News 7/13/15

Top News

The House passes the 21st Century Cures Act in a 344-77 vote. Though the bipartisan bill has gained the support of hundreds of health groups, it has yet to fully win the hearts and minds of the AMA, which has expressed continued discontent with its interoperability section, which “would refocus national efforts on making systems interoperable and holding individuals responsible for blocking or otherwise inhibiting the flow of patient information throughout our healthcare system.”

Webinars

July 14 (Tuesday) noon ET. “What Health Care Can Learn from Silicon Valley.” Sponsored by Athenahealth. Presenter: Ed Park, EVP/COO, Athenahealth. Ed will discuss how an open business structure and strong customer focus have helped fuel success among the most prominent tech companies and what health care can learn from their strategies.

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.

Previous webinars are on the YouTube channel. Contact Lorre for webinar services including discounts for signing up by July 31.

Tweet Chat

Don’t miss the next #HIStalking tweet chat on July 16 at 1pm ET. Dave Chase (@chasedave) and Leonard Kish (@leonardkish), co-authors of “95 Theses for a New Health Ecosystem,” will host. Check out discussion topics here.

Acquisitions, Funding, Business, and Stock

Greenway Health gives followers a sneak peek of its new brand.

Forbes takes a look at the rising pay of primary care docs in the wake of an uptick in value-based payments and the tried-and-true law of supply and demand. While the percentage of medical grads electing family practice fell by half between 1997 and 2009, that number may soon be on a sluggish upswing thanks to the downstream financial gains primary care practices are now bringing to their health system overlords.

Announcements and Implementations

Medfusion launches a new patient payment and revenue management solution. Medfusion Pay includes a mobile pre-check app and online bill pay for patients, and payment processing dashboard and POS terminal for physicians.

NextGen connects to the state of Massachusetts’s three year-old Mass HIway HIE via its NextGen Share HISP solution. 

Online training company Relias Learning will offer ICD-10 educational courses from DecisionHealth via its Relias Learning Management System. The 70 courses are targeted to administrators, clinical staff, billers, and intake staff.

Telemedicine

The City of Kansas City, MO partners with the Kansas City Health Care Trust, Blue Cross and Blue Shield of Kansas City, and Mosaic Life Care to install a telehealth kiosk for employees at City Hall. “It’s an excellent way to make it easier on employees when they have minor illnesses or injuries, notes City Councilman John Sharp. “Not only is it convenient, but it is also affordable, with no copays or deductibles. Employees do not have to pay a thing to receive care.”

People

KaZee promotes Michael “Mickey” Bourdeau to CEO. Former CEO and company founder Albert Woodard will become chairman of the board. 

Research and Innovation

An AMA study finds that over 60 percent of physicians still work in small practices of 10 or fewer physicians, and that practice size did not change much between 2012 and 2014, despite healthcare delivery reforms. Other nuggets from the study include: physician practice ownership decreased from 53.2 percent to 50.8 percent, while hospital ownership of practices increased from 23.4 percent to 25.6 percent. Solo physician practices decreased from 18.4 percent to 17.1 percent.

Other

Houston-based cardiologist and Texas Medical Association President Tom Garcia, MD makes no bones about his lack of love for ICD-10, emphasizing the burden it will place on the 60-70 percent of TMA members that have not yet adopted EHRs. He also notes that some physicians believe it’s an attempt by large corporations with strong lobbying clout to get access to patient information to obtain and then sell it. “These people are salivating to get this data,” he says, “so they can mine this data to determine what is the best way to make money off the relationship between the doctor and the patient.”

Contacts

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

More news: HIStalk, HIStalk Connect.

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Democratizing Health Data – #HIStalking Tweet Chat Thursday, July 16 at 1pm ET

Join Dave Chase (@chasedave) and Leonard Kish (@leonardkish), co-authors of “95 Theses for a New Health Ecosystem,” plus @JennHIStalk on Thursday, July 16 at 1pm ET for a lively #HIStalking chat about the ways in which healthcare will reach its fullest potential with new incentives and the democratization of health information. Dave and Leonard have based their discussion topics on four of their theses, plus thrown in a fifth for good measure:

#HIStalking Discussion Questions

Thesis #2
"Open source, open APIs, and open knowledge (such as wikis) will become central to defining a common architecture to support this new science. These are modern versions of peer-review."
Q1: Interoperability is relatively easy with more open frameworks. Beyond Meaningful Use, how do we create the will for more open frameworks?

Thesis #8
"Open access to information will enable individuals to make the best decisions and become well-informed individuals, particularly when curated and contextualized by clinicians."
Q2: How do we enable better curated data for individuals? Will physician jobs shift to become trusted curators?

Thesis #73
"The best care is and will be collaborative beyond the walls of any one institution. Just as “the smartest people work for someone else,” the smartest providers practice outside of this clinic and this hospital. The smartest provider may, in fact, be a collective, or the crowd. New ways to open communications will drive better care."
Q3:  How do we provide more open communications beyond interoperability? Can current EHRs become communication tools?

Thesis #85.
Customers will, in effect, “self-deny” their own claims. A new metric for success is the “Negaclaim” — an unnecessary claim avoided. This isn’t about denying care. Just as energy consumers aren’t interested in kilowatt hours, individuals aren’t interested in health claims. They want health restored and diseases prevented.
Q4: What is the role of today’s EHR in a future without traditional claims for payment. Can they adapt?

We’ll finish up with a more general question about how to create a more open world and virtuous cycle where everyone’s small data can become part of societal big data, and how we incentivize this cycle and manage the process.
Q5: To get to a data-driven, precision health, and precision medicine future, how do we create a virtuous circle between individual data, "a Google Map of me" and big data?

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

More news: HIStalk, HIStalk Connect.

Get HIStalk Practice  updates.
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Population Health Management Weekly Wrap Up 7/10/15

Top News

The Minnesota Dept. of Human Services selects data management, analysis, and data access and reporting resources from 3M Health Information Systems to support its Integrated Health Partnership initiative, which serves 204,000 residents on Medical Assistance. The new tools will help the partnership’s 16 healthcare organizations analyze cost of care, service utilization, and risk data to better identify cost savings and care transformation opportunities.

Webinars

July 14 (Tuesday) noon ET. “What Health Care Can Learn from Silicon Valley.” Sponsored by Athenahealth. Presenter: Ed Park, EVP/COO, Athenahealth. Ed will discuss how an open business structure and strong customer focus have helped fuel success among the most prominent tech companies and what health care can learn from their strategies.

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.

Previous webinars are on the YouTube channel. Contact Lorre for webinar services including discounts for signing up by July 31.

Tweet Chat

Don’t miss the next #HIStalking tweet chat on July 16 at 1pm ET. Dave Chase (@chasedave) and Leonard Kish (@leonardkish), co-authors of “95 Theses for a New Health Ecosystem,” will host. Stay tuned for discussion topics.

Acquisitions, Funding, Business, and Stock

PM and population health technology company Privia Health partners with Shenandoah Independent Practice Association (VA) to manage its population health activities, including management of its 400-provider ACO. In addition, Privia’s Quality Network will become the exclusive contracting entity for all of SIPA’s performance-based arrangements and clinical integration initiatives.

Florida Blue’s GuideWell division partners with population health management tech company Alignment Healthcare to launch primary care clinics for seniors beginning in January 2016.

Announcements and Implementations

VisiQuate launches Team Performance Analytics, Missing Charges Analytics, and the Flo 2.0 advanced operational business intelligence and workflow engine.

RCM solutions company PMMC adds a benchmarking module to its Online Analytics market analysis tool. The new module will give users access to portions of the CMS Standard Analytics File that have been formatted around bundling and population health initiatives.

Sogeti USA launches the Data Driven Decisions for Healthcare platform incorporating analytics and interface tools from Microsoft and HP. The new solution, which targets providers caring for chronic and complex patients, is the first in a series of similar products for multiple verticals.

Indiana Regional Medical Center selects Aegis Health Group to help improve its population health management programs. Aegis will help IRMC implement its OneCommunity website, which allows users to track health and wellness activities, and employers to anticipate worker health needs and hospital services.

Summa Health (OH) chooses Merge Healthcare’s cardiology and hemodynamic solutions to support its population health and wellness initiatives.

Cerner and University of Missouri extend their healthcare collaboration, which includes the Tiger Institute for Health Innovation, for another 10 years. They will add the Tiger Institute Leadership Academy to host industry peers and place new emphasis on mobile healthcare and population health.

Florida-based PremierMD ACO selects the eClinicalWorks CCMR population health platform to help it evaluate population health and quality improvement initiatives, and advance its ACO objectives. PremierMD has also named eCW as its preferred EHR solution.

Government and Politics

President Obama nominates Andrew Slavitt as the next CMS administrator, a position he has held on an interim basis since Marilyn Tavenner stepped down in February.

People

Arcadia Healthcare Solutions names Richard Parker, MD (Beth Israel Deaconess Care Organization) as chief medical officer.

Vanderbilt University Hospital promotes Mitchell Edgeworth to CEO of Vanderbilt University Adult Hospital and Clinics. He succeeds David Posch, who has been named to the newly created position of associate vice chancellor for population health.

Research and Innovation

A California Healthline report highlights Way to Wellville,  a year-old health technology project run by technology investor Esther Dyson that will try to address the public health problems in a rural California county and four other US locations. They’re using IBM Watson to target more Medicaid signups and hope to use iPhone collaboration and Fitbit monitoring. The county’s public health officer seems skeptical in how Silicon Valley types can parachute in and change the county’s culture.

Sponsor Updates

• GE Healthcare partners with the NBA to promote orthopedic and sports medicine research.
• Medicomp Systems offers “Addiction vs. Innovation.”
• Nordic offers the latest episode of its “Making the Cut” video series on Epic conversion planning.

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 7/9/15

Top News

CMS releases its proposed Physician Fee Schedule for 2016, its first since the repeal of the Sustainable Growth Rate through the Medicare Access and CHIP Reauthorization Act of 2015. At 800-plus pages, the draft contains a number of items relating to healthcare IT, including:

• Potential expansion of Medicare’s comprehensive primary care initiative, which is intended to boost primary care with technology, and to reward physicians more with value-based payments.
• The ability of rural health clinics and qualified health centers to use the new chronic care management code, provided they use current, certified EHRs and are available to patients via secure messaging.
• Payment for some in-home telemedicine services related to end-stage renal disease counseling, and unique cases of prolonged observation.

Webinars

July 14 (Tuesday) noon ET. “What Health Care Can Learn from Silicon Valley.” Sponsored by Athenahealth. Presenter: Ed Park, EVP/COO, Athenahealth. Ed will discuss how an open business structure and strong customer focus have helped fuel success among the most prominent tech companies and what health care can learn from their strategies.

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.

Previous webinars are on the YouTube channel. Contact Lorre for webinar services including discounts for signing up by July 31.

Tweet Chat

Don’t miss the next #HIStalking tweet chat on July 16 at 1pm ET. Dave Chase (@chasedave) and Leonard Kish (@leonardkish), co-authors of “95 Theses for a New Health Ecosystem,” will host. Stay tuned for discussion topics.

Announcements and Implementations

OU Physicians, Oklahoma’s largest physicians group, posts patient satisfaction survey rates on its website in an effort to promote transparency and accountability. “We’re proud of the care we deliver and we want patients to see what their peers are saying about our providers, whether that feedback is positive or negative,” explains CEO Brian Maddy.

Triarq Health will integrate TransFirst’s electronic payment processing technology into its gloStream EHR.

Telemedicine

Mississippi Governor Phil Bryant officially welcomes TelehealthOne, the state’s first and only telemedicine business, to Madison County during a ribbon-cutting ceremony. The company, which helped local Mosby’s drug store become the first private pharmacy to offer telemedicine services, anticipates creating 40 jobs over the next 12 months.

Fruit Street Health receives an undisclosed amount of seed funding from unnamed physicians and angel investors, bringing its total funding to $1.7 million since it launched just over a year ago. The company made news earlier this summer when it partnered with Validic to integrate data from 175 wearable devices and apps into its telehealth and wellness software.

People

Bert Miuccio (Transport for Christ) joins HealthTeamWorks as CEO. Former CEO Marjie Harbrecht, MD has taken on the role of chief medical and innovation officer.

Harbin Clinic (GA) promotes Marc Dean, MD to assistant medical director of clinical informatics; and Kelly Mayfield, MD to assistant director of medical malpractice, risk management & compliance.

Government and Politics

The White House voices its approval of the 21st Century Cures Act bill making its way through Congress, specifically pointing out the roll its Precision Medicine Initiative will play in advancing care. The administration subtly adds that the initiative’s success will “require enabling patients to access their data and accelerating interoperability between electronic health records.”

Research and Innovation

Harvard researchers put 23 online symptom checkers to the test, finding that the different software algorithms listed the correct diagnosis first in 34 percent of cases, and provided accurate triage advice in 58 percent of cases. Researchers also found that tools with the most accurate diagnoses (Isabel, iTriage, Mayo Clinic, and Symcat) were not among those that did the best job of recommending appropriate levels of care.

Other

ESPN reporter Adam Schefter tweets images of NFL player Jason Pierre-Paul’s medical records alongside the news he had his right finger amputated, prompting cries of HIPAA violations from patient privacy watchdogs. Sports Illustrated legal analyst Michael McCann quickly tweeted in, noting that an employee of Jackson Memorial Hospital – not ESPN – would likely face the HIPAA police.

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.

HIStalk Practice Interviews Michael Dueñas, OD Chief Public Health Officer, American Optometric Association

Michael Dueñas, OD is chief public health officer of the American Optometric Association. The St. Louis-based organization made news recently for its efforts to develop a Measures and Outcomes Registry for Eyecare (MORE) with data from an initial set of six EHR vendors – Eyecare Advantage from Compulink Business Systems, MaximEyes from First Insight, RevolutionEHR from Health Innovation Technologies, Eyefinity EHR, Crystal Practice Management, and Practice Director EHR from Williams Group.

Tell me about yourself and the AOA.
I have been with the association a little over 6 years. I came to the AOA as President Obama came into office, leaving my post in as a health scientist at the CDC just as my wife was recruited by the new administration to serve in a senior position at EPA headquarters in Washington, D.C. While at the CDC, I served on the ONC’s Review Task Force and helped establish vision modules for national surveys (BRFSS and NHANES); and on the Podiatry, Pharmacy, Optometry and Dentistry (PPOD) working group of the National Diabetes Education Program (NDEP), framed by an operational example of my own practice’s integrated clinical approach to diabetes care.

Prior to the CDC, my professional experience included private clinical and hospital-based optometry practice, teaching, and applied research with a focus on the public health and epidemiology of diabetes and other chronic diseases.

With regard to the AOA, it represents 33,000 doctors of optometry and optometry students. Optometrists serve patients in nearly 6,500 communities across the country, and are the only eye doctors in 3,500 of those communities.

What was the impetus for creating the MORE registry project?
The registry project, the first of its kind for optometry, was initiated by the AOA Board of Trustees in response to the growing emphasis on quality reporting and measurements through registries as part of healthcare. It will allow optometry, as a profession, to analyze clinical outcomes for the benefit of improving care over time. It will also enable us to advocate to insurance regulators, state legislatures, and the public about the services and value of our profession. For example, with data from MORE, we can advocate to the media and public about patient demographics and the quality eye exams we collectively perform.

Why were the six initial EHR vendors chosen to contribute registry data? Is AOA be open to working with additional vendors in the future?
MORE requires the use of one of our approved EHR vendors. The list of approved vendors is constantly expanding. AOA has worked with these initial EHR vendors to ensure that data entered into the electronic exam record of ODs flows accurately to MORE. A cloud based platform is a necessity.

Each week, the participating EHR vendors send clinical data from their systems to MORE’s receiving area. It is not going into EHRs to get data. The information is “pushed” from their EHR to MORE by systems their EHR vendors put into place. Data is encrypted using industrial-strength encryption and remains encrypted while in transit and at rest. Once the data has been validated and processed, it is imported into the registry where it is stored securely.

MORE will expand to add additional EHR vendors. We track EHR vendors in use by ODs and the demand for additional vendors going forward. In addition, we encourage ODs to let their vendor know their preference to participate in the registry.

How long do you anticipate the registry will be in development?
The short answer is it will be in constant development and will keep abreast and ahead of federal requirements. Its query functionality will enable us to better understand how and where to expand its functions to provide essential data to improve healthcare systems and remain more patient centered in our care.

What do you hope AOA members will use it for once its operational?
ODs will be able to access statistics derived from their own patient base by viewing the AOA MORE dashboard. The registry is preprogrammed to provide statistics on many topics including patient demographics compared to national averages; most common diagnosis codes compared to national averages; and most common medicines prescribed compared to national averages. Benchmarking is a privately viewed comparison of an OD’s care to the profession as a whole. For example, ODs can see their individual performance rates on PQRS measures or the number of glaucoma patients they diagnose compared to national registry averages in optometry.

MORE will also help ODs stay compliant by tracking encamps, and assist with Meaningful Use Stages 2 and 3 and PQRS reporting. In MU2, optometrists need to meet core objectives, menu set objectives and also CQM objectives. In general for CQMs, optometrists must meet nine different CQM objectives to satisfy MU2 criteria. Examples include recording full medication lists our patients are using, screening for tobacco use, and sending a letter to a primary care physician when our patient has diabetic retinopathy.

The same logic is now applying to PQRS. We must meet nine different objectives to avoid a PQRS penalty. Some of the ideas will overlap (sending a letter to a PCP about diabetic retinopathy is found in both PQRS and as a CQM in MU2).

Why did you choose to partner with Prometheus Research on the registry project?
We partnered with Prometheus Research because of their experience and reputation in developing high-quality registries. They have spent the past decade building integrated registries to address the challenges of acquiring, integrating, and repurposing health data for biomedical researchers, academic health centers, philanthropic institutions, and professional societies. Staffed by a unique combination of clinical research informaticians and open-source software engineers, they stand apart from traditional “registry” companies with a partnership model that avoids software licensing fees and vendor lock-in strategies. Instead, they are in favor of empowering their clients to the point that they will no longer need most — if not all — of expert data management consultation from Prometheus once the registry is completely built and running. Of course, Prometheus Research will continue to house and maintain the registry for AOA into the future and make improvements as needed.

How have you seen AOA members embrace healthcare IT like EHRs over the last several years?
Doctors of optometry have participated in the Medicare and Medicaid EHR incentive programs in strong numbers. Since its inception, nearly 17,000 doctors of optometry have enrolled to participate in the Medicare or Medicaid EHR incentive programs and more than 12,000 have achieved Meaningful Use. Optometrists treat millions of Medicare and Medicaid beneficiaries annually, and the AOA encourages its members to use EHRs to enhance that care.

A registry will allow ODs to participate in the new value-based payment system that Medicare and other insurers are using. Participation in a registry is one of the requirements for maximum reimbursement rates by Medicare. This new Merit-based Incentive Payment System (MIPS) includes PQRS, Meaningful Use, and other clinical quality improvement measures.

Do you anticipate any barriers to MORE adoption?
2017 PQRS data will be the first time AOA MORE is able to submit to CMS on behalf of optometrists (reported by the end of February 2018). This means that even though ODs will be using AOA MORE during 2015 and 2016, they will still need to submit their own PQRS data (either claims-based or EHR-based) during 2015 and 2016.

A noted barrier includes the CMS rule that requires any registry to be functioning for one full year prior to applying for qualified status. Think of this CMS requirement as a registry "practice year." CMS wants to ensure that every registry is properly working for one year before they deem it an official “qualified” registry for PQRS. Furthermore, the CMS rule states that registry start dates must be January 1 of a given year. With these CMS rules in mind, AOA will get doctors integrated and acclimated to MORE during 2015 and beyond. While you will be able to view your PQRS dashboard metrics in MORE during this time, it will not be officially submit your PQRS data to CMS until early 2018 for your 2017 data. Continue to submit on your own for your patients in 2015 and 2016.

That being said, MORE advantages include ease of use and cost. As I mentioned previously, there is no manual entry required for MORE, and members can sign into MORE using their AOA.org login credentials. MORE is a member benefit to those who are current with their dues. Non-AOA members will pay $1,800 per year to use it.

Do you have any final thoughts?
In addition to the advocacy efforts I mentioned, AOA is using the new registry to apply for its first ever CMS TCPI Support and Alignment Network Grant for $3 million over four years. MORE will also provide de-identified data that may better describe the importance of a comprehensive eye exam by a doctor of optometry to children entering first grade, where currently two in five children begin first grade anchored by refractive errors, focusing issues, and alignment difficulties. These are most often missed by vision screening, which suffers a 73-percent error rate.

In closing, I learned very well while I was at the CDC that, “In God we trust, all others bring data.” Through MORE, the AOA will now have that data.

Contacts

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

More news: HIStalk, HIStalk Connect.

Get HIStalk Practice  updates.
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Become a sponsor.