News 6/16/16

Top News

Apple furtively announces that HealthKit in IOS10 will allow users to request medical records that adhere to the the HL7 standard through apps on their phones. The apps (including Mail and Safari) will then “translate” the HL7-standardized documents into more understandable formats, which users can then send to other people in their caregiving circles. The new operating system is expected to launch this fall; the healthcare technology Twitterverse, however, is already getting excited about the notion that patients will have easier access to and control of their records.

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

Medfusion adds its patient payment and portal capabilities to Meridian Medical Management’s VertexDr PM/EHR software. The Cary, NC-based company became the “Official Healthcare IT Provider” of the Carolina RailHawks soccer team earlier this month.

Acquisitions, Funding, Business, and Stock

Xerox moves forwards with plans to split into two companies, announcing that its business process outsourcing company will be known as Conduent, while its traditional document technology business will retain the Xerox name. Announced in January, the split is expected to wrap up by the end of 2016. Conduent will include Xerox’s healthcare business (including its new telemedicine service line), plus customer care and transportation solutions.

Healthcare startups take note: Philadelphia-based private equity firm 1315 Capital launches a $200 million fund that it will use to invest in medical technology, healthcare services, and specialty pharmaceutical businesses. The company’s portfolio includes Encore Dermatology, JDS Therapeutics, and Onkos Surgical.

Government and Politics

The local paper looks at the underwhelming prescriber adoption of Minnesota’s statewide prescription drug monitoring program. Established in 2010, the program has seen only a third of eligible physicians and PAs sign up to participate. Over 60 percent of pharmacists have signed up; dentists lag behind at just 20 percent. As of July 1, 2017, every eligible prescriber will be required to maintain login credentials for the PDMP, though they won’t be required to check it before prescribing or dispensing controlled substances. The new requirement seems to cater to prescriber complaints that mandatory login would add to their workloads, compromise patient privacy, or get in the way of professional judgment.

Other

As someone who read Emily Post’s “Book of Etiquette for Young People” many years ago, I find this so refreshing: Google thanks 86 year-old May Ashworth for using “please” and “thank you” in a search request. The British grandmother was under the impression that a Google staff member would address her request, which asked for a translation of the Roman numerals MCMXCVIII.

Contacts

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

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News 6/15/16

Top News

Emergency Care Specialists partners (though merge might be a better term) with Answer Health to form Answer Health Telemedicine, a Grand Rapids, MI-based joint venture that will combine the ECS MiDirectCare technology and expand it to include behavioral health, primary care, specialty care, and wellness programs. The collaboration will spur an August rebranding of the MiDirectCare product to Answer Health Care On Demand.

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.

People

The AMA inaugurates orthopedic hand surgeon Andrew Gurman, MD as its 171st president.

Former Amazon CFO Tom Szkutak joins the Athenahealth Board of Directors.

Announcements and Implementations

Keystone HIE connects to the PA Patient & Provider Network (P3N). Five additional health information organizations are expected to connect to P3N by the end of the summer.

Government healthcare program services company SynerMed selects house call technology from MedZed for its Medi-Cal members.

Research and Innovation

A Peer60 report on payers finds that BCBS and Medicare are the ambulatory provider favorites by far, with UnitedHealthcare trailing the pack. Providers like payers that get them paid more quickly with minimal staff involvement, while their least-favorite attributes are time-wasting practices, denials, and poor customer service.

A Council of Accountable Physician Practices survey of 30,000 consumers and 626 physicians shows that half of patients are benefiting from coordinated care efforts, and that just one third have access to around-the-clock care outside of the ER. These statistics seem to directly correlate with the fact that only 20 to 30 percent of patients have used digital access tools like email or text reminders, and less than half have access to online health data.

Other

Facebook plans to offer users the ability to flag the posts of friends they deem suicidal or indicative of self-harm. The flags will then be reviewed by a trained Facebook team who will reach out to the person at risk with information on suicide prevention. Perhaps it’s too Big Brotherish, but what if these flags could also trigger some sort of alert in the user’s EHR or PHR? While a message from the Facebook suicide prevention team would no doubt be beneficial, outreach from the user’s PCP or caregiver could truly get the ball rolling on mental health help.

Sponsor Updates

Blog Updates

• 4 Reasons Private Physicians Should Be Thankful That They’re Self-Employed (AdvancedMD)
• Shift in Prostate Cancer Treatment has Roots in Foundation’s History (Healthwise)

Contacts

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

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News 6/14/16

Top News

The telemedicine wars heat up as a federal court in Boston dismisses a patent infringement suit filed by American Well against Teladoc. The legal wrangling began last year when Teladoc petitioned the US Patent and Trademark Office to invalidate several American Well patents. American Well then initiated the infringement suit against Teladoc just before its IPO last summer, asserting that Teladoc’s business model illegally copied one of its cornerstone patents. American Well plans to appeal the decision.

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

Altex Business Solutions makes HealthFusion’s MediTouch EHR and billing software available to its small-business clients.

CureMD adds Izenda’s business intelligence tools to its PM and EHR software.

People

Sturdy McKee, PT (San Francisco Sport and Spine Physical Therapy) joins Clinicient as senior director of client executives.

The AMA names Missouri-based family physician David Barbe, MD president elect.

Telemedicine

Philadelphia-based AllyHealth opens an office in Albany, NY. The employer-focused telemedicine startup, which provides its services through the MDLive platform, hopes to double its Albany staff of four by the end of the year.

Kareo adds telemedicine technology from Chiron Health to its EHR and PM software for independent practices.

Alpine, UT-based Azova launches a white-label telemedicine solution that includes house call, secure messaging, and e-commerce technologies.

Florida lawmakers pass legislation giving public schools the ability to receive Medicaid reimbursements for telemedicine visits.

The Atlantic highlights the Desert Senita Health Center in its profile of rural Ajo, AZ. The article is a thoughtful look at how the FQHC offers many important services to the remote town’s 2,300 residents, yet makes no mention of the vital role telemedicine plays in its services. The center, 100 miles from the nearest hospital, is a member of the Arizona Telemedicine Network.

AMA adopts ethical guidelines relating to telemedicine at its annual meeting in Chicago. Developed over the last three years, the new guidance stresses the potential limitations such technologies might place on care, and the need for ongoing refinement and standards relating to telemedicine technology.

Other

Accountable physician group CAPG publishes a guide to alternative payment models, highlighting CAPG member experiences with APMs ranging from bundled payments to capitated, coordinated care.

Today’s Google Doodle features 1930 Nobel Prize winner Karl Landsteiner, MD the Austrian-born immunologist and pathologist who created the ABO blood group system still used today.

Contacts

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

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From the Consultant’s Corner 6/14/16

Snipes and Revenue Cycle Key Performance Indicators – Don’t Take the Bait

[A snipe hunt is a type of practical joke that involves experienced people making fun of credulous newcomers by giving them an impossible or imaginary task.]

With summer now upon us, I think of those lazy summer camp days in Texas as a kid and the ritual of the snipe hunt. In the simplest of terms, a snipe hunt is a hazing tradition where older campers initiate younger campers to “hunt” that illusive small bird, the snipe, shortly after dark on a moonless night with flashlights and burlap bags. The funny thing is that snipes actually exist – just not in central Texas.

What does this have to do with revenue cycle key performance indicators (KPIs)? A lot, these days. We are now in the era of big data, with a virtual endless supply of structured and unstructured data related to the performance of our hospitals and physician practices. Large healthcare organizations have implemented enterprise-wide EHRs and related administrative support systems for patient registration and scheduling, billing, population health, quality reporting, and other specialized functions. These systems come with countless “canned” reports and hundreds of data points. But finding what is important is like finding that illusive snipe. As we all know, data does not always equal actionable information. That’s where business analytics come into play. Healthcare organizations often “bolt-on” companion software applications to their enterprise system so they can find what’s important and actionable in all of that data – in short, making it easier to find a snipe.

(Full disclosure: I’m a data junky. I love business analytics and the focus it can bring to organizations who use it well, but it is really easy to lose sight of the forest for the trees.)

Now, one of the great thing about being a consultant are the great organizations and executives I have the opportunity to work with on a variety of engagements. Over the last couple of months, several colleagues and I have had a chance to work with a great healthcare organization that serves millions of patients across multiple states. The focus of our work was a high-level assessment of professional billing operations for a medical group with a nine-digit annual revenue stream – a big and complex operation. Like most big organizations and medical groups, they have an enterprise-wide EHR with associated administrative support systems, centralized billing with hundreds of employees, a companion business analytics software application, and a passionate and engaged leadership team. Top-level KPIs are good, but they wanted to get better and lower costs – a common 21^st century healthcare goal.

As we started our work, it became obvious to us (as the outsiders) that data governance and discipline were needed. Staff members were working really hard preparing weekly dashboards for operating units, supplying data for monthly financial statements and corporate scorecards, and managing the canned system reports. The problem was that too much information was available. Our feedback on business office operations from the clinical executives was good, but a general theme was, “We don’t have time to deal with all of those reports – it’s not actionable.” The corporate scorecard tracked 18 separate KPIs. The weekly divisional dashboard had 10 KPIs. Their impressive analytics software had 27 KPI “views” with a staggering 103,702 discrete filter view options. To help professional workflows, they had set up nearly 10,000 “to do lists” within their billing system. Big data is alive, well, and flourishing. And, who knows, there might be a snipe somewhere in those millions of data points.

The challenge we faced was getting our arms around all of the data to benchmark the client to national norms for professional billing. We chose the KISS principle (a termed coined by the Navy in the early 1960s) and focused on outcomes.

Besides cash (because making payroll is important to most organizations), the most important professional billing KPI is the Days in Accounts Receivable (AR Days) that remain uncollected for a practice. Jim Denny in his 2013 publication and Mark Coronella in his 2014 publication also agree AR Days should be a major focus of medical practices. In addition, several national organizations, such as MGMA, AMGA, and the Faculty Practice Solution Center benchmark AR Days in their survey data. Collectively, these organizations reported AR Days on more than 250 medical groups representing thousands of healthcare providers. AR Days makes benchmarking to other groups more manageable than other revenue cycle metrics such gross collection rates, which can vary widely because differences in where professional charges are set, payer mix, and confidential managed care contract rates.

In the KPI world, AR Days should be viewed as a lagging indicator for a practice’s professional billing process – in short, an outcome to what is going well or not going very well. Other KPIs, such as denial rates, charge entry lag days, or point of service collections should be viewed as leading indicator for professional billing. Each of these leading indicators -along with others – are important to revenue cycle performance, but they all impact AR Days in a positive or negative way.

We suggested to our data-rich client that they become more disciplined and simplified around data governance and focus on actionable, top-of-mind issues that impact AR Days. As they evaluate business initiatives to improve their revenue cycle performance, they should evaluate each of these programmatic endeavors with the simple question, what will it do for my AR Days?

Randy Jones is senior vice president of Culbert Healthcare Solutions.

Contacts

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

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News 6/13/16

Top News

CMS announces that it will dole out $10 million in technical assistance grants over three years to help practices affiliated with Support and Alignment Networks or Practice Transformation Networks transition to new payment models under MACRA and MIPS. Applicants must have received signed commitments to enroll 5,000 or more eligible clinicians and their practices that are in advanced states of readiness (including EHR utilization). Letters of intent are due July 1; applications, July 11. 

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

A Merritt Hawkins report based on recruiting data over the last two years shows that 90 percent of its search assignments were for employment, while just five percent were for solo practice settings, many of which were for concierge or direct pay models. Starting salaries have spiked over the last year, especially for family medicine, psychiatry, obstetrics-gynecology, and dermatology.

Announcements and Implementations

Midwest Orthopaedic Consultants (IL) selects care coordination technology from PinpointCare to assist in care navigation for Medicare patients managed under the Bundled Payments for Care Improvement initiative.

Raintree Systems adds MedBridge educational material to its TherapyRehab Plus and PediatricTherapy Plus EHRs.

The Pennsylvania Dept. of Health, Athletic Trainers’ Society (PATS), and Medical Society develop a consumer-facing online database of physicians who have completed an educational training program focused on concussion evaluation and management.

People

Amar Desai, MD (University of Southern California Medical Group and Ambulatory Services) returns to DaVita Healthcare Partners as president of its HealthCare Partners California Coastal region.

Justin Barnes joins IHealth as partner and chief growth officer. Atlanta-based RCM technology vendor IHealth was formed when IHealth Solutions acquired DNA Healthcare in late May.

Telemedicine

Charleston, SC-based pediatrician Chad Hayes, MD warns parents away from telemedicine services, especially those that offer to treat strep throat, ear infections, UTIs or pneumonia without first performing necessary testing. “As a pediatrician,” he adds, “I’m obviously biased [he is, in fact, opening a new practice next month], but my advice is to find a doctor you trust, hopefully one with some after-hours and weekend availability, and maybe even one who offers some supplementary care by smartphone, text, or email.”

Colorado becomes the 17th state to enact the Interstate Medical Licensure Compact.

Fred’s Pharmacy will install another nine TelehealthOne telemedicine kiosks at stores in Mississippi. The retail pharmacy chain installed its first kiosk last fall.

The Arkansas State Medical Board approves a regulation allowing first-time physician visits to take place through audio-visual technology. The board stipulated, however, that sending a patient’s online medical history to a physician doesn’t count as a valid patient-physician relationship and doesn’t qualify as "store-and-forward" technology.

Research and Innovation

A survey of 1,300 medical groups of five or fewer physicians finds that 67 percent believe MACRA is the root of all evil that will drive them to either close up shop or become employed. Nearly 90 percent of surveyed solo physicians expect to decrease Medicare patient volumes so they won’t have to report on quality and clinical practice improvement activities. Just over 75 percent of small practices identify as “financially struggling” due in part to less-than-adequate billing software. Surprisingly, a combined 63 percent of practices haven’t yet settled on software products that meet their myriad needs. Of those that have, EHRs from SRS Soft, ADP AdvancedMD, and Practice Fusion earned top rankings.

Government and Politics

HHS Secretary Sylvia Burwell and Cuban Minister of Health Roberto Tomás Morales Ojeda, MD sign a healthcare collaboration agreement that will  prompt the two countries to work on health issues including global health security, communicable and non-communicable diseases, research and development, and information technology.

Don’t forget …

Other

The local paper highlights the success nine Albany, GA-based primary care practices are seeing through participation in Blue Cross Blue Shield of Georgia’s Enhanced Personal Health Care program. The program, which incentivizes participating PCPs to improve quality and value, has prompted several practices to tweak their EHRs for improved care coordination.

Steven Stack, MD gives his final address as president of the American Medical Association during the AMA’s annual meeting in Chicago. He kept his remarks light (with just the right amount of gravitas), encouraging his colleagues to persevere in light of the many challenges they face on a day-to-day basis. CMS Acting Administrator Andy Slavitt also made an appearance to talk with AMA delegates about MACRA and physician burnout.

Sponsor Updates

• Black Book names E-MDs the top ambulatory EHR for thoracic and vascular surgery specialties.

Blog Posts

• Do More with Your Versus Badge: Call for Help, Monitor Rounding & More (Versus Technology)

Contacts

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

More news: HIStalk, HIStalk Connect.

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