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

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News 4/5/16

Top News

Cactus Software and Symplr merge in order to offer their newly combined customer base a single source for physician credentialing solutions. The companies will retain their leadership and locations in Texas and Tennessee, offer each other’s software, and maintain individual brands. The combined company has 200 employees.

HIStalk Practice Announcements and Requests

Oh happy day, the Flight of the Conchords have returned. The comedy folk-rock duo from New Zealand is touring this summer with new material, which gives me a great excuse to go back and binge watch their eponymous HBO series in an effort to reacquaint myself with oldies but goodies like “Business Time” and “Foux du Fafa” (and Murray).

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

Patient payments tech startup SwervePay acquires StatPayMD, a Blueprint Health IT accelerator graduate and former Matter occupant that offers patients out-of-pocket cost estimates based on insurance benefits. The news comes just a month after SwervePay completed a $10 million Series B funding round led by Garland Capital Group.

Announcements and Implementations

DuPage Medical Group (IL) taps PinpointCare to manage its Medicare Advantage and BCBS value-based care insurance programs. DMG, the largest independent physician group in Chicago, already uses the company’s care coordination platform to manage CMS orthopedic bundles and risk-based contracts.

Beach House Center for Recovery (FL) joins MAP Health Management’s Recovery Network.

Clearwave and Aprima Medical Software integrate Acuant’s credential management software into their respective patient check-in and EHR/PM solutions.

People

Jonathan Sherman (Ability Network) joins Cureatr as chief product officer.

GeBBS Healthcare Solutions names Jerry Jorgensen (Eclat Health Solutions) (not shown) vice president of operations, coding & HIM solutions; and Cara Friederich (Altegra Health) director, professional coding & audit services.

Telemedicine

The American Telemedicine Association appoints Mark Seraly, MD (Iagnosis) vice chair of its Special Interest Teledermatology Group.

TV, Internet and home security company Connect Your Home partners with telemedicine vendor CareClix to offer its customers access to telemedicine services.

A study in JAMA Internal Medicine compares the quality of eight direct-to-consumer telemedicine companies over the course of nearly 600 visits. Researchers found “a significant variation [in quality of care] across companies and by condition.” Antibiotics were prescribed at rates similar to in-person settings, while 14 percent of patients were referred to local physicians for in-person follow-up.

Primary care physician Lan Nguyen, MD takes to the local paper to voice her support for the role telemedicine can play in enhancing the patient/physician relationship. “Breaking down barriers such as cost, convenience and time enables patients to ‘see’ their primary care providers instead of delaying care,” she writes, “which often occurs in rural areas. Telehealth can play a very big role in extending that follow-up and nourishing an established patient/doctor relationship, thus increasing trust and improving quality of care.” Her statement offers a stark contrast to the study results noted above. Consumers eager for a quick, virtual consult may begin to rethink turning to somewhat anonymous telemedicine physicians if they can instead book one with their more trusted PCP.

Contacts

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

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From the Consultant’s Corner 4/5/16

Improve Patient Access – and ROI to Boot

Providers understand how important it is for patients to have easy access to healthcare services in order to achieve higher patient satisfaction and potentially better outcomes. However, figuring out how to improve patient access in an affordable way can sometimes be a challenge.

One way to improve patient access is by optimizing physician capacity through a centralized patient access center. This approach is attractive to patients because it offers a single, easy-to-reach contact point for scheduling appointments, checking benefits eligibility, and getting answers to billing or clinical questions. With one resource, they can reach all providers and resolve multiple issues. Likewise, multispecialty practices can secure multiple appointments with just one phone call, improving care coordination.

Despite the cost to develop a central access center, practices can actually realize significant ROI by conducting an in-depth analysis of physician capacity to accept additional appointments. Increasing capacity isn’t as easy as simply adding another slot to an already-packed schedule. Instead, an analysis should be used to design a business plan based on benchmark data that helps increase both access and practice revenue.

A Win-Win for Patients and the Bottom Line
Patient access challenges — including scheduling delays and long appointment wait times — may be linked to poorer health outcomes, and can be a financial burden on patients who may seek non-network and possibly more distant care. Delays in care, because of poor patient access, may also cause unnecessary physical discomfort for patients, and dissatisfaction with the healthcare system as a result.

In most cases, practice administrators already know when their group has a patient access problem because of complaints from new or existing patients about long wait times for appointments. Therefore, the first step toward improving patient access is to determine and document the scope of the challenge. Identifying access challenges allows practices to decide where they need to concentrate the bulk of their efforts —such as which providers or specialties have longer waits than others.

Maximizing Capacity Yields New Revenue Opportunities
Implementing a centralized patient access center is an efficient and effective way to help maximize physician schedules while also delivering a satisfying patient access experience. A centralized patient access center certainly requires an investment in staff, hardware, software, and services, yet practices often can generate enough revenue to cover the costs — and even more — by simultaneously analyzing provider capacity. In fact, it is not uncommon for practices to realize an ROI of 25 percent, while some larger practices have even generated revenue of almost double the investment.

The key is to evaluate access at the individual provider and the practice level, taking a hard look at factors such as:

• Practice capacity policies and standards: Does each provider’s wRVUs, for example, match practice expectations? Establishing and enforcing administrative policies regarding the required number of patient care hours or wRVUs is essential to ensure long-term behavioral changes.
• Benchmark data: Sharing practice or other peer benchmark data can help prompt any behavioral changes needed to overcome capacity shortfalls.
• Individual schedule variations: How long until each provider’s next available appointment, on average? Is time being spent on activities that could be delegated to clinical support staff? In some cases, analysis might reveal that there are truly so many patients on a provider’s panel that the panel should be closed for a time.

Improving physician capacity first requires verifiable data and benchmarking. Once this evidence is available, strong physician leadership is necessary to drive policy enforcement. Success with scheduling and behavioral change is much more likely when capacity conversations are led by a clinical peer rather than an administrator. Physician leaders who can speak with their colleagues one-on-one typically are better able to focus the conversation on benefits to patient care and the patient experience, resulting in a more open dialogue and positive results.

Good for Business, Good for Care
Patient demand for healthcare services is rising. Concurrently, healthcare markets are consolidating due to mergers and acquisitions. From a business perspective alone, practices should take a closer look at how improving patient access could help them succeed in highly competitive environments.

By optimizing physician capacity through a centralized patient access center, practices have an opportunity to grow revenue and marketplace reputation, while serving more patients and enhancing the patient experience. This can result in healthier and more engaged patients, which is the ultimate benefit for any practice improvement.

Johanna Epstein is vice president of management consulting services for Culbert Healthcare Solutions in Woburn, MA.

Contacts

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

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