendations and methodologies against these changes because lost productivity doesn’t just impact financial performance — it also impacts the patient experience. Whenever affiliated practices or hospitals are included in an implementation, the negative PR of a less-than-successful implementation can — and often does — impact future clinical alignment plans and opportunities.

3. “Accelerate” cash flow before go live. As early as eight to 12 months prior to go live, organizations should begin cleaning up their A/R and identifying opportunities to accelerate cash flow. The goal is to create a cash buffer to offset any dips in cash flow caused by declines in clinical productivity or billing performance once billing begins in the new system.

First, design a plan to aggressively work down legacy A/R in the old system before the new system is activated. If internal staff don’t have the bandwidth to shoulder the responsibility, consider outsourced opportunities for an interim period.

Then, decide how to handle the period of time between when some staff must work out two separate systems to work legacy A/R out of the old system and current billing out of the new system. Operating in dual environments — with two different workflows and two different sets of policies and procedures — presents challenges. Old habits are reinforced through use of the old system, just as you’re trying to instill new roles, workflows, policies, and procedures. To overcome these challenges and hasten the learning curve on the new system, many practices outsource A/R from their legacy system after the first two or three months, during which most of the easier-to-collect accounts are resolved.

4. Develop application talent internally. The key is to tap trusted employees who fully understand the practice’s business, values, and culture. Outside assistance is best used to streamline your team’s learning curve on the new system, to advise you on alternative implementation decisions (and their strengths and drawbacks), for peak periods of build, for date conversion or short term technical expertise, for training, and for go-live support and stabilization.

5. Convert clinical activity to cash through focused integration of clinical and revenue cycle functionalities. Don’t make the mistake of replicating legacy workflows; use the implementation as an opportunity for process improvement, such as the consolidation and/or standardization of visit types. Look at your documentation, charge capture, charge triggering, and charge routing for ways to improve physician efficiencies, and to produce thorough, timely, and clean claims. The ability to close encounters in a timely manner is a necessity. In addition, validate vendor recommendations to make sure your organization’s unique operational requirements — not just application best practices — are supported. Conduct integrated testing with real-life scenarios.

6. Automate data conversions. Some vendors advise against the automated conversion of certain patient and scheduling information. This may be due to the extensive amount of in-house technical expertise an organization would need to have on the brand-new application — which is not typically present. However, such data conversions involve a concentrated work effort for only a finite period of time. If qualified resources aren’t available internally, organizations may find it worthwhile to engage with an outside consultant. Automating data conversion offers a major ROI opportunity compared against tens of thousands of hours of manual data entry.

7. Test, test, test. The importance of system testing cannot be overstated. At a minimum, organizations should test their top volume- and top revenue-generating clinical services through a fully integrated clinical and revenue cycle. That means testing that starts with patient access, continues through the clinical encounter (including clinical documentation and charge capture), and continues through the entire billing cycle (including claims production, remittance, denial management, payment variance analysis, and reporting).

As healthcare organizations continue to align with affiliated practices, IT system builds are becoming more complex. Consider, for example, what happens when multiple practices and facilities all share a common billing system, yet their disparate financial information must be kept separate. In all such situations, a vendor’s standard implementation approach and timeline must be vetted and either validated or modified according to practice needs. Training and go-live strategies should always be grounded in reality; it’s better to reset expectations upfront than to put revenue at risk on the back end.

Brad Boyd is president of Culbert Healthcare Solutions.

Contacts

Jenn,  Mr. H, Lorre, Dr. Jayne, Dr. Gregg

More news: HIStalk, HIStalk Connect.

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News 8/24/16

Top News

South Carolina public radio looks at the ways in which private practice physicians are getting into telemedicine through partnerships with organizations like Palmetto Care Connections, Hope Health, the Medical University of South Carolina, and public schools. Danette McAlhaney, MD offers virtual consults with local schools from her office in Bamberg, and also receives a fee – typically $15 a pop – for helping patients connect with specialists via her office’s telemedicine capabilities, provided with help from PCC. “Let’s face it,” she adds, “I don’t get electricity for free and my staff doesn’t come to work for free,” she said. “I have to be aware of the bottom line.”

HIStalk Practice Announcements and Requests

I’m hoping to hit the road for a fall foliage tour the last week of September, which, coincidentally, is when HIMSS will host National Health IT Week activities. I don’t want to leave HIStalk Practice readers hanging, however, and so am open to running, in lieu of the usual news updates, guest posts that fit the following criteria:

• Topical (extra points for humor).
• No gratuitous use of company or product names.
• No hyperlinks.
• Between 500 and 800 words.
• Author headshots a must.

Feel free to contact me if you’d like to contribute.

Webinars

None scheduled in the coming weeks. Contact Lorre for webinar services, including produced and promoted options. Past webinars are on our HIStalk webinars YouTube channel.

Acquisitions, Funding, Business, and Stock

Patient intake technology startup HealthAsyst joins Athenahealth’s More Disruption Please program, adding its CheckInAsyst software to the MDP marketplace.

Announcements and Implementations

The Bronx RHIO formally implements the ZenPRM CRM tool from Algonquin Studios after beta testing it for the last several months. The RHIO is part of New York’s SHIN-NY statewide HIE.

Alpine Foot and Ankle Clinic (UT) rolls out a patient portal from EClinicalWorks.

Access Community Health Network adopts the UpToDate Anywhere clinical decision-support tool from Wolters Kluwer across its 36 FQHCs in Chicago. Access has integrated the tool with its Epic EHR.

People

Barry Mathis (HIS Professionals) joins Pershing Yoakley & Associates as principal.

David Buxton, MD (ApolloMD) joins MyIdealDoctor as CMO for behavioral health.

CitiusTech names Mohit Kaushal, MD (Stanford University) to its Board of Directors.

Other

You’ve got mail: San Antonio, TX resident and Medicare beneficiary Debra Garcia receives 505 letters from CMS in a single day – all Medicare part B statements from 2011 to 2015, and all duplicates of statements she’d previously received. “They complain about paying for a needle for injection,” Garcia says, “but they have the money to mail out so many letters.” For those keeping count, that amount of mail amounts to $187 in postage.

Sponsor Updates

• GE Healthcare employees volunteer at Milwaukee area schools to help spruce up classrooms before students return for the new school year.
• EClinicalWorks will exhibit at Medical Fair Asia August 31-September 2 in Singapore.

Contacts

Jenn,  Mr. H, Lorre, Dr. Jayne, Dr. Gregg

More news: HIStalk, HIStalk Connect.

Get HIStalk Practice updates.
Contact us online.
Become a sponsor.