Portals, Mobile Devices, and Patient Engagement – #HIStalking Tweet Chat Thursday, September 24 at 1pm ET

Join @JennHIStalk and @iatricFJF (Frank Fortner, president of Iatric Systems) for a discussion on portals, mobile devices and patient engagement. Preview #HIStalking discussion questions below and brush up on how to participate in a tweet chat towards the end of this post.

The healthcare industry – patients, providers, and vendors alike – have discussed patient-centered healthcare for a while. Today’s patient engagement isn’t the end-game because data from various, disparate systems sit in silos and isn’t easily accessed by patients. Further, most of today’s tools deliver a monologue of data flow “to” the patient, with very few solutions able to receive data “from” the patient. Providers must find better ways to deliver the tools patients need to truly become active in their own healthcare, where patient data from all sources is presented to patients in a simple, clear, and actionable way; and where appropriate patient-generated data has a pathway back to providers.

A recent run-in with my two year-old Lab mix named George and a sidewalk sent me to the local ED with a separated shoulder. The ED and orthopedist’s office separately emailed me instructions on how to enroll in their patient portals, and yet, like many patients, I did nothing with them.

I quickly realized the issue may not be that providers aren’t trying to engage patients or that there’s even a lack of technology; it might be that we aren’t using the technology already sitting in our hands.

Pew Research Center recently found that 64 percent of Americans own smartphones, with a large majority being used for Internet access. Combine this with the abundance of customized smartphones apps and it seems these handheld devices can be used for just about anything. The question then becomes, why aren’t these devices more prevalent in healthcare as a bridge across the patient engagement chasm?

As the president of a healthcare technology company that has created various patient portals, I completely see their value. But, combining portals with today’s smartphone technology – the device most have integrated into their every waking hour – would better enable patients to view, download, and transmit their health data from, and even back to providers. This would lay the groundwork for creating a more patient-centric and patient-involved environment.

During my time in the ED, if I could have enrolled my mobile device, which I would’ve done to take my mind off the pain, I would now have my imaging report, diagnosis, and electronic discharge instructions in my pocket and available for the next provider.

With that, I’m excited for the opportunity to host this Thursday’s #HIStalking tweet chat about patient portals, mobile devices, and how they can help engage patients.

#HIStalking Discussion Questions

Q1: How have you personally benefited from a patient portal or mobile patient access application?

Q2: Would consumerism have eventually drawn focus to patient engagement without the government’s push?

Q3: Patient portal adoption rates are near 25 percent, or one in four patients in physician practices of all sizes. Why isn’t this higher?

Q4: What killer app or feature is missing in today’s patient engagement solutions?

Q5: Technology has been the initial focus, but patient engagement is so much more. What has the industry missed by concentrating on portals?

Bonus Q: Looking down the road,  in the next five-plus years, how do you feel today’s patient engagement initiatives will impact the healthcare experience?

Tweet Chat Instructions

It’s easy to join the Twitter conversation by logging into TweetChat, which automatically keeps you in the conversation by tagging all tweets with the #HIStalking hash tag. If you are unable to access the TweetChat room, simply search in Twitter for #HIStalking and follow the conversation. To contribute, be sure and tag your tweets with #HIStalking so they can be seen by other chat participants.

Contacts

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

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News 9/21/15

Top News

ONC releases the final Federal Health IT Strategic Plan 2015-2020, a 50-page action plan for agencies that use or influence the utilization of health IT as they work towards establishing interoperability across the healthcare continuum. The final plan incorporates the December 2014 draft, input from 35 federal agencies, and recommendations from over 400 individuals and organizations. In introducing the plan, National Coordinator Karen DeSalvo, MD explains, “With this Plan, the federal government signals that, while we will continue to work towards widespread use of all forms of health IT, efforts will begin to include new sources of information and ways to disseminate knowledge quickly, securely, and efficiently. This Plan will help guide the nation’s shift towards focusing on better health and delivery system reform.” I hope to give the entire plan my full attention while en route to Boston tomorrow. Feel free to share your impressions of ONC’s five-year guide for health IT in the comments below.

Webinars

September 22 (Tuesday) noon ET. “Just Step on the Scale: Measure Ongoing EHR Success and Focus Improvements Using Simple but Predictive Adoption Metrics.” Sponsored by The Breakaway Group. Presenters:  Heather Haugen, PhD, CEO and managing director, The Breakaway Group; Gene Thomas, VP/CIO, Memorial Hospital at Gulfport. Simple performance metrics such as those measuring end-user proficiency and clinical leadership engagement can accurately assess EHR adoption. This presentation will describe how Memorial Hospital at Gulfport used an EHR adoption assessment to quickly target priorities in gaining value from its large Cerner implementation, with real-life results proving the need for a disciplined approach to set and measure key success factors. Commit to taking that scary first step and step onto the scale, knowing that it will get measurably better every day.

September 22 (Tuesday) 5 p.m. ET. “Laying the Groundwork for an Effective CDS Strategy: Prepare for CMS’s Mandate for Advanced Imaging, Reduce Costs, and  Improve Care.” Sponsored by Stanson Health. Presenters: Scott Weingarten, MD, MPH, SVP and chief clinical transformation officer, Cedars-Sinai; Anne Wellington, VP of informatics, Stanson Health. Medicare will soon penalize physicians in specific settings who do not certify that they consulted "appropriate use" criteria before ordering advanced imaging services such as CT, MRI, nuclear medicine, and PET. This webinar will provide an overview of how this critical payment change is evolving, how it will likely be expanded, and how to begin preparations now. A key part of the CMS proposal is clinical decision support, which will help meet the new requirements while immediately unlocking EHR return on investment. Cedars-Sinai will discuss how they decreased inappropriate utilization of diagnostic tests and treatments, including imaging.

#HIStalking Tweet Chat – Portals, Mobile Devices, and Patient Engagement

Frank Fortner (@iatricFJF) will host the next #HIStalking tweet chat on Thursday, September 24 at 1pm ET. Check out discussion topics here.

Announcements and Implementations

Aprima expands its “Rescue Plan” that offers licensing discounts of up to 65 percent to users of an expanded list of EHRS that originally included only Allscripts MyWay.

Memorial Medical Group (IL) selects the EClinicalWorks EHR for its 78 Memorial Hospital-employed physicians across 30 locations. The hospital migrated to Meditech 6.0 about four years ago.

Acquisitions, Funding, Business, and Stock

Boca Raton, FL-based Modernizing Medicine closes a Series E financing round of $38 million, bringing its total raised to $87 million. Investors include Pentland Group, Summit Partners, and Sands Capital Ventures. The specialty EHR vendor completed its acquisition of gastroenterology-specific tech vendor gMed earlier this month.

Government and Politics

ONC awards $1 million in grants to 10 community programs to support their efforts to gather and share health data for improved patient decision-making and outcomes. The programs will use the new funding to support the EHR adoption efforts of providers that are ineligible for EHR Incentive Program participation. Grant awardees include the National Health Start Association, Georgia Health Information Network, and Rhode Island Quality Institute, which manages the state’s CurrentCare HIE. I interviewed RIQI President and CEO Laura Adams earlier this summer. 

The California Dept. of Insurance works with Consumer Reports and researchers at UC San Francisco to launch California Healthcare Compare. The consumer-friendly website offers quality data on common conditions and procedures, as well as pricing information by county for 100 procedures.

New data from ONC show that at least 8 out of 10 physicians used an EHR in 2014 – an increase of four percentage points from the year before. The new statistic, led by primary care docs, leads ONC to conclude that nearly three-quarters of physicians used a certified EHR last year. The news isn’t so rosy when it comes to solo physicians. Less than two-thirds had adopted an EHR, certified or otherwise, in 2014, while just over half had adopted a certified tool.

People

DaVita HealthCare partners promotes Atul Mathur to EVP of global operations. Mathur’s new role comes on the heels of the company’s acquisition of The Everett Clinic, a chain of 20 specialty and primary care sites north of Seattle.

Evelyn Whitlock, MD (Kaiser Permanente Northwest) joins the Patient-Centered Outcomes Research Institute as its new chief science officer.

Telemedicine

Chattanooga, TN-based WeCounsel adds automatic insurance verification to its telemedicine platform for behavioral health providers. The upgrade also enables physicians to bill for co-pays and submit claims through a designated clearing house. Side Note: Chattanooga has become one of my favorite get-away spots. It’s an extremely pedestrian- and bicycle-friendly town with unique tourist spots like Ruby Falls and Rock City, not to mention a great restaurant scene. Give Tony’s a whirl if you’re in the mood for Italian and find yourself in the Bluff View Arts District.

I’m beginning to wonder if the folks at ONC ever sleep … The office releases a white paper on consumer-centered telehealth, offering nine recommendations including the need for frictionless user experience, an increased focus on the security of patient data, and being wary of potential data overload. The need for Interoperability is of course included, as are telemedicine’s three biggest barriers to ubiquity: payment models; physician licensure; and care fragmentation and data fracturing.

Other

Amidst the fretting and fingernail-biting, Scientific American points out the impact ICD-10 will have on healthcare: “More detailed medical billing codes could eventually improve your healthcare. Those new codes could provide a clearer picture of why individuals seek care and which health problems are growing or contracting in communities —helping inform what health issues should be researched and improved. At least, that’s the hope.” That “at least” is a big caveat, given that most ICD-10 coverage has focused on the revenue damage control physicians are preparing for in the wake of October 1. (Dr. Jayne’s latest EPtalk alludes to one physician’s fear – and panic room preparation efforts – that he won’t be able to pay his staff due to ICD-10-related revenue problems.)

Author Tom Chiarella conducts an informal study of people’s reactions to uniforms, including that of a doctor. Donning scrubs, a lab coat, and an air of exasperation combined with busyness, he finds that, “The world wants to help a doctor. The uniform conveys a responsibility that people are willing to share. They took little bits from the priest, and ignored the security guard, and didn’t bother to see the mechanic, but they gave to the doctor. Ceaselessly and for many city blocks.”

Sponsor Updates

• TriZetto Provider Solutions receives the Visionary for Children Award from the Children’s Home Society of Missouri.

Blog Posts

• Patient engagement: strategies, barriers, and quick wins (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 9/20/15

The HealthLinc FQHC (IN) goes live with Forward Health Group’s PopulationManager and The Guideline Advantage. The local paper provides a pretty good synopsis of the value the FQHC is already deriving from the new software, including improvements in controlling patient blood pressure and diabetes, and promoting smoking cessation.

Secure-messaging technology vendor Kryptiq rebrands as Enli Health Intelligence to better reflect its new focus on population health management tools. CEO Luis Machuca says the new name was derived from the notion that customers want to make “enlightened” choices for their patients based on accurate data and medical evidence.

The local paper looks at the ways in which healthcare technology is helping to reduce health disparities in certain patient populations, including those suffering from depression. Telepsychiatry in concert with EHRs are making an impact at Excela Health Medical Group (PA): A query of EHR data helped Excela staff realize that only 7 percent of patients with depression made recommended follow-up appointments. An outreach effort was then launched that boosted the rate to over 50 percent.

HIMSS ramps up promotions for its Population Health Summit November 8-11 at the Gaylord National Resort just outside of Washington, D.C. The lineup of speakers, which includes folks from Geisinger, Montefiore, and Vanderbilt, seems intriguing enough. The structure of the event – co-located with the mHealth Summit and CyberSecurity Summit –  plus the $795 price tag give me pause. I don’t know that I’d be able to totally immerse myself in one topic or wind up spreading myself too thin across all three. I will give the Gaylord resort high marks. It may be a bit inconvenient to get to from D.C. proper, but it’s a beautiful facility with tons of amenities, and great shopping and restaurants just across the street.

IGetBetter works with two hospitals in New England to develop and roll out its new COPD Care Plan, part of its library of plans for post-acute care transition and long-term population health management. The plan, which enables patients to monitor and better care for themselves at home, incorporates daily assessment tests and reminders, as well as activity monitors with customized alert levels. The hospitals piloting the new plan hope to reduce COPD readmissions and costs.

The worlds of academia and workforce development collide with the increasing need for predictive analytics and population health management experts at Saint Louis University Center for Health Outcomes Research, which has announced a new graduate program for training healthcare data scientists. The Healthcare Data Science program will offer students the chance to learn modern database management and analytics, with applications for patient care and public health. “The program addresses an important and growing demand for skilled professionals with ‘big data’ expertise to assist healthcare systems with reducing costs, improving safety, and managing population health,” says Eric Westhus, program director and assistant professor.

The Brookings Institution takes a look at improving chronic asthma management through population health, calling for team-based care, community engagement, and new payment models to transform care at the practice level. Healthcare technology comes into play in its suggested long-term action steps, including improving information sharing via the establishment of an information exchange clearinghouse.

Send me your population health management news for potential inclusion in future weekly wrap ups.

Contacts

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

More news: HIStalk, HIStalk Connect.

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News 9/17/15

Top News

Echoing the Senate HELP Committee’s most recent call to delay Stage 3 of Meaningful Use, the AMA and 41 other medical societies write to HHS and the Office of Management and Budget, strongly urging them to pause the final stages of the Meaningful Use program in light of major changes to Medicare. “There is growing bipartisan recognition in Congress that the direction of the Meaningful Use program needs to be reassessed in light of usability and interoperability challenges with electronic health record systems,” says AMA President Steven J. Stack, MD. “Poorly performing systems that do not facilitate the seamless exchange of data would severely undermine the ability of the health system to support the implementation of the payment reforms outlined in MACRA. Pausing to reassess Stage 3 rules will not stop or delay progress with EHRs,” said Dr. Stack. “On the contrary, we firmly believe a temporary period of reevaluation will help move the program forward and drive innovation and adoption.”

HIStalk Practice Announcements and Requests

There are just a few days left to take advantage of special rates on HIStalk Practice sponsorships (HIStalk sponsors get an extra discount) to make sure your message stands out. Contact Lorre for details.

Webinars

September 22 (Tuesday) noon ET. “Just Step on the Scale: Measure Ongoing EHR Success and Focus Improvements Using Simple but Predictive Adoption Metrics.” Sponsored by The Breakaway Group. Presenters:  Heather Haugen, PhD, CEO and managing director, The Breakaway Group; Gene Thomas, VP/CIO, Memorial Hospital at Gulfport. Simple performance metrics such as those measuring end-user proficiency and clinical leadership engagement can accurately assess EHR adoption. This presentation will describe how Memorial Hospital at Gulfport used an EHR adoption assessment to quickly target priorities in gaining value from its large Cerner implementation, with real-life results proving the need for a disciplined approach to set and measure key success factors. Commit to taking that scary first step and step onto the scale, knowing that it will get measurably better every day.

September 22 (Tuesday) 5 p.m. ET. “Laying the Groundwork for an Effective CDS Strategy: Prepare for CMS’s Mandate for Advanced Imaging, Reduce Costs, and  Improve Care.” Sponsored by Stanson Health. Presenters: Scott Weingarten, MD, MPH, SVP and chief clinical transformation officer, Cedars-Sinai; Anne Wellington, VP of informatics, Stanson Health. Medicare will soon penalize physicians in specific settings who do not certify that they consulted "appropriate use" criteria before ordering advanced imaging services such as CT, MRI, nuclear medicine, and PET. This webinar will provide an overview of how this critical payment change is evolving, how it will likely be expanded, and how to begin preparations now. A key part of the CMS proposal is clinical decision support, which will help meet the new requirements while immediately unlocking EHR return on investment. Cedars-Sinai will discuss how they decreased inappropriate utilization of diagnostic tests and treatments, including imaging.

#HIStalking Tweet Chat

Frank Fortner (@iatricFJF) will host the next #HIStalking tweet chat on Thursday, September 24 at 1pm ET. Stay tuned for discussion topics. Check out past chat recaps here.

Announcements and Implementations

AHIMA adds expanded mobile capabilities to its Clinical Documentation for ICD-10 by Specialty: Principles and Practice app, developed with ImplementHIT. New features include an additional Evaluation and Management Coding library, targeted notifications tied to corresponding training modules, and the ability to build and distribute custom content.

San Francisco-based FairCare launches an iOS version of its healthcare price transparency app.

The Bonnie J. Addario Lung Cancer Foundation launches the ALCF Patient Portal as an interactive, educational resource for patients and caregivers.

Telemedicine

Atlanta-based MyIdealDoctor joins the CommonWell Health Alliance, making it the first telemedicine-focused company to join the organization. Additional new members include Varian Medical Systems and Beyond Lucid Technologies.

Authentidate partners with Aeon Clinical Laboratories to offer a genetic cancer test with telemedicine-based genetic counseling for prescribing physicians. The test, which looks at 38 genes, is designed to identify increased risk of colorectal, breast, pancreatic, ovarian, gastric, melanoma, and stomach.

People

Jason Adams (West Central Behavioral Health) joins Medytox Solutions – parent company of Medical Mime and Medical Billing Choices – as CFO.

Patrick Kennedy (PJ Consulting) joins RemitData’s Board of Directors.

Acquisitions, Funding, Business, and Stock

VillageMD secures a $36 million Series A financing round led by Oak HC/FT. Ann Lamont, managing partner of Oak HC/FT, will join VillageMD’s Board of Directors. The Chicago-based company, which assists physicians in transitioning to a value-based business model driven by primary care, plans to use the funding to expand beyond the markets it serves in Texas and Indiana. (I interviewed VillageMD co-founder Clive Fields, MD earlier this month.)

Government and Politics

ONC’s EHR complaint form goes live (no joke).

Research and Innovation

An AMGA survey reveals that multi-specialty medical groups and integrated delivery systems anticipate fee-for-service payments will decline by 24 percent over the next two years – not a huge vote of confidence for government and industry attempts to shift to value-based care. Major impediments to a quicker shift include inadequate access to administrative claims data; poor data transparency and data-exchange processes; and a lack of attribution, benchmarking, and risk-adjustment methods.

The Office of Naval Research and Charles River Analytics develop the Mobile, Virtual Enhancements for Rehabilitation (MOVER) system to help veterans recover from brain injuries through virtual coaching. When installed on a Webcam-equipped computer, the MOVER software creates a virtual “skeleton” of the user, which mimics the person’s movements throughout each therapy exercise and offers corrective feedback. The software can also be displayed on televisions via Microsoft’s Kinect gaming system.

An IMS Institute for Health Informatics study finds that there are now over 165,000 smartphone apps geared to health and wellness, yet just 36 make up nearly half of all downloads. The most popular include MyFitnessPal’s Calorie Counter and Endomondo’s fitness tracker. Robert Wergin, MD a practicing family physician and president of AAFP, won’t start recommending apps to patients until he sees more evidence-based research to back up their healthcare claims. “But I think there’s great potential,” he adds. 

Other

The local news asks, “Who wouldn’t want a job that pays over $100,000 a year?” in its report on the big bucks associated with working in medical group practice management. The market for group practice management jobs is expected to grow by 23 percent over the next five years. Salaries in the triple digits sound like great opportunities, but I wonder if the job’s stress level is on par with its compensation.

Dilbert puts a humorous spin on data and dashboards. Thanks to @spencerhamons for sharing.

Contacts

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

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From the Consultant’s Corner 9/17/15

Downstream Revenue: Evaluating the Financial Return of Clinical Alignment Tactics

Hospital-based medical practices have increasingly become a major component of a health system’s clinical integration strategy. Over the past 30 years, many employed physicians have not viewed hospital-based practice models in a positive light. Governance, organizational structure, and leadership in the typical hospital operational model remain foreign to many physicians coming from private practice. These physicians have struggled with the perceived bureaucracy of hospital systems, and often become frustrated and disillusioned with the relationship.

Hospitals have also struggled to justify ongoing financial support of these physician practices, which on their own frequently operate at a loss. The physician-hospital relationship has historically been one of mutual distrust and perceived competing interests. Developing an employment relationship with physicians without a foundation of trust and a clear understanding of the role and objectives of each party typically results in strained relationships and constant conflict over operations and finances.

The investment in any hospital-employed or -affiliated group is significant. Without an accounting of the impact the group has on the downstream revenues brought into the health system, the parent organization naturally exerts pressures to reduce medical group expenses and losses. Analysis of downstream revenues is much broader than reviewing an individual practice or physician P&L. This would include referrals to specialists within the health system, ancillary services such as lab and radiology, and inpatient admissions. Development of the methodology to quantify the downstream impact of the practice’s physicians has been a historic challenge for every group and parent organization. To effectively and efficiently monitor downstream revenues, organizations often utilize business intelligence tools to evaluate the revenues, expenses, and contribution margin of the health system’s broader ambulatory (i.e., specialists) and hospital service lines.

Ultimately, technology in combination with a strong commitment from executive leadership drives downstream revenue within healthcare organizations. Ongoing analysis of this revenue is critical to both the enterprise and its affiliated physicians. Just as organizations want to understand the value practices bring, providers likewise want to understand their overall contribution to the organization – for business reasons and for personal satisfaction.

Accurate analysis allows healthcare organizations to grow through acquisition and alignment, with the confidence to make informed decisions based on a complete understanding of return on investment. They can build their brands within their communities and grow the number of patients under their care.

Health systems, hospitals, and academic medical centers can no longer afford to write blank checks to acquire practices. To achieve success in a value-based world, they must dedicate the resources – including experienced leadership and technology – to measure and drive downstream revenue.

Brad Boyd is vice president of sales and marketing for Culbert Healthcare Solutions.

Contacts

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

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