News 12/22/15

Top News

The House and Senate pass S. 2425, a bill that provides blanket hardship exemptions that will allow practices and hospitals attesting to Meaningful Use to avoid 2017 reimbursement penalties.

HIStalk Practice Announcements and Requests

The news cycle has slowed to a crawl as we approach December 25. This will be the last regular update until business resumes on January 4. I hope everyone has a very merry Christmas and happy New Year! Feel free to drop me a note describing the latest technology you find under your tree or in your stocking on Christmas morning.

Announcements and Implementations

Medfusion launches a Spanish-language patient portal.

Government and Politics

GAO recommends that HHS should consider paying the same Medicare rates for evaluation and management office visits at physician practices and hospitals in order to prevent the current shift of services from lower-paid practice settings to higher-paid hospital settings. The recommendation, made at a time when hospitals are gobbling up practices at seemingly unprecedented rates and raising service prices accordingly, comes with the caveat that any savings had as a result of the equalized payment should be poured back into the Medicare program.

Green Spring Internal Medicine (MD) wins the ONC EHR Innovations for Improving Hypertension Challenge, a two-phase competition run in conjunction with the Million Hearts Initiative that honors practices that have successfully used clinical decision support to implement evidence-based blood pressure treatment protocols.

Telemedicine

The Federation of State Medical Boards convenes the second meeting of the Interstate Medical Licensure Compact Commission in Salt Lake City. The group, which now includes 12 states, is working to establish a process that will enable physicians to become licensed quickly and easily in member states.

The local news touts the success of the Southwest Medical Associates (NV) NowClinic, a two year-old telemedicine service set up in partnership with American Well. The medical group has performed 1,300 consults so far via the virtual clinic. 

Research and Innovation

Athenahealth posts the latest flu statistics culled from the diagnoses of over 23,000 primary care physicians. Flu rates remain lower than in years past, with just under 1 percent of office visits resulting in flu-related diagnoses for the week ending December 12. Pediatric visits are also down compared to 2014 and 2013 rates.

Other

The Boston Globe looks at the non-technology side of primary care chain Iora Health, which emphasizes physician eye contact during EHR charting, and exam room layout of side-by-side chairs for face-to-face conversations.

The DoJ looks into the likelihood that Lyft was involved in the May 2014 data breach at Uber. An internal Uber investigation found that an Internet address potentially associated with the breach was traceable to Lyft Engineering Manager Chris Lambert. The federal look-see comes just as Lyft is in talks to raise up to $1 billion. No word yet on whether Lyft will look to enter healthcare as Uber has attempted to do over the last two years.

Contacts

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

More news: HIStalk, HIStalk Connect.

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News 12/21/15

Top News

OrbiMed launches a new venture capital fund, OrbiMed Private Investments, with nearly $1 billion in partner commitments. The fund will target healthcare IT, medical devices, diagnostics, and biopharmaceutical companies in North America and Europe. Past healthcare IT investments include Practice Fusion, Sikka Software, TigerText, and Treato.

Webinars

Here’s the video of Wednesday’s webinar, “A Sepsis Solution: Reducing Mortality by 50 Percent Using Advanced Decision Support,” sponsored by Wolters Kluwer Health and featuring guest presenter Rick Corn, VP/CIO of Huntsville Hospital (AL).

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

Announcements and Implementations

The Healthcare Collaborative of Greater Columbus launches ourhealthcarequality.org to offer consumers a look at Ohio-based physician performance data. The website includes data on nearly 200 physicians and advance-practice nurses on three measures, plus national goals.

Acquisitions, Funding, Business, and Stock

21st Century Oncology, a chain of treatment centers based in Florida with locations throughout the US and Latin America, pays nearly $20 million to settle fraud charges stemming from a whistleblower lawsuit. The whistleblower and former 21st Century medical assistant brought to light a spate of medically unnecessary tests ordered between 2008 and 2012 that were then billed to Medicare and Tricare. The individual will receive $3.2 million for bringing the matter to light.

People

Jaime Ojeda (Point of Care Decision Support) joins Meridian Medical Management as general manager and executive vice president of its PrecisionBI division.

Telemedicine

Dave Soleymani, MD develops the Dermio secure messaging app to offer patients an easier way to correspond with him about skin ailments. A video consult version is in the works.

Government and Politics

More than 6 million people sign up for January 1 coverage at Healthcare.gov, the deadline for which was extended by two days. The federal government expects over 10 million users to sign up for coverage through the entire enrollment period, which lasts through January.

Research and Innovation

Booz Allen Hamilton’s annual healthcare perceptions study finds that over half of the 1,000 consumers surveyed believe the sharing of PHI is essential to better coordinating and managing care amongst their providers.On a less tech-y note, 24 percent of the 400 physicians surveyed are optimistic about the direction in which healthcare is heading, a stat that remains unchanged from last year.

Other

Fox River Counseling Center (WI) alerts 509 patients of a data breach that resulted from the theft of an employee’s unencrypted laptop. The stolen data included the usual personal stats, plus more sensitive medical histories, diagnoses, mental status interviews, psychological testing results, and work-capacity statements. The center has since updated its encryption software.

Security incident response times need improvement: This amusing video depicts the Galactic Trade Federation’s decision to hire a cybersecurity consulting firm to ensure rebels can’t hack the Death Star.

Sponsor Updates

• Medicity is positioned in the Leaders category in the 2015 IDC MarketScape.

Blog Posts

• What do cross-country skis have to do with your EHR running more efficiently? (Nordic)
• 10 Tips for Choosing the Right RTLS for Your Hospital (Versus Technology)
• 5 questions with Nordic CEO Bruce Cerullo (Nordic)

Contacts

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

More news: HIStalk, HIStalk Connect.

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Population Health Management Weekly Wrap Up 12/20/15

Kaiser Permanente announces plans to open a medical school in Southern California. Classes will begin in 2019, and will likely accommodate up to 50 students. “We have the opportunity to help train future physicians on 21st century medicine and be on the cutting edge of all the changes we are experiencing,” says CEO Bernard Tyson. “Our model of care is best for the current and future diverse populations in this country.” The organization has noted there will be a strong focus on population health management, team-based approaches to patient care, and patient engagement.

Health analytics company Pulse8 licenses population health management tech vendor Altruista Health’s Chronic Illness and Disability Payment System to better calculate its risk adjustment analytics for Medicaid, Medicare Advantage, and private payers.

KLAS Research ranks Atlanta-based Wellcentive as one of the top five vendors of population health management technology.

Greenway Health embarks on the second phase of its population health project with Vanderbilt University Medical Center (TN). Funded by the Patient-Centered Outcomes Research Institute, the next phase builds on the data warehouse development and clinical trials recruitment conducted in 2014. Patient recruitment is expected to increase to 3,000 by October 1, 2016 and to 5,000 the following year. The project will also aim to increase the number of Greenway Health provider sites connected to the data warehouse, growing to nearly 2,000 by 2017.

Pennsylvania-based Pocono Health System and Lehigh Valley Health Network agree to a full-asset merger that will take effect in the first half of 2016. The new entity will develop a “hospital of the future” tentatively named Pocono Medical Center, as well as open additional ambulatory health centers. LVHN representatives see the merger as LVHN part of its commitment to providing more integrated care to the Pocono region through population health management, including sharing a common EHR. LVHN announced it will spend $200 million on Epic over the next four to six years. PHS seems to be an EClinicalWorks shop, so it seems likely the Epic assets played a part in merger talks.

Contacts

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

More news: HIStalk, HIStalk Connect.

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News 12/17/15

Top News

Kaiser Permanente announces plans to open a medical school in Southern California. Classes will begin in 2019, and will likely accommodate up to 50 students. “We have the opportunity to help train future physicians on 21st century medicine and be on the cutting edge of all the changes we are experiencing,” says CEO Bernard Tyson. “Our model of care is best for the current and future diverse populations in this country.” The organization is also putting out feelers for a dean, who will hopefully embed healthcare IT into the curriculum.

Reader Comments

From Greg Chittim: “Re: The FlowingData “Day in the Life” of Americans. I am a huge fan of FlowingData (we have both of his posters up in our office) and read Nathan’s stuff regularly. I thought you’d appreciate our “Day in the Life of Dr. Jones,” which is an artistic representation of what exists in our core Analytics platform. We are able to mine data from the HIPAA audit trail required in all EHRs to visualize the minute-by-minute lives of physicians and care teams as they interact with their EHR and PM systems. From that, we can make very detailed inferences about when/how they get behind schedule, the effect of same-day appointments, and if the care teams are working to the ‘top of their license.’”

Announcements and Implementations

ProHealth Physicians  (CT) partners with OptumCare for administrative and clinical support. Optum will provide ProHealth’s 370 clinicians with data, analytics, connectivity, and population health management tools plus front-office services.

IPatientCare signs on with Area 51 Data Solutions to improve data security, support, and backup services for its EHR customers.

MedAllies, a Direct Reference implementation vendor, will leverage Merge Healthcare’s vendor-neutral referral management platform to simplify image ordering and results delivery for its nearly 300,000 connected users.

Acquisitions, Funding, Business, and Stock

CVS Health completes its acquisition of Target’s pharmacy and clinic businesses for $1.9 billion. Included in the buy-out are 1,672 pharmacies and 79 clinics, which will be rebranded as MinuteClinics. CVS expects to open up to 20 new clinics in Target stores within the next three years. CVS Health Executive Vice President and Associate CMO Andrew Sussman, MD alluded to the Target clinic integration during my interview with him earlier this month.

Government and Politics

The Syracuse, NY-based HealthEConnections HIE and Fort Drum Regional Health Planning Organization sign an agreement with the DoD making the digital medical records of nearly 20,000 local soldiers and military families shareable with physicians outside of the VA. “What’s been missing all these years has been the military,” explains FDRHPO CIO Corey Zeigler. “Now, when soldiers and their family get care in our area, all of that information goes back to their primary physician on post.”

Medicare will provide physician-level data to Amino, a San Francisco-based startup that is the first for-profit company to earn access to the full range of Medicare data for providers. Amino will initially use the data to help patients, particularly women, find physicians whose practice patterns and skills meet their needs, and plans to roll out services related to procedures, treatment options, and costs in the near future.

Other

Missouri’s St. Louis County conducts a feasibility study on the idea of opening health clinics at MetroLink stops. The Bi-State Development agency, which runs the county’s public transportation, is conducting the $42,000 study, scheduled for completion early next summer. The clinics would be the first of their kind in the country. “This will bring healthcare closer to the community, particularly for those who are transit dependent,” says Project Manager John Wagner.

Brazil shuts down WhatsApp for 48 hours after the Facebook-owned messaging app fails to comply with a court order related to criminal gang activity. As I mentioned last week, 80 percent of the country’s physicians use the app to communicate with patients. No word yet on how treatment plans or appointment scheduling were affected.

Contacts

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

More news: HIStalk, HIStalk Connect.

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DOCtalk with Dr. Gregg 12/17/15

E-Prescribing in the Dark

I don’t know about anybody else’s experiences, but my relationship with e-prescribing reminds me of Helen Keller’s quote about “walking with a friend in the dark.”

Not having seen much posted about this topic may be more a result of my ignorance than anything, but a quick search didn’t lead to many practical perspectives that I could find. Thus, maybe adding one to the blogosphere wouldn’t be just a rehash.

First, we’ve used e-prescribing for years. Love it. Period. When it works.

And it mostly does work, and typically works quite well. It makes it easy to prescribe, reduces the risk of error from illegible handwriting, lowers the chances of lost prescriptions to almost null, and makes tracking of prescribed meds MUCH easier.

But, all of that’s true only when it works. As mentioned, it doesn’t always work, and that’s when the dark creeps in.

(The e-prescribing solution that our EHR employs has been called the “giant” of the industry. There are others, and they may work differently, but my experience is limited to our little giant.)

The two main times I’ve noted when it doesn’t work:

1. When something is amiss in the patient demographics
2. When an “Unknown Drug” gets pulled into the patient record

The first issue is really problematic. If our system sends an inquiry to the e-prescribing solution and there’s some kind of glitch in the demographics, here’s one of the responses we receive:

I ask you: What do you do with that? There are no instructions, no next steps. You’re only told that this person, who you know for a fact exists and whose insurance eligibility you’ve verified, can’t be found. And you’re not allowed to do anything about it. (“Resubmission not allowed.”)

There are some similar rejection notices as I recall, but they all have the same thing in common – no info on what exactly is wrong, no way to correct whatever errors there are, and no option to do anything about it.

The second problem isn’t always quite as vexing, but still should have some improved address. Here’s an example from one of my patient’s charts (patient and prescribing doctor de-identified):

With this one, I can at least call the pharmacy and try to determine which of the medications this patient was dispensed on that day might be the elusive “DRUG UNKNOWN.” This involves figuring out which CVS pharmacy is “#1691,” finding their phone number, calling them to ask them to look up prescribed Rx from that day for that patient, and then manually charting the now known drug into the patient’s chart. As I said, problematic, but at least it has a resolution, even if it isn’t simple or one automated by the e-prescribing solution.

My personal ask for our (or any) e-prescribing solution is this: You’re good to have as a friend. I appreciate you. Walking with you even though it’s sometimes in the dark is far better than walking without you. But, please … please … add transparency and end user-friendly info and advice. Cryptic messages that provide no value or direction may make some programmer on your end feel as though they’re doing something, but it isn’t something that’s at all helpful to us provider grunts – be they us little trench grunts or those in the bigger trenches. We would all benefit from a little more light.

From the trenches…

“Walking with a friend in the dark is better than walking alone in the light.” – Helen Keller

Dr. Gregg Alexander, a grunt in the trenches pediatrician at Madison Pediatrics, is Chief Medical Officer for Health Nuts Media, an HIT and marketing consultant, and sits on the board of directors of the Ohio Health Information Partnership.

Contacts

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

More news: HIStalk, HIStalk Connect.

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