News 12/9/14

Top News

ONC issues its Federal Health IT Strategic Plan 2015-2020, which will serve to set the stage for the Nationwide Interoperability Roadmap that will be released early next year. The 28-page plan, open for comments through February 6, describes the government’s strategies to achieve five goals:

1. Expand adoption of health IT.
2. Advance secure and interoperable health information.
3. Strengthen healthcare delivery.
4. Advance the health and wellbeing of individuals and communities.
5. Advance research, scientific knowledge, and innovation.

It’s a fairly concise and well thought-out document, listing expected outcomes for each goal and the federal agencies that are expected to play a part in achieving them. My only concern at this point would be the stability of ONC leadership over the next five years, and the likelihood that the big healthcare IT vendors will step in to create meaningful assistance rather than additional layers of half-baked interoperability. I’ll be interested to see how this gets whittled down to a tighter framework once the comment period concludes.

HIStalk Practice Announcements and Requests

The spate of telehealth-related press releases and traffic around the #mhealth14 hashtag means the 2014 mHealth Summit is in full swing. Having never attended, I have to rely on show-floor correspondents and tweet streams to fill me in on the digital health action. Mrs. Blackwell tells me that, “Everyone is in black here including me. We are in D.C. after all, where everything and everyone is conservative!” She added that she loved Dr. Jayne’s latest Curbside Consult, which picks apart a rather ridiculous Forbes article that suggests how female presenters should attire themselves at the event. I agree with Dr. Jayne’s colleague who said, “The only trend in healthcare that we should care about is the one that comes from having a true longitudinal and holistic and normalized view of a patient from birth to present. All other trends should be left at the hatters and haberdashers.” That being said, fashion can be fun, and can certainly help you stand out in a sea of black-clad colleagues.

It’s official – HIStalk readers have voted Atlanta as the “Healthcare IT Capital of the U.S.” Atlanta’s health IT network and civic pride turned out the vote with 45 percent of the 1,600 votes cast (including mine and Mr. H’s.) I came across this video from the Metro Atlanta Chamber explaining why Atlanta is THE place to be for health IT. I’m hoping to arrange a special visit with Atlanta’s health IT leaders to present them with some sort of HIStalk-style award, which I know they’ll want to proudly display at the Georgia pavilion at HIMSS next year.

Webinars

December 17 (Wednesday) 1:00 ET. There Is A 90% Probability That Your Son Is Pregnant: Predicting the Future of Predictive Analytics in Healthcare. Sponsored by Health Catalyst. Presenter: Dale Sanders, SVP of strategy, Health Catalyst. Predictive analytics is more than simple risk stratification. Once you identify an individual’s risk, what are the odds that you can change their behavior and what will it cost to do so? This presentation, geared towards managers and executives, addresses scenarios in which predictive models may or not be effective given that 80 percent of outcomes are driven by socioeconomic factors rather than healthcare delivery.

HIStalk is offering 25-percent off webinars (promoted or produced) through the end of the year. Email Lorre for all the details. You can pretty much guarantee they’ll be a hit, as we put your webinar content before several executive-level members of our review committee to ensure your presentation is engaging and educational (rather than a blatant and typically boring sales pitch).

Announcements and Implementations

Johnson County Mental Health Center connects with Kansas Health Information Network’s HIE via Netsmart’s Care Connect solution.

HL7 launches the Argonaut Project to address the standards recommendations of the federal government’s JASON group, including HL7’s FHIR (fast healthcare interoperability resources). Working with HL7 will be athenahealth, Beth Israel Deaconess Medical Center, Cerner, Epic, Intermountain, Mayo, Meditech, McKesson, Partners HealthCare, SMART from Boston Children’s, and The Advisory Board Company. HL7 says the group will create FHIR-based EHR data sharing API specification by the spring of 2015.

I asked Jitin Asnaani, athenahealth’s director of technology standards, to weigh in on the announcement given that he has been knee-deep in the company’s interoperability initiatives:

“In the past, standards have been thrust upon the industry by the government – especially through incentive programs such as Meaningful Use – and this project represents a distinctive instance where competitors have reached across the aisle to build and adopt the standards to enable health information exchange, and thus determine our own fate. The fact that ONC has lauded this effort is further testament to its alignment with national priorities for health information exchange. 

“The great benefits of this standard will accrue across the healthcare industry.  It can allow patients, providers, and others directly involved in care delivery to exchange crucial health data that enables more efficient and effective care coordination.  Yet it also simplifies engagement and amplifies the value created by other participants in the healthcare ecosystem, such as laboratories, pharmacies, post-acute settings, and the like.  Ultimately, FHIR will be a critical building block of our learning health system. Athenahealth applauds the small group of providers and vendors who have invested in what will ultimately be a public good available to the healthcare community at large. We are excited to accelerate work that helps healthcare work as it should.”

The big news here, as reported late last week by Mr. H, is that: (a) the second JASON report called for a big vendor to propose an open API standard instead of waiting around for the government to do it; (b) FHIR and APIs are a lot better than today’s document-based interoperability standards and probably better than the customized jungle that the HL7 standard has become; and (c) getting Epic, Cerner, Meditech, and McKesson together at the same table covers nearly all of the hospital EHR market and Epic, particularly, is a key member given its non-participation in CommonWell (and Epic and Cerner already have customers using APIs).

While Asnaani seems confident the Argonaut project will provide a way forward for interoperability efforts (and it just might given that it’s goals coincide with those of the ONC as laid out in its new strategic plan) I can’t help but wonder if the industry isn’t just creating one more level of competitive and still somewhat siloed bureaucracy for providers to wade through. (As a Forbes editorial points out, “The technology has always been there. It’s the will that’s missing.”)

Micky Tripathi, president and CEO of the Massachusetts eHealth Collaborative, chair of the ONC HIT Policy Committee’s Interoperability Workgroup, and co-chair of its JASON Report Task Force, was kind enough to weigh in with this clarification: “The project is not creating an organization,” he explains. “It’s simply a mechanism to pool funding and project management and technical know-how to accelerate and focus some specific standards development work to make it available to the market (and ONC) faster than it otherwise would be available.  And then that’s it – once those specs and implementation guides are delivered, the project is complete.”

The Louisiana Health Information Technology Resource Center achieves its target for Meaningful Use attestation, helping over 1,000 providers participate in the program.

Sequenta launches the ClonoSIGHT Secure Portal to better integrate its ClonoSIGHT process (an ultra-sensitive, next-generation sequencing-based technology for minimal residual disease detection and quantification) into the care of patients with lymphoid cancers.

Walgreens offers consumers in California and Michigan access to MDLive physicians through its Walgreens mobile app. The new tool, which will be rolled out to additional states in the coming months, builds on the app’s Pharmacy Chat feature launched last year. (Check out Lt. Dan’s more thorough recap of the news here.)

Qualcomm Life integrates chronic disease management solutions from vitaphone e-health into its HealthyCircles Care Coordination and 2net Device Connectivity Platforms to capture biometric data from medical devices and coordinate team-based care.

Acquisitions, Funding, Business, and Stock

Welch Allyn acquires HealthInterlink, a developer of remote patient monitoring software. HealthInterlink will continue to develop, source, and sell the solution during the transition. Once the acquisition is complete, Welch Allyn plans to use its newly acquired technology to help primary care physicians and cardiologists manage hypertensive patients.

Government and Politics

ONC announces a 10-part webinar series on health IT and patient safety. The first presentation – “The Role for the EHR in Patient Safety: What does the Evidence Tell Us?” – will kick the series off on Thursday, December 18 at 1pm.

ONC also releases a data brief on the motivations behind physician adoption of EHRs between 2010 and 2013, using data from the 2013 National Ambulatory Medical Care Survey Physician Workflow Survey. Not surprisingly, solo practice physicians had the highest percentage of providers who were uncertain on adoption or who never planned to adopt, leading ONC to conclude that “narrowing the EHR adoption gap overall will involve continuing to focus efforts on these physicians.” None of the findings are particularly surprising, especially those regarding the importance of financial incentives pre- and post-HITECH Act. While the ONC says it will use the findings to better understand the influence of existing policies on adoption, you have to wonder if it will also use the data to determine if and how to alter the MU program  in light of low Stage 2 attestation numbers.

People

Steven Russell (Quantros) joins Leidos Health as senior vice president for sales and strategic accounts.

Other

BioSensive Technologies looks to raise $30,000 through Kickstarter to develop its Ear-O-Smart earring, which monitors heart rate, caloric intake, and activity level. It expects to start shipping product in June 2015, provided it raises enough cash. I can’t help but paraphrase some of its marketing shtick: Would you want to wear a bulky wrist monitor to a party or on a date (or to the mHealth Summit)? This Digital Diva thinks not.

Officials in Dallas reveal that the city spent $155,000 to respond to the health crises of Ebola patients Thomas Eric Duncan, Amber Vinson, and Nina Pham. Nearly $27,000 (the majority of which will be offset by donations and grants) went to care for Pham’s dog, which included bedding, toys, and boarding at a decommissioned naval air base while Pham was treated at the National Institutes of Health (MD).

Contacts

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

More news: HIStalk, HIStalk Connect.

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5 Questions with Nancy Adams, Executive Director, Monroe County Medical Society

Nancy Adams is Executive Director of the Monroe County Medical Society and New York Chapter 1 of the American Academy of Pediatrics. She was honored last month with the AMA’s Medical Executive Lifetime Achievement Award for her more than 15 years of dedication to improving the lives of physicians.

How have you seen technology transform healthcare delivery in the physician practice setting over the last 10 to 15 years? Do you think we’re on the right track as far as interoperability is concerned, or woefully behind where we need to be?
Technology has significantly changed the practice of medicine. Through the use of Regional Health Information Organizations, the availability of lab tests and imaging results has improved care, created efficiencies and reduced duplication of services. EHRs have proved to be more challenging.  Interoperability? How about achieving operability first? Physicians are reporting significant challenges in terms of EHR usability. Addressing the issue of operability will be a focus for MCMS in 2015.

You created a $3.1 million grant-funded EHR service bureau to support local medical practices with the purchase and implementation of HIT, and a New York State e-Collaborative Regional Extension Center grant to assist clinicians with requirements for participating in Meaningful Use. Why do physicians still need services such as these, and why did you personally feel the need to step up and create them?
Through a grant provided to our local RHIO by NYS and the Greater Rochester Health Foundation, MCMS was able to assist practices with EHR adoption. The grant provided financial support for the purchase of the EHR system, and MCMS provided technical support to help the practices achieve successful adoption of the EHR. I personally felt this service was sorely needed as most practices do not have the technical expertise to make an informed decision about purchase, nor do they have the change management expertise to move from paper records to EHR.

How have these projects been received by the colleagues you are trying to serve? What are the goals for each initiative?
The projects have been well-received, especially when we were handing out checks! Physicians truly appreciated the financial and technical support. Goals for the EHR project were to successfully implement EHR systems into 65 practices. The Regional Extension Center work is focused on assisting the physicians with achieving MU requirements.

What other HIT projects are you currently involved with?
As I mentioned before, MCMS will focus on usability of EHRs in 2015. Very little is being done to address this issue. In addition, we continue to work on policies and principles related to sharing health information electronically. I have a personal interest in protecting a minor’s right to confidentiality in the electronic world, and am privileged to work with our local RHIO on this issue.

What are your thoughts on recent trade group calls to overhaul MU to refocus it solely on interoperability? If you had your way, how would you reinvigorate this program for the benefit of providers and patients?
We are hearing loud and clear from our physicians that Meaningful Use lacks meaning. I couldn’t agree more that the program needs an overhaul. If I had my way, physicians and other actual users would have significant input into the program.

Contacts

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

More news: HIStalk, HIStalk Connect.

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

News 12/4/14

Top News

International Rescue Committee plans to roll out a new EHR at its Ebola treatment unit opening the week of December 15 in Monrovia, Liberia. The tool, developed by IRC along with healthcare IT vendor Vecna, will be accessed via waterproof Sony tablets that can be taken into high-risk zones. Wilson Wang, MD senior clinical advisor for IRC’s Ebola response team, is confident the new EHR – the first to be used by providers working in the midst of the West African outbreak – will enable better physician support, especially in light of the fact that there is not yet a single source of information for the most up-to-date data on what’s working in the current outbreak. “We think this has the potential to really change not only how quality and safety is addressed in an Ebola situation, but it can also be adapted to any health care situation,” Wilson adds.

HIStalk Practice Announcements and Requests

The folks behind National Ugly Christmas Sweater Day (December 12 this year) contacted me to let me know they have partnered with Save the Children for the Make the World Better with a Sweater campaign. The idea is to spread holiday cheer all in the name of a good cause. Money raised will go towards Save the Children’s mission of “giving children in the United States and around the world a healthy start, the opportunity to learn, and protection from harm.” Seems like a good excuse to get a few co-workers together and have some fun on a Friday. Send me pictures of you in your ugliest Christmas sweater, and I’ll make a donation on behalf of HIStalk Practice readers.

HIStalk is offering 25-percent off webinars (promoted or produced) through the end of the year. Email Lorre for all the details. You can pretty much guarantee they’ll be a hit, as we put your webinar content before several executive-level members of our review committee to ensure your presentation is engaging and educational (rather than a blatant sales pitch).

Webinars

December 17 (Wednesday) 1:00 ET. There Is A 90% Probability That Your Son Is Pregnant: Predicting the Future of Predictive Analytics in Healthcare. Sponsored by Health Catalyst. Presenter: Dale Sanders, SVP of strategy, Health Catalyst. Predictive analytics is more than simple risk stratification. Once you identify an individual’s risk, what are the odds that you can change their behavior and what will it cost to do so? This presentation, geared towards managers and executives, addresses scenarios in which predictive models may or not be effective given that 80 percent of outcomes are driven by socioeconomic factors rather than healthcare delivery.

Acquisitions, Funding, Business, and Stock

E-commerce services and on-demand software vendor Ebix acquires Oakstone Publishing, which develops continuing education and certification materials for physicians, dentists, and allied healthcare professionals. Ebix will integrate Oakstone into its A.D.A.M. Health Information Exchange Division.

Announcements and Implementations

CareSync launches its Chronic Care Management tool to better connect providers, patients, families, and caregivers. The new tool offers care plan development, appointment scheduling, medical records collection, and discrete data entry to create meaningful reports.

Ingenious Med joins athenahealth’s More Disruption Please program. (I am kicking myself for picking up just one pair of shades at Ingenious Med’s booth at the Health IT Leadership Summit a few weeks ago. The color screams “Digital Diva,” don’t you think?)

Seven health plans in Colorado – all part of the CMS Comprehensive Primary Care Initiative – are working to develop an online data-sharing tool that will offer physicians a single source for claims data from each health plan. Rise Health will partner with the state’s Center for Improving Value in Health Care to build the tool, which will be available in early 2015.

Oscar Insurance Corp. selects NaviNet’s Clinical Document Exchange and Open payer-provider collaboration platform to work more closely with its physician network in New York and New Jersey, and to support patient-centered clinical workflows and value-based reimbursement models. (You can read Lt. Dan’s summary of Oscar’s evolution here.)

EHR vendor CureMD chooses DrFirst’s EPCS Gold to add e-prescribing of controlled substances (EPCS) to its system. DrFirst reports that EPCS volumes jumped by 200 percent in the most recent three-month period, likely boosted by New York’s I-STOP mandatory e-prescribing requirement for all drugs beginning March 27, 2015.

Government and Politics

Several medical associations, including the National Physicians’ Council for Healthcare Policy, push for Congress to further delay ICD-10, which is set to be implemented by October 1, 2015. Politico reports that a second delay could be attached to a continuing resolution on the $157 billion labor, education, and HHS funding bill, which expires December 11, or to a repeal of the sustainable growth rate, which physicians also are pressing for. Draft language on the continuing resolution is expected next week.

An ONC blog post by Karen DeSalvo, MD called “Health Data Outside the Doctor’s Officer” references a new JASON report titled “Data for Individual Health.” The report addresses the steps needed to move to “a system focused on health of individuals rather than care of individuals” in creating a learning health system. Some of its recommendations:

• HHS: take action on previously created reports and measure progress.
• HHS: adopt interoperability standards and incentives.
• HHS: support open API standards and pay providers more (the report suggests a 0.25 percent bonus in CMS’s Hospital Value-Based Purchasing Program) for using “ecosystem-friendly EHRs” that follow those standards.
• HHS: encourage non-profits (such as disease-specific advocacy groups) to mark consumer apps with their stamp of approval to increase their adoption.
• Joint Commission and professional schools: add informatics training requirements.
• FDA: loosen control of product services that could be construed as practicing medicine, for example, allowing apps to report their information to both provider and consumer as a risk mitigation strategy.

Research and Innovation 

A HIPAA compliance survey of nearly 1,200 physician practices and billing companies finds that:

• 66 percent of respondents were unaware of HIPAA audits.
• 35 percent said their business has conducted a HIPAA-required risk analysis.
• 34 percent of owners, managers, and administrators were "very confident" that their electronic devices that contain PHI were HIPAA compliant.
• 24 percent of owners, managers, and administrators have evaluated all of their BAAs.
• 56 percent of office staff and (non-owner) care providers have received HIPAA training in the last year.

Coincidentally, a local business paper highlights what many of those survey takers already know: Physician practices aren’t doing enough to protect patient information. Small practices need to “understand that just because they are small doesn’t mean they aren’t targets; in fact, they may just be easier targets.”

Canada’s National Physician’s Survey finds that 75 percent of MDs use EHRs to enter or retrieve clinical patient notes on a laptop or desktop. That number has tripled since the survey was given in 2007 by the College of Family Physicians of Canada, Canadian Medical Association, and Royal College of Physicians and Surgeons of Canada. The biggest physician challenges to accessing information include reporting technical glitches, compatibility issues with other systems, and firewall or security issues. The survey’s upbeat findings contrast sharply with news out of Quebec that its $1.4 billion EHR project is an abysmal failure.

In case you were wondering, a Bankrate survey reveals that nearly two-thirds of respondents find selecting a new health insurance plan to be at least as bad as having a cavity filled, and over 70 percent say the process compares to the fun of doing their own taxes or sitting in the middle seat on an airplane. In other amusing, but barely relevant news, former CMS Administrator Kathleen Sebelius compares Healthcare.gov’s first open enrollment to “buying an airline ticket using your fax machine.”

People

Laurens Albada (Greenway Health) joins Vista Equity Partners (Greenway’s owner) as managing director of financial services.

Anthelio Healthcare Solutions names Gary Trickett (Allscripts) SVP of IT services.

Glen Loomis, MD (St. Elizabeth Physicians) receives the Citizen Doctor of the Year Award from the Kentucky Academy of Family Physicians.

Kim Snare (Greenway Health) joins DocsInk as vice president of sales.

Navid Asgari is promoted to vice president of service and support for CompuGroup Medical’s Ambulatory Information Services division.

Medecision expands its leadership team with the appointment of Jennifer Ponski (White Goose Innovations) to chief administrative officer; Augusta Kairys (Highmark) to senior vice president, market owner, health plans; Greg Leder (Elsevier) to senior vice president, sales and account management, health delivery solutions; and Mary Sirois (Divurgent) to senior vice president, consulting and professional services.

Other

News of Allied Physicians Group (NY) acquiring three physician practices prompts one merging MD to comment that, "I have been in solo practice now for 25 years. Trying to keep pace with the technical requirements necessary to administrate a medical practice, as well as the increasing costs, had pushed my resources to the brink. Joining Allied will now liberate me from the onerous responsibilities of administration, and allow me to focus on patient care. This should make my practice financially stronger, and allow me to do what I wanted to do for years: hire additional pediatricians to help me shoulder the load."

Sony Pictures Entertainment suffers a hack resulting in the theft of over 25 gigabytes of data on tens of thousands of company employees, including Social Security numbers, salary information, and health savings account data on over 700 staffers. The news comes nearly a week after another cyberattack took down the company’s corporate email system, prompting the FBI to designate it the “first major destructive cyber attack waged against a company on U.S. soil.” Fingers have been pointed at hackers in North Korea, whose government is not happy with SPE’s latest film, “The Interview.” North Korean officials have denounced it as “undisguised sponsoring of terrorism, as well as an act of war.” Seems like a marketing gimmick to me.

Sponsor Updates

• PerfectServe posts a blog entry titled “Evolving Healthcare: Six New Realities for the C-Suite.”
• NextGen connects its Share platform with Merge Healthcare’s iConnect Network.

Contacts

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

More news: HIStalk, HIStalk Connect.

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

News 12/2/14

Top News

New RAND research finds that it’s too soon to determine the benefits of HIEs due to a lack of evidence. Funded in part by the VA, the research finds that only 13 of the nation’s 100-plus HIEs have been evaluated, with six of those being in New York. It also concluded that most medical groups claim they want exchanges, but must overcome barriers to acceptance and sustainability. “The real message here is that we don’t have enough data to draw conclusions,” said lead author Robert Rudin. “It’s very possible some of these operational [exchanges] are doing a great job and producing a lot of value in terms of cost savings and benefits. Until we have more evidence of impact, every health information exchange effort in the country should be considered as an experiment. The only way to learn from experiments is to evaluate them.”

HIStalk Practice Announcements and Requests

I’m a bit biased as far as the latest HIStalk poll goes, given that I live in one of the seven cities contending for the title of the “Nation’s Capital of Health IT.” Not that I’ve tried, but you can only vote for your city of choice once.

#GivingTuesday kicks off December 2, and I’d like to use it as an excuse to highlight HIStalk Practice readers over the next several weeks who are doing good things for their patients, customers, and communities. Staff at the Greater Buffalo United Accountable Healthcare Network (NY) are a great example. They gave away 100 Thanksgiving turkeys to patients most in need for the second year in a row. Send me a short write-up of your organization’s good deed along with a pic or two, and I’ll post it here, inducing warm fuzzies and hopefully inspiring others to follow in your charitable footsteps.

Thanks to the following renewing sponsors for their support of HIStalk Practice. Click a logo for more information.

Acquisitions, Funding, Business, and Stock

Fruit Street Health amends its certificate of incorporation to become a Delaware Public Benefit Corporation, chartered to "to use business to have a social impact." The press release announcing the switch focuses more on the company’s recent media coverage than it does on explaining why the change was made. It does note that CEO Laurence Girard decided to convert the company to a DPBC to “hold the company true to its social mission and also ensure that this time around the directors act in the interest of not only investors, but also employees, society, and the patients and healthcare providers that Fruit Street serves.” It expects to launch its $300-a-month digital health and wellness platform in the next few weeks.

Royal Philips acquires a minority stake in Image Stream Medical as part of its agreement to incorporate ISM’s surgical image stream management technologies into its hybrid suite and interventional lab solutions with integrated video and live-streaming capabilities. Terms of the deal were not disclosed. The deal comes just two months after the company announced it will combine its healthcare and consumer lifestyle divisions under the HealthTech name.

The National Institutes of Health awards Leidos a $113 million contract to support IT services for its Electronic Research Administration, which manages the NIH’s multibillion-dollar research and non-research grants program.

Cybersecurity firm FireEye discloses that an unidentified hacking ring dubbed FIN4 has spent the last 18 months stealing corporate secrets in order to cheat the US stock market. The group has attacked email accounts at over 100 US firms, most of them pharmaceutical and healthcare companies, looking for insider data that could be used to profit on trades before the data was made public.

Announcements and Implementations

Advocate Community Partners (NY) selects the eClinicalWorks Care Coordination Medical Record and Electronic Health eXchange interoperability platform to help it meet Delivery System Reform Incentive Payment program objectives, which include reducing avoidable hospital use by 25 percent over the next five years. ACP, formerly known as AW Medical Office, serves 437,000 patients from primarily Asian and Latino communities.

GE Healthcare announces keynotes for its Centricity LIVE 2015 user conference, April 29-May 2, 2015, in Orlando: Atul Gawande, MD, MPH (surgeon and author), Melissa Etheridge (singer-songwriter), and LeVar Burton. I wonder if Burton, who hosted beloved children’s series Reading Rainbow for over 20 years, will talk about the benefits of crowdfunding given that he raised $6 million to revive the show as an app earlier this year. 

Gila River Health Care (AZ) selects NextGen’s ambulatory EHR, PM, and NextPEN solutions as part of its efforts to transition its behavioral health services from paper to digital, and to prepare for Meaningful Use Stage 2 and the transition to ICD-10. GRHC is part of the Gila River Indian Community, which manages healthcare administered by the federal Indian Health Services.

Government and Politics

HHS announces that over 462,000 people signed up for or renewed health insurance coverage during the first week of open enrollment at Healthcare.gov. Enrollment numbers were likely given a boost during Black Friday, thanks to outreach kiosks set up at malls in Florida, Illinois, New Jersey, Connecticut, Maryland, New York, and the state of Washington. HHS has also announced marketing partnerships with the National Community Pharmacists Association and the XO Group, which runs websites targeting brides, new mothers, and homeowners.

CMS seeks comment on its proposed final ACO rule, which makes adjustments to the Medicare Shared Savings Program that include:

• Providing more flexibility for ACOs seeking to renew their participation.
• Encouraging ACOs to take on greater performance-based risk and reward.
• Emphasis on primary care.
• Alternative methodologies for benchmarks.
• Streamlining data sharing and reducing administrative burden.

Those of you itching to comment are out of luck at the moment. Links to the full proposal and comments page both seem to be down as of Monday night.

People

Community Health Services of Lamoille Valley (VT) honors Diana Smith with its annual Spirit Award for her work as the EHR systems specialist for the organization’s eClinicalWorks software program.

Research and Innovation

A MIT Technology Review article titled “Google Glass is Dead; Long Live Smart Glasses” says interest in Glass has rapidly evaporated as Google has lost key personnel and failed to advance the product from geek beta experiment to consumer mainstream. The article says the technology is fine, but the form factor needs to evolve so that the technology is hidden within the glasses instead of being perched like a prism on top of them, perhaps even being incorporated into a contact lens. Despite MIT’s dire prediction, Glass is looking to develop a more consumer-friendly, second-generation headset featuring an Intel processor. Rumor has it Intel will promote the new model to hospitals and manufacturing companies.

Researchers from the Pitt Graduate School of Public Health identify six categories of barriers to sharing medical data worldwide: technical, motivational, economic, political, legal, and ethical. Dean Donald Burke explains that, “These barriers and categories describe a landscape of challenges that must be addressed comprehensively, not piecemeal. We must work together as a global community to develop solutions and reap the benefits of data-sharing, which include saving lives through more efficient and effective public health programs.”

Other

Practice Fusion co-Founder and VP Matthew Douglass takes to TechCrunch to argue for “an open and unbiased Internet” to “ensure a future of American digital healthcare progress and startup innovation.” He points out that:

“This new concept of tiered pricing based on the type of content being delivered would disrupt the internet as we know it and would harm doctors, patients, and smaller startup Internet companies working diligently to upgrade our nation’s digital healthcare infrastructure. To ensure America’s healthcare technology infrastructure can continue to grow and flourish for the rich and poor alike, it is imperative that ISPs are not allowed to create tiers of speeds in this manner.”

Several commentators point out that his argument is weak on facts, but I give the guy high marks for responding to each naysayer.

Brant S. Miller, MD shares his frustration with the walk-in clinic experience after waiting 65 minutes for a flu shot at a clinic affiliated with the University of Texas Health Science Center at San Antonio:

1. The CVS MinuteClinic business model appears to be in trouble.
2. It has severe IT problems.
3. It doesn’t take a NP to give flu shots.
4. It doesn’t take an electronic medical record to give flu shots.
5. There appears to be little, if any, supervision of the MinuteClinic NPs by the UT system.
6. If this were a heart attack patient coming in with symptoms masquerading as "the flu," the NP would be so busy fooling around with the computer that she wouldn’t recognize the potentially fatal acute condition until it was too late.
7. It’s important to focus on the patient first, and not on the computer or the business model.
8. I wonder if and when the business gurus managing this clinic will figure out that it is taking way longer than 8 minutes to administer flu shots.

Wired paints a pretty complete picture of the Kiva robots Amazon uses at its fulfillment center in Tracy, CA to handle the frenetic online shopping associated with the long Thanksgiving weekend. The center houses 21 million items, with the capacity for 5 million more, and ships out 700,000 items on a peak day.

No mention is made of the percentage of ugly Christmas sweaters stored and shipped via Amazon. I haven’t felt the need to don one (ever), but that might change come National Ugly Christmas Sweater Day, which falls this year on December 12.

Contacts

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

More news: HIStalk, HIStalk Connect.

Get HIStalk Practice  updates.
Contact us online.

From the Consultant’s Corner 12/2/14

Portals: The Next Step in Patient Engagement

Although healthcare practices are racing to adopt patient portals to meet MU Stage 2 requirements, these tools offer much more than just a way to receive incentive dollars. When employed strategically, they can facilitate personalized patient engagement, improve satisfaction and maintain loyalty, elevating an organization’s clinical and financial performance as well as its service delivery.

How Portals can Capture Patient Attention
Portals facilitate engagement, and ultimately the patient experience, by providing significant benefits to both patients and providers. For example, a portal operates on the patient’s timeframe with 24/7 availability anywhere the patient wants to use it. Moreover, it provides a confidential communication platform for personalized two-way dialogue between patients and providers, allowing patients to get their questions answered in a private and secure manner without having to make an appointment and spend time visiting the doctor’s office. This often encourages patients to address health issues more readily.

Portals also increase efficiency by offering real-time, online appointment booking that saves patients and staff time. Patients can even pre-register for appointments online, streamlining their arrival to the office and getting them in front of the physician faster.

On the business side, portals facilitate patient payment through electronic statement delivery and remittance capabilities. Not only does this make payment more convenient, it increases the likelihood patients will pay, helping the practice improve cash flow while decreasing the risk of bad debt.

Strategies for Optimizing Portals
When used to their potential, portals can provide a competitive advantage over market peers, especially those without a robust tool. The technology communicates that a practice is forward-thinking and patient-focused while enabling convenient and responsive care. As healthcare reform gives patients more flexibility in where they seek services, it is becoming even more important to fully leverage portals to foster patient engagement and satisfaction. This increase in patient satisfaction can ultimately help improve a practice’s financial performance.

In my opinion, practices can get the most out of their portal by implementing the following tactics:

• Create a multi-disciplinary group to develop an overarching portal strategy. When viewed as an IT project, portal implementation tends to focus on meeting MU requirements rather than enhancing the patient experience. To avoid this scenario, practices should bring together clinical, practice management, and IT leaders to define portal goals and objectives, keeping the patient top-of-mind. During this time, the group should clearly outline roles, so that everyone knows the part they play in optimizing portal use before, during, and after implementation.
• Use clinical staff to promote portals and get patients registered. The portal’s credibility goes up when physicians or nurses talk with patients about the tool’s capabilities and benefits, and encourage enrollment. Clinicians should take advantage of one-on-one time with patients to explain how current care could be more efficient if the patient used the portal, providing specific examples the patient can understand. For instance, the provider could point out that patients are able to refill prescriptions via the portal, reducing the time the physician and patient need to spend during the onsite visit discussing refills. To further prompt enrollment while the patient is in the office, practices should provide convenient registration opportunities—perhaps through a designated kiosk, desktop, laptop or tablet.
• Engage patients when sign-up occurs. To fully reap the benefits of a portal, practices should look beyond enrollment. If patients sign up and nothing happens, they probably won’t use the portal in advance of the next visit. On the other hand, if the practice immediately contacts the patient with a personalized acknowledgement, the patient may be more likely to use the technology long-term. I’ve seen practices send a message to patients a few hours after enrollment with a communication from the physician explaining lab results and providing prescription renewals. This draws the patient in and clearly demonstrates the portal’s value. In my opinion, organizations that commit to regularly using the portal to communicate information of value can dramatically expand patient adoption and care involvement.

The Future Looks Bright
As providers and patients increasingly accept portals, new applications will broaden their impact on care delivery and the patient experience. For example, portal-enabled e-visits are an emerging way to streamline care for certain patient types and non-urgent issues, while meeting consumer demand for convenience. Instead of making an appointment and driving to and from the practice — sometimes requiring more time than the appointment itself — the patient communicates directly with a nurse practitioner or other clinician via the portal. The e-visit carries a flat fee that is payable when the patient books the appointment online. Even though the cost is not currently covered by all payers, this has not deterred patients in those practices now offering e-visits.

Given the current trajectory, portals stand to play an expanding role in healthcare delivery. In my view, organizations that are prepared with a patient-focused portal strategy can ensure they get the most out of the technology, helping to improve the overall patient experience and strengthening the practice’s future viability.

Brad Boyd is vice president of sales and marketing for Culbert Healthcare Solutions.

Contacts

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

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