December 13, 2015NewsComments Off on 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.
December 10, 2015NewsComments Off on 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.
December 10, 2015NewsComments Off on 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 Peresis Co-Founder and CEO of Everseatin Baltimore.
San Francisco-based concierge medicine provider One Medical Group raises $65 million to expand its service area and to further develop its enterprise and mobile technology solutions, increasing its total raised to $182 million.
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
Tri-County Health Dept. (CO) partners with its EHR vendor, Patagonia Health, to integrate an Omaha System charting platform (used to automate health care assessments and services at the point-of-care) within its new EHR.
White Mountain Community Health Center completes its transition from paper records to the E-MDs EHR.
Acquisitions, Funding, Business, and Stock
EHR vendor WebPT announces plans to move into a 120,000 square-foot tech campus in Phoenix’s Warehouse District. The company’s new space will accommodate up to 500 employees. Fun fact: Husband-and-wife team Brad and Heidi Jannenga launched the company in the back of a downtown Phoenix coffee shop in 2008.
Mobile house call startup DrNow launches in Houston, with plans to serve the entire state of Texas by early next year. President and founder Akash Bhagat, MD is also CEO of Houston-based Memorial Emergency Center.
People
Ron Duplessis (MISO) joins Zotec Partners as vice president of information security.
Former CMS Administrator and Massachusetts gubernatorial candidate Donald Berwick, MD will join the state’s Health Policy Commission next year as an appointee of Attorney General Maura Healey. Berwick will take over the seat designated for a professional with expertise in healthcare consumer advocacy.
Robert Rinek (Piper Jaffray) and Brant Heise (Memorial Care Innovation Fund) join the PerfectServe Board of Directors.
Government and Politics
A Kaiser Family Foundation Analysis shows that the cost of the ACA’s individual coverage mandate penalty is cheaper than purchasing the least expensive insurance plan for 7.1 million of the nearly 11 million uninsured eligible to enroll on the exchanges. Designed to be be phased in over three years, penalties will jump 47 percent in 2016. Adults will pay $695 each, and $347.50 per child, or 2.5 percent of a household’s income.
AHRQ makes available up to $12 million to fund projects that support implementation of medication-assisted treatment for opioid abuse in rural primary care practices. Participants may study how online training for physicians, in-office coaching, and virtual patient counseling sessions can overcome known barriers, including limited physician training opportunities and lack of supporting social services. Grant applications are due March 4.
Senator Jeff Flake (R-AZ) compiles 100 examples of “egregious, outrageous, and unnecessary government spending” in the latest installment of his Wastebook franchise. Flake points out overspending on VA salaries, Obamacare banking, unnecessary data centers, and an eye doctor’s storefront, to name just a few healthcare-related examples. Flake hopes that the report “gives Congress – which only ever seems to agree when it comes to spending money – something to Chewie on before the taxpayers strike back.”.
Research and Innovation
Rock Health seeks input from digital health entrepreneurs on their experiences working with the FDA.
A British business paper highlights an unnamed study that finds nine in 10 Brazilian physicians use WhatsApp to communicate with patients. Two percent of British GPs, and 62 percent of Italian physicians have used the messaging app. I couldn’t dig up the original study and am left wondering why the uptake in Brazil is so high. Are their privacy regulations more lax? Is smartphone penetration higher? I found these reader comments on the role of privacy and trust in Brazil insightful. Readers, feel free to chime in with your thoughts.
EClinicalWorks will invest $30 million over the next two quarters to build out a new data center and expand technology capabilities in India. The company, which employs 4,000 at its US headquarters, will hire at least 300 people there within the next three months, an aggressive hiring spree that will better enable it to use India as its secondary data center. It plans to launch an appointment-booking and health records app for patients in India early next year.
HIStalk Practice Announcements and Requests
This yet-to-be personalized ornament caught my eye while browsing at the local trim-a-tree shop. I’d snap up a bunch if it read “Best Health IT End User Ever!”
Webinars
December 9 (Wednesday) 12 noon ET. “Population Health in 2016: Know How to Move Forward.” Sponsored by Athenahealth. Presenter: Michael Maus, VP of enterprise solutions, Athenahealth. ACOs need a population health solution that helps them manage costs, improve outcomes, and elevate the care experience. Athenahealth’s in-house expert will explain why relying on software along isn’t enough, how to tap into data from multiple vendors, and how providers can manage patient populations.
December 9 (Wednesday) 1:00 ET. “The Health Care Payment Evolution: Maximizing Value Through Technology.” Sponsored by Medicity. Presenter: Charles D. Kennedy, MD, chief population health officer, Healthagen. This presentation will provide a brief history of the ACO Pioneer and MSSP programs and will discuss current market trends and drivers and the federal government’s response to them. Learn what’s coming in the next generation of programs such as the Merit-Based Incentive Payment System (MIPS) and the role technology plays in driving the evolution of a new healthcare marketplace.
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 innovation lab and VP of clinical development and informatics for clinical software solutions, 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.
Acquisitions, Funding, Business, and Stock
PatientsLikeMe receives a $900,000 grant from the Robert Wood Johnson Foundation, some of which it will use to collaborate with the National Quality Forum on incorporating patient-reported outcome measures into routine clinical care to assess physician performance.
Allscripts breaks ground on a 12-story, 33,000 square-foot office building in Raleigh, NC. The company will move its 1,200 nearby employees into the first nine floors of the new office tower once it’s completed in May 2017, and already anticipates further expansion.
ZocDoc and Oscar Health join the #GetCovered bandwagon, encouraging consumers to sign up for insurance at Healthcare.gov by the December 15 deadline. Payer Oscar Health has created a video explaining how health insurance works, while ZocDoc, an online appointment-booking company, is in the midst of calling customers who have paid out-of-pocket for healthcare in the past. While ZocDoc CEO Oliver Kharraz says the company’s efforts are “all in the name of removing barriers to get access to care,” I’m pretty sure there’s hope of attracting new customers, too.
Announcements and Implementations
Medfx and GenieMD develop the Connected PHR app, integrating it with Medfx’s HIE to give patients and physicians access to health data from anywhere at anytime.
Telemedicine
Rock Health names Doctor on Demand the Fastest Growing Company in its annual Top 50 in Digital Health. The company has raised $63 million so far this year, and secured deals with major players like CVS Health, as well as 200-plus employer groups.
MediKey, an online healthcare pricing and purchasing search engine, partners with Teladoc and EDocAmerica to offer telemedicine services to under- and uninsured consumers. Given the Doctor on Demand accolades mentioned above, I find it interesting that MediKey CEO Joe Truscelli says the company is “opening the floodgates for consumers to take advantage of many healthcare services – like Teladoc and EDocAmerica – which have not yet reached their true potential market penetration.”
Government and Politics
The Congressional Budget Office estimates that the ACA will shrink the US economy by 2 million jobs over the next 10 years as consumers, particularly seniors past retirement age and lower-wage earners, decide to stop working without fear of losing employer-sponsored insurance coverage.
A coalition of healthcare IT vendors and lawmakers send House Speaker Paul Ryan and several other legislators a letter calling for an end to talks of delaying Stage 3 of Meaningful Use. Despite their desire to steam ahead with MU, the authors are well aware of the need to make EHRs more interoperable, and offer several suggestions including: banning information blocking, creating vendor incentives for better usability, drafting a definition of interoperability, and more testing and enforcement around EHRs.
The Bipartisan Policy Center hosts such health IT luminaries as ONC’s Karen DeSalvo, MD Acting CMS Administrator Andy Slavitt, and American College of Physicians CEO Steven Weinberger, MD at an afternoon event on improving health through interoperability. I didn’t catch any of the live stream, but did come across tweets related to Weinberger’s call for physicians to “involve” patients with their EHRs.
Research and Innovation
The National Patient Safety Foundation publishes a 46-page report outlining the need to accelerate patient safety improvements, including in the area of healthcare IT. Recommended calls to action include:
Establish mechanisms for vendors and users to be transparent about health IT safety hazards and best practices.
Identify and measure the adverse effects and unintended consequences of health IT and implement best practices for risk mitigation.
Establish expectations for health IT safety performance, such as routine testing for unsafe orders.
Design health IT to facilitate communication and coordination with the patient and family.
A Commonwealth Fund study comparing care coordination across 10 developed nations finds that only about 30 percent of family physicians in the US are “always notified” when a patient is seen in the ED or discharged from the hospital. The report concludes that US physicians are “among the least prepared to manage conditions associated with aging outside of hospital or nursing home settings.”
Other
The Sequoia Project releases the Carequality Interoperability Framework, including legal terms, policy requirements, technical specs, and governance processes to help healthcare stakeholders “unlock previously unseen levels of connectivity.” The framework’s 12 collaborators will roll out the initial phase of the framework, which will focus on query-based exchange of clinical documents.
Almost half the students taking the Comics in Medicine class at Penn State depict their supervisors as monsters, a statistic their professors tie in to the greater problem of medical residents screening positively for depression or depressive symptoms. Thomas Schwenk, MD dean of the University of Nevada Medical School, feels that educators today “don’t teach in ways that encourage wellness and good mental health and coping mechanisms. There’s got to be a shift back toward dedicated teaching and mentorship. We’ve lost that because of the craziness of the system.”
The article about Pediatric Associates in CA has a nugget with a potentially outsized impact: the implication that VFC vaccines…