News 1/27/15

Top News

HHS Secretary Sylvia Burwell unveils a new plan and timeline for moving healthcare providers from a fee-for-service model to a value-based reimbursement model. Goals include getting 50 percent of all Medicare provider payments switched over to alternative payment models by 2018, and for nearly all Medicare fee-for-service payments to be tied to quality and value by the same year. Burwell also announced the formation of the Health Care Payment Learning & Action Network, calling on providers, consumers, employers, payers, industry, and other government agencies to help HHS keep to its aggressive timelines.

Acquisitions, Funding, Business, and Stocks

New Jersey-based MaxMD receives clearance from the Minnesota Department of Health to operate as a Health Data Intermediary in the state, meaning that providers there now have access to its Direct Messaging services. (On a whim, I looked up Minnesota’s state motto. “L’etoile du Nord” dates back to 1861, though “the Land of 10,000 Lakes” is far more well known.)

This article digs into telemedicine company Doctor on Demand’s revenue model, breaking down the cut it takes from patient fees and employer utilization. The San Francisco-based company also brings in revenue from its white-label offering for health systems. Given that it raised $21 million late last year, I’ll be interested to see how its MGMA booth compares to its HIMSS booth.

Emdeon is considering an IPO, sources say. The earnings multiples of recent sector deals suggest a valuation of $5.4 to $6.6 billion, which would create huge profits for the two private equity firms that took Emdeon private in 2011 for $3 billion.

The local business paper profiles the healthcare technology investment plans of GE Ventures, which has 17 healthcare-related companies in its portfolio. The firm typically invests in five HIT companies each year, to the tune of between $3 million and $8 million apiece. “The sort of companies we’re looking for are divided into three verticals across health care,” explains Alex de Winter, director, “Minimally invasive medical devices, healthcare IT and services and precision medicine, which got a shoutout from Obama, clinical diagnostics, and life sciences instrumentation.”

Announcements and Implementations

Three-hundred fifty Kaiser Permanente ambulatory clinics receive the Stage 7 Ambulatory Award from HIMSS Analytics. The award recognizes the organization’s use of its HealthConnect EHR, the largest non-governmental EHR in the world.

Florida Cancer Specialists & Research Institute selects Athenahealth’s revenue cycle and PM services as part of a pilot program in which the new technology will be rolled out in phases to 300 providers.

Community Eye Center Optometry (CA) selects the VersaSuite EHR and PM system.

EHNAC announces new versions of criteria for 15 accreditation programs. Applicant candidates beginning the accreditation process in this year will adhere to the updated criteria versions for accreditation and/or re-accreditation.

Government and Politics

CMS adds star ratings to its Dialysis Facility Compare website. The annually updated ratings summarize performance and quality, joining similar rating systems used for Physician Compare and Nursing Home Compare.

Telehealth already seems to be the healthcare business buzzword of 2015, and we’re only 27 days in. The Federation of State Medical Boards launches LicensePortability.org to track the progress of the Interstate Medical Licensure Compact in state legislatures. (Nine states have already introduced it this year.) Originally introduced in September 2014, the compact proposes legislation that would speed up the process of issuing licenses for physicians who wish to practice in multiple states, in turn making it significantly easier for telemedicine companies to operate to their fullest potential.

Teladoc continues to make news as its services get shut out of Texas and Arkansas due to medical board concerns over patient-physician relationships. The company, based in Dallas of all places, went so far as to sue the Texas Medical Board (for the second time) for its declaration earlier this month of an emergency rule requiring physicians to meet patients "face-to-face" before prescribing them a controlled drug. “There is no imminent peril,” the company’s complaint states. “There is no emergency. There is only a state agency ignoring its legal limitations in a blatant attempt to get its way.” Teladoc does not operate in Idaho for similar reasons.

The state of Colorado’s House Health, Insurance, and Environment Committee approves a bill that would expand the use of telemedicine across the state. If approved, the bill would prevent payers from requiring in-person care if consulting, monitoring, and other care could be as effectively administered at a distance.

HRSA Administrator Mary Wakefield, RN tours the South Dakota facilities of telemedicine network Avera, which provides remote care to rural populations via its growing e-Care network. “We have so many parts of the United States that are under served,” explains Wakefield, “that are what we call health profession shortage areas. [Avera e-Care] is, over time, part of the solution I think to that problem.”

HHS reduces the outbound flow of personal consumer data from Healthcare.gov to third-party sites, caving to public outcry over the revelation that the exchange was delivering personal registrant details including age, ZIP code, and income to websites related to advertising, and data mining for marketing and performance metrics. The agency had previously contended that the outside companies used the data only to analyze and improve Healthcare.gov.

Research and Innovation

The American Society of Clinical Oncology partners with SAP to develop CancerLinQ, a computer network that will help cancer doctors make treatment decisions for their patients based on the outcomes of comparable patients. ASCO expects to roll the first version of CancerLinQ out by the end of 2015 to 15 oncology practices that are contributing half a million patient records to the big data project.

This article highlights the parameters the VA has set around its two-year, $16 million Watson pilot project. They include initially operating in a safe-harbor environment where simulated patient encounters will be run using real clinical data, assessing the ability of the system to perform clinical semantic searches of the EHR and clinical literature, and assessing its ability to generate problem lists from the EHR.

Other

Silicon Valley-based Doximity launches an interactive map highlighting physician compensation trends and salaries across 48 specialties, plus potential career opportunities in rural areas with shortages. Dr. Jayne, who seems to be considering career options at the moment, may want to think about going rural: Doximity data indicates that physicians in rural areas see an average of $1,500 more in salary each year compared to those in urban areas.

Those interested in historical clinical career data may want to check out ONC’s updated Health IT Dashboard, which now includes state and county estimates for the number of MDs, PCPs, NPs, and PAs from 2011 to 2013.

Sponsor Updates

• Healthwise wins gold and silver Web Health Awards for its health education videos.
• E-MDs CEO David Winn pens a new article entitled, “Time to Let the Air Out of the Tires on ICD-10.”

Contacts

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

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Readers Write: Good News, Physicians. Patients Do Want to Access Online Portals

Good News, Physicians: Patients Do Want to Access Online Portals
by Tamara St. Claire

Americans are generally interested in participating in online patient portals. In Xerox’s annual survey on the usage of EHRs, more than half of respondents who don’t already use portals (57 percent), said they would be more interested and proactive in their personal healthcare if they had online access to their medical records. I personally love using the portal provided by my doctor, particularly to view test results without scheduling another in-person appointment.

This motivation is good news for providers, many of whom are working on the Meaningful Use Stage 2 view, download, and transmit requirement. Aside from MUS2, there are many benefits to patient engagement that help providers as they strive to deliver quality care in a patient-centric healthcare system.

Many patients simply aren’t hearing from their physicians about the option to access portals. Thirty five percent of Americans surveyed said they were unaware that they existed. Another 31 percent said their physician had never spoken to them about patient portals. When we look at some of the best practices out there, we see that having that conversation multiple times along the patient’s path through the office is most effective. People view the physician as the trusted voice, so it’s really important for physicians to engage in that conversation in the exam room.

However, the survey also highlighted patient preferences that were somewhat divided along generational lines, with Millennials and Baby Boomers reporting different ideas about what they like to see and do when it comes to online engagement. Personalizing the discussion is key to helping providers overcome engagement challenges and increasing patient engagement long term.

For example, our survey found that Baby Boomers are really interested in using portals on a transactional basis. For them, the utility of a patient portal is about efficiency. They want to be able to schedule appointments, view test results, ask questions, and order refills. Providers can motivate Boomers to use a portal to get answers to questions more quickly, and order refills – without ever picking up the phone.

On the other hand, we found that Millennials want to see information and resources in a portal that are individualized for them. Forty four percent of patients aged 18 to 34 said they wanted to view tailored recommendations or learn more about other services their healthcare provider has available. They also prefer the convenience of doing so on a mobile device. Therefore, engaging Millennials is about providing them with an individualized experience that suits their lifestyle, whether that’s through smartphones, tablets, or other devices.

This year, providers seeking MUS2 will be required to succeed during a full, 365-day MU reporting period, compared to just a 90-day reporting period in 2014. Patient engagement must be a top priority for providers – both for this reason, and because a knowledgeable and active patient is ultimately a healthier patient, demonstrated by the fact that 59 percent of respondents who already are using portals feel they are now more interested and proactive in their personal healthcare.

Tamara St. Claire is Chief Innovation Officer of Xerox Commercial Healthcare of Norwalk, CT.

Contacts

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

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News 1/22/15

Top News

A group of 35 industry associations including CHIME, the AMA, AAFP, and MGMA urge ONC National Coordinator Karen DeSalvo, MD to make the following changes to EHR certification in a bid for improved patient safety:

1. Decouple EHR certification from the Meaningful Use program;
2. Re-consider alternative software testing methods;
3. Establish greater transparency and uniformity on UCD testing and process results;
4. Incorporate exception handling into EHR certification;
5. Develop C-CDA guidance and tests to support exchange;
6. Seek further stakeholder feedback; and
7. Increase education on EHR implementation

The authors explain that, “We believe the Meaningful Use certification requirements are contributing to EHR system problems, and we are worried about the downstream effects on patient safety. Physician informaticists and vendors have reported to us that MU certification has become the priority in health information technology design at the expense of meeting physician customers’ needs, patient safety, and product innovation.”

Announcements and Implementations

Missouri Health Connection receives a $375,000 grant from the Healthcare Foundation of Greater Kansas City to connect EHRs at Swope Health Services, Samuel U. Rodgers Health Center, and KC Care Clinic to the Missouri HIE. Additional funding from St. Luke’s Health System (MO and KS) will be used for EHR upgrades, which will affect 68,000 patients at 17 clinics.

Non-profit community healthcare provider ARcare installs i2iTracks, a population health management and analytics product from i2i systems, at 37 facilities. ARcare received the HIMSS Analytics Stage 7 Ambulatory Award last summer. I had the opportunity to interview ARcare CIO Greg Wolverton shortly thereafter.

Akasha Center for Integrative Medicine (CA) selects Open Source Health Inc., which provides digital patient engagement solutions for women, to advise it on the development of a cloud-based EHR for integrative health and personalized medicine. (If you need to take a break from the hustle and bustle of healthcare IT for a few minutes, check out the Akasha website, which plays extremely soothing sounds of nature upon opening.) 

ExamMed launches a healthcare technology platform that includes video, EHR, patient portal, “smart” coding, and physician network and referrals. The new tool also includes MedCoins, which act as forms of credit patients can put towards services or gift to family members.

Custom PC Programming’s DoseTracer inventory and payment tracking software for pharmaceuticals joins the Greenway Health Marketplace.

Zotec Partners introduces ZARi, a new analytical reporting interface for radiologists.

GE Healthcare and NextGen earn EHNAC’s first practice management system accreditation.

Acquisitions, Funding, Business, and Stock

Medical diagnostic device company Welch Allyn acquires Hubble Telemedical, which specializes in remote diabetic retinopathy screening and analysis in primary care settings. The deal is the second acquisition in six weeks for Welch Allyn, which acquired remote vital-signs monitoring company HealthInterlink late last year.

Smart jewelry startup Ringly raises $5.1 million in Series A funding led by Adreessen Horowitz, bringing its total funding to $6.1 million. While the investment probably won’t affect product development in time for this Valentine’s Day (it’s still working to fill pre-orders from Christmas), the company does plan to use it to add new features to its collection, build partnerships with fashion brands and designers, and hire additional staff for its New York City office. 

Kaiser Permanente becomes the “Official Health Care Partner” of the NBA, WNBA, NBA D-League, and USA Basketball. It is the provider’s first national partnership with a professional sports league. Through the partnership, Kaiser and the NBA will conduct 14 community health and wellness events in NBA markets, as well as an annual Health and Wellness Forum.

Government and Politics

Media reports suggest that ONC National Coordinator Karen DeSalvo, MD has appointed board certified Ob/Gyn Michael James McCoy, MD as its first chief health information officer, effective January 26. As CHIO, McCoy will develop clinical policy and serve as the department’s leading expert on interoperability. He will report directly to DeSalvo. His ties to Atlanta, Georgia (recently voted by HIStalk readers as the nation’s capital of healthcare IT) run deep. He received his degrees from Georgia State University and the Medical College of Georgia, and worked in various physician leadership roles at healthcare facilities in Gwinnett County. His vendor experience includes executive positions at Allscripts, Xerox, Physician Technology Services, and digiChart.

The Pew Charitable Trusts, Geisinger Health System (PA), Intermountain Healthcare (UT), The Leapfrog Group, and seven other industry organizations write to HHS Secretary Sylvia Burwell strongly urging the government to mandate a field for unique identification numbers of medical devices in EHRs so that they can be better tracked and recalled. They believe this objective will support Meaningful Use Stage 3 priorities including better clinical decision support, care coordination, and patient engagement.

The local paper covers the Texas Department of Criminal Justice’s use of telemedicine within its prison system to curb healthcare costs, which have climbed steeply in the last several years due to the state’s aging inmate population. While telemedicine has saved the department $780 million from 1994 to 2008, it does have its detractors. “I see the potential for danger where, for example, psychiatric care is not given in person and a doctor doesn’t see the cuts on the person’s arm and the next day they commit suicide,” says Wayne Yang with the Texas Civil Rights Project. “Telehealth could save money, but it could hurt health care.”

The White House releases details on the new precision medicine program President Obama announced during his State of the Union Address. The program will work to individualize treatment plans through advances in genetic research, medical imaging, and health information technology.

Research and Innovation

Mobile health service HealthTap releases its first report ranking apps by physician recommendations. The report includes apps in 30 health categories such as pregnancy, heart health, and weight loss. Top apps include Fooducate (I can vouch for this as being great if you are just starting to pay attention to nutrition labels.), Glucose Buddy, First Aid – American Red Cross, Sleep Cycle Alarm Clock, and Stroke Riskometer.

An American Well survey conducted by Harris Corp. finds that 64 percent of respondents are willing to have virtual visits via telemedicine, with slightly fewer indicating virtual visits should cost less than in-office visits. The majority of the 2,019 consumers surveyed chose video as their preferred method of telemedicine. While these sorts of surveys tend to be fairly self-serving, it’s worth noting that 70 percent would rather have an online video visit than an in-office visit to obtain primary care prescriptions – yet another indication that the primary care business model will have to change to meet consumer demands for convenience, access, and affordability.

Other

The American Telemedicine Association seeks nominations for its annual President’s Awards for the Advancement of Telemedicine. Nominations are due February 15. Winners in three categories – Health Delivery Quality and Innovation, Leadership, and Remote Health Care – will be presented at ATA’s annual meeting in May.

Cerner will co-host a virtual career fair with the VFW February 18 from 10 a.m. to 3 p.m. CT. to connect service members and their family members with job openings at the company. Veterans can qualify for such positions as system engineer, technical support analyst, implementation consultant, nurse, and a variety of operational roles. They can even use the online military decoder tool at Cerner’s website to match their enlisted position with suggested roles within the company. Cerner is also working to help modernize the VFW’s IT infrastructure, and evaluate the creation of a patient portal for VFW members.

A North Carolina OB-GYN says physicians should use computers and not vice-versa, urging his peers to look at the patient instead of the screen. “The folks who sold us these systems talked about all the wonderful things EMR can do … One might assume the EMR would excise the tumor, lower the blood glucose and stop the hallucinations. The problem is that the EMR really should not ‘do’ anything. Patients tell us their concerns. Practitioners do their best to listen and perform the appropriate evaluation, with or without technology … everything we need to know about our patients is in their face, in their voice, and in their eyes.”

Sponsor Updates

• ADP AdvancedMD offers tips on leveraging practice data to view key performance indicators in a new blog.
• ABCNews.com lists Clockwise.md amongst other companies making a name for themselves developing online booking software.

Contacts

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

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News 1/20/15

Top News

CMS Administrator Marilyn Tavenner, most known for her key role in the botched rollout of Healthcare.gov and for miscounting its enrollees, resigns. Former Optum executive Andy Slavitt will take the role as interim. The current enrollment period seems to be back on track, with HHS Secretary Sylvia Burwell making the final rounds of photo ops as the February 15 deadline for sign ups draws near. Nearly 6.6 million consumers have enrolled for coverage via Healthcare.gov as of earlier this month. The administration is hoping that 9 million will enroll through federal and state exchanges.

HIStalk Practice Announcements and Requests

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Announcements and Implementations

Yavapai County Community Health Services (AZ) launches a patient portal from NextGen.

The Auburn University Medical Clinic (AL) plans to go live on a Med-Pass electronic immunization record-keeping system this spring. The system will be fully functional for student use just in time for the new school year this fall. Medical Director Fred Kam, MD notes that, “The majority of universities are currently not using a system like this. The new system not only will decrease errors but will also allow students to log on to their online account to access their records should they need a copy at any time.”

Wake Emergency Physicians P.A. (NC) develops and launches telemedicine service RelyMD. Co-founder Bobby Park, MD attributes the service’s growing popularity to a decision by the North Carolina Medical Board to allow prescriptions through telemedicine visits.

Practice Fusion adds an online check-in module that collects patient information via practice-customizable online forms, then sends it to its EHR.

Acquisitions, Funding, Business, and Stock

Chicago-based Matter, a hub for medtech and healthcare entrepreneurs set to launch next month, partners with healthcare investment bank Healthios. The partnership will give Matter members free access to the HealthiosXchange platform, a crowdsourcing marketplace for private equity in the healthcare industry.

Qualcomm Ventures plans to launch an investment firm with Novartis Pharmaceuticals that will invest up to $100 million in early stage digital health companies. Qualcomm, which has 18 startups in its global healthcare portfolio, plans to focus heavily on ventures that go “beyond the pill” to benefit patients and physicians.

Government and Politics

The Defense Health Agency announces that military pharmacies now can accept e-prescriptions from civilian physicians. The transition to the new eRx system began early last year, and is now available at clinic pharmacies in the U.S., Guam, and Puerto Rico.

Alberta Health Services leaders are at odds over the expected go-live date of the Canadian province’s anticipated digital health records system. Spokesman Steve Buick anticipates some parts of the system will be up and running by the end of 2015, while Health Minister Stephen Mandel won’t commit to a timeline until he hears back from an internal task force looking into the feasibility of building it. “I’m not prepared to comment on what we will or won’t have at any time until I get the report,” Mandel says. “I am just cautious. You end up getting into trouble with these computer IT plans because they end up materializing in many different ways.”

A House Committee on Energy and Commerce work group creates a draft policy that would require HHS to pay for telehealth services at the same rate as in-person visits within four years.

The AAFP submits comments on the ONC’s draft Federal Health IT Strategic Plan 2015-2020, expressing frustration over the burden physician practices are having to bear as a result of ONC initiatives, and frustration that its proposed goals of collecting and sharing health information were "indistinguishable" from the goals and objectives that should have been met during the previous decade. AAFP Board Chair Reid Blackwelder, MD said that, “Given the breadth and depth of the work that could be initiated around health IT, we are concerned that resources may be spread so thin that no significant achievements are made toward the goals laid out in the Federal Health IT Strategic Plan.”

Research and Innovation

A Kaiser study uses statistical software to match EHRs to home addresses of California Kaiser patients who are unvaccinated, enabling Kaiser physicians to better target vaccination efforts and prevent disease outbreaks more quickly. Lead investigator Tracy A. Lieu, MD says that, “Anecdotally, doctors have reported that a lot of parents in a particular neighborhood or county have hesitations about vaccines. This is the first time we’ve used computers to actually find these clusters.”

An AAFP survey finds widespread discontent among physicians who have switched EHRs in the last several years. Given that the AAFP requires a subscription to read the full survey results, I had to rely on a slightly skewed press release from Praxis EMR to glean further information. The PR uses questionable wording like “physician coercion,” “forced to switch,” and “traumatizing transitions” to convey the emotions the 305 physicians felt over the issue. EpicCare Ambulatory and Praxis had the most net gains in customers. Praxis took home the best user experience ratings.

A new study reveals that a higher percentage of office-based physicians using healthcare IT received patient data necessary for care coordination than non-users, and that over a third did not regularly receive the needed patient data at all via electronic means. Given that the study analyzed data from physicians who responded to a 2012 survey on the use of EHRs and electronic information sharing, I have to wonder if the results are even valid anymore.

A survey finds that over half of 396 healthcare managers expect to recoup their investments in population health management programs within three to four years (no doubt good news to firms like Aledade.) Twenty percent believe that their investments in healthcare IT, and data and analytics tools will pay off in as little as one to two years. PHM-solution vendors will also be happy to know that only 24 percent of respondents consider their PHM capabilities as mature; 38 percent describe themselves as in the “elementary stages.”

People

Eugene Borukhovich (SoftServe) joins the HealthXL network of advisors.

Other

Berkeley, CA-based startup Eko Devices announces the $200 Core 1, which clips onto a standard stethoscope to record its sounds to any smartphone or tablet via Bluetooth, allowing doctors to share the sound file in consulting with a remote specialist.

The local paper highlights the sleeping giant/economic driver Athenahealth has become in Belfast, ME. The company opened its first office there in 2008 with 12 staff, and now employs over 800 in the area to handle all of the company’s insurance claims and physician bills. (I had to chuckle when I saw the copious amounts of paper in the picture above.) The company is also getting ready to move its 70 employees in Austin, TX to bigger offices in the renovated Seaholm Power Plant. That facility will enable Athena to employ over 600 in the next 10 years.

Northern Kentucky Medical Society board member Mark Schroer, MD makes the case in an op/ed for greater physician/retail clinic collaboration, asking some pretty pointed questions:

“Physicians have criticized the retail clinic model. But we also need to examine ourselves, which is part of our great tradition. We need to ask why these models of care are successful in the first place. What does it tell us about our own practices? Doctors often project an image of being too busy. We are too busy to listen, too busy to look and sometimes, too busy to care. In short, do we project empathy? Not important? Ask the Cleveland Clinic. It now has an entire training program on empathy for all employees including physicians. As a result, patients perceived their care was better. Perhaps, if we did a better job letting patients know "we are there for you" they would never leave home in the first place. Obviously, there are many questions that need to be answered. Maybe retail clinics are not such a bad thing after all.”

Security Divas Scrutinize the Current State of Cyber Threats

Mr. H’s decision to create a section for healthcare privacy and security news over at HIStalk.com makes perfect sense considering the growing number of facility breaches meriting media attention these days. It’s perhaps even more timely given President Obama’s push to revive cybersecurity legislation that has stalled over the past few years. If enacted, the updated proposal would promote better cybersecurity information sharing between the private sector and government, and enhance collaboration and information sharing amongst the private sector. While organizations like the Health Information Trust Alliance (HITRUST) applaud the proposal, it remains to be seen just how effective this type of increased information sharing would be to smaller physician practices that are already dealing with declining reimbursements, burdensome Meaningful Use criteria, and a shrinking pool of physicians looking to work independently.

Do physician practices even have time to worry about potential breaches, much less pony up money to prevent them? Former ONC chief safety officer Joy Pritts told Politico that, “The health sector is just beginning to realize what a potential threat cybercrimes can be. As people realize how valuable health information is, and also realize how it’s not protected by many organizations, they’re going to wake up."

Other industries are already waking up to the threat (and potential financial straits) security breaches pose to their organizations. The ATP “Divas of Security” event offered first-hand insight into how the financial, utility, banking, and manufacturing industries are dealing with cybersecurity. Aside from the fact that I thought it would be fun to be in a room with other divas, I went hoping to glean a few security tips for healthcare. I came away with the realization that the outside world doesn’t have as great an understanding of the threats healthcare faces as they probably should. When polled, the majority of the audience chose “retail” as the sector most likely to see breaches over the next 12 months, perhaps because they noted in an earlier poll that they had recently experienced a personal or professional breach. Moderator Becky Blalock of Advisory Capital quickly put that assumption to rest when she stated that it will in fact be healthcare.

When asked what top things their firms are doing to deal with cybersecurity threats, panelists noted that they are getting more serious about scrutinizing their vendors, and are becoming increasingly interested in information sharing, which is reflected in the President’s new proposal. Big data and analytics were mentioned, as was the fact that IT companies too often work in siloes (where have I heard that before?).

I found it fairly telling that Blalock had to pull a few teeth to get the panel to offer up best practices. I wonder if a panel of healthcare IT experts would respond any differently? When the crickets finally stopped chirping, Robbie Hudec from Novelis said it’s imperative to get the C-suite on board, and that it’s absolutely necessary to help your employees understand the risk.

Security firms in the audience were probably happy to hear that hackers and breaches aren’t going anywhere anytime soon. Jill Knesek with BT, told us that hackers will always be one step ahead: “They have to be right only once. We have to be right all the time.”

Sponsor Updates

• ADP AdvancedMD offers “4 surefire signs you need a new EHR for MU2 and beyond” in its latest blog.
• Versus client Dan Chambers, MBA, COE, of Key-Whitman Eye Center writes in the January issue of Ophthalmic Professional magazine about RTLS and how the technology improves patient flow.
• Healthwise SVP Molly Mettler reflects on the opening of Healthwise 40 years ago in a new blog.
• NVoq shares the top three things providers should know about its SayIt speech-recognition technology.
• NextGen offers a new e-book, “5 Fast Fixes for Painless Productivity Challenges.”

Contacts

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

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DOCtalk with Dr. Gregg 1/15/15

The 2037 Advanced Health Information Technology Conclave

The following is a verbatim transcript from the 2037 worldwide conclave for Advanced Health Information Technology in London (purveyed from the future by my old pal and favorite spirit guide, Madam Blavatsky):

Moderator: Welcome, all, to the twenty-first annual Advanced Health Information Technology Conclave. We’re excited to have such a wonderful attendance. This shows that HIT is now truly, as our acronym says, “A HIT.” Today, we’re honored to have the grandfather of all advanced HIT with us to give the conclave’s Grand Keynote address … Dr. Harry Schmeed!

(Applause, applause, applause)

Moderator: As you all know, Dr. Schmeed was talking health information technology before most of you were born. Thanks to the recent progress in genomics and bioengineering, he’s still with us today, and still a powerhouse in the industry at the wonderful age of 114! It’s quite the honor to have him here, so, without further ado … ladies and gentlemen, please welcome … DOCTOR HARRY SCHMEED!!!

(Applause, applause, applause … standing applause)

Dr. Schmeed: Thank you, thank you. That’s so very kind of y’all. Please … be seated, everyone. I haven’t had such a warm reception since my cheapo replacement smart-pants battery ignited my back pocket.

(Chuckles, chuckles)

Dr. Schmeed: It’s so very gratifying to look out on this sea of geeky faces – so pale and so wonderfully nerdy in your old-style Google Glasses, mud-styled hairdos, and sharp line ups. Isn’t it amazing how geekdom has taken control of the world?!

(Cheers, cheers)

Dr. Schmeed: Just a little background to start. When I first began studying ways to make healthcare smarter, I noted one very important thing: so much of what healthcare providers do is repetitive. They see the same type problems again and again, they document the same things time after time, and they calculate the same equations repeatedly, like a dog chasin’ its tail. This was when very few people had even heard of a personal computer – and when most of you were just chocolate bars in your daddy’s back pockets.

(Little chuckles, little looks of “Huh?”)

Dr. Schmeed: My early undergrad experience at MIT gave me insight into computer systems far beyond what most anyone else in healthcare – at the time – had experienced. Now it seems that computer nerds are as common in healthcare as V.D. in a bordello …

(Scattered snickering, scattered slight gasps)

Dr. Schmeed: You’ll have to pardon my somewhat colorful, sorta euphemistic style. I‘m from Texas and we were raised with some real timbre to our tongues. My mama taught me well; she was a serious chin musician. She could turn out more weasel word turns of phrase in one sentence …  enough to make any Washington politician go frog-green with envy. I’ll try to keep my tongue toned down for all you youngsters who were raised on concrete, but you’ll pardon me if some country coinage comes through the chow slot now and again.

Anyway, back to the early days. It sure seemed to me that all this repetitious work docs and nurses were doing back then was just beef gravy for computer capabilities. Why couldn’t all those laborious chores that didn’t really contribute directly to diagnostic inquiries and medical decision-making be shunted off to the ones and zeroes of computers allowing providers to focus more cleanly on care?

Seemed as natural a concept to me then as having snap in your garters. What I didn’t know was how much trouble it might muster to digitize all these processes and make them work within the confines of the world of healthcare – a world with more rules than a Saturday night dance and more silos than all the granaries from Odessa to Omaha.

We couldn’t just take computers – what we all now call “information technology” – and tie them into healthcare with a simple running stitch; it was far too messy and convoluted. It needed some fancy cross stiches and even some embroidery. We needed to make it smart, so that it worked within the fences of the healthcare barnyard without getting the neighbor’s tail all up. Thus was born the concept of “health information technology.”

To say the least, we’ve been straining from the get go. We had to pass some pretty large … um, hurdles … before we got on track, but once we did the value of what we started was pretty danged apparent. Back then, and into the early part of this century, we all though our HIT was pretty smart. Looking back, I’d say most of it was [using little air quotes for emphasis] “Smart HIT” – if you get my little acronymic drift.

(Scattered chuckles and guffaws)

Dr. Schmeed: We’ve moved on, from smart HIT to today’s truly advanced HIT. And I can tell you, it’s been a helluva ride on this bucking bronc, but well worth the backache. We’ve learned a lot. But there’s one thing that’s always rung true, one concept that helped me, and all of us, keep things in perspective as we’ve ambled – and often stumbled – along this long HIT path. My mama used to say it best: “You can’t expect a cat to bark or a whale to walk.” In other words, you shouldn’t expect things to be or act differently than what they are, or than what they’re designed to be. You need to design for real needs, for real people, in ways that don’t force unrealistic change. Design in ways that take into account the true nature of things … and especially of people.

My one prayer, my one wish for you all, is that you learn and respect the most important lesson that has consistently helped us as we eked along from “smart HIT” to “advanced HIT” – from that less pretty acronym to today’s more mixed-company-acceptable version. And that lesson is: “Don’t expect a cat to bark or a whale to walk, but if you do it right, you can expect HIT to be A HIT.” Thank you.

(Resounding applause, feet-stomping, and cheers)

From the trenches…

“Don’t expect a cat to bark.” – Soda Pop Man

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, Dr. Travis

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