News 12/15/15

Top News

A Texas court denies the Texas Medical Board’s motion to dismiss a federal lawsuit filed by Teladoc. The ruling, which addressed TMB’s attacks on Teladoc’s antitrust and Constitutional challenges to several TMB rules, is the seventh time in the last four years that Texas courts have sided with Teladoc against the board’s attempts to limit its operations.

Webinars

December 16 (Wednesday) 1:00 ET. “Need for Integrated Data Enhancement and Analytics – Unifying Management of Healthcare Business Processes.” Sponsored by CitiusTech. Presenters: Jeffrey Springer, VP of product management, CitiusTech; John Gonsalves, VP of healthcare provider market, CitiusTech. Providers are driving consumer-centric care with guided analytic solutions that answer specific questions, but each new tool adds complexity. It’s also important to tap real-time data from sources such as social platforms, mobile apps, and wearables to support delivery of personalized and proactive care. This webinar will discuss key use cases that drive patient outcomes, the need for consolidated analytics to realize value-based care, scenarios to maximize efficiency, and an overview of CitiusTech’s integrated healthcare data enhancement and analytics platform.

December 16 (Wednesday) 2:00 ET. “A Sepsis Solution: Reducing Mortality by 50 Percent Using Advanced Decision Support.” Sponsored by Wolters Kluwer Health. Presenters: Rick Corn, VP/CIO, Huntsville Hospital; Stephen Claypool, MD, medical director of the innovation lab, Wolters Kluwer Health. Sepsis claims 258,000 lives and costs $20 billion annually in the US, but early identification and treatment remains elusive, emphasizing the need for intelligent, prompt, and patient-specific clinical decision support. Huntsville Hospital reduced sepsis mortality by 53 percent and related readmissions by 30 percent using real-time surveillance of EHR data and evidence-based decision support to generate highly sensitive and specific alerts.

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

Telemedicine

Austin-based startup Chiron Health raises a $2.3 million seed round and releases an app for patients.

Wisconsin Governor Scott Walker signs Assembly Bill 253, officially bringing the state into the Interstate Medical Licensure Compact. Wisconsin is the twelfth state to join the compact, which is being spearheaded by the Federation of State Medical Boards. The FSMB Commission, which is working to enact the compact, meets again on December 18.

Georgia Partnership for TeleHealth donates telemedicine equipment to Mercy Care, an Atlanta-based nonprofit that works with the homeless. Mercy Care will use the equipment to bolster its mobile medical unit, which visits patients at their homes or public dwellings including underneath bridges, in tent cities or vacant lots.

People

OptimizeRx appoints James Brooks (ICare) to the new position of senior vice president of business development.

Paul Kleeberg, MD (Stratis Health) joins Aledade as medical director. Mark McClellan, MD (Duke University-Robert J. Margolis, MD, Center for Health Policy) joins the company’s Board of Directors.

Acquisitions, Funding, Business, and Stock

The team behind My Personal Trainer Website dips its toe into digital marketing for physician practices with the launch of Medical Practice Marketing Group. The company, which seems to be based mainly in Thailand though it does list offices in the US, UK, and Australia, seems to be a fun bunch, given the picture above. (Civet coffee, by the way, goes for $60 per 4-ounce bag, or $10 a cup at select retailers.)

Government and Politics

Minnesota’s MNsure health insurance exchange returns $500,000 in grant money to CMS after spending it on office space preparations for its call center and staff. Minnesota is one of at least four states to have used federal grants for purposes that weren’t allowed. The state received $189 million in total grant funding for the exchange and a new IT system for its public health insurance programs.

Announcements and Implementations

Allscripts adds patient payment tools to its FollowMyHealth patient engagement platform.

Trilium Health Resources, a government agency that manages mental health, substance abuse, and disability services in North Carolina, develops and installs two screening kiosks at local government facilities to help people identify behavioral health issues and connect with resources. The roll out is part of a pilot program that could eventually see a kiosk the 24 counties THR serves.

Radiology Associates of Corpus Christi (TX) implements a patient portal and onsite kiosk registration system from Royal Solutions Group across its three facilities.

Research and Innovation

An Association of American Physicians & Surgeons survey of 571 physicians reveals that over 80 percent believe EHRs impede patient care, while 47 percent feel that it puts patient safety at risk. Over 63 percent say that it compromises confidentiality. The best statistic: 76 percent believe EHRs to be "cash cows for data miners." Write-in comments were equally unfavorable wit one disgruntled MD noting that, “Electronic medical records are really electronic medical lies.” I would love to know what system he or she uses.

Good news for the C-suite: An American Medical Group Association survey shows that salaries for CMOs, CIOs, and chief compliance officers have increased between 11 percent and 17 percent this year. Other executive titles experienced more modest changes. No mention is made of titles associated with security or privacy, and so I’ll be interested to see if next year’s expected increase in medical records breaches leads some medical groups to take a chance on the new role.

An AHRQ literature review of HIE effectiveness finds no reported impact on primary clinical outcomes or identified harms. While “low-quality evidence” points to HIE as being associated with reducing duplicate tests, ED costs, and hospital admissions as well as improving ambulatory quality of care, clinician experience has also shown that HIE has not saved time and may not be worth the expense.

Other

All I can say is, “Oh, dear” … An Indian woman names her baby Uber after giving birth in the back of an Uber car en route to the hospital. While I question the name, I certainly can’t question her choice of transportation. Apparently she had placed multiple calls for an ambulance to no avail before calling the taxi service. What’s almost as surprising is that Uber already has a policy of handing out onesies to mothers that give birth in their cabs. Perhaps the company will offer this kid some stock options should it ever decide to go public.

Contacts

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

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News 12/14/15

Top News

Consumers attempting to sign up for insurance coverage at Healthcare.gov before the December 15 deadline for coverage starting January 1 face 10 minute-plus wait times, a not-unexpected predicament that nevertheless has the site’s developers working to expand capacity for tomorrow’s last-minute rush. The site hit 160,000 simultaneous users earlier today, about 20,000 more than the peak on December 15, 2014. One million new users have signed up since enrollment opened on November 1, while close to 1.8 million have renewed their plans.

Webinars

December 15 (Tuesday) 1:00 ET. “CPSI’s Takeover of Healthland.” Sponsored by HIStalk. Presenters: Frank Poggio, CEO, The Kelzon Group; Vince Ciotti, principal, H.I.S. Professionals. Frank and Vince are back with their brutally honest (and often humorous) opinions about the acquisition. They will review industry precedents (such as Cerner-Siemens), the possible fate of each Healthland product, the available alternatives, and steps Healthland customers should take now. Their previous webinar that covered Cerner’s takeover of Siemens has drawn nearly 7,000 views and this one promises to be equally informative and entertaining.

December 16 (Wednesday) 1:00 ET. “Need for Integrated Data Enhancement and Analytics – Unifying Management of Healthcare Business Processes.” Sponsored by CitiusTech. Presenters: Jeffrey Springer, VP of product management, CitiusTech; John Gonsalves, VP of healthcare provider market, CitiusTech. Providers are driving consumer-centric care with guided analytic solutions that answer specific questions, but each new tool adds complexity. It’s also important to tap real-time data from sources such as social platforms, mobile apps, and wearables to support delivery of personalized and proactive care. This webinar will discuss key use cases that drive patient outcomes, the need for consolidated analytics to realize value-based care, scenarios to maximize efficiency, and an overview of CitiusTech’s integrated healthcare data enhancement and analytics platform.

December 16 (Wednesday) 2:00 ET. “A Sepsis Solution: Reducing Mortality by 50 Percent Using Advanced Decision Support.” Sponsored by Wolters Kluwer Health. Presenters: Rick Corn, VP/CIO, Huntsville Hospital; Stephen Claypool, MD, medical director of the innovation lab, Wolters Kluwer Health. Sepsis claims 258,000 lives and costs $20 billion annually in the US, but early identification and treatment remains elusive, emphasizing the need for intelligent, prompt, and patient-specific clinical decision support. Huntsville Hospital reduced sepsis mortality by 53 percent and related readmissions by 30 percent using real-time surveillance of EHR data and evidence-based decision support to generate highly sensitive and specific alerts.

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

Announcements and Implementations

Versus Technology announces a new Wi-Fi locating platform and asset tags.

SPH Analytics selects Clinical Architecture’s Symedical and Sift terminology management solutions to extend the capabilities of its healthcare analytics solution.

Acquisitions, Funding, Business, and Stock

Chicago-based Matter welcomes 20 startups to its healthcare innovation co-working space. Two have direct ties to physician practices: StatPayMD helps practices estimate and collect out-of-pocket patient costs, while Markit Medical assists referring physicians with educating patients about in-network specialist options, price estimates, quality data, and scheduling.

MedicalReputation.com opens for business, offering practices online reputation management services, patient satisfaction survey tools, and benchmarking reports on online reviews and survey results. Founder Uri Turk seems to have spent time in the world of healthcare marketing and in the Israeli Defense Forces.

Government and Politics

ONC shuffles its Health IT Standards Committee members. Arien Malec, vice president of data acquisition and platform tools at RelayHealth and Lisa Gallagher, vice president of technology solutions at HIMSS North America, become co-chairs. Deloitte Director Andrew Wiesenthal takes over the Precision Medicine Task Force with Leslie Hall, senior vice president of policy at Healthwise.

The Precision Medicine Initiative ramps up with a goal of enrolling 79,000 participants in 2016, eventually working up to 1.1 million by 2020. NIH will be working with a budget of $130 million next year, $230 million in 2017, and $330 million in 2018, after which it will level off.

ONC issues corrections and clarifications to the final rule, aka the 2015 Edition Health IT Certification Criteria, 2015 Edition Base EHR Definition, and ONC Health IT Certification Program Modifications. The rule goes into effect January 14.

Research and Innovation

AMA opens up its Physician Innovation Network to beta testers. The network will connect and match physicians and health IT vendors based on their interests and needs.

A Consumer Technology Association report predicts that sales of health and wellness devices will increase by 18 percent to reach $1.8 billion by the end of this year. I’m still surprised that consumers place these types of devices on such a pedestal, but I supposed the adoption rate speaks for itself. Nearly 75 percent of surveyed online consumers plan to purchase health technology within the next year; over a third plan to buy a smartwatch.

IBM Watson Health teams up with Israeli startup Nutrino to develop an app that helps pregnant women make better food choices. Moms-to-be pose nutritional questions to the app, which responds with customized answers using Watson’s computing power matched with the user’s profile. The company developed the app as part of the IBM Alpha Zone Accelerator Program in Israel.

Telemedicine

Rep. Kristi Noem (R-SD) makes the case for telemedicine in her local paper: “[S]mall-scale healthcare providers are struggling to stay afloat, making it more difficult to attract families to small towns. I’m hopeful new technologies can change this, which is why I’ll be fighting to make sure folks in Washington, D.C., understand why it’s so important that we support telehealth programs. It’s worth the investment. After all, telehealth might be just the prescription we need to bridge the gap between rural America and state-of-the-art medical care.” The state, home to Avera Health System’s 24-hour, multi-state telemedicine hub, does not allow licensure exemption for physician-to-physician out-of-state consultation.

AHRQ releases a draft telemedicine literature review, urging researchers to focus future studies on primary and urgent care, and serious pediatric conditions to help fill gaps in those areas.

The National Conference of State Legislatures releases “Telehealth Policy Trends and Considerations,” a 27-page report detailing telemedicine policy issues like coverage and reimbursement, licensure, and safety and security. If you need a primer on the current state of telemedicine in the U.S., this is it.

UnitedHealthcare rolls out teledermatology services to Medicaid beneficiaries in Arizona.

The local business paper highlights the challenges many Connecticut physicians face in their attempts to offer telemedicine services, including a lack of patient awareness and a fear of having to learn multiple systems to accommodate different telemedicine programs. "For us, the notion of having to use different platforms for different patients is just untenable,” explains Bethany Kieley, vice president of practice programs and services at ProHealth Physicians. “We wouldn’t be able to do it.” The practice has rolled out an Anthem-sponsored program to little fanfare, and is negotiating with UConn Health to launch a teledermatology service.

Other

Recommended reading for new graduates: “Lost and Found: A Consumer’s Guide to Healthcare,” by Team Care Medicine President Peter Anderson, MD and Patient-Centered Primary Care Collaborative President Paul Grundy. The book focuses on finding and keeping a familiar physician, encouraging your physician to participate in a medical home, understanding insurance plans, and shopping for healthcare treatment and pharmaceuticals.

Northwest Primary Care (OR) notifies its patients that an employee stole the names, birth dates, Social Security numbers, and credit card numbers of 5,372 employees between April and December of 2013. No misuse of the information has yet been detected, though the incident has prompted the practice to expand its cyber security efforts and employee training on safeguarding and accessing patient records.

In other medical records security news, HHS data show that hackers have stolen healthcare data from 55 providers and payers, affecting 110 million Americans in 2015 (so far).

Sponsor Updates

• Versus joins the Cisco solution partner program.

Blog Post

• 12 Days of Giveaways (Nordic)

Contacts

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

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Population Health Management Weekly Wrap Up 12/13/15

Wellcentive’s Advance population health management solution earns 2014 Patient-Centered Medical Home Prevalidation from the National Committee for Quality Assurance.

Toronto-based NexJ Systems announces plans to spin off its healthcare business early next year in order to focus solely on its enterprise customer management solutions for the financial services industry.

Privia Health launches Privia Medical Group – Georgia to offer physicians access to the company’s population health management programs, infrastructure, technology, and support teams. First Georgia Physicians Group President Jim Sams, MD will serve as market president.

Population health startup GNS Healthcare closes a $10 million Series C funding round. Lt. Dan takes a closer look at the Cambridge, MA-based company’s investment history here.

Upstream Health Systems opens an office on Missoula, Montana’s “Hip Strip.” The startup, founded by GCS Research founder Alex Philip, offers health analytics software for population health management programs to providers, payers, and pharmaceutical companies. “We are very focused on environmental factors,” says Philip. “Where you live matters in terms of lifestyle behavior, exposure to carcinogens, and in terms of accessibility to clean foods and water. We build software that allows our clients to take all of these factors together into one application. There are hundreds of variables that can be analyzed to see a health trajectory.”

India-based Indegene Lifesystems acquires the SmartCare population health analytics platform from Vantage Point.

BioIQ and EDoc4U develop a health screening tool for population health programs that offers users personalized, risk-based educational material in a range of media formats and toolsets.

Contacts

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

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News 12/10/15

Top News

American Well inks a formal deal with physician social network Doximity in hopes of recruiting new employees to Online Care Group, which contracts physicians to the telemedicine company. The companies have had a similar, more informal recruiting relationship for the last several years; over half of physicians caring for patients via the AmWell app were sourced through Doximity. American Well is no doubt trying to swell its ranks to accommodate new business partners like CVS Health, and the increasing consumer-friendliness of telemedicine reimbursement policies in individual states.

Webinars

December 15 (Tuesday) 1:00 ET. “CPSI’s Takeover of Healthland.” Sponsored by HIStalk. Presenters: Frank Poggio, CEO, The Kelzon Group; Vince Ciotti, principal, H.I.S. Professionals. Frank and Vince are back with their brutally honest (and often humorous) opinions about the acquisition. They will review industry precedents (such as Cerner-Siemens), the possible fate of each Healthland product, the available alternatives, and steps Healthland customers should take now. Their previous webinar that covered Cerner’s takeover of Siemens has drawn nearly 7,000 views and this one promises to be equally informative and entertaining.

December 16 (Wednesday) 1:00 ET. “A Sepsis Solution: Reducing Mortality by 50 Percent Using Advanced Decision Support.” Sponsored by Wolters Kluwer Health. Presenters: Rick Corn, VP/CIO, Huntsville Hospital; Stephen Claypool, MD, medical director of the innovation lab, Wolters Kluwer Health. Sepsis claims 258,000 lives and costs $20 billion annually in the US, but early identification and treatment remains elusive, emphasizing the need for intelligent, prompt, and patient-specific clinical decision support. Huntsville Hospital reduced sepsis mortality by 53 percent and related readmissions by 30 percent using real-time surveillance of EHR data and evidence-based decision support to generate highly sensitive and specific alerts.

December 16 (Wednesday) 1:00 ET. “Need for Integrated Data Enhancement and Analytics – Unifying Management of Healthcare Business Processes.” Sponsored by CitiusTech. Presenters: Jeffrey Springer, VP of product management, CitiusTech; John Gonsalves, VP of healthcare provider market, CitiusTech. Providers are driving consumer-centric care with guided analytic solutions that answer specific questions, but each new tool adds complexity. It’s also important to tap real-time data from sources such as social platforms, mobile apps, and wearables to support delivery of personalized and proactive care. This webinar will discuss key use cases that drive patient outcomes, the need for consolidated analytics to realize value-based care, scenarios to maximize efficiency, and an overview of CitiusTech’s integrated healthcare data enhancement and analytics platform.

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

Announcements and Implementations

Pulmonary and Sleep Associates of Huntsville (AL) selects chronic care management technology from Persivia to tap into revenue streams afforded by the new CMS CCM payment rule.

Georgia Health Information Network awards $1 million via its Intermediary Grant Program to Georgia Health Connect, Georgia Regional Academic Community HIE, HealthEConnect, plus several area hospitals. The GaHIN members will use the funds to speed up connection to and use of the HIE. GaHIN Executive Director Denise Hines explains that grant program “helped us to provide a high level of support to practices and hospitals to allow them to access and exchange health information, bringing value to them and the patients they serve.”

People

Gurpreet Singh (MD Revolution) joins Caresync as vice president of interoperability.

Robb Ellis (Vista Equity Partners) joins Greenway Health as CFO.

Government and Politics

HHS Acting Deputy CIO Beth Killoran, who is also executive director for the office of IT strategy, policy, and governance, adds to her already lengthy title by taking on the duties of acting deputy assistant secretary for IT and interim CIO.

The American College of Physicians asks the House’s Committee on Appropriations for a blanket hardship exemption from Meaningful Use Stage 2 penalties. As many of their peers have already attested, ACP leaders feel that CMS published the rule too late in the year for physicians to comply with a 90-day reporting period. The organization also expressed dismay at the proposed elimination of AHRQ, and decline in funding for patient-centered outcomes research.

Texas Medical Association President Tom Garcia, MD asks CMS to “back off” from penalizing physicians who have, in good faith, participated in the the agency’s Physician Quality Reporting System and Value-Based Modifier program. CMS has publicly stated it has had issues with physician-submitted data, which could potentially impact their Medicare payments. “Our experience of just the past few months has proven that CMS is much better at generating mass confusion than it is at helping physicians care for Medicare and Medicaid patients,” Garcia writes. “The agency’s incompetence only multiplies the burden of numerous, overly complex regulations it forces onto physicians.”

Research and Innovation

Researchers at MIT develop a stretchy hydrogel that can be embedded with various electronics. The “Band-Aid of the future” is capable of releasing medicine in response to skin temperature changes, and can even light up when medicine starts to run low.

An IDC report predicts that one in three patients will be the victim of a medical records breach next year. It seems healthcare technology will become a victim of its own interoperability success: IDC Analyst Lynne Dunbrack attributes this increase to the explosion of electronic healthcare data, and the digitized formats that now allow sharing of patient data between providers.

Other

LocumTenens.com opens up nominations for its fourth annual MedicalMissions.org Physician of the Year Award. Nominations are due January 6. LocumTenens.com will donate $10,000 on behalf of two winners to the medical mission organization of their choice.

Patient Advocate Regina Holliday launches a GoFundMe campaign to help raise funds for The Walking Gallery.

Contacts

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

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Readers Write: Missed Appointments Affect More Than Just Revenue

Missed Appointments Affect More Than Just Revenue
By Jeff Peres

Most physicians and practice managers know that missed appointments are bad for business. How bad? Some experts say that these no-shows and late cancellations cost the American healthcare system more than $150 billion per year, and individual practices between $100 and over $1,000 per appointment, depending on specialty and location.

And these figures reflect just lost revenue, not the additional costs associated with lost staff time and sicker patients. Also hidden behind the numbers is the level of frustration experienced by patients who must wait longer to get an appointment because doctor schedules appear full, even though each day brings a few more unfilled seats.

Yes, last-minute appointment cancellations and no-shows drain your bottom line, but their implications lie elsewhere in your practice, too.

Patients don’t get the care they need
There are a myriad of reasons why your patients may not be showing up for their visits — money, nerves, or a lack of convenience or appointment availability all can play a role. And these missed appointments have very real, negative implications for their health. The scope of the problem is enormous: Some 49 million adults skipped recommended care in 2012 because of cost alone.

Some studies have indicated no-show rates in community practices ranging from 5 percent to 55 percent. These missed sessions disrupt continuity and compromise quality of care for the patients who miss the appointments and for those who “would have been scheduled in those appointment slots,” according to Family Medicine.

Patient satisfaction takes a hit
It’s not just the cancellation or no-show who is negatively affected by a missed appointment — the health of other patients, not to mention their opinion of the practice, suffers too. That’s because every missed appointment could have been filled by another (potentially ill) person, inadvertently increasing the length of time that patients have to wait to see the doctor.

Captain Kim Decker, chief of the Martin Army Community Hospital Healthcare Management Division at Fort Benning in Georgia, puts it succinctly: “An appointment missed by you is an appointment missed by two.” In other words, the person who misses an appointment is likely to need to re-book, and “whoever didn’t get an appointment initially is also still needing one.”

Frustration is more than understandable. The average cumulative wait time to see a family physician in 15 US markets was just shy of three weeks in 2014. One Consumer Reports survey of 1,000 Americans showed that “difficulty in getting an appointment when sick” ranked among the top five biggest complaints that patients have about their doctors.

Further, the problem may actually compound itself: some studies indicate that no-show rates increased and the “likelihood an appointment would be kept decreased” the further in advance an appointment was scheduled. In other words, missed appointments cause longer wait times, and vice versa.

Your staff loses valuable time
When patients do call to let a practice know that they won’t be able to make their appointment, the great scramble to fill the now-vacant appointment begins. If there is no good system in place to keep track of people on the waiting list hoping for an earlier appointment, the result could be duplicative phone calls, double-booking, or worse, patients could fall through the cracks.

What can be done?
There are a few simple steps to addressing the problem of late cancellations and no-shows that your practice should start taking right away. The first is making regular reminder calls and/or sending reminder texts around two days in advance of a given appointment. Reminding patients the day or night before doesn’t leave time to fill the appointment in the event of a cancellation, and reminding them too many days ahead allows too much time to forget. Additionally, letting patients who call to cancel or reschedule know that it could take up to a month or two months to get another appointment can help incentivize them to keep their originally scheduled slots.

Because we know that patients who can schedule their appointments in the near future are less likely to cancel than those who schedule many weeks in advance, it can also be helpful to set aside a few hours of each day (or every other day) for walk-ins or same-day appointments. This allows patients in need of acute care or patients who simply desire the flexibility to receive same-day care to feel accommodated by your practice.

Cloud- and app-based scheduling systems, which put the power to book and adjust appointments in real time into the hands of patients, can help reduce the rate of no-shows and cancellations, as well as lengthy phone wait times. With online scheduling becoming the norm for everything from vehicle emissions testing to haircuts, people are used to (and will appreciate the convenience of) being able to access their appointments on a mobile device.

Spending valuable time on a wild goose chase for patients is not cost-effective and takes front desk staff away from their other duties, including greeting and checking in patients, as well as communicating with doctors and nurses about the status of the waiting room and more. Consider the suggestions above to make your practice’s unfilled seats a thing of the past.

Jeff Peres is Co-Founder and CEO of Everseat in Baltimore.

Contacts

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

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