5 Questions with Caesar Djavaherian, MD Founder, Direct Urgent Care

Caesar Djavaherian, MD is founder of Direct Urgent Care, a chain that employs 90 staff to care for close to 100 patients a day across its three facilities in California. The company, which has attested to Meaningful Use via its Drchrono EHR, recently began using an Eko stethoscope that captures heart and lung sounds and transmits them to its EHR.

What was the impetus for adopting the EHR-integrated Eko stethoscope? Were you already an Eko/Drchrono customer?
At Direct Urgent Care, we are driven by the idea that patients need to feel better faster. Being able to easily share findings related to heart or lung sounds with a specialist who can aid in timely diagnosis and treatment decisions is critical to getting them feeling better.

How do you hope its utilization will benefit DUC and its patients?
We know it will. It is an additional way to get objective data in the right hands.

What sort of healthcare technology adoption/implementation challenges are unique to urgent care practices?
The nature of urgent care is that we care for accidents and injuries that are often unpredictable. We have to be nimble enough to check things like insurance eligibility, and set up proper patient communication channels for a large number of disease processes. Being able to leverage technology to get these things done so that patients find it to be a seamless process drives our technology adoption.

There’s been a lot of industry chatter recently about the need for a simpler patient bill. HHS has even launched a design contest to help foster better design and greater patient-centeredness. How have you seen technology impact the likelihood of your patients to pay in a timely manner? From a design perspective, can urgent care bills be improved?
Billing is a pain point for patients as well as providers. If healthcare acted more like a free market, we would have much better bills, much more price transparency, and more informed patients. It is criminal to have patients and providers agree to work with each other without knowing what the costs would entail. We have created a price list for patients who do not have insurance or prefer not to use their insurance for care. We need to have better communication around billing and pricing for patients to be true consumers and help drive the cost of healthcare down and away from high-cost care such as emergency departments.

What’s next on the horizon for Direct Urgent Care in terms of new healthcare technologies, particularly those that will better enable patient engagement? Any plans to look in to telemedicine?
We imagine ourselves as a technology-enabled healthcare startup. We would like connected devices to help us speed up the patient data acquisition process so that patients can very quickly be assessed and treated. We constantly evaluate devices to help us achieve this, which is how we got to Drchrono and Eko.

Contacts

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

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News 6/1/16

Top News

ONC makes good on provisions in the 2015 Edition Final Rule that call for increased transparency around certified health IT products. The office has upgraded its online certified health IT product list and launched a corresponding website that brings together transparency, performance, and corrective action plan information for each product.

HIStalk Practice Announcements and Requests

Thanks to PerfectServe for supporting HIStalk Practice. Click the logo above for more information. Email Lorre if your company is interested in benefiting from HIStalk Practice sponsorship.

Webinars

June 28 (Tuesday) 2:00 ET. “Your Call Is Very Important.” Sponsored by West Healthcare Practice. Presenters: Cyndy Orrys, contact center director, Henry Ford Health System; Brian Cooper, SVP, West Interactive. The contact center is a key hub of patient engagement and a strategic lever for driving competitive advantage. Cyndy will share how her organization’s call center is using technologies and approaches that create effortless patient experiences in connecting them to the right information or resource. Brian will describe five key characteristics of a modern call center and suggest how to get started.

Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.

Announcements and Implementations

MedAxiom and Magellan Health partner to offer accountable care services to cardiovascular physician groups looking to transition to value-based care models.

Bizmatics adds patient and telemedicine-friendly payment technology from Integrity Payment Systems to its PrognoCis EHR.

Care Management Solutions of Louisiana and telemedicine partner Advance Telehealth Consulting Solutions select population health management software from EQHealth Solutions to help support their chronic care management program.

People

Kraig Brown (Consolo Services Group) joins Office Practicum as chief revenue officer.

The Little Clinic promotes Navy veteran Marc Watkins, MD to CMO.

Government and Politics

ONC’s annual meeting continues …

Other

I think this story is apropos for HIStalk readers, especially given Mr. H’s efforts to regularly list his linguistic pet peeves: Capitol Hill Books owner Jim Toole presents patrons with a “Not Spoken Here” list of words and phrases not to be voiced in the store. Toole explains that, “I hear ‘Perfect,’ I hear ‘Like, like, like, like,’ and I hear ‘Awesome’ every 32 seconds and it was causing me to have brain damage. So I try to ask people when they’re here to use one of the 30,000 words in the thesaurus other than, ‘Perfect! Awesome! Oh my God!’ When you’re sitting here for 20 years and hear that limited amount of vocabulary that people seem to enjoy using, it really [causes] destruction of gray matter.”

Scientists discover – after 108 screenings of 16 different movies – that the breath of theater-goers can reveal the type of movie they’re watching. Heightened levels of isoprene, which has ties to the body’s fight-or-flight instinct, were consistently seen during action movies, while suspenseful films were linked to high levels of methanol, acetaldehyde, 2-furanone, and butadiene. Romantic films didn’t elicit any noticeable chemical correspondence, which makes me wonder if they’ll waste more money with further scientific study of The Notebook.

Contacts

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

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News 5/31/16

Top News

Caving to stakeholder complaints (including admonition from former National Coordinator turned Aledade CEO Farzad Mostashari, MD), CMS opens up the Comprehensive Primary Care Plus program to 1,500 eligible primary care practices enrolled in the Medicare Shared Savings Program.

Webinars

June 28 (Tuesday) 2:00 ET. “Your Call Is Very Important.” Sponsored by West Healthcare Practice. Presenters: Cyndy Orrys, contact center director, Henry Ford Health System; Brian Cooper, SVP, West Interactive. The contact center is a key hub of patient engagement and a strategic lever for driving competitive advantage. Cyndy will share how her organization’s call center is using technologies and approaches that create effortless patient experiences in connecting them to the right information or resource. Brian will describe five key characteristics of a modern call center and suggest how to get started.

Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.

Acquisitions, Funding, Business, and Stock

Aprima medical software reseller DAS Health (fka Doctors Administrative Solutions) acquires Las Vegas-based healthcare IT services firm Falcon Healthcare Systems for an undisclosed sum. FHS CEO Russell Suzuki will join DAS as vice president of information services. DAS will maintain its Tampa, FL headquarters and add a regional office in Las Vegas. The company seems to be on a bit of a buying spree, having acquired ConXit Technology Group, Jackson Key Practice Solutions, and Spectra Healthcare’s RCM business within the last eight months.

People

Jean Hansen (Kansas City Internal Medicine) joins DataFile as COO.

The American Telemedicine Association elects Grant Chamberlain (Ziegler) to its Board of Directors.

Former CMS administrator and FDA commissioner Mark McClellan, MD (Duke University) joins American Well’s advisory board.

Announcements and Implementations

Amazing Charts offers RCM services from Physicians Group Management Billing.

The Diary develops a CareKit-based chronic condition management app featuring care plan and prescription reminders; as well as the ability to dictate and share symptoms and vitals. The company plans to launch a corresponding data-sharing app for providers in the near future.

DirectTrust develops the Partnership for Patients Program, giving members secure-messaging access to its network of 58,000 healthcare organizations and 1.2 million email addresses.

Government and Politics

Marin County, CA officials authorize the use of nearly $775,000 to build a data hub that will connect Marin Community Clinics, Coastal Health Alliance, Marin City Health and Wellness Center, Ritter Center, the county’s health clinics — including behavioral health — and Emergency Medical Services, all of which operate separate EHRs. County supervisors hope that the hub, which will take two years to build, will eventually connect to local hospitals.

ONC’s annual meeting kicks off with a half day of sessions, including a tête-à-tête between HHS Acting Assistant Secretary for Health and National Coordinator Karen DeSalvo, MD and former HHS Secretary Kathleen Sebelius, who wasn’t afraid to drop a little humor into their conversation about consumer-friendly health data.

Research and Innovation

MGMA’s annual compensation survey finds that annual PCP salaries now surpass $250,000, a 4.3 percent rise from 2014 that the association attributes to the increasing prevalence of value-based care models. PCP salaries have increased 18 percent over the last five years and still lag far below that of their specialist counterparts, who earned an average $425,509 in 2015.

Sponsor Updates

• Intelligent Medical Objects and Leidos Health will exhibit at the International MUSE 2016 conference May 31-June 2 in Orlando.
• Noel Allender (Jacobus Consulting) joins Leidos Health as Epic managing director.

Blog Posts

• Community Connect versus EpicCare Link: Nordic’s take (Nordic)
• Speech Recognition does much more than convert speech to text. (NVoq)
• Aprima Earns Fundamental Building Block for Patient-Centered Medical Homes (Aprima)
• Choosing the Right Real-time Locating System (Versus Technology)

Contacts

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

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News 5/26/16

Top News

The White House releases the final Data Security Policy Principles and Framework for President Obama’s Precision Medicine Initiative. The framework, which builds on the existing PMI Privacy and Trust Principles, establishes security expectations for PMI participants, and offers a risk-management approach to achieving those expectations. Over 40 private-sector organizations, including seven EHR vendors, have already committed to the initiative.

Webinars

None scheduled in the coming weeks. Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.

Announcements and Implementations

Medical Advantage Group adds Live Compliance’s HIPAA compliance and training program to its HIPAA consulting services.

CVS Health MinuteClinics roll out an online wait time and appointment reservation app at select stores. The new tool will be available at the company’s Target-based clinics later this year.

Change Healthcare (fka Emdeon) offers its Revenue Performance Advisor tool with SourceMed’s PM and Ease Eligibility technologies to outpatient providers.

People

Sharon Wolf (UMassMemorial Medical Center) joins FluidEdge Consulting as vice president of business intelligence and informatics.

The Vermont Information Technology Leaders Board of Directors elects Bruce Bullock, MD (Marble Valley Health Networks) chair, and welcomes new board members Michael Del Trecco (Vermont Association of Hospital and Health Systems), Rep. Avram Patt, Richard Elmore (Allscripts), and Jerry Ford (Marathon Health).

Acquisitions, Funding, Business, and Stock

Consulting and practice management firm Nueterra Physical Therapy rebrands to PT Partners to better attract new business from clinics, ACOs, and hospitals.

Government and Politics

Principal Deputy National Coordinator Vindell Washington, MD blogs about the ways in which technology has supported his journey from a combat hospital in Haiti to an ER residency to physician practice in Louisiana. Though physicians have more to lean on the first-generation personal digital assistants, Washington notes that the promise of health IT has yet to be fully realized:

“To get there, useful and useable electronic health information needs to flow freely, from research institutions and quality improvement body databases, to EHRs and other transactional systems, to consumer-facing apps, and back again. This data ecosystem can and does enhance clinical care at the bedside—as I have seen in my own practice many times over. This is part of the true promise of health IT.”

CMS Acting Administrator Andy Slavitt sits down with the Massachusetts Medical Society to discuss MACRA, interoperability, registries, and the agency’s determination to listen to physician feedback, while stressing that the move to alternative payment models will happen in iterations. An excerpt:

“The point I was making about the iPhone is that we are in early generations of some of these payment models. The clinicians who participate should be aware that models are meant to reinforce the good practice of medicine, but the models are not going to be perfect. The models are going to have to get better over time based upon how they get used in the real world and improved upon. For instance, in our second generation models we have made changes, like adding telemedicine or adding patient incentives to make sure that the patient is aligned with their physician in staying healthy.

And where did the changes come from?  They came from listening to physicians and patients. The physicians tell us this model would be better if it could do this, if it could do that. And that’s the thinking that has to continue. So, like any other good, user-driven program, we want an ongoing dialogue so that year over year the program improves for patients and clinicians.”

Other

Perhaps healthcare needs to take a cue from Microsoft, which now allows administrators to ban too-easy-to-hack passwords like “123456” and the always popular “password.” The move is timely, given last week’s news that hackers were selling 117 million LinkedIn usernames and passwords, and survey results indicating that the average US consumer values improved security over Internet speed. (Millenials were the exception to the rule, with the majority of that age group only too happy to give up what shred of privacy they have left for faster connections.)

Contacts

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

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News 5/25/16

Top News

Louisville, KY-based healthcare consulting and IT firm IHealth Solutions acquires RCM technology vendor DNA Healthcare for an undisclosed sum. IHealth CEO Venkat Sharma will lead the newly combined company while, DNA Healthcare CEO Sreeram Mantha will take on the role of COO.

Webinars

None scheduled in the coming weeks. Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.

People

WEDI promotes Interim CEO Charles Stellar to president and CEO.

The American Telemedicine Association elects Peter Yellowlees (UC Davis) president elect of its Board of Directors.

Just a few weeks after hiring Google X lab co-founder Yoky Matsuoka to head up health-related projects like ResearchKit, Apple posts a job opening for a lawyer focused on HIPAA and health. The candidate will work on “privacy by design reviews and projects,” assist with “privacy complaints and breaches,” and will “advise on the privacy aspects of licensing and procurement deals and corporate acquisitions.” The personnel moves further emphasize CEO Tim Cook’s plans to truly infiltrate healthcare, most likely via the Apple Watch.

Telemedicine

MyTelemedicine adds support for Spanish-speaking patients to its software.

The State of Connecticut passes a bill requiring Medicaid to cover telemedicine visits.

Announcements and Implementations

RCM technology and consulting company Risarc launches a management platform for ACOs that will guide them through required Medicare Shared Savings Program benchmarks, including chronic care management, via data analytics.

InstaMed updates its Estimator patient payment technology, adding more consumer-friendly payment options, long-term collection data, and a single view of patient payment and clearinghouse data.

Research and Innovation

A National Association of ACOs survey reveals that single and multi-ACOs spent an average of $501,300 on healthcare IT, population analytics, and reporting as part of their MSSP participation. That figure is second only to costs associated with clinical and care management operating expenses, which averaged $642,044. Average total operating costs comes out to $1.6 million per year. When it comes to MACRA, over half of respondents will likely leave the program if they are not eligible for the 5 percent Advanced Alternative Payment Model bonus.

Government and Politics

The Ohio Automated Rx Reporting System partners with The Health Collaborative and its HealthBridge technology division to develop a drug-monitoring database that sends controlled substance prescription data to a patient’s EHR in real time. The system is expected to go live in the Greater Cincinnati area later this year.

ONC’s Certified Health IT Product List now includes surveillance results for solutions and developers that have been found non-compliant with requirements of the office’s certification program. ONC stresses that people who use the list should keep in mind that “just because a product has been found non-conforming does not automatically indicate that a product is ‘defective,’” and that “many non-conformities or deficiencies are resolved quickly.”

Other

Wearable apparel startup We:ex develops a smart running jacket that will “tap” the wearer on the shoulder to indicate which direction to turn, with double “taps” indicating final destination. Similar technology will be embedded into yoga pants to help practitioners perfect their downward dogs.

Sponsor Updates

• Aprima will exhibit at the Practice Management Institute June 2-3 in New Orleans.
• Healthwise will exhibit at the Cerner Great Lakes RUG May 31 in Chicago.

Blog Posts

• Medical Practice Optimization Simplified, Part 1 of 5 (AdvancedMD)
• A "food insecurity" primer for healthcare providers (Nordic)
• Think You can Design a Better Medical Bill? (EClinicalWorks)

Contacts

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

More news: HIStalk, HIStalk Connect.

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Contact us online.
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