News 1/19/16

Top News

In what’s either part of a well-executed PR strategy or an attempt at Twitter damage control, National Coordinator Karen DeSalvo, MD and Acting CMS Administrator Andy Slavitt outline next steps for Meaningful Use as it will look under MACRA, all of which will be guided by the following principles:

• Rewarding providers for the outcomes technology helps them achieve with their patients.
• Allowing providers the flexibility to customize health IT to their individual practice needs.
• Leveling the technology playing field to promote innovation through open APIs. 
• Prioritizing interoperability by implementing federally recognized, national interoperability standards and focusing on real-world uses of technology. Information-blocking business models will not be tolerated.

The authors concede that the EHR Incentive Program “helped us make progress, [but] has also created real concerns about placing too much of a burden on physicians and pulling their time away from caring for patients.”

Webinars

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

Announcements and Implementations

Fairfax Ob-Gyn Associates P.C. (VA) implements paperless billing services from PatientPay across its three offices.

Best Practices Academy, a chiropractic educational and PM company based in Brookings, SD, will offer its members EHR and RCM services from IPatientCare.

AdvancedMD develops AdvancedEPCS e-prescribing technology to help independent physicians meet EPCS (electronic prescription for controlled substances) regulatory requirements.

Boston-based startup VerbalCare launches a patient-centric, care team communications tool and secure messaging app at its national sales meeting in San Diego. 

Acquisitions, Funding, Business, and Stock

EHR and PM vendor AllMeds rebrands and expands the reach of its limited-release RCM service line to a national audience. The Oak Ridge, TN-based company, which plans to transition to fully Web-based solutions in the near future, will release a Meaningful Use-friendly EHR later this year.

People

Adrienne Craig-Kennard (Strand Life Sciences) joins CollabRx as vice president of global business development and strategic alliances.

Jerri Ivey (Innovative Consulting Group) joins Culbert Healthcare Solutions as director of consulting services.

Vindell Washington, MD will join ONC as principal deputy national coordinator on January 25. Washington formerly served as CMIO at Franciscan Missionaries of Our Lady Health System in Louisiana (where I assume he interacted with National Coordinator Karen DeSalvo, MD), and as president of the health system’s medical group.

Telemedicine

Map Health Management adds 1,200 licensed counselors to its recovery support telemedicine services.

Research and Innovation

Navicure’s final ICD-10 survey of 360 practice staff finds that, on average, 14 percent felt a “significant” impact to productivity as a result of the October 1, 2015 switch. Over 30 percent have seen a decrease in revenue of up to 20 percent, and 44 percent have seen an increase in denial rates of between 1 and 10 percent. Just 11 percent have reported denial-rate increases of up to 40 percent – statistics in line with pre-transition expectations. Surprising to me was the fact that 20 percent of respondents didn’t know how much was spent on training.

The Institute for Critical Infrastructure Technology releases a 97-page report on lessons healthcare can learn from last year’s OPM breach. The authors call the lack of a dedicated security team one of the office’s largest failings, pointing out that “a healthcare breach is highly likely to begin with an attack campaign against employees. Security is only as strong as its weakest point because attackers tend to focus on the point of least resistance.”

Other

Scientific American looks at the increasingly slippery slope of selling de-identified health data, pointing out that anonymity is increasingly harder for patients to come by and as such they should be given a chance to opt out of sharing their data. “It is getting easier and easier to identify people from anonymized data,” says Chesley Richards, director of the Office of Public Health Scientific Services at the CDC. “You may not be identifiable from a particular data set that an entity has collected, but if you are a broker that is assembling a number of sets and looking for ways to link those data, that’s where, potentially, the risk becomes greater for identification.”

Contacts

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

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News 1/18/16

Top News

Cognitive computing company Digital Reasoning acquires Shareable (fka Shareable Ink) for an undisclosed sum. Shareable CEO Hal Andrews – the company’s third since its founding in 2009 – will become president of Digital Reasoning’s new healthcare business. Both companies are based in Nashville, TN.

Webinars

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

Announcements and Implementations

Medical Transcription Billing Corp. releases an e-prescribing app for Apple Watch. The new app is part of a broader company effort to extend its healthcare IT ecosystem to smartwatches and other wearables.

Physiotherapy Associates (PA) rolls out the Athletic Trainer System EHR from Keffer Development Services across its facilities, touting its ability to capture and research injury data as part of its injury prevention initiatives.

Allscripts adds Total Child Health to its roster of strategic partners based on the interest the company’s CHADIS behavioral and developmental screening and decision-support tool has seen as part of the Allscripts Developer Program.

People

Stacy Hiquet (Cengage PTR) joins Zotec Partners as executive vice president of education.

Research and Innovation

An AMIA literature review reveals – not surprisingly – that healthcare IT, particularly EHRs, impact the physician-patient relationship positively and negatively, influencing eye contact and gaze, sharing of information, relationship building, and flow of conversation. The level of impact depends on a combination of factors including consultation room layout, patient and physician styles of interaction with technology and each other, and the ways in which physicians integrate tech into consultations.

A study of over 10,000 family physicians finds that just over half work in solo or small practices, negating the rumor that smaller physician practices are closing up shop in record numbers. While these types of practices continue to keep their doors open, the study points out that they are losing ground when it comes to keeping up with access to care coordinators and patient-centered medical home certification – all of which require resources more easily found in their larger medical group counterparts.

Telemedicine

AmeriHealth New Jersey offers members telemedicine services from MDlive at no additional cost.

Other

University of Pennsylvania physicians make a strong case for rethinking the ways in which employers promote healthy lifestyles via wearable devices:

• Ditch the leaderboards and offer small, immediate rewards. Mitesh Patel, MD stresses (and recent Powerball insanity has shown) that, “It’s better to put people in a lottery where they have a 1 in 10 chance of winning $10 than a 1 in 100 chance of winning $100.”
• Motivate employees by the prospect of losing something rather than gaining something.
• Create accountability teams – groups of employees that know each other and can hold each other accountable for their participation (or lack thereof).
• Create a “daily feedback loop” to encourage near-term rewards rather than, say, the distant promise of a discount in next year’s health premiums.

Sponsor Updates

• Versus real-time location solutions receive Novation’s Innovative Technology designation.

Blog Posts

• After reading 2016 trends, let’s take some actions (Nordic)

Contacts

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

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Population Health Management Weekly Wrap Up 1/17/16

Munson Healthcare promotes Kimberly Speese to executive director of population health management.

Shareholders approve Toronto-based NexJ’s previously announced plan to spin off its healthcare business, which consists primarily of its cloud-based population health management platform. The plan includes spinning off the business to new corporation NexJ Health Holdings.

Apollo Medical Holdings subsidiary Apollo Care Connect acquires population health management technology company Healarium for an undisclosed sum. In other company news, Mark Fawcett has joined ApolloMed’s Board of Directors.

Health plan MDwise will extend its use of ZeOmega’s Jiva population health management solution to monitor medication adherence and safety.

Indiana-based Michiana Health Information Network (MHIN) partners with case management technology developer ClientTrack to integrate public health data with its HIE’s clinical data to improve outcomes and reduce costs. “Combining data from health and human services with clinical data will allow our providers and partners to effectively address the social determinants of health in their care and evaluation process and positively impact the overall care for an individual and support they receive,” says Waldo Mikels-Carrasco, MHIN’s director of community and population health development.

Sponsor Updates

• Leidos Health will exhibit at the Meditech Executive Institute January 17-19 in San Diego.
• Nordic representatives will attend the HIMSS Dallas/Fort Worth Chapter event January 22 in Arlington, TX.

Blog Posts

• When a Patient is Transferred with Incomplete Records (Medicity)
• 2016 Trends: What’s Ahead in Healthcare IT? (PerfectServe)

Contacts

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

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News 1/14/16

Top News

It’s official: HealthSpot files for Chapter 7 bankruptcy liquidation. The Dublin, OH-based company had raised nearly $50 million and signed several high-profile clients since launching its line of telemedicine kiosks in 2012. “There were some positive events in the operation of the business,” explains filing attorney David Whittaker, “but the company simply did not have enough cash flow to continue to operate and continue to execute on those positive opportunities.” The filing listed assets of $5.2 million, with its largest single debts linked to $10 million owed to Cox Communications and $6 million owed to investor Xerox.

Acquisitions, Funding, Business, and Stock

Venture capital funding in healthcare IT totals $4.6 billion via 574 deals made in 2015, slightly less than 2014’s $4.7 billion across 670 deals. Total corporate funding amounted to $7.9 billion. Funding growth was strongest in the areas of comparison shopping, appointment booking, and wellness.

People

Jackson Healthcare promotes Chris Franklin to president of LocumTenens.com.

Announcements and Implementations

Physician-owned and operated National ACO selects Drchrono’s EHR, PM, and billing solution for its 230 physicians. The Beverly Hills, CA-based organization joined the Medicare Shared Savings Program in 2013 and cares for 114,000 patients.

Icon Eyecare (CO) will roll out Compulink Business System’s Ophthalmology Advantage EHR and PM technology to 20 physicians across 11 locations in Colorado and Texas.

Telemedicine

Doctor on Demand signs its 400th employer customer. The company announced a $50 million funding round last summer, bringing its total funding to $71 million.

Kansas City, MO-based NuWin Enterprises launches the NuWinCare telemedicine service for employers.

Genesis Psychiatric Group (NE) implements Bryan Health’s telemedicine solution.

Government and Politics

FTC hosts its first PrivacyCon in Washington, DC. As I mentioned in a recent post, healthcare was represented by panels dedicated to personalized medicine and genetic testing. Funnily enough, FTC forgot to CC the email addresses of attendees before it sent out conference messaging a few days before the event. One recipient found it “surprising that FTC.gov team would not hide all of the email recipients on a blast in regards to a conference on … digital security and best practices.”

Vice President Joe Biden calls on “data and technology innovators” to aid him in his “moonshot” to cure cancer.” Biden, who lost his son to the disease last year, plans to work with a wide range of stakeholders to help break down the data and communications silos between doctors, and ensure that patients have access to their own data and the ability to contribute to research.

Research and Innovation

Pew Research Center looks at sharing health information in its 47-page report on privacy and information sharing. When given the hypothetical opportunity to access medical records and schedule appointments via a new physician website, 52 percent gave the ok. Several of the 26 percent who found the scenario unacceptable commented on their reasoning: “There is no such thing as a secure site. Hackers are always finding entry points into databases. Insurance companies can afford to hire hackers. The gleaned database information would allow insurance companies to deny coverage to the patients whose information was compromised. Doctors charge excessive fees to patients to use and access this online record tool. Many patients cannot afford the online record service.”

Contacts

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

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Readers Write: 2016 is the Year of the Patient

2016 is the Year of the Patient
By Fauzia Khan, MD

Now that EHR systems are no longer a distant “to do” project and wearable devices track our every move, we can finally acknowledge that information is not only widely available, but actively consumed on a daily basis. Whether we are mapping our daily run or closely managing a chronic condition, these valuable data points are strengthening the patient and provider relationship by enabling more accurate, real-time information that can support more personalized care. As we continue to get back into the swing of “business as usual,” I can’t help but think about the exciting changes that are coming to healthcare in 2016. Will this be the year that we see patients truly at the center of their care?

Here are my top 5 predictions for 2016.

1. More power to patients and families.
With mobile devices and apps at their fingertips, we have reached a tipping point where patients are finally active participants in their own health and wellness. However, much of this information is still fragmented. Therefore, demand for support tools will skyrocket as patients look for ways to enhance overall communication throughout the entire care team and effectively manage healthcare finances. Patients are looking for easy technology solutions that provide holistic support, not individual portions of their care.

2. Thinking beyond EHRs. 
EHR adoption is the norm, but with so many varieties of standards, we will never get to true interoperability without landing on a single set of data standards and forcing all vendors to comply and open up their systems. We will finally stop talking about what a barrier EHRs are to innovation and how they control the desktop and access. We will start thinking of apps and systems that either sit on top of or outside of the EHR. Think of EHRs as smartphones with different apps!

Fast Healthcare Interoperability Resources or FHIR is a next-generation HL7 standards framework in healthcare data integration and is meant to facilitate interoperability. FHIR APIs will fuel innovation and we will start to see development of useful apps.

3. Documentation and HCC scores will add to physician office burdens. 
The physician office bears many burdens and one of the biggest is continually combatting reductions in Medicare reimbursements. Though it has been around for many years, Hierarchical Condition Category (HCC) is one way to ensure that the physician’s office is being reimbursed appropriately, especially for Medicare Advantage plans. Because of the proven success of HCCs in predicting resource use, the model has been extended under the ACA to determine reimbursement for other programs including ACOs. With value-based reimbursements, more providers are assuming risk and the need to accurately document health status for their patients. Focusing on HCC coding and documentation is now also critical for commercial payers.

4. Chronic Care Management adoption barriers will be addressed. 
Physician reimbursement from CMS for 20 minutes of non-face-to-face care per patient per month could provide a new revenue opportunity for physicians and enables greater freedom for patients. Unfortunately, according to recent surveys, half of responding healthcare organizations lack a formal chronic care management structure, and as a result, are missing out on this new reimbursement opportunity. Why are physicians not adopting this program more quickly? Though the program is one with many benefits, there are many barriers that need to be overcome in order to see increased adoption.

The American College of Physicians hopes to see legislation enacted this year to help remove the barriers, specifically waiving the copayment requirement and reducing the overall administrative burden to practices. The American Academy of Family Physicians has also echoed this sentiment. Chronic care management is definitely a topic of interest for many providers and I am hopeful that Washington will address these barriers quickly.

5. CMS will continue its path on alternative payments and release more options. Other payers will follow.
Alternative payment models are here to stay, and we are beginning to see more and more payers follow the lead of CMS. This year marks the introduction of bundled payments with CCJR and more are on the horizon. We will also see the Chronic Care Management Program act as a bridge from fee-for-service to value-based reimbursement. Chronic care management has already been introduced by United Healthcare and Humana, and I expect to soon see other payers follow suit as the benefits of the program start to be seen by physicians.

Fauzia Khan, MD is CMO of Persivia in Lowell, MA.

Contacts

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

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