DOCtalk with Dr. Gregg 5/3/16

This is What it Sounds Like When MACRA

Dig if you will the process
Of you and me engaged in healthcare
The sweat of my typing covers me
Can you, my patient
Can you process this?

Dream if you can a system
Of payments and data run smooth
Providers strike curious poses
We feel the heat
Of changes from old MU

How can you just leave us standing?
In constant changes so cold? (So cold)
You’re definitely too demanding
Or maybe I’m just ancient, too old
You certainly aren’t a good mother
You’re never satisfied (You’re never satisfied)
Why can’t we just see our patients?
This is what it sounds like
When MACRA

Touch if you will my keyboard
Feel how it burns overused
I’ve got arthritis in all my fingers
Don’t make me type more
I sure feel abused

How can you just lead us new ways?
With constant changes untold (Untold)
Think you could be too demanding?
Or maybe I’m just tired, old mold
You certainly aren’t a good mother
You’re never satisfied (You’re never satisfied)
Why can’t we just see our patients?
This is what it sounds like
When MACRA

How can you just leave us hanging?
In management changes so bold? (Changes what’s so bold)
Maybe you’re just a bad steward (Maybe, maybe you’re a too cold)
Maybe I’m just a sad baby, whiny (Ya know I’m whiny)
Maybe you’re just a real “mother” (Maybe you’re just a real “mother”)
You’re never satisfied (You’re never satisfied)
Why can’t we just see our patients? (Can’t we just be, why?)
This is what it sounds like

When MACRA
When MACRA (MACRA, MACRA)
When MACRA (MACRA, MACRA)

Don’t cry (Don’t cry)

When MACRA
When MACRA
When MACRA

When MACRA (MARCA, MACRA, MACRA)

Don’t cry
Doctor, don’t cry
Don’t cry
Don’t cry
Don’t, don’t cry

————————————

Rest in peace, sweet Prince

From the trenches…

“Act your age, not your shoe size.” – Prince

Dr. Gregg Alexander, a grunt in the trenches pediatrician at Madison Pediatrics, is chief medical officer for Health Nuts Media, an HIT and marketing consultant, sits on the board of directors of the Ohio Health Information Partnership, and is the semi-proud author of “Monsters Don’t Fart!”

Contacts

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

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News 5/2/16

Top News

Mednax subsidiary MedData acquires patient engagement software company Duet Health for an undisclosed sum. The national medical group company seems to be making acquisitions an annual trend. It acquired MedData in 2014 and receivables management firm Alegis Revenue Group in 2015.

Webinars

May 5 (Thursday) 2:00 ET. “Reducing CAUTI and Improving Early Sepsis Detection Through Clinical Process Measurement.” Sponsored by LogicStream. Presenters: Jen Biltoft, director of quality improvement, SCL Health; Marla Bare, EHR architect, SCL Health. This webinar will describe how SCL Health reduced catheter-associated urinary tract infections by 30 percent in just three months through clinical process measurement. The SCL Health presenters will also share their plans for applying a similar process to the early detection of sepsis.

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

Acquisitions, Funding, Business, and Stock

Athenahealth CEO Jonathan Bush talks with Bloomberg about Obamacare’s effect on the company’s bottom line, consolidation across healthcare markets, and its push into the enterprise market. Bush points out that Athenahealth now handles 10 percent of all ambulatory visits in the US via AthenaNet, and has averaged 25-percent organic growth annually over the last 10 years. You can read Mr. H’s highlights from the company’s earnings call here.

People

Rick Von Pusch (Dealertrack) joins Modernizing Medicine as chief revenue officer.

AHRQ reiterates its call for US Preventive Services Task Force nominations, particularly for new members in the areas of pediatrics and preventive medicine. USPSTF members are charged with making evidence-based recommendations on the effectiveness of preventive services and health promotion. Nominations are due May 15.

Announcements and Implementations

Medical practice and dialysis facility management company Boson Health (TX) selects mobile charge capture software from MDTech. The vendor, which is also headquartered in Houston, has joined the Allscripts Developer Program.

The University of Vermont’s Child Health Improvement Program selects care coordination and secure messaging software from Act.md to improve care planning between its pediatrics and family medicine teams.

Telemedicine

Behavioral health telemedicine company WeCounsel Solutions secures $3.5 million in Series A equity funding from Longmeadow Capital Partners, Point Judith Capital, and CVH Holdings. The five-year-old startup calls Chattanooga, TN (one of my favorite cities) home. It plans to use the financing to scale business development and enhance its software for providers and employers.

Government and Politics

Haven’t yet had a chance to wade through the 900-plus page proposed MACRA rule? CMS will hold MACRA and MIPS overview webinars this week and a provider call next week to help providers digest the proposed changes. Don’t forget – comments on the rule are due June 27.

Other

Chiropractic office Vibrant Body Wellness (CA) notifies 600 patients of a potential data breach due to an early March burglary that included the theft of an encrypted laptop and backup hard drive. No fraudulent activity has been detected thus far.

AMA adds value-based care transition resources to its STEPS Forward library of practice-improvement strategies. It has also created a set of MACRA-specific resources to help physicians better understand the new program, including a guide to physician-focused payment models, and MIPS highlights and preparation tips.

Google Project Zero researcher Tavis Ormandy discovers a security vulnerability in Fitbit’s Aria smart scale, which the company quickly patched. Media outlets, however, have been slow to let the pun-friendly story go. An example: “While a scale hack is a relatively lightweight issue, it opens up the long-standing fears over security flaws in the bloating ranks of Internet of Things hardware. With more companies hooking their appliances up to the internet, security researchers are finding tons of new holes in connected devices that allow for everything from the remote control of appliances to the ability to siphon off personal information. The issue has become so heavy that the US government has had to weigh in on the matter and offer its own recommendations.”

Contacts

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

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News 4/28/16

Top News

Apple releases the first four apps made using CareKit, the company’s new open-source platform that lets developers create IPhone apps to help consumers manage their health and share their health data with physicians. The apps focus on diabetes management, pregnancy and infant development tracking, and a depression tracker – a positive sign for those health advocates that have long sought for tighter integration between mental health and primary care. While the company’s coinciding release of CareKit’s’ development framework certainly bolsters its foray into healthcare, it remains to be seen just how physician- and EHR-friendly CareKit-based apps will be.

Webinars

May 5 (Thursday) 2:00 ET. “Reducing CAUTI and Improving Early Sepsis Detection Through Clinical Process Measurement.” Sponsored by LogicStream. Presenters: Jen Biltoft, director of quality improvement, SCL Health; Marla Bare, EHR architect, SCL Health. This webinar will describe how SCL Health reduced catheter-associated urinary tract infections by 30 percent in just three months through clinical process measurement. The SCL Health presenters will also share their plans for applying a similar process to the early detection of sepsis.

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

Acquisitions, Funding, Business, and Stock

Ability Network announces plans to expand operations at its headquarters in Tampa, FL with the addition of 75 jobs by 2017. The company, which offers clinical support systems, RCM services, and connections to payers, will look to fill roles in administration, IT, and sales with the help of $229,000 in government incentives.

Analytics company CloudMedx acquires Gyrus Labs for an undisclosed sum. CloudMedx will integrate the company’s technology into its NLP engine for faster analysis and risk stratification. Gyrus Labs co-founder Dongyang Zhang, MD will join CloudMedx as senior medical scientist.

Announcements and Implementations

Health Images, a chain of 12 imaging centers in Colorado, joins the CORHIO HIE. It is the first organization of its kind to join CORHIO, which has connected 54 hospitals and over 4,000 office-based physicians since it was founded in 2010.

DoctorConnect.net messaging service joins the Allscripts Developer Program, enabling Allscripts customers to access its appointment reminder service via their PM systems.

People

AHRQ names Andrew Bindman, MD (UC San Francisco) director.

Anita Pramoda (Owned Outcomes) joins the Health Catalyst Board of Directors, while Health Catalyst EVP and co-founder Steve Barlow steps down at the end of his five-year term.

Telemedicine

CirrusMD upgrades its telemedicine platform, enabling physicians to consult with up to eight patients at a time thanks to improved text-messaging capabilities. The company, which focuses on text-first, video-second virtual consultations, raised over $1 million in March, bringing its total funding to $2.5 million.

Research and Innovation

Fitbit partners with the Boston-based Dana Farber Cancer Institute to launch a six-year study of 3,200 patients that will analyze the ways in which breast cancer recurrence is affected by weight loss in overweight patients. The study monitor patient progress remotely via phone calls with dieticians, and will incorporate the Fitbit HR, which monitors heart rate, steps, and sleep; and the company’s Aria smart scale. Fitbit devices are already being used in over 100 clinical programs.

Contacts

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

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5 Questions with Gene Farber, COO, Reliance ACO

Gene Farber is COO of Reliance ACO in Farmington Hills, MI. Founded in 2014, the ACO employs 25 full- and part-time staff, and includes 61 practices and 292 physicians. Reliance implemented chronic care management services from CSC in March.

What type of ACO is Reliance? Why was this particular type chosen?
Reliance is physician owned, funded, and operated. The founders had been part of a hospital ACO in the Pioneer model. While it had been successful in saving money, the administrative costs of a large organization meant that the doctors did not see any of the savings. The founders of Reliance believed that a physician-run organization would be more efficient and could achieve the goals of the ACO.

How has technology impacted the ACO’s ability to coordinate care, and begin to move from fee-for-service to value-based care?
Technology is critical to the success of Reliance. We receive ADTs (admission, discharge, transfer alerts) to let us know when patients are in the hospital. We use a care management program from Synapse, which is on a Salesforce platform and allows our staff to access the information wherever they may be via our secure remote desktop computer. We use telephone alerts to securely send information directly to doctors in the ACO about their patients or the programs of the ACO. We link up with skilled nursing facilities to determine where our patients are after they leave the hospital. Technology is involved with every aspect of Reliance ACO.

Why did Reliance decide to implement chronic care management services? How do you foresee CCM impacting patient care and the ACO’s bottom line?
Many of the doctors in Reliance have inquired about CCM. A committee of medical directors reviewed various vendors and felt CSC was a good choice. The hope is that CCM will positively impact patient care. Based on the way the ACO receives shared savings, CCM will negatively impact the ACO’s bottom line in many cases. If the ACO has a large number of patients that receive this service, they have to save double the cost of CCM just to break even because they only receive 50 percent of the savings. I think this will be very difficult to do. Again, just because CMS says a program will save money does not mean it will happen in real life and that is my concern.

What sort of healthcare technology adoption/implementation challenges are unique to ACOs?
The ACO’s attempt to coordinate a large number of practices, most of which have different levels of technological integration as well as different systems. The challenge is to work with many different systems. Reliance also has doctors in at least six different hospital systems, so any integration has to be done separately with each system.

Is Reliance considering implementing additional new healthcare technologies in the near future? If so, why?
We are in the process of implementing our phone app to each doctor. We will be developing a portal for doctors to interface directly into our system, and are planning to develop a patient portal for ACO patients.

Contacts

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

More news: HIStalk, HIStalk Connect.

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News 4/27/16

Top News

HHS takes its first steps in implementing certain parts of MACRA by releasing a proposed rule that would streamline Medicare payments to physician offices, essentially replacing Meaningful Use. Physicians can participate in the Quality Payment Program via two options – the Merit-based Incentive Payment System (MIPS) or Advanced Alternative Payment Models, which includes the new Comprehensive Primary Care Plus and Next Generation ACO models. CMS expects most Medicare physicians to initially participate via MIPS, which offers more reporting flexibility than MU and bases first-year payments on the scoring of quality, interoperability (touted as “Advancing Care Information”), clinical practice improvement, and cost. HHS will accept comments on the rule through June 26. If finalized, the program will begin in 2017.

Webinars

May 5 (Thursday) 2:00 ET. “Reducing CAUTI and Improving Early Sepsis Detection Through Clinical Process Measurement.” Sponsored by LogicStream. Presenters: Jen Biltoft, director of quality improvement, SCL Health; Marla Bare, EHR architect, SCL Health. This webinar will describe how SCL Health reduced catheter-associated urinary tract infections by 30 percent in just three months through clinical process measurement. The SCL Health presenters will also share their plans for applying a similar process to the early detection of sepsis.

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

People

Ardy Arianpour (Pathway Genomics) joins Base Health as chief business officer.

Government and Politics

Vice President Joe Biden joins the speaker lineup of Health Datapalooza, happening May 8-11 in Washington, DC. He’ll speak for a brief 30 minutes, presumably on his Cancer Moonshot Initiative. Keynoters include HHS Secretary Sylvia Burwell, Israel Ministry of Health Director General Moshe Bar Siman Tov, and CMS Acting Administrator Andy Slavitt, who has an even shorter 20-minute timeslot.

Legislators from both sides of the aisle introduce the HHS Data Protection Act, which, among other things, calls for the appointment of a CISO on October 1. )I’m surprised they didn’t use the more headline-grabbing job title of “Cybersecurity Czar.”) The bill comes in response to a House Energy and Commerce Committee report that found that hackers had breached at least five HHS divisions over the last three years, among deficiencies.

Telemedicine

UniVision partners with Careington International to launch UniConsulta in 12 states. The Spanish-language health and wellness telemedicine service offers a bevy of member benefits for $50 a month, including up to five consults per month and unlimited access to UniConsulta clinicians via email.

Other

Four Kauri Family Medical Centre in Australia takes temporary shelter in a local motel after a fire forced it to relocate last summer. The practice currently occupies six rooms on the bottom floor of the motel – the largest for the waiting room, one room for the nurses, one break room, and three consult rooms. Practice staff, who expect to move into their new location this fall, say the biggest plus has been the convenient parking.

The Houston Chronicle echoes a familiar refrain: PCPs are overwhelmed by long hours, not enough staff, lower reimbursements, and deteriorating physician-patient relationships thanks to escalating technology burdens. “The key word right now is efficiency,” says independent physician Elizabeth Torres. “But do you want someone who is going to listen to you and take care of you, or do you want someone who will be efficient? I may not be doing financially the best that I can do, but I am able to pay my bills, I’m happy with how I take care of the patients, and that to me is the important part.”

Sponsor Updates

• Aprima will exhibit at the American College of Physicians Internal Medicine Meeting May 5-7 in Washington, DC.
• EClinicalWorks will exhibit at the American College of Physicians Internal Medicine Meeting May 5-7 in Washington, DC.
• Healthwise will exhibit at the ZeOmega Client Conference May 2-4 in Plano, TX.

Blog Posts

• Raise Your Patient Satisfaction Scores, 2 Planning Tips (Part 1 of 2) (AdvancedMD)
• Securing Your Practice (E-MDs)

Contacts

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

More news: HIStalk, HIStalk Connect.

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Contact us online.
Become a sponsor.