5 Questions with Shaun Ginter, CEO, CareWell Urgent Care

Shaun Ginter is CEO of CareWell Urgent Care, a chain of 10 urgent care facilities in Massachusetts and Rhode Island that serves 130,000 patients each year. The organization is in the midst of migrating from an EHR that did not support Meaningful Use attestation to Athenahealth’s platform. As Ginter explains it, “The MU attestation process requires registration of all the physicians under CareWell. Providers who have registered elsewhere can take more than a year to change their attestation site. Because we are a new company and many physicians are new hires from other sites, this has been a work in progress. The goal is to have all the full time providers in the process at year’s end.”

You have a history of working in the retail pharmacy/urgent care space. How have you seen technology help these types of healthcare facilities evolve into more consumer-focused businesses?
Yes, in the past decade there have been many innovations in technology and new products that help us focus on the consumer. These include marketing tools, consumer-friendly websites (mobile and PC), online appointments, social media, merchant services, customer satisfaction survey tools and many others.

What EHR vendor did you switch from? Why the decision to change, and why specifically go with Athenahealth?
We moved from a vendor that had a product built with the EHR in mind and less focus on the PM side of the house. We still have a good working relationship with them. We have a large focus on the business analytics, performance metrics, and revenue cycle management side of the equation. Based on our research and due diligence, Athenahealth was able to satisfy all our requirements and then some.

How do you believe cloud-based solutions will help urgent care facilities better manage population health as part of the broader continuum of care?
Cloud-based systems provide urgent care centers with a level of sophistication that comes from a full understanding of the healthcare landscape throughout the country. Athenahealth has thousands of interfaces that allow our EHR to communicate with just about any system in use today.

Do you foresee CareWell tapping into local/regional HIEs?
Yes, we are currently working on connecting to the Mass Highway. which will allow us to share information on our patients through this HIE. With our new EHR, we also have the opportunity to connect directly to any health systems or large groups using preexisting interfaces.

What are your thoughts on the state of interoperability as it relates to urgent care? Do you foresee organizations like CareWell becoming a part of groups like CommonWell?
Urgent care providers around the country are looking at ways to move forward with interoperability. The challenges we all face are the costs of this technology and the understanding of how interoperability will improve the care of our patients in the long run. We do not know enough specifically regarding CommonWell. However, if we can determine that system interoperability can and will improve patient outcomes then we would consider it.  There is good potential with these systems; we just don’t know enough about them as of yet.

Contacts

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

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News 5/12/15

Top News

MinuteClinic announces it has seen over 25 million patient visits since it first opened in 2000. Acquired by CVS Health in 2006, the retail clinic now has 1,000 locations in 31 states, with plans to surpass 1,500 by 2017. It is in the midst of rolling out Epic’s EHR across all of its sites.

Webinars

May 19 (Tuesday) 2:00 ET. “Lock the Windows, Not Just the Door: Why Most Healthcare Breaches Involve Phishing Attacks and How to Prevent Them.” Sponsored by Imprivata. Presenters: Glynn Stanton, CISSP, information security manager, Yale New Haven Health System; David Ting, CTO, Imprivata. Nearly half of healthcare organizations will be successfully cyberhacked in 2015, many of them by hackers who thwart perimeter defenses by using social engineering instead. The entire network is exposed if even one employee is fooled by what looks like a security warning or Office update prompt and enters their login credentials. This webinar will provide real-world strategies for protecting against these attacks.

May 20 (Wednesday) 1:00 ET. “Principles and Priorities of Accountable Care Transformation.” Sponsored by Health Catalyst. Presenter: Marie Dunn, director of analytics, Health Catalyst. Healthcare systems must build the competencies needed to succeed under value-based payment models while remaining financially viable in the fee-for-service landscape. This webinar will outline key near-term priorities for building competency at successfully managing at-risk contracts, with a particular focus on the importance of leveraging data to drive effective decision making.

I had a nice chat with Regina Holliday in our most recent webinar. We had a chance to discuss the evolution of the patient advocacy movement in health IT circles, next steps for The Walking Gallery, and the best ways for patient advocates to be effectively disruptive at large industry events.

Tweet Chat

Amanda Greene (@LAlupusLady) will host the next #HIStalking tweet chat on Thursday, May 14 at 1pm ET. As a lupus sufferer, she’s is particularly excited about hosting during Lupus Awareness Month. You can view discussion topics here.

Announcements and Implementations

Non-profit Delaware Health Net selects SA Ignite’s MU Assistant software to help its FQHCs access quality performance data within their respective EHRs, and improve their ability to monitor Meaningful Use attestation progress.

In other Delaware news … Aledade announces that its Delaware-based ACO has doubled in size to 24 doctors in the first four months of this year. The ACO, whose daily operations are managed by Quality Insights of Delaware, now covers 18,000 Medicare patients.

Alliance Health and Amiigo partner for a new chronic care management program, which will merge patient data collected using Amiigo wearables with patient-reported data gathered through Alliance Health’s social networking platform. The data will then be shared with care teams in an effort to reduce treatment costs and improve outcomes. The companies are working on a pilot program focusing on 300 patients who are at-risk for cardiovascular events.

Telemedicine

Dean Lewis (University City Science Center) joins MyTelemedicine.com as CFO and COO.

Government and Politics

Massachusetts Governor Charlie Baker deals with fallout from a Pioneer Institute study that contends the state’s administration acted illegally in attempts to cover up the disastrous rollout of its health insurance exchange in 2013. Comments from anonymous whistleblowers that worked on the rollout of the Health Connector site are peppered throughout the report, including gems like this one: “It’s like when you’re a kid and you do something wrong and you are waiting to be caught. We were waiting for people to realize how bad this was.”

Research and Innovation

An AAFP study finds that family doctors who provide more care themselves, rather than passing it off to specialists, reduce hospitalizations and healthcare costs. The study also found that physicians who performed a wider range of services reduced overall patient costs by between 10 and 15 percent. Accompanying commentary notes that, “This probably trumps any other innovation in terms of reducing Medicare costs.”

A survey of clinicians who participate in the Meaningful Use program and who work for practices that have earned patient-centered medical home status finds that only half of them receive timely notification of hospital discharges, a capability they believe is “very important.” One-fourth of the respondents actually worked for hospital-owned practices, so the percentage of independent practices that receive hospital discharge alerts for their patients is pretty abysmal.

People

Michael Murphy (Sharp HealthCare) replaces David Feinberg, MD on the Cal INDEX Board of Directors.

Other

Family practice physician Edward Bujold, MD paints a pretty clear picture of the frustration he and his staff have experienced as a result of keeping up with the certifications, attestations, and other regulatory paperwork that go along with patient-centered medical home status:

“The NCQA and the Office of the National Coordinator say they are improving care, but I don’t see them improving their recognition processes in ways that relieve the burden of work placed on practices that have active quality improvement programs. I am considering walking away from the PCMH recognition process even though I believe in the practice transformation it is intended to guide. I realize that if we decide not to seek ongoing recognition as a PCMH, we will suffer financial hardship, but we have more important business at hand—taking excellent care of patients, improving our practice, and engaging with our patients in a meaningful way.”

A KQED Science article covers patients accessing their own data, the MUS3 dial-back of view / download / transmit requirements, the cost of obtaining copies of medical information, and the lack of provider incentive to provide it.

The Brookings Institution publishes a concise, easy-to-read paper on the “Origins and Future of Accountable Care Organizations.”

Mashable points out that every date this week is a palindrome (in the U.S.), and suggests we celebrate by “buying a race car, eating an evil olive or saying the phrase ‘Mr. Owl ate my metal worm’ over and over again.”

Contacts

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

More news: HIStalk, HIStalk Connect.

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Passion in Action During Lupus Awareness Month – #HIStalking Tweet Chat Thursday, May 14 at 1 pm ET

Join @JennHIStalk and @LAlupusLady (Amanda Greene) for a discussion on the role of technology and patient communities, with a special focus on Lupus Awareness Month taking place in May. You can check out her background here, preview discussion questions below, and brush up on how to participate in a tweet chat towards the end of this post.

#HIStalking Discussion Questions

“As a Lupus patient for over 33 years, it is especially poignant for me to lead the chat during Lupus Awareness Month. I am a proud healthcare advocate and will travel to Washington, D.C. this June as part of the  National Lupus Advocacy Summit, sharing my passion on Capitol Hill. I would like to focus the chat on how patients can take active roles in their health and advocacy, highlighting passion in action.”

Q1 How does your health impact your life?

Q2 How have you or your care team used technology to improve your health?

Q3 How can you become your own best advocate in improving your health?

Q4 How have you seen online communities turn patient concerns into action with impact?

Q5 What resources, tech, apps do you recommend for lupus patients/advocates?

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.

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News 5/11/15

Top News

Grove Medical Associates (MA) is named a 2015 HIMSS Ambulatory Davies Award recipient in recognition of its use of healthcare IT to improve patient outcomes while achieving ROI. The internal medicine practice, which implemented its eClinicalWorks EHR in 2005 and patient portal in 2007, is affiliated with the Central Massachusetts Independent Physicians Association.

Webinars

May 12 (Tuesday) 1:00 ET. “HIStalk Interviews Regina Holliday.” Catch up with Regina Holliday and her recent patient advocacy efforts as she chats with HIStalk’s Lorre and Jenn about the HIMSS conference, The Walking Gallery, her upcoming advocacy events, and her new book. Regina will talk about how providers and vendors are working to make the patient voice heard.

May 19 (Tuesday) 2:00 ET. “Lock the Windows, Not Just the Door: Why Most Healthcare Breaches Involve Phishing Attacks and How to Prevent Them.” Sponsored by Imprivata. Presenters: Glynn Stanton, CISSP, information security manager, Yale New Haven Health System; David Ting, CTO, Imprivata. Nearly half of healthcare organizations will be successfully cyberhacked in 2015, many of them by hackers who thwart perimeter defenses by using social engineering instead. The entire network is exposed if even one employee is fooled by what looks like a security warning or Office update prompt and enters their login credentials. This webinar will provide real-world strategies for protecting against these attacks.

May 20 (Wednesday) 1:00 ET. “Principles and Priorities of Accountable Care Transformation.” Sponsored by Health Catalyst. Presenter: Marie Dunn, director of analytics, Health Catalyst. Healthcare systems must build the competencies needed to succeed under value-based payment models while remaining financially viable in the fee-for-service landscape. This webinar will outline key near-term priorities for building competency at successfully managing at-risk contracts, with a particular focus on the importance of leveraging data to drive effective decision making.

Acquisitions, Funding, Business, and Stock

Sixteen startups faceoff this week in the Challenge Cup semifinals in Washington, D.C. Presented by local Incubator 1776 and Philips, the event will whittle the competition down to eight businesses, two of which will ultimately walk away with $50,000 each. Keet, a startup focused on patient engagement and PM tools for physical therapists, is covering its investment bases by competing in the challenge and participating in Healthbox’s new Miami Studio.

DrFirst raises $3.5 million in new financing.

Announcements and Implementations

New Jersey-based Regional Cancer Care Associates and Osler Health IPA collaborate to share data between their physicians via combined use of RCCA’s COSTA analytics tool and Osler’s proprietary MDclick population health management, disease severity stratification, and analytics platform.

Research and Innovation

A University of Michigan study finds that patients aged 9-18 were almost three times as likely to receive the HPV vaccine when their physicians received EHR reminders. Similarly aged patients were also 10 times more likely to complete the vaccine regimen when reminders were issued. Author Mack Ruffin, MD stresses that “workflow and culture of individual clinics is also a critical factor when it comes to prompts influencing vaccine rates.”

Government and Politics

Connecticut Senate President Pro Tempore Martin Looney (D-New Haven) and Senate Minority Leader Len Fasano call for support statewide interoperability in Bill 812, which outlines the need for implementation of EHRs and a publicly accountable HIE, while banning the practice of information blocking on the part of health systems and vendors. Introduced at the beginning of this year, the bill now faces review by the Committee on Appropriations.

Telemedicine

The American Association of Telemedicine awards its second Accreditation for Online Patient Consultations to mental health services provider HealthLinkNow. The business was launched five years ago by a husband and wife team with backgrounds in psychiatry and nursing.

The Center for Telehealth and E-Health Law crunch CMS numbers to find that Medicare paid out nearly $14 million for telemedicine services in 2014, compared to about $12 million in 2013. Both figures are far below the original 2001 Congressional Budget Office estimate of $30 million a year for telehealth encounter reimbursements.

Former U.S. Senator and Teladoc Board Member Bill Frist, MD fails to mention his business ties in a Fortune op-ed advocating for telemedicine services in Texas.

Prescription benefit management company Appro Rx President Kyle Fields invests $100,000 in Appro Connect, a new company that will install telehealth kiosks in independent pharmacies and workplaces. Kiosk users will connect to physicians via the Doctor on Demand app. A prototype will debut later this month near the company’s headquarters in Waynesville, Ohio, with a wider roll out expected this summer. 

Other

University of Melbourne Professor Alan Lopez suggests that mobile phones be used to transmit birth and death statistics, enabling public health officials to collect patient data that physicians could then use to determine the most common causes of death. Lopez doesn’t go into detail about how this would play out technologically, aside from a vague reference to algorithms, though he does point out that “140 countries, or 80 percent of the world’s population do not have reliable cause of death statistics. How can you influence country and global policy and intervention programs if you don’t know the underlying causes of illness and death?”

An Amazon patent application suggests the company is looking for ways to have its drones come directly to wherever a user’s smartphone is located via a “Bring it to Me” delivery option. I wonder if this likely super-pricey option is just the first step in Amazon’s bid to takeover the drive-through pharmacy business model.

Sponsor Updates

• Medicity’s Brian Ahier contributes “5 things we have to do to make health IT work.”
• Nordic focuses on pharmacy in the sixth installment of its “Making the Cut” video series on Epic conversion planning.
• Versus Technology offers “Nursing’s Impact on Patient Care Transcends the Bedside.”
• Healthwise offers “Apps and APIs: A Positive Step for Patients.”

Contacts

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

More news: HIStalk, HIStalk Connect.

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Readers Write: ICD-10 – To Train or Not to Train?

ICD-10: To Train or Not to Train?
By Caleb Clarke

We’re getting close. The much anticipated transition to ICD-10 is set for Oct. 1, 2015 – only five months away. While many people are adamant that we must move forward, there is still talk of another delay. This puts healthcare professionals, especially those in small practices, in a tough position.

Aside from all of their external partners (payers, clearinghouses, software vendors, etc.), coders, billers, and physicians have a lot to learn to adapt to the new changes in coding standards. To spend significant time training and preparing, only to be hit with another delay, can be very frustrating.

Personally, I think the deadline will hold, and I believe ICD-10 will benefit our industry immensely in the long run. That said, findings from our recent “Attitudes Towards ICD-10” survey make me a little uneasy.

The survey says …

A little background: We’ve conducted three “Attitudes Towards ICD-10” surveys since 2012. Our goal is to get a sense of whether or not people’s attitudes and expectations are changing as we near the transition deadline. In the past, we saw significant resistance to ICD-10, especially among smaller practices. This year was no exception.

Right off the bat, we asked respondents how they felt about the new coding standards and the proposed timeline. In both cases, the top response was “There should be no transition to ICD-10” (a little less than a third for both questions). Unfortunately, these numbers aren’t much different than those from the past two surveys.

Participants reported the highest level of concern for “claims processing,” with 65 percent saying they’re “significantly” or “highly” concerned. When asked how they expect the switch to affect certain areas of their business, “finances” and “operations” drew the most negative outlook, with 70 percent saying they expect negative effects.

Training, or lack thereof

To get an idea of how much progress people are making in terms of training, we asked about their level of concern as it relates to “training and education” — the majority (56 percent) said they were “significantly” or “highly” concerned.

When we asked how confident they were that their employees will be adequately trained by October 1st, 35 percent said “not at all confident,” with only 11 percent noting they are “highly confident.” Five months out, we had hoped those numbers would be a little more skewed in the positive direction. So that brings us back to the question at hand …

To train, or not to train?

We know it can be tough with the chance of another delay looming, but … yes, train! Even if there is another delay, it’s too risky to wait. People’s concerns about claims getting backed up and finances struggling are very real threats. It can be difficult to account for all of your external partners, but one thing you can do is make sure your coders, billers, and physicians are comfortable and ready with the new code set.

If you’re able to spend a little extra time and money, there are several training programs you can invest in. For example, both the AAPC and AHIMA offer training webinars, resources, and assessments. Prices for the materials generally range from $100 to several hundred dollars each.

We also highly recommend checking out RoadTo10.org, the “one-stop source for all things ICD-10” from CMS. You’ll find a wealth of free information, including ICD-10 basics, physician perspectives, and webcasts on preparing and documenting for your specialty.

And perhaps the most simple, and most effective, way to train …

Practice, practice, practice!

Both the code set and the documentation style needed to accurately code are changing significantly. While ICD-9-CM included 14,025 diagnoses codes, ICD-10-CM has 69,823 codes – almost five times as many! This expansion is due to a much higher level of specificity. In the long term, it’s great – we’ll be able to much more accurately classify diagnoses and learn from the data. But in the short term, that’s a lot of learning.

Start with your list of common ICD-9 codes. Many coders and billers can rattle off their top 20 without thinking twice. Now they need to reach that same level of comfort with the new, expanded set of codes. Using a tool like ICD9Data.com, you can see how your most common ICD-9 codes map to ICD-10.

Additionally, the AMA offers simple “Snapshot Coding Cards” to help you find the right ICD-10 code. They offer cards for a number of different specialties, and they’re pretty cost effective (around $20 each).

While coders and billers are familiarizing themselves with the new code set, physicians should become comfortable with an increased level of specificity in their documentation. They should take the time to learn new codes as well – at least the most common ones. If they understand the level of specificity coders need to do their job, it will save a lot of frustrating conversations later (“Remember that patient you saw three days ago?” … “No.”).

To all the small shops out there who are struggling to prepare, I hope these tips and resources offer a little help. Even a few minutes per day can go a long way in keeping cash flow strong and steady through October 1.

Caleb Clarke is director of strategic development, sales, and marketing at NueMD.

Contacts

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

More news: HIStalk, HIStalk Connect.

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