5 Questions with Cathy Petti, Chief Health Officer, AncestryHealth

Cathy Petti is chief health officer of AncestryHealth. Launched by Ancestry.com last month, the new service gives users the ability to create a digital record of diseases and causes of death that have affected their families over the decades. The company plans to partner with EHR vendors so that users can share family health histories electronically with physicians. It also plans to add genetic information to the mix soon via its AncestryDNA testing service.

What was the impetus for launching AncestryHealth?
Currently, when a patient provides family health histories to his or her doctor, it is in the doctor’s office, where doctors generally feel rushed. It is unfortunate, because family health history is one of the richest data sets available to help identify risks for various medical conditions. Knowing that history may help patients choose different lifestyles, behavior modifications, or to undergo screening at an earlier age.

Even the Surgeon General says family health history is one of the most effective screening tools that we have at our disposal, and it is free and non-invasive. Yet far too few use it. At AncestryHealth, we look forward to tapping into consumer curiosity about their health and motivators to be mindful of health and wellbeing.

AncestryHealth is committed to providing individuals with meaningful information and relevant research to help them make choices that could lead to longer, healthier lives. Our integration of health information and unparalleled genealogical expertise will help consumers trace their own health conditions along family lines and understand what it means, while allowing individuals to record this valuable information to share with their physicians and family.

How does the company plan to integrate its Health and DNA offerings in the near future?
AncestryHealth is considering incorporating ethnicity as part of the health profile so that customers can see how research shows that risk may be affected by ethnic background; for example, that certain conditions are more common among certain ethnic groups.

What EHR vendors will AncestryHealth work with? Why were these particular companies chosen?
We’re currently considering a number of different EHR vendors based on the ease of their ability to work seamlessly with diverse physicians and healthcare institutions nationwide. We plan to work closely with these institutions to integrate family health history data into EHRs to better help physicians use family health history as a screening tool.

Given healthcare’s notorious interoperability problem, how does AncestryHealth plan to ease the burden of sharing medical records for its users?
Ancestry has robust experience organizing and streamlining massive amounts of family history information (10 petabytes of data), including 16 billion records from 67 countries made up of birth, death, census, military and immigration records; 70 million user-contributed family trees and associated photos and stories; and, through AncestryDNA, more than 1 million genotyped DNA samples. Scaling and making searchable a rapidly growing database of billions of records from various sources requires significant technological capability to provide useful results for Ancestry members, whether they access the company’s service through traditional Web and software access or by other mobile applications. We understand the unique challenges and opportunities of managing enormous data sets. We place critical importance on the ability for the end-user (whether consumer or physician) to easily digest actionable health information.

Does Ancestry have any plans to use de-identified user health data to engage in research projects with academia, government or businesses?
We carefully consider all research collaboration options. Consistent with the informed consent on the AncestryHealth site, AncestryHealth will only share information with third parties for research or publication if the user has accepted the informed consent. In all instances where we share user information, we will remove information that traditionally permits identification of specific individuals, such as names and birth dates.

Contacts

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

More news: HIStalk, HIStalk Connect.

Get HIStalk Practice  updates.
Contact us online.
Become a sponsor.

News 8/4/15

Top News

MapLight reports that the top three lobbyists – AMA, the US Chamber of Commerce, and Boeing – spent $14.4 million to lobby Capitol Hill lawmakers between April and June of this year. AMA spent $12,400,000 in Q2 of 2015, more than in any quarter since 2008 and nearly twice as much as in Q1. The timeframe neatly coincides with the lead up to the AMA/CMS announcement regarding easing into ICD-10. It would be interesting to crunch numbers and see if the amount of AMA lobbying money outweighs any savings physicians will realize as a result of the 12-month transition period.

Webinars

None scheduled in the next two weeks. Previous webinars are on the YouTube channel. Contact Lorre for webinar services including discounts for signing up by Labor Day.

Acquisitions, Funding, Business, and Stock

Atlanta-based Azalea Health secures a $1.5 million credit facility from Square 1 Bank, which the company will use to drive continued growth. The new funding comes almost exactly a year after its acquisition of SimplifyMD.

Announcements and Implementations

The National Committee for Quality Assurance launches an eMeasure Certification program to certify software that is capable of producing electronic clinical quality measures using EHR data.

The Kansas Health Information Network, an HIE founded in 2010 by the Kansas Medical Society and the Kansas Hospital Association, adds Isabel Healthcare’s Symptom Checker to its MyKSHealtheRecords PHR. KHIN’s patient portal and PHR are powered by NoMoreClipboard, which is still making headlines due to a security breach earlier this summer.

Telemedicine

The Center for Connected Health Policy publishes a whopping 229-page report on telemedicine payment laws and regulations. It found that all but three state Medicaid agencies – Iowa, Massachusetts, and Rhode Island – pay for live online consults, 16 pay for remote monitoring, and nine pay for store-and-forward services.

People

The Florida Medical Association elects private-practice obstetrician/gynecologist Ralph Nobo Jr., MD president.

Greenway Health appoints David Wirta (Vista Consulting Group) to the new role of chief revenue officer.

Government and Politics

The White House’s inaugural Demo Day features a number of healthcare IT-related companies. St. Louis-based Sparo Labs has developed AsthmaWing, a sensor and app that enables asthma patients to measure lung capacity. California-based Open Health Network offers a mobile platform to help healthcare stakeholders create device-agnostic apps in a single day without any coding. Thirty-two startups across a range of industries participated in the event.

As part of his recently announced AHCCCS CARE program, Arizona Governor Doug Ducey plans to submit a CMS waiver request in the coming months to overhaul the state’s Medicaid program. Part of the request requires the use of “modernized communications” to help patients take more accountability for their care. “With the use of innovative technology, patients would receive reminders about upcoming appointments, access chronic disease management tools, find primary care doctors or urgent care locations at the touch of a button and manage all aspects of their account online,” the Governor’s office explains. “These features will ensure patients get the timely care they need and better manage their illnesses – while protecting taxpayers from paying for missed appointments, unnecessary emergency room visits, and avoidable hospitalizations.”

Research and Innovation

A study from AAFP’s Robert Graham Center finds that primary care physicians were more likely than specialist physicians to participate in the Meaningful Use program. The researchers advise policymakers to extend EHR incentives to smaller practices with tighter margins that haven’t yet joined the world of EHRs due to prohibitive upfront costs.

Other

South Korean startup Dot creates the world’s first smartwatch for the visually impaired. The watch uses a new technology that enables the dots on its face to pop in and out to form braille characters, and enables the user to control how quickly the dots are read.

Contacts

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

More news: HIStalk, HIStalk Connect.

Get HIStalk Practice  updates.
Contact us online.
Become a sponsor.

News 8/3/15

Top News

HHS awards $38 million to 20 organizations involved in three health IT grant programs. The Advance Interoperable HIT Services to Support HIE program will receive the bulk of the funding – $29.6 million – which it will dole out to 12 states to help them expand HIE technology and adoption, and overall interoperability. The Community Health Peer Learning Program will give health services and policy research organization AcademyHealth $2.2 million to work with over a dozen communities on population health strategies, and the Workforce Training Program will spread $6.7 million in between seven organizations to update training materials from the original Workforce Curriculum Development program funded under HITECH.

HIStalk Practice Announcements and Requests

Dedicated readers may have noticed HIStalk Practice has been a bit light on news over the last several weeks, due to my decision to take a working vacation in more tropical climes. As Dr. Jayne attested to earlier this summer, it is hard to completely unplug even when cool ocean breezes and calm waters beckon just outside the door. WiFi at my beach bungalow was contentiously predictable in going down for at least 12 hours every time a significant afternoon storm rolled in. Luckily, I had the foresight to drop by my favorite used bookstore on the way into town. Rainy day beach reads included The Queen’s Fool by Philippa Gregory, and the Memoirs of Cleopatra by Margaret George. I am a sucker for weighty (literally) works of historical fiction.

For those of you who may also have been out of the office last week, don’t miss the great interviews and guest contributions that kept HIStalk Practice going:

• 5 Questions with Shashi Kusuma, MD CEO, Symplast
• 5 Questions with Murray Fox, MD CEO, Premier Patient Network
• Readers Write: Physicians Have an Influential Role in Driving Wearables Adoption
• 5 Questions with Brian Loftus, MD CMO, iHeadache MD
• 5 Questions with John Sawyer, MD Hudson Headwaters Health Network

Today finds me back at the home office with reliable connectivity, thankful that the healthcare IT news cycle is slowly picking up as everyone trickles back into the office from their summer holidays. I’m also thankful for the following sponsors, new and renewing, that recently supported HIStalk Practice. Click a logo for more information. Email me if you’re interested in joining their ranks.

Webinars

None scheduled in the next two weeks. Previous webinars are on the YouTube channel. Contact Lorre for webinar services including discounts for signing up by Labor Day.

Acquisitions, Funding, Business, and Stock

HealthlinkNY – a RHIO serving an 11-county area of southern New York – expands operations with the opening of a new 9,500 square-foot office space in Binghamton. The nonprofit has grown to 21 employees since it was founded in 2005 as Southern Tier HealthLink.

Announcements and Implementations

Allscripts adds OptimizeRx’s SampleMD technology to its Touchworks EHR, enabling physicians to automatically view, print, and electronically transfer prescription vouchers and copay savings to a patient’s pharmacy.

Microwize Technology launches a cloud version of its Lytec medical billing software.

The Michigan-based Consortium of Independent Physician Associations helps 212 physician practices earn patient-centered medical home designations from Blue Cross Blue Shield of Michigan. Managed by The Medical Advantage Group consulting firm, CIPA represents 1,400 physicians from independent physician associations, FQHCs, rural health centers, and group practices.

Government and Politics

New Jersey State Assemblyman Bob Andrzejczak (D) introduces a measure that would cap the fees charged to patients for copies of their own medical records. Providers could charge no more than $100 for paper records with a copying fee of 50 cents per page and a $15 administrative fee. The maximum fee for electronic records would be a far more “affordable” $50. The records would also have to be provided within 30 days, which still seems like too long a timeframe for patients who may be in the midst of life-saving care transitions.

A group of 18 healthcare stakeholders including MGMA, ACP, Cerner, and Greenway Health write to HHS Secretary Sylvia Burwell imploring her to finalize a proposed rule issued in April that would modify Stages 1 and 2 of Meaningful Use. As the authors explain, “The Oct. 3rd deadline to begin the final possible 90-day reporting period in calendar year 2015 is fast-approaching. If providers do not receive the final rule shortly, it will be very difficult to make workflow adjustments in a timely manner to meet programmatic deadlines and facilitate meaningful use tracking and reporting.”

People

CMS names Richard Ottomeyer, DC a Medicare Physician Champion Community of Practice Provider for his efforts to educate physicians in Minnesota about the transition to ICD-10. He is the first chiropractic physician to be awarded the honor.

Corey Stevenson (CMS) joins Cognosante as vice president and deputy general manager of its health data and communications business.

Practice Fusion names Matt Ackley (Marin Software) chief marketing officer; Dorothy Gemmell (Havas Life) senior vice president, life science practice and strategic partnerships; Tim Rauschenbach (Level Five Solutions) vice president, customer service and support; and Dave Caldwell (Transcend Insights) senior vice president, enterprise solutions. The company, which is gearing up for an IPO, also welcomes Alan Black (Zendesk) to its Board of Directors.

Telemedicine

ATA is accepting presentation submissions for its 21st annual meeting and tradeshow, which will be held May 14-17, 2016 in Minneapolis. Presentations on nine main areas of interest including direct-to-consumer services, chronic disease management, and population health will be accepted in a variety of formats.

Research and Innovation

A WEDI ICD-10 industry preparedness survey conducted in June finds that just 20 percent of physician practices have commenced or completed external testing, while less than half are ready or will be ready for the switch on October 1 (just 58 days away). Vendor readiness fared slightly better, with 75 percent of respondents noting they have completed product development, and 100 percent committing to readiness by the compliance date. Based on its findings, WEDI has recommended that HHS appoint its new ICD-10 Ombudsman position as soon as possible, among other WEDI-friendly suggestions. (Is it just me, or is the switch to ICD-10 beginning to feel like the doomsday predictions associated with Y2K?)

The Vitality Institute, a New York City-based research organization, drafts a set of proposed guidelines to address legal, social, and ethical concerns associated with consumer-generated health data. Guidelines for providers include: protect user privacy; clearly define who owns the data; make it easy to interpret, enable access to underserved populations, and incorporate evidence-based approaches to behavior improvement. Comments are due October 15.

Other

HHS announces that the data of 3.9 million people was exposed in the Medical Informatics Engineering / NoMoreClipboard hack that took place in late May. Affected facilities included Concentra (TX), Rochester Medical Group (MI), and Franciscan St. Francis Health Indianapolis.

Rutgers profiles Ron Weiss, MD and Ethos Health, the farm-based primary care practice he launched in 2014 on 342 acres in Long Valley, NJ. Ethos trains patients in selecting from over 40 different vegetable and fruit crops from the fields just outside the waiting room, plus offers cooking classes.

Contacts

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

More news: HIStalk, HIStalk Connect.

Get HIStalk Practice  updates.
Contact us online.
Become a sponsor.

5 Questions with John Sawyer, MD Hudson Headwaters Health Network

John Sawyer, MD is an internal medicine physician at Hudson Headwaters, a federally qualified health center in upstate New York. The FQHC’s 150-plus physicians and mid-level providers care for a total of 50,000 patients over 320,000 visits each year. The practice, which uses Athenahealth’s AthenaOne platform, has fully attested to Stage 2 of Meaningful Use, and has been recognized as a patient-centered medical home.

What type of population health management program is Hudson Headwaters participating in?
I am trained as a primary care physician, but Hudson Headwaters provides pediatric and family care, as well behavioral health, women’s health, and dental care. In that way, you could say that we practice the essence of population health management for all of our patients; we’re managing their total health for a good portion of their lives, if not for their entire lives. We are also a patient-centered medical home, which means that we embody a primary care delivery model structured around coordinated, continuous, comprehensive, and community-based care. That’s a lot of “Cs,” but we believe in all of them!

As an FQHC, we are required by law to think about our population’s health. We are responsible for coordinating a patient’s care — from immunization to pap smears — even if we only see that person irregularly and for reasons outside of our control. Our funding is tied to this type of basic care coordination, and we have enormous reporting requirements that cover not only the kinds of care that we provide but also the quality targets we reach. Our cloud-based technology lets us drill down into that data to closely track and analyze our performance. We run population health campaigns using our patient engagement service, AthenaCommunicator, to identify and communicate with patients who are due for care and ensure that they come in to receive it. Hudson Headwaters also has an incredible team of care managers and outreach staff who identify high-risk patients for intervention and who generally ensure smooth care transitions. I credit a lot of their work to our excellent quality metrics. Our illness rates and average hospital and ER visits are quite favorable compared to other Medicaid blocks in New York State.

How has healthcare technology impacted HH’s population health management programs?
Healthcare technology has made coordinating care so much easier for our practice, and it’s made the experience of receiving care better for our patients. Hudson Headwaters has 16 geographically dispersed offices, ranging from Champlain, New York — one exit from Canada — to the central western Adirondacks. That’s over a two-hour spread. We staff outpatient facilities, two busy urgent care centers, and even inpatient facilities at several local hospitals. We work in nursing homes and offer home visit programs. Sharing paper charts between all of those care sites was virtually impossible before we implemented cloud-based health IT services. With them, our care teams are now able to communicate seamlessly. We can see the same patient in different offices, review their charts remotely, and respond to questions during off-hours via the patient portal. It’s a much more streamlined process, and one that has encouraged efficiency and patient engagement. Rural regions like ours historically struggle with patient engagement; having flexible technology that connects us to our patients outside the encounter has been essential.

What types of IT challenges do FQHCs face when it comes to implementing population health management strategies?
It can be quite difficult to get the cost data we need to build a really data-rich analytics model for our population health strategies. We look carefully at utilization, benchmark our providers and locations, and try to identify opportunities to increase quality while reigning in costs. But, we can never get all the data we need. Currently, we use a homegrown solution, running reports out of hospital discharge logs. We have started with our first imports of Medicare data with full cost information processed through Athena’s ACE population management system. It will allow us to define the sorts of care our patients are using and who the most efficient providers of service are. I believe that the transparency and network intelligence offered from cloud-based software will be able to satisfy our data reporting and analysis needs.

What plans does HH have for the next phase of its population health management projects?
Finances have traditionally been tight for FQHCs. It’s really hard to execute your mission when you have no margin, so population health incentives open up a whole world of financial opportunity for us. We need a solution that will unite all of our data with our outreach efforts, to automate tasks and reporting. That way, we can better prove the value we’re creating and get compensated for it. Currently, Hudson Headwaters lives with its feet split between the fee-for-service and fee-for-value world. We participate in a few pay-for-performance programs with private insurers and an ACO with Medicare Shared Savings Program. I anticipate that Hudson Headwaters will continue to compete in the fee-for-value world, as those opportunities continue to appear.

What are the biggest IT challenges HH faces at the moment? How will these be overcome?
Interoperability is a big and entrenched problem. Hudson Headwaters needs to be able to exchange health information with other care sites that treat our patients. Even though this exchange is technically possible, there are many economic and business disincentives in the industry that prevent it. Some of the fault lies with the big software vendors, who charge enormous fees to build technical interfaces with other vendor systems. And some of the fault lies with hospitals and health systems, who intentionally lock-in their data to control where patients are able to receive care and where providers are able to offer it. I believe that the free exchange of health information is best for healthcare overall, and I hope that in the future, we are able to meaningfully interoperate with all of the care sites that touch our patients.

Contacts

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

More news: HIStalk, HIStalk Connect.

Get HIStalk Practice  updates.
Contact us online.
Become a sponsor.

5 Questions with Brian Loftus, MD CMO, iHeadache MD

Brian Loftus, MD is a practicing neurologist at Texas-based Bellaire Neurology, where he sees close to 20 patients a day with the help of three medical assistants and one office administrator. The practice has used Aprima’s EHR for close to 14 years, and participated in Meaningful Use for three before backing out of the program. As Loftus explains, “It has now become a burden and not worth the extra time, as most of the clinical measures do not apply to headache therapy.”

Loftus is also CMO of iHeadache MD, a digital diary that enables patients to document headache symptoms and frequency, as well as securely share the data with their physician.

How have you seen healthcare IT improve patient access and outcomes? Is the practice working on any new implementations?
EHRs are good for tracking labs, making sure screening tests get performed, and patients make their follow-ups. They generally do not drive improved decision-making processes for most diseases; however, there is nothing about an EHR that specifically supports headache care. It does not make you a better physician. It does make for more legible notes, but if the MD does not type in what they are thinking, then they are no more useful than old handwritten notes when the doctor did not write down what they were thinking.

I type my notes while I am in the room with the patient. By the time they check out, my documentation is complete and they leave my office with a typed plan that states what we discussed about their care, what was done at the visit, a list of current medications, and a plan for follow-up.

Regarding implementations, we are working on integrating our depression, anxiety, and migraine disability assessment screening forms into our EHR. They will be saved as formatted data in the chart and then I can compare these scores over time. Patients will fill them out on an iPad when they arrive. We do not have a timeline established for this, but it is relatively easy and we should have it implemented by the end of the year. Our EHR has also released a brand new version, so we will be upgrading soon.

What prompted you to develop iHeadache?
I would ask patients to keep a headache diary and most could not keep up with a paper diary. They either forgot to fill it out or forgot to bring it to their appointment, so I saw the need for an electronic diary that they could carry with them all the time. As I did medical research studies, it was clear that we could bring quality of life metrics and treatment tracking that we did in studies to routine medical care. Therefore, my wife and I started Better QOL – Better Quality of Life. I was originally a chemical engineer who did computer process control programming for a couple of years before going to medical school, so I have an engineering and software background. We also have a third partner who devotes a lot of time and energy, does the nitty-gritty programming, and oversees a programmer we hired who lives up in New York.

We self funded the development of the app and as we receive funding from advertising, we have added features and over time developed iHeadache Online. My wife and I have not made any money from iHeadache; all profits from advertising are used to further development.

Do you foresee releasing new technologies via the iHeadache company? Will the company grow within the next few years? Do you anticipate gaining additional funding from outside investors?
iHeadache Online and iHeadache App do not sync at the moment, but we have nearly raised the funding to start programming a brand new iHeadache app as well as a mobile-enhanced website for people without iPhones . Both will sync with www.iHeadache.com so people will be able to enter headache data on their mobile devices as well as on the website.

We also started a non profit and our goal is to adapt iHeadache for research use so that fellows, residents, and physicians can use it for their own studies. We have also considered starting a pregnancy registry for headaches, and that may be our next endeavor after we finish developing the new iHeadache app. We would love to do more and develop a multiple sclerosis diary, a chronic pain diary, and diaries for other diseases, but we plan to grow organically as our time and finances allow.

As a private-practice physician, what are your biggest healthcare IT challenges?
Aprima is very good at supporting their product. Dell support has been very good when needed, but you do have to have someone to interface with them. Having IT you can call on only when needed is probably the biggest challenge for us. We do not have any need for ongoing IT work, but have needed it when we have upgraded servers. This issue is somewhat by choice. There is a VAR that will run Aprima as a service, and there is a VAR that will place and maintain a server in your office, but I have chosen to have my own server. I am probably more comfortable with this than most. I like not being dependent on the Internet to function and only having an onsite server allows this. I like the multiple levels of backup that we run and the offsite backups that we generate as well. I don’t like having something that is critical for my business to run day in and day out to be dependent on another company. I have had one down day due to server issues in the eight years of my practice.

What best practices would you offer colleagues facing similar situations?
Because most EHR vendors will go out of business, I strongly recommend you use a service that has a server in your office and, if needed, use an outside company to help maintain it. Besides the server’s built-in raid functions, you should have backups. A mirrored drive is not a backup. I back up nightly to one drive, and backup up weekly to a second onsite drive and offsite storage as well. Given how cheap hard drives are these days, the weekly backups will go back for months, and then a monthly backup will be kept for a couple of years in case it is important to get back to something that gets deleted and changed accidentally. In eight years, I have only gone back to a remote backup once, so maybe all of this is overkill. On the other hand, I can remember a company that went out of business because they did not understand the difference between mirroring and backups. There are medical practices that have lost charts due to flooding or fire. There is no reason why this should happen anymore. Of course, all backups should be encrypted whether they are stored onsite or offsite.

For my practice in general – we have been moving to an out-of-network model and charging reasonable prices to become less dependent on payers. Headache medicine has few procedures, and for the most part, we are being paid for our time and our thinking abilities. Insurance has traditionally paid poorly for this. By charging reasonable amounts and offering services not typically found at other practices, I can run the kind of practice I want to have.

Contacts

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

More news: HIStalk, HIStalk Connect.

Get HIStalk Practice  updates.
Contact us online.
Become a sponsor.