Population Health Management Weekly Wrap Up 7/24/15

Top News

Anthem finalizes its acquisition of Cigna in a deal valued at $54.2 billion, $6.2 billion more than the initial bid. The newly combined company will cover close to 53 million members, making it the country’s largest payer by enrollment. Cigna CEO David Cordani will become president and COO of the new organization, while Anthem CEO Joseph Swedish will serve as chairman and CEO.

Webinars

July 29 (Wednesday) 11:30 ET. “Earning Medicare’s New Chronic Care Management Payments: Five Steps to Take Now.” Sponsored by West Healthcare Practice. Presenters: Robert J. Dudzinski, PharmD, EVP, West Healthcare Practice; Colin Roberts, senior director of healthcare product integration, West Healthcare Practice. Medicare’s new monthly payments for Chronic Care Management (CCM) can improve not only patient outcomes and satisfaction, but provider financial viability and competitiveness as well. Attendees will learn how to estimate their potential CCM revenue, how to use technology and clinical resources to scale up CCM to reach more patients, and how to start delivering CCM benefits to patients and providers by taking five specific steps. Don’t be caught on the sidelines as others put their CCM programs in place.

July 30 (Thursday) 3:00 ET. “De-Silo Your Disparate IT Systems Around the Patient with VNA.” Sponsored by Lexmark. Presenters: Steven W. Campbell, manager of diagnostic applications and interfaces, Piedmont Healthcare; Larry Sitka, VNA evangelist, Lexmark. The entire patient record, including both DICOM and non-DICOM data, should be available at the point of need. Disparate, aging systems that hide data inside departmental silos won’t cut it, nor will IT systems that can’t integrate medical images meaningfully. Learn how Piedmont Healthcare used a vendor-neutral archive to quickly and easily migrate its images and refocus its systems around its patients.

Previous webinars are on the YouTube channel. Contact Lorre for webinar services including discounts for signing up by Labor Day.

Announcements and Implementations

KLAS recognizes Cerner as “a supplier most considered for future population health management (PHM) capabilities” in its latest report.

Morrissey Associates launches a practitioner performance reporting tool to offer physicians an enterprise view of improvement opportunities and benchmarking, as well as recommended performance metrics and implementation guidelines.

Population health management and wellness company U.S. Preventive Medicine earns validation from the Intel-GE Care Innovations Validation Institute for its ability to achieve a significantly sustained reduction in healthcare costs associated with wellness-sensitive medical events.

People

University of Missouri Health Care promotes Michael LeFevre, MD to medical director of population health.

Intermedix Corp. names Jack Hemmert (Verisk Health) CIO and promotes Melissa Leigh to chief compliance officer.

Government and Politics

HHS launches the Response and Recovery Resources Compendium to support government officials in managing health and emergency operations during disaster response and recovery operations. The compendium includes resources across 24 categories including patient movement, hospital care, and personnel such as medical staff from the U.S. Public Health Service and National Disaster Medical System.

Research and Innovation

Dell Services and Massachusetts-based Baystate Health’s TechSpring technology innovation center announce three innovation programs, including a telehealth pilot, evaluation of freestanding healthcare kiosks, and use of Dell’s  Population Health Analytics to target patients for more effective care management.

Other

Lincoln/Lancaster County, NE launches PulsePoint AED, a smartphone app that helps users locate the nearest automated external defibrillators. The app also allows “citizen-rescuers” to add and edit AED locations. County officials will integrate the desktop app into the emergency dispatch system later this year so that dispatchers can direct callers to the nearest potentially life-saving device.

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.

Readers Write: Interoperability – the Solution for EHR Frustrations

Interoperability: the Solution for EHR Frustrations
By Ruby Raley

Physicians are frustrated with EHRs – in part, because EHRs often do not allow for the transfer of patient records to colleagues outside of their own network. This frustration is a thorn in the side of healthcare – one that quickly needs to be removed.

More efficient interoperability is on the way to help streamline the industry, but the important question we need to ask today is this: What can doctors do in the meantime, while they wait for better interoperability?

First, let’s consider why physicians are frustrated with EHRs.

EHR/EMR vendors initially focused on the clinical workflow, as it was critical to capture information and fit it into the practice routines. It was less important for information to be shared externally when workflow and usability were critical to productivity for physician offices. Physician practices can experience a drop in the number of patients seen in a day when they have to enter data into an EHR. A few years ago, vendors were focused on solving this roadblock – physicians could not afford an EHR if their revenues dropped on adoption.

While the good news is the industry is maturing. The bad news is that we have a new issue: We need to improve care coordination, and more fully engage the patient in their own healthcare decisions and course of treatment. The pressure is on from government and consumer advocates to exchange data freely – the ONC interoperability roadmap calls this out explicitly.

What are the issues now? Vendors often charge extra for connectivity, especially point-to-point interfaces between partners in the healthcare community. Direct (a secure email exchange program) was conceived to address this issue, and this approach has seen steady adoption over time. However, a few issues with the automation remain. Direct can require practice team members to review and manually load the secure email received from all partners. This is time consuming, and it is time that small practices and busy physicians can’t afford. Direct can interoperate with more sophisticated use cases. There are protocols that enable cross-community collaboration (XCA), but these have not been consistently adopted by industry and some offices do not have the technical skills to support this type of exchange without external help from a vendor or service provider – leading to more cost.

HIEs were envisioned and subsidized by ONC with grants to serve as a clearinghouse and facilitator of clinical data exchange at a state level. HIEs received a lot of press and focus, which led to limited success in communities and states across the U.S., but never achieved the goal of ubiquitous data exchange.

There are a few changes on the horizon that may offer a solution to the challenges of interoperability. ONC has stated it intends to ‘encourage interoperability’ through public information sharing (or shaming) and regulatory pressure from CMS. Congress has even held hearings on interoperability – challenging vendors to make it simple and cheap (or free) to share data with others. Vendors are forming alliances to promote interoperability and including data exchange functionality in base releases. Many see the challenges of data exchange easing and gradually disappearing through the work of the vendor community. Additionally, a new protocol, FHIR, has emerged to address some of the challenges of sharing Continuity of Care Documents (CCDs). (You can think of a CCD as an electronic version of your paper chart that the doctor reviewed and marked on your visit). FHIR makes it easy to share only the portion of the CCD needed – medications, for example. FHIR is receiving a lot of attention, but it is not yet widely adopted. In a few years, we may see this as a widely used protocol for data exchange.

What can physicians do about it? They should expect data exchange to be included in their EHR platform. Ask questions and seek this functionality in new releases or when purchasing a new platform. Physicians should look to join communities that facilitate data exchange – such as HISP (a service provider for the Direct solution). Advocacy is important for all of us – there are real advantages to data exchange, and we all can benefit. Vendors who get that value of data exchange will do more than move data from one door step to another (data interoperability). They will ensure process interoperability is achieved – cleansing and consuming the data so it is usable without manual effort. Process interoperability is essential for the physician office. Physicians want to focus on helping patients; most do not want to juggle technical issues and program workarounds in their systems. The vendor community with support and guidance from regulators must provide the tools and capabilities to resolve the challenge.

Ruby Raley is executive vice president of product strategy at Edifecs.

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 7/22/15

Top News

The Patient-Centered Outcomes Research Institute approves nearly $142.5 million to support development and expansion of its National Patient-Centered Clinical Research Network. The PCORnet project is  designed to link researchers, patient communities, and providers in research partnerships that leverage the power of large volumes of health data maintained by the partner networks. The new funding includes support to add seven such networks, which will focus on Parkinson’s, Alzheimer’s, autism disorders, heart disease, obesity, and behavioral health disparities among low-income population, among other areas.

Webinars

July 29 (Wednesday) 11:30 ET. “Earning Medicare’s New Chronic Care Management Payments: Five Steps to Take Now.” Sponsored by West Healthcare Practice. Presenters: Robert J. Dudzinski, PharmD, EVP, West Healthcare Practice; Colin Roberts, senior director of healthcare product integration, West Healthcare Practice. Medicare’s new monthly payments for Chronic Care Management (CCM) can improve not only patient outcomes and satisfaction, but provider financial viability and competitiveness as well. Attendees will learn how to estimate their potential CCM revenue, how to use technology and clinical resources to scale up CCM to reach more patients, and how to start delivering CCM benefits to patients and providers by taking five specific steps. Don’t be caught on the sidelines as others put their CCM programs in place.

July 30 (Thursday) 3:00 ET. “De-Silo Your Disparate IT Systems Around the Patient with VNA.” Sponsored by Lexmark. Presenters: Steven W. Campbell, manager of diagnostic applications and interfaces, Piedmont Healthcare; Larry Sitka, VNA evangelist, Lexmark. The entire patient record, including both DICOM and non-DICOM data, should be available at the point of need. Disparate, aging systems that hide data inside departmental silos won’t cut it, nor will IT systems that can’t integrate medical images meaningfully. Learn how Piedmont Healthcare used a vendor-neutral archive to quickly and easily migrate its images and refocus its systems around its patients.

Previous webinars are on the YouTube channel. Contact Lorre for webinar services including discounts for signing up by Labor Day.

Announcements and Implementations

Summit Software Technologies offers SwervePay’s payment processing technology to its GE Centricity customers.

Athenahealth offers a new secure text messaging service as part of its EHR and Epocrates app.

Garner Internal Medicine surpasses 10,000 electronic referrals with Infina Connect’s Intelligent Care Coordinator referral solution.

Black Book Market Research ranks Drchrono as the top mobile EHR for the third consecutive year.

IPatientCare integrates PatientPay’s billing solution into its EHR and PM technologies.

ChartWise Medical Systems integrates new ICD-10 PCS Query Wizard technology into its 2.0 documentation software.

Clarity Health integrates its preauthorization and referral management solutions with Athenahealth’s EHR.

Signix incorporates its digital signature and authentication technology into Relatient’s patient relationship management platform.

Acquisitions, Funding, Business, and Stock

Virtual physician assistant tech startup Bright.md raises $3.5 million in Series A financing from Oregon Angel Fund, Stanford-Start X, and Seven Peaks Ventures. The Portland-based company raised $1 million in a seed round last fall.

Iora Health opens a third clinic in Seattle, a city in which it is working with Humana to serve Medicare Advantage patients. The company also plans to open six additional clinics in Arizona and Colorado. I interviewed  CEO and co-founder Rushika Fernandopulle, MD earlier this year.

Specialty EHR vendor Modernizing Medicine acquires GMed, a Florida-based company specializing in healthcare IT solutions for gastroenterology. The deal, terms of which were not disclosed, is expected to close in the third quarter of this year, at which point GMed President Joe Rubinsztain, MD will join the Modernizing Management senior management team.

People

Wayne Orchard (New Benefits) joins MyTelemedicine.com as vice president of strategic partnerships.

Clinicient welcomes Steven Sipowicz (ShiftWise) as CFO and Jim Neumann (Webmark Partners) as vice president of marketing.

Telemedicine

Illinois becomes the 11th state to enact the Interstate Medical Licensure Compact.

The Colorado Medical Board proposes new draft guidelines that would allow telemedicine providers to see patients virtually "so long as the relationship is established in conformance with generally accepted standards of practice." The legislation could be decided on as early as next month.

Research and Innovation

Wichita State University biomedical engineering students develop a remote health monitoring system that enables physicians to check on patients via a Pebble smartwatch. The students, which took third place for the Mobile HealthLink technology at WSU’s Shocker NewVenture Competition in May, are beta testing their prototype at Via Christi Hope and Advanced Orthopedic Associates, both based in Wichita, KS.

Other

Houston physician Samuel Pegram, MD takes to the local paper to air his grievances with ICD-10, calling transition to the new code set part of the “never-ending siege waged by CMS against the private practice of medicine in our country.” He adds that, “For physicians in private practice, transitioning to this new system will range in cost from $83,290 to $2.7 million depending upon the size of your medical practice; use of the system is mandatory for a single-physician practice in Angleton, just as it is for physicians at the Texas Medical Center. The substantial administrative cost and financial burdens of new software, computers, training, etc., will force many small practices out of business at a time when patient access to care is already in dire jeopardy.”

Physicians converge on a town-hall meeting hosted by the AMA and Medical Association of Georgia to express their dissatisfaction with EHRs and Meaningful Use. Rep. Tom Price (R-GA) and AMA President Steven Stack, MD hosted the 90-minute event, which they used to raise awareness of AMA’s Break the Red Tape campaign to delay finalization of MU Stage 3 regulations.

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.

DOCtalk with Dr. Gregg 7/21/15

Dr. Happy and Dr. Mad

Dr. Happy burst forth into the physicians’ lounge yesterday, his typical ear-to-ear grin stretched across his clean-shaven face. Dr. Mad sat across the room, sullen and slinking well into his faux leather club chair. Ensconced in a copy of the Journal of Medical Ethics, I denied the impulse to engage, preferring to fly-on-the-wall it while listening to the ensuing debate. I just knew it’d be fun.

Dr. Happy: So, Dr. Mad, did you have a chance to review the new system updates and play around a bit with the new EHR features they rolled out last week? Weren’t they great?! I love the new customizability they added to our Note Tags.

Dr. Mad: Great?? Seriously? Took me three hours just to figure out where they put the link to my custom notes section! These geeks never leave well enough – or should I say, “bad enough?” – alone. Just when you start to have a pseudo-feel for how to navigate these confounded digital charts, some dweeb has to come along and rearrange everything, all in the name of “system enhancements.”

Dr. Happy: Oh, now … it’s not that bad. These systems are so much better than what we used to have, and light years beyond our old pen-and-paper days. You can find information so much better and faster, plus the old “I can’t read the handwriting” issue is obliterated.

Dr. Mad: Not that bad, my butt. The hospital system has gotten so bloated that I often can’t find a thing. It often seems like the old “you can’t get there from here” thing. “Bloatware” would be insulted if it were compared with our EHR. As to the bad handwriting thing, I don’t think going from the proverbial frying pan into the digital fire is a good trade, not at all. Maybe I couldn’t read every note or scribble in somebody’s chart before, but now I can’t find a freakin’ thing amidst all the massive amounts of useless data incorporated into each and every note. Last week I got a copy of a note from the ER for a child who had an ear infection. SEVEN PAGES! Seven pages just to tell me the kid had an acute right otitis media with a cold and was treated with amoxicillin. I just told you in 12 words what it took the system seven full pages to document. You call that “better”?

Dr. Happy: OK, so there are some things we need to work on, I’ll grant you that. But that’s exactly what the new system upgrades are all about: making the EHR work better for you and me.

Dr. Mad: Better for you and me?! Hah! I don’t believe that for a blippin’ nanosecond. The only reasons they made us all go to electronic records in the first place was so that the number crunchers and the bureaucrats could increase their control over us. The C-suiters, the insurance companies, the feds – that’s all any of them want. They want to control us, to tell us what to do and how to do it … and they want to take a huge cut of our pie as they do it. Greedy so-and-sos.

Dr. Happy: Oh, come on now, doc. You don’t really believe that all this wonderful technological improvement for capture and manipulation of healthcare data is about some giant conspiracy to undermine and steal from us providers, do you?

Dr. Mad: You bet your 401K I do! Back in the day, you never had to explain every little thing. You treated people and helped them get better. They paid you for it. Period. Now, every managerial Tom, Dick, and Harry wants to know how many commas and periods you use in you notes, they want to tell you what you should and shouldn’t do, and they want to bill you for the intrusion. Back in the good old days, I never once had a patient demand a refund. Lordy, I never even knew what the term “take-back” meant… well, except maybe as a kid on the school playground. This whole digital healthcare revolution is all about money, nothing more. And the digital tools they are forcing us to use are all about controlling us and keeping us off balance so they can figure out even more ways to cut into our business.

Dr. Happy: Oh, you just have your Grinch hat on today. You know all this technology is leading us toward a better future in healthcare. I know you know that the overload of medical information was just becoming unmanageable with our old ways of doing things and that we just couldn’t continue down that paper-strewn path for long.

Dr. Mad: Well, bah, humbug. All the Whos down in Whoville can just go without their roast beast for all I care. All these changes are killing me! Just when I get one good workflow down, they go and pull the electronic rug from under me. Perfect case in point: this doggone ICD-10 conversion. I mean it… good lord… I mean it… (getting aggravated) …it’s not bad enough that I have to deal with these confounded billing codes in the first place – and I have learned almost all the codes I need to know on a regular basis – but now they wanna throw all those out the window and bring in some Extormity-based new mega-set of codes. Hector’s pup, I’ll be retired by the time I learn all these new ones. Don’t tell me this isn’t all about keeping us off-base so more money can be finagled from our coffers!

Dr. Happy: Well, my friend, I’m sorry you are so unhappy with our system. Me? I find it fascinating, and an enjoyable challenge. I love all the little bells and whistles that come along with it, and I love all the new ways I can manage patient info. I even love using the patient portal to communicate and even think it’s enhanced my patient care.

Dr. Mad: As I said, and I’ll say it again, “Bah, humbug.”

Dr. Happy: (Leaving) You’re such a curmudgeon. See you at the golf outing fundraiser?

Dr. Mad: Yes, though I bet it’ll rain.

From the trenches…

"I was going to buy a copy of "The Power of Positive Thinking", and then I thought: What the hell good would that do?” – Ronnie Shakes

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.

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

News 7/20/15

Top News

The Michigan-based Great Lakes Health Connect surpasses its goal to have 1,000 physician practices utilizing its closed-loop Referrals application. The HIE, which also recently surpassed 1 billion annual health information transactions, plans to link 1,000 practices to the state’s immunization registry.

Webinars

July 22 (Wednesday) 1:00 ET. “Achieve Your Quality Objectives Before 2018.” Sponsored by CitiusTech. Presenters: Jeffrey Springer, VP of product management, CitiusTech; Dennis Swarup, VP of corporate development, CitiusTech. The presenters will address best practices for building and managing CQMs and reports, especially as their complexity increases over time. They will also cover quality improvement initiatives that can help healthcare systems simplify their journey to value-based care. The webinar will conclude with an overview of how CitiusTech’s hosted BI-Clinical analytics platform, which supports over 600 regulatory and disease-specific CQMs, supports clients in their CQM strategies.

July 29 (Wednesday) 11:30 ET. “Earning Medicare’s New Chronic Care Management Payments: Five Steps to Take Now.” Sponsored by West Healthcare Practice. Presenters: Robert J. Dudzinski, PharmD, EVP, West Healthcare Practice; Colin Roberts, senior director of healthcare product integration, West Healthcare Practice. Medicare’s new monthly payments for Chronic Care Management (CCM) can improve not only patient outcomes and satisfaction, but provider financial viability and competitiveness as well. Attendees will learn how to estimate their potential CCM revenue, how to use technology and clinical resources to scale up CCM to reach more patients, and how to start delivering CCM benefits to patients and providers by taking five specific steps. Don’t be caught on the sidelines as others put their CCM programs in place.

July 30 (Thursday) 3:00 ET. “De-Silo Your Disparate IT Systems Around the Patient with VNA.” Sponsored by Lexmark. Presenters: Steven W. Campbell, manager of diagnostic applications and interfaces, Piedmont Healthcare; Larry Sitka, VNA evangelist, Lexmark. The entire patient record, including both DICOM and non-DICOM data, should be available at the point of need. Disparate, aging systems that hide data inside departmental silos won’t cut it, nor will IT systems that can’t integrate medical images meaningfully. Learn how Piedmont Healthcare used a vendor-neutral archive to quickly and easily migrate its images and refocus its systems around its patients.

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

The Texas Tribune covers the growing trend of private-equity firms looking to buy into primary care practices. While investors contend they are not interested in micromanaging physician offices, some physicians worry they’d lose their independence, leading to higher costs and less personalized care. Technology has factored into the equation: Younger, more tech-savvy docs seem to be more open to the idea of an outside firm taking control in return for otherwise impossible funding for new healthcare IT.

Announcements and Implementations

Healthcare CRM vendor Updox launches Updox Dmail, a secure, personalized Direct email address that physicians can register for and keep as they change practices or if they have an additional address through their EHR.

Research and Innovation

A small Northwestern Medicine study finds that smartphone sensor data including number of usage minutes and daily geographical locations can be used to detect depression. Researchers found users were more likely to be depressed if they spent more time on their phone in fewer locations. Based on the phone sensor data, the researchers could identify people with depressive symptoms with 87 percent accuracy.

Telemedicine

The Mississippi Board of Medical Licensure withdraws a proposed rule that would require telemedicine companies operating in Mississippi to establish a formal agreement with a Mississippi-based healthcare entity and to use only secured video conferencing when medication is prescribed. The board has decided to commission an economic impact statement before it decides on a final rule. Teladoc chimed in with a statement declaring that the proposed rule would be “unreasonably limiting” to Mississippi physicians looking to practice via telemedicine.

The Federation of State Medical Boards will receive a $225,000 grant from the Health Resources and Services Administration to implement the Interstate Medical Licensure Compact, which will help to expedite physician licensing processes across state lines. FSMB will use the funding to develop specifications for technical infrastructure and educational outreach.

Senators Joni Ernst (R-IA) and Mazie Hirono (D-HI) introduce the Telemedicine for Medicare (TELE-MED) Act, a bill that would enable Medicare patients to receive care across state lines via telemedicine. The bipartisan bill has gained the support of the Healthcare Leadership Council, Health IT Now Coalition, and the Parkinson’s Action Network.

Government and Politics

The #SaveAHRQ movement has transcended Twitter and landed in Congress, courtesy of a letter sent by nearly 200 organizations calling for the Senate to spare the agency from the its proposed 35-percent funding cut. The House, as you may recall, has proposed doing away with the agency entirely in 2016.

Mark your calendars: Politico reports that ONC will hold its annual Consumer Summit in Washington, D.C. on October 1, lending even more weight to a date that is already fortunate enough to be associated with my birth and the transition to ICD-10.

Other

Athenahealth CEO Jonathan Bush calls the rise of the convenient care movement one of the most important in the last decade, pointing out the retail power of a company like Target, and the overall impact it will have on healthcare’s demand curve (not to mention the leverage it has in demanding that local healthcare organizations connect to its IT systems, rather than the other way around.)

Ancestry.com launches AncestryHealth, a product the company hopes will enable consumers to create a digital record of diseases and causes of death that have affected their families over the decades. The company is working on a corresponding mobile app, and plans to partner with EHR vendors so that users can share family health histories electronically. The company, which also offers AncestryDNA, plans to add genetic information to the mix soon via its own testing service.

Sponsor Updates

• NVoq offers “Your iPhone has Good Dictation. Why Doesn’t your Enterprise Application?”
• PerfectServe offers “Care Transitions – Tips for Bridging the Gaps.”
• Greenway Health announces its new brand. (Check out my interview with CEO Tee Green about the rebranding and refreshed company focus here.)

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.