News 11/21/13

From TruthSeeker: “Physician dissatisfaction. KLAS had a report on ambulatory EMR usability earlier this year that seems to contradict the recent IDC Health Insights report. KLAS found 55 to 85 percent of physicians were achieving high usability with their EMRs and only eight percent said they were unable to achieve even moderate usability. IDC claims that lost productivity was the top reason that almost 60 percent of physicians were dissatisfied with their EHRs.” In looking at the KLAS report it appears the focus was more on “usability” than “productivity.” Can an EMR be easy to use but not necessarily a boon to productivity? Participants in the KLAS survey were primarily physician leaders at practices with 25 or more providers, so it’s likely the KLAS survey population included an abundance of EMR champions and power users. Given the differences in the studies I don’t think you can conclude their findings contradict one another. In terms of physician dissatisfaction, I’m sure there are plenty of  “in the trenches” providers who are dissatisfied with their existing EMR products and have legitimate concerns over lost productivity.

RelayHealth Financial announces that all its financial connectivity solutions meet the current ICD-10 standards and that ICD-10 testing is available at no cost to its customers.

Hartford HealthCare Medical Group (CT) selects MediRevv to provide A/R liquidation management services for its 250 providers.

MDS Medical, Greenway Medical’s top-producing channel partner, acquires the PrimeSUITE assets and customers of EHRsolutions, Greenway’s second largest reseller.

Ophthalmology Associates (WI) selects SRS EHR for its six providers.

eClinicalWorks will invest $50 million over the next 12 months in addition to the $25 million it had already committed to enhance and expand population health solutions and patient engagement tools under its Health & Online Wellness business unit.

If you follow HIStalk regularly you may have read about my ongoing attempts to secure new insurance coverage through the HealthCare.gov marketplace. Today I got an email from the new carrier requesting additional information and asking me to name my primary care provider. I rarely get sick and haven’t had a PCP in years, so I went to the Internet to search for a potential candidate. I ending up reading a number of patient reviews from sites like Healthgrades, Yelp, and Vitals.com and found a disturbingly high percentage of doctors with ratings below the national average. I was left wondering if, 1) my new carrier only attracts crappy doctors, or, 2) people are more prone to post reviews if they have a negative experience. I am betting on the latter (and of course hoping not to test the theory any time soon). I did finally select a physician who had very positive reviews from both an ER nurse and a pharma rep. The experience has me thinking that physicians would be well-served to send their (happy) patients to these ratings sites in the same way my hairdresser and veterinarian do.

The AMA House of Delegates calls for continued advocacy to delay or cancel the implementation of ICD-10 and to seek federal legislative and regulatory reform to require funding assistance for physician practices to offset the cost of the transition.

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News 11/19/13

From Bob Christgau: “Re: NextGen User meeting. I thought the meeting itself was great, though the bands were terrible.The opener was the Brian Setzer Orchestra (and I actually like them) but it was so loud and distorted it was not enjoyable. The second act was Big and Rich who were clearly already drunk before they started the performance, which forced me to retire to the bar.” I wonder if vendors would be better off spending their money on a great cover band like Vitera did at MGMA. I recall a few great entertainers (Zac Brown and Colbie Caille come to mind) during HIMSS parties, but I also remember looking for the nearest exits during a couple user group meetings featuring pathetic performances by Kasey and the Sunshine Band and a tired Loretta Lynn.

An IDC Health Insights report highlights disturbingly high levels of physician dissatisfaction with their ambulatory EHRs. In a relatively small survey of 212 providers, 58 percent said they were very dissatisfied, dissatisfied, or neutral about their EHR. The providers, which included both PCPs and specialists, used over 25 different EHR products and cited lost productivity as the biggest problem with the technology. The top reasons for EHR satisfaction were a reduction in lost or missing charts, the ability to access charts remotely, and incentive payments.

Also disturbing: this essay by an Alabama physician who describes the inefficient and cumbersome EMR she uses to document a visit with a dementia patient suffering knee pain. Based on the results from the above survey, there must be plenty of EMR users with similarly clunky systems; however, I know of plenty of products that sound far more user-friendly than the one she is using. If you are a provider or a vendor, please assure me your product is more efficient.

Greenway Medical releases Intergy v9.00, which includes a dashboard to track the progress of a practice’s transition to ICD-10 or MU attestation. It may take me awhile to get used to the new Greenway/Intergy name combination.

ONC announces an interoperability project to enhance data exchange between EHRs, prescription drug monitoring programs, and pharmacies to help prescribers identify potential abusers directly from order entry. The initiative would establish common technical standards and a standard vocabulary to allow EHRs and HIEs to integrate data from state-run prescription drug abuse databases.

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News 11/14/13

A Pennsylvania physician sues his billing company for more than $100,000 in lost revenue after thousand of patient records were wiped from the billing company’s computer. Bholo Roy, MD claims that more than 100 clients lost data after the billing service’s computer failed with no usable backup. Roy concludes, “It is all in the cloud, and if the cloud disappears someday, we are all in trouble.”

MGMA finds that almost 80 percent of medical practices deemed “better performers” use patient-satisfaction surveys to evaluate and improve practice operations. About 10 percent of the better-performing practices use patient-satisfaction survey results as part of their physician compensation formula.

Kareo launches Kareo Marketplace, a solution center to help private practices identify cloud-based applications and services to optimize their operations. All offerings integrate with Kareo’s medical office software platform and include solutions for practice marketing, EMRs, document management, billing services, and consulting.

CareCloud names Kevin Brown (athenahealth) VP of west coast sales.

Join me in giving a big shout out to ESD, HIStalk Practice’s newest Platinum sponsor. ESD has been a HIStalk sponsor since 2009 and recently opted to extend their support to both HIStalk Practice and HIStalk Connect. ESD is one of the country’s largest HIT consulting firms and works with organizations to implement new or upgraded systems or just make existing systems work better. Their clinical professionals know all facets of HIT and can help with EMR implementations, staff augmentation and training, ICD-10 readiness, project management, physician help desk, and more. Solutions expertise includes Allscripts, NextGen, and  Epic. For the last three years ESD has been named a Best Place to Work in Healthcare based on employee retention, employee benefits, and economic success. I also happen to know they a fun bunch since they hosted a very lively HIStalkapalooza in 2012 and brought a top-notch bowling team to this year’s event. Thanks to the ESD folks for supporting HIStalk Practice.

NextGen announces NextPen Voice, a pen that accepts either voice or written input depending on user preferences and activities.

E-MDs recognizes its customer Jennifer Brull, MD (KS) for being named an 2013 EHR All-Star for her use of EHR to improve quality care and increase practice profitability.

Beacon Medical Group (IN) will deploy Phytel’s population health management and enterprise care management products for its 145-physician practice.

DrFirst launches Patient Advisor Report Card, which advices physicians of prescription fill rates at the point of care and sends alerts patients of unfilled prescriptions.

Doctors blame EMRs for slowing them down and reducing productive face-time with patients, according to a physician practice preference survey. Physicians point to declining reimbursements and administrative hassles as the top reasons for income dissatisfaction and express frustration with the limits of hospital contracts and pay structures. A third of the 1,474 physicians and staff survey say a portion of their compensation is tied to quality and cost of care provided.

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From the NextGen Healthcare UGM 11/12/13

Special Report from Dr. Jayne

My personal physician is attending the NextGen User Group this week in Las Vegas and agreed to send her impressions of the meeting. I’m always begging for people to report in from various user group meetings so was glad to have a dedicated roving reporter I can live vicariously through while I sit in the office addressing provider quality initiatives. It’s her first trip to a vendor user group so I’ll be looking forward to her insights:

The NextGen User Group Meeting kicked off Sunday night in Las Vegas with a poolside cocktail reception at the MGM Grand sponsored by Itentive. Monday featured keynote speaker Jeffrey Hayzlett from Bloomberg Television. The NextGen leadership team presented as well, showcasing some new products such as NextPen Voice which allows dictation and transcription into the EHR on top of the existing pen functionality that allows capture of discrete data using the pen.

In addition to the Mirth-based NextGen Share product that Inga mentioned on HIStalk Practice, they also announced the new NextGen Patient Portal mobile solution. Attendees were given the opportunity to test drive it using a personalized patient account on their demo system. I have to say it’s a very slick solution and you have to admire the fact that they staffed a mock practice to respond to “patient” requests for appointment, refills, and other services. I thought the fact that available providers included Elvis Presley and Wayne Newton was a nice touch. Also clients who tested it out had the opportunity to win poker chips at a daily drawing. I guess that’s one way to beta test!

Monday night featured customer appreciation events from clearinghouses Navicure and Gateway EDI (TriZetto) as well as HIStalk sponsor IMO. Tuesday features the NextGen client event which I’ve been told is always over the top. I hope I make it that long because my feet already hurt. This convention center is huge.

The way she was gushing about it, I didn’t want to wait until HIMSS to see it (plus I needed a diversion from the above mentioned quality reports) so the folks at NextGen were happy to set me up with a demo account. I wasn’t too happy to see that I already owe a patient balance of $205 for my recent visit with The King but I enjoyed the opportunity to check it out. Apparently I have an appointment pending with Wayne Newton next month.

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News 11/12/13

From Caymus: “Re: Patient portals. I know a number of practices who already charge patients to access their portal and have for years. Some actually want to have different charges based on tiered portal service. Note that the portal is often wrapped into other concierge-style options.” CMS agrees with me that it’s not “appropriate” for providers to charge patients a fee to access their portal or online PHR. If patients are willing to pay, however, then good for the providers that are successfully collecting fees. I’ll mention that there was a time I paid about $40 a month for home phone service, $15 a month for AOL so I’d have browser and email access, and $5 for movie rentals at the neighborhood Blockbuster store. Perhaps we should re-visit this fee issue in another year or two and see if there are still patients willing to stick with providers that charge for online record access.

NextGen Healthcare hosts 5,000 attendees at this week’s annual User Group Meeting in Las Vegas. During the opening session on Monday, Nextgen introduced NextGen Share, an interoperability solution based on the Mirth HIE platform that facilitates clinical data exchange and referrals from within the NextGen EHR.

The 11-provider Ocean Eye Institute (NJ) selects SRS EHR.

CMS tells MGMA and other stakeholders it might reconsider performing external, end-to-end ICD-10 testing with physician offices following recent problems with its Healthcare.gov site. Previously CMS has said it would not offer external testing and that it was confident with its current internal testing procedures.

Epic, Allscripts, eClinicalWorks, and NextGen customers represent almost half of all EPs that have attested to Stage 1 MU with a 2014 edition base EHR product. CMS reports that through the end of September 47 percent of all EPs (over 325,000) have attested for MU and been paid $2.4 billion.

Medical Radiologists (OH) deploys RadNet’s eRAD technology for its 14-physician group.

Emdeon reports Q3 results: revenues up nine percent, net loss of $16.2 million vs. $15.2 million.

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