HIStalk Practice Interviews Bill Moreau, DC Managing Director of Sports Medicine, US Olympic Committee

Bill Moreau, DC is managing director of sports medicine for the United States Olympic Committee and CMO for the 2016 Summer Games in Rio.

Tell me about yourself and the organization.
My name is Dr. Bill Moreau and I am the managing director of sports medicine for the United States Olympic Committee, and I am the chief medical officer for the 2016 Summer Games in Rio. It is a privilege and tremendous responsibility to serve Team USA athletes. The USOC’s mission is to support US Olympic and Paralympic athletes to achieve sustained competitive excellence while demonstrating the values of the Olympic movement, thereby inspiring all Americans. The pathway through which sports medicine achieves this goal is to provide three pillars of support for Team USA athletes including clinical care, Games care, and through the USOC National Medical Network.

The world is a very competitive place when it comes to sports. The difference between earning an Olympic or Paralympic medal and just missing the podium is measured in hundredths of a second and the smallest fraction of an inch. My job is to lead high-performance sports medicine to protect and enhance the athlete’s health through the three USOC Sports Medicine Clinics, and at the Olympic and Paralympic Games.

How has Team USA historically incorporated healthcare technology into the games?
In the recent past, before the 2012 London Summer Olympics, we maintained paper records. These records were lacking in legibility, a poor resource for analytics, and unavailable for timely access for patient care. Team USA athletes travel the world and paper records made it essentially impossible to have one repository of the health records because there was no conduit to gather the medical records from all over United States and the world.

When we switched to GE Centricity Practice Solution (CPS) in 2012, we were driven by the need to engage healthcare technology to create a single medical record, and to provide the ability to perform analysis in regards to the prevention of illness and injury. CPS was the data repository that allowed USOC Sports Medicine analytics to become a reality. We now know so much more than we did before in regard to evidence-based care pathways and important data points that allow the USOC to really focus on the prevention of illness and injury in our athletic population. The application of healthcare technology is one large component of how USOC Sports Medicine meets our mission of “Providing the Edge” for competition through high-performance sports medicine.

What sort of criteria did the selection committee use when looking at EHR vendors?
GE has been and is a great partner to the USOC and International Olympic Committee. This EHR initiative was a great opportunity to leverage the GE relationship to the benefit of the athlete. USOC Sports Medicine requires proven highest-level security in order to protect patient data, and the ability to maximally customize our forms and GE’s CPS provided the solution.

Given that you’ve had used CPS since 2012, have you made any modifications to it to better suit the needs of athletes and their care teams?
Since implementing the EHR in 2012, Sports Medicine has made some changes to the system to increase functionality, efficiency, and output. We have customized all medical documents to meet the needs of a multidisciplinary clinic, assigning observation terms that allow for data collection and analysis. With a goal of onboarding our National Governing Bodies, we have created confidentiality levels specific to department and sport (i.e., Sports Medicine, Sports Psychology, the National Governing Bodies). Additionally, we have utilized the patient portal and DocuSign to create and distribute electronic health history questionnaires and medical consent forms. From BISCOM we have purchased eFax, an electronic fax system that allows athletes to fax their medical records into the EHR via DM Indexing Client from anywhere in the world. USOC Sports Medicine continues to research new ways to utilize CPS to increase functionality and use for both providers and athletes.

Why did USOC decide to open up the EHR to caring for both athletes and spectators?
USOC Sports Medicine’s number-one priority is to document medical encounters for Team USA athletes. We have shared how we do this with our IOC Sports Medicine partners as well as the next two Olympic Games CMOs. We shared that CPS allowed us to create one centralized database for medical records that can be utilized to also study the epidemiology of patient encounters to best prevent future injury and illness, and plan for future events. Our system is focused on the athletes, but we also register coaches and staff that have been treated for injuries while involved in athletic competitions and training at the Olympic Training Center. In doing this, we document the types of encounters as well as the assessment and management strategies.

Will the EHR offer any sort of interoperability in terms of sharing information with an athlete’s trainer or local physician?
The EHR has the capability of providing access to medical and non-medical personnel. Security rights can be adjusted to grant read-only access of charts and medical histories. The system also allows for downloading and printing of records if non-medical personnel need to view specific charts or documents. Medical providers can be given access to view athlete medical records and diagnostic testing. As with non-medical personnel, they can also be given PDF documents of specific charts and information particular to their needs.

How are you using the patient portal?
USOC Sports Medicine currently has a patient portal linked to our EHR through Surescripts. In the past, our CPS patient portal was used to distribute and collect health history and medical consent forms from our athletes competing at the Olympic and Paralympic Games. The portal also has the capability of viewing medical records, emails, and appointments.

How has EHR utilization helped improve outcomes over the last several Olympic and Paralympic Games?
Since we have implemented GE’s EHR, we have evolved from a reactive sports medicine clinic that treats injuries as they present to us to a data-driven sports medicine division with the ability to leverage real-time reporting and predictive analytics to improve long-term outcomes for our athletes. For example, we now better understand the true injury incidence of our patient population, and can identify risk factors for injury occurrence based on this data. During the Games, we now use live dashboards of injury occurrence and can use this information to help align the appropriate resources to keep an athlete in the field of play. These progressions give us an advantage over our competition – many of whom still use pen and paper medical records.

Are you aware of any other types of new healthcare technology that will be implemented in time for the Rio games – telemedicine, wearables, etc.?
Advances in wearable technology are changing the landscape of sports medicine and science. What was once only used and monitored in a lab a few times a year is now broadly available in real time. Our athlete population is very diverse, and each individual athlete’s needs, from a technology standpoint, differ slightly. During the lead up to Rio, our athletes will use dozens of different monitoring devices – measuring things like sleep quality, heart rate, heart rate variability, mood states, and distance traveled with GPS. How each athlete support team views and makes decisions on this data differs depending on the individual and their health and training needs.

Do you have any final thoughts?
The USOC is dedicated to providing the best opportunities to support and sustain high-performance outcomes for Team USA athletes who are working very hard, every day, to reach for Gold at the Olympic and Paralympic Games. One of Team USA’s best competitive advantages on the field of play is the high level of medical care made available before they reach the competition. Similar to the team of providers that rally to support an individual athlete, the partnership between the USOC and GE has been instrumental in allowing Team USA to “Provide the Edge” through leveraging our mutually supportive relationship in applying healthcare technology in new and innovative ways.

Contacts

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

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News 4/11/16

Top News

CMS announces the Primary Care Plus model, a five-year program kicking off in January 2017 that will incentivize PCPs to give patients 24-hour access to information and care, deliver preventive care, engage patients and families in caregiving, work with other providers to better coordinate care, and support chronically ill patients in achieving their health goals. CMS will implement the CPC+ model in up to 20 regions that will be identified based on payer interest in supporting the initiative through data sharing and quality metrics alignment. PCPs will have two tracks to choose from, the second of which includes a commitment from health IT vendors to enhance a practice’s HIT capabilities.

HIStalk Practice Announcements and Requests

I love it when my professional and personal passions collide. In the most recent case, new HIMSS friend and nursing informatics student Danielle Siarri, RN turned me on to her “InnoNurse” bag, which I ordered and promptly turned into a tennis carryall. It’s made for a great conversation starter in between sets.

Webinars

Check out the recording of last week’s “Ransomware in Healthcare: Tactics, Techniques, and Response” by Sensato CEO John Gomez. It’s worth watching — we asked John to put this together purely as a public service, so there’s zero pitch or commercial influence involved.

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

Announcements and Implementations

Nine physician practices and two local pharmacies join Western New York’s HealtheLink HIE, part of the part of the Statewide Health Information Network of New York.

Gee Eye Care (MO) implements Practice CoPilot’s Zulu mobile messaging software.

The Georgia Health Information Technology Extension Center reaches 100 percent of its MU goal, helping over 4,000 EPs and 56 critical access and rural hospitals achieve Stage 1 of Meaningful Use through April 2016. (You can read my interview with GA-HITEC Medical Director Dominic Mack, MD here. Mack is also the director of the GA-HITEC-affiliated Morehouse School of Medicine’s National Center for Primary Care.)

Health Choice Network selects population health management software and services from Wellcentive to enhance care management and quality reporting at its 46 health centers in 15 states.

Telemedicine

Teladoc facilitates 240,000 visits in the first quarter of 2016, a 61-percent jump over the 149,000 visits it saw during the same timeframe last year.

Government and Politics

MGMA makes available a downloadable presentation, including presenter notes, outlining MACRA, what’s known thus far about MIPS and alternative payment models, and what to expect as new Medicare payment rules are proposed in the coming weeks.

Other

Keeping up with the Joneses: Popular blogging platform WordPress announces it will automatically upgrade all custom domains hosted on WordPress.com to the HTTPS encryption protocol.

I’m willing to bet these aren’t WordPress websites: The GAO identifies vulnerabilities in the health insurance websites of California, Kentucky, and Vermont that could offer hackers an easy way to obtain sensitive personal information about consumers. The vulnerabilities included a lack of encrypted passwords and servers, and improper use of filters to block hostile attempts to visit the website. The office wouldn’t identify which state was responsible for which vulnerability. Kentucky’s Kynect insurance exchange will be dismantled later this year due to skyrocketing costs.

A study of 15 outpatient facilities reveals that staff fail to follow hand hygiene recommendations 37 percent of the time and safe injection practices 33 percent of the time. As one would expect, the authors conclude that, “These findings highlight the need for ongoing quality improvement initiatives regarding infection prevention policies and practices in outpatient settings.”

Sponsor Updates

• RTLS technology from Versus earns Cisco Compatible Extensions certification.
• Intelligent Medical Objects will exhibit at HealthCon2016 April 10-13 in Lake Buena Vista, FL.

Blog Posts

• Medicity Highlighted in KLAS HIE 2016 Specialty Report (Medicity)

Contacts

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

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News 4/7/16

Top News

ONC issues a request for information on how to measure interoperability as part of the broader MACRA objective of achieving widespread health data exchange through the use of interoperable, certified EHRs. HHS has been tasked with developing metrics with the help of healthcare IT stakeholders. The RFI is looking for input on:

• What populations and elements of information flow should be measured?
• How can it use current data sources and associated metrics to address the MACRA requirements?
• What other data sources and metrics should HHS consider to measure interoperability more broadly?

Webinars

April 8 (Friday) 1:00 ET. “Ransomware in Healthcare: Tactics, Techniques, and Response.” Sponsored by HIStalk. Presenter: John Gomez, CEO, Sensato. Ransomware continues to be an effective attack against healthcare infrastructure, with the clear ability to disrupt operations and impact patient care. This webinar will provide an inside look at how attackers use ransomware; why it so effective; and recommendations for mitigation.

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

Acquisitions, Funding, Business, and Stock

Melville, NY-based Millenium HealthCare launches a Services Division offering development, support, and administration services for physician practices.

Chicago-based startup HealthJoy raises $3 million in seed funding from health insurance marketplace Go Health and angel investors. Founded in 2014, the company offers telemedicine services and offers a “virtual concierge” service to help guide consumers through healthcare decision-making.The company plans to use the new funding to start selling directly to employers.

Announcements and Implementations

Practice marketing firm MedPB launches an Online Review Builder service to help physician practices manage their online reputations.

The Augustine Recovery Center (FL) joins MAP Health Management’s Recovery Network, giving it access to outcomes-tracking and telemedicine technologies.

The New York State Office for People With Developmental Disabilities selects EHR and intellectual and developmental disabilities software from Foothold Technology to better enable its support of 38,000 patients across the state.

Telemedicine

A report from the Urban Institute looks at the impact payer-based telemedicine programs have had on healthcare access and outcomes in six states. As expected, the authors conclude that payers aren’t using virtual care models to the best of their abilities due in large part to uncertainty around state and federal regulations, lack of payer and provider investment in necessary technology, and a lack of infrastructure and integration into physician workflows.

Arkansas Governor Asa Hutchinson encourages the state medical board to recognize the establishment of patient-physician relationships via video visits in an effort to help provide greater access to care, particularly to underserved populations. “It is important to increase access to care for Arkansans by fully taking advantage of technological innovations,” he writes. “For this reason, I encourage you to allow the initial visit, facilitated by audiovisual communication, to establish the patient-physician relationship.” Legislators are working on defining an initial visit in the hopes of passing telemedicine-friendly legislation in the near future.

Government and Politics

CMS updates 64 electronic clinical quality measures for EPs and 29 for hospitals.

Other

New York-based physician Barry Weinstein, MD calls it quits in light of New York’s mandated e-prescribing. “It’s a cost in money and time,” says Weinstein, who ran a paper-based practice for over 40 years. “I’m not particularly computer efficient – older people generally are not – and it’s more a cost of time and aggravation. As I talked to the patients the last couple of months and they told me about experiences with doctors, they don’t seem to have a lot of face time with doctors. They all seem to be putting their energy in their computers.”

Contacts

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

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Readers Write: What’s Holding Physicians Back from Making the Wearables Leap?

What’s Holding Physicians Back from Making the Wearables Leap?
By Waqaas Al-Siddiq

While wearables are being readily adopted by consumers as an integral part of their wellness and fitness regimens, integration into healthcare and the use of wearables in clinical settings has been much slower. There is some reluctance on the part of physicians to integrate wearables into patient care. It is not that physicians are averse or unreceptive to wearables, and it certainly is not their lack of understanding that wearables have the ability to transform patient care and healthcare management. In fact, physicians are well aware of how wearables can assist in long-term assessment and monitoring of patients. They realize its value in providing personalized care. The crux of the problem is that physicians are uncertain of wearables and their place in today’s healthcare landscape.

While wearables have the capacity to provide ample amounts of data, physicians do not always have the time to sift through pages and pages of that data to find applicable information. However, pertinent information does not necessarily translate to clinically relevant information. i.e. data that is medically meaningful. Even if clinical relevance were to be achieved, there is another hurdle in the form of integrating and interfacing data into existing workflows. The challenge for wearable manufacturers is to develop products that not only can be clinically validated and seamlessly integrated into existing physician workflows, but that also understand and address a physician’s concerns.

How Wearables Are Poised to Disrupt Healthcare
As I mentioned, physicians already understand that the benefits of wearables, both fiscally and in terms of patient care and long-term health management, are multifold. The integration of wearables into healthcare practices has the ability to reduce patient visits, as physicians will be able to remotely monitor and track patient health. Through data obtained from wearables, physicians will be able to assess the health of the patient and determine whether the symptoms warrant immediate medical attention. This initial assessment has the potential to drive down rising healthcare costs, as patient visits for non-emergencies will be reduced.

Wearables will also pave the way for adoption of preventive care measures into mainstream healthcare practices. The current healthcare landscape is predominately reactive, where physicians diagnose and treat conditions and diseases after its manifestation. Physicians realize the usefulness of wearables in correlating symptoms and to diagnose conditions even before onset. Wearables will allow physicians to keep in touch with their patients and monitor their overall health – not just in cases where the patients are sick. Given these points, and regardless of their understanding of the benefits and challenges, why are physicians struggling to incorporate wearables into patient care?

Traditional Barriers to Adoption
Simply put, one of the biggest obstacles to adoption is due to a physician’s limited time, as they are already bombarded with too much information. Already overwhelmed, a typical physician will not have the interest or the time to sort through volumes of data collected by wearables, which may or may not be of value. Most of today’s wearable devices only correlate data derived from various metrics (e.g. caloric burn, step count, etc.), and to extrapolate from this data to find relevant information that can be used to diagnose or monitor a patient’s condition is time consuming and difficult. After all, a patient’s step count may not be obvious in how it relates to their heart condition. For physicians to utilize data from wearables, data needs to be separated and summarized, which again, due to time restraints, cannot be done by all medical professionals. In conjunction with developing wearables that utilize clinical-grade data, health technology companies must derive solutions that will make it easier for physicians to extrapolate the right patient data at the right time.

How Data and IT Integration is Key to Physician Acceptance
As they should, physicians place high importance on the quality of data coming from all sources. Data from wearables is most often not medical grade and, in fact, several high-profile cases have recently highlighted the problems associated with the accuracy and integrity of this data. For wearables to be implemented into patient care, they need to have the capacity to produce medically relevant, clinical-grade data. While this will be the first and foremost step to integrating wearables into patient care, simply providing clinical-grade data will not be enough. Physicians need to see data that not only is clinically relevant but that will also measure clinical improvement, as monitoring improvement is an important part of preventative care.

However, even if wearables were able to provide data that is pertinent and achieves clinical relevance, health technology companies must figure out how to develop an infrastructure that will enable the integration of wearables into the physician’s workflow. Doctors will not be able to do this themselves, so health technology companies and physicians alike must uncover how wearable technology can be utilized and deployed under different circumstances and and in different scenarios. This may prove to be the most challenging of issues, as there is a lack of clarity on the integration/interfacing process and it requires a core understanding of not only the technology but also the physician’s workflow.

Waqaas Al-Siddiq is CEO and Founder of Biotricity Inc. in Redwood City, CA.

Contacts

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

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News 4/6/16

Top News

New research from Rock Health shows that digital health funding reached $981.3 million in the first quarter of this year, a year-over-year growth of almost 50 percent. This year’s initial quarter marks the highest first-quarter total since the organization started tracking the data five years ago. Deals of note included One Medical Group’s acquisition of mobile app developer Rise, plus Flatiron Health and Jawbone’s combined $340 million funding rounds.

Webinar

April 8 (Friday) 1:00 ET. “Ransomware in Healthcare: Tactics, Techniques, and Response.” Sponsored by HIStalk. Presenter: John Gomez, CEO, Sensato. Ransomware continues to be an effective attack against healthcare infrastructure, with the clear ability to disrupt operations and impact patient care. This webinar will provide an inside look at how attackers use ransomware; why it so effective; and recommendations for mitigation.

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

Acquisitions, Funding, Business, and Stock

The local business paper shares mock-up photos of Kaiser Permanente Northwest’s (OR) new convenient care clinic, set to open this fall. The pilot space will offer a limited range of urgent care services and will offer members the ability to conduct virtual visits for colds and minor burns. Patients will also be able to access their medical records and health information at the “Thrive Bar.”

Tribeca Pediatrics (NY) founder Michel Cohen, MD recounts the ways in which he single-handedly transformed his nearly bankrupt practice into a now-thriving chain. A few highlights:

• Installing a new billing system, which he’s tweaked to track the status of unpaid claims each week.
• Sometimes hiring for personality over experience.
• Creating a centralized customer support department that handles all patient calls, including insurance claim disputes.
• Opening up his own fabrication workshop to supply furnishings for new locations.

Telemedicine

Konica Minolta’s Business Innovation Center partners with SnapMD to launch a telemedicine pilot. The accompanying press release is light on details; media outlets report urgent care and chronic care management will be initial target areas.

Research and Innovation

The Robert Wood Johnson Foundation and Luminary Labs announce the Mood Challenge for ResearchKit as part of their New Venture Fund program. The challenge, which is looking for proposals for ResearchKit studies that will further understanding of mood and how it relates to daily life, will offer finalists mentoring and piloting opportunities. Up to $500,000 will be awarded throughout the competition. Submissions are due May 22.

An informal Fast Company survey of 1,000 presumably Web-savvy consumers finds over 75 percent want access to their medical records, contradicting the author’s (and healthcare industry’s) belief that patients have historically been “indifferent” to their medical records. The overwhelming response in favor of record access doesn’t surprise me given OCR’s recent push to make providers more away of patient record access rights, the expansion of OpenNotes, and the ease with which patient portals should make access a non-issue.

People

SCI Solutions names Maryanne Pace (Radius Global Solutions) senior vice president of client delivery and Tammy Wood solution consultant.

Other

The American College of Physicians joins the AMGA Foundation’s Diabetes: Together 2 Goal campaign. Launched last month, the campaign is working with healthcare organizations across the country to improve care for 1 million people with Type 2 diabetes by 2019. The program heavily emphasizes healthcare IT including the use of patient registries and point-of-care tools.

Inverse takes a look at the ways in which drone delivery business Zipline is helping remote clinics in Rwanda. The San Francisco-based company will soon deliver medical supplies such as blood or vaccines across the 10,000 square mile country via two launch hubs of 10 to 15 drones each.

As if our world weren’t connected enough: Raden introduces a line of app-connected travel cases that include a built-in weight sensor to help travelers avoid overweight baggage fees and a battery that can charge a mobile phone up to four times. The accompanying app offers airport travel tips and security line wait times, alerts users when their baggage is on the carousel, and tracks luggage destinations.

Sponsor Updates

• EClinicalWorks will exhibit at the NCCHC Spring Conference on Correctional Health Care April 10-12 in Nashville, TN.
• Healthwise will exhibit at the Allscripts Central Region User Group April 13-15 in Minneapolis.

Blog Posts

• Little Known Facts About Doctors Day (AdvancedMD)
• Automating Documentation and Billing Makes Chronic Care Management More Achievable (Aprima)
• Mixed Use Patient Access Centers Improve the Patient Experience (Culbert Healthcare Solutions)
• ICD-10: Focusing on Assessing & Maintaining (E-MDs)

Contacts

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

More news: HIStalk, HIStalk Connect.

Get HIStalk Practice updates.
Contact us online.
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