From MGMA 10/8/13 Afternoon Update

I’m a little weary from my day so this update will be brief. I’ll have a complete wrap-up tomorrow.

I have an important announcement to make: I’ve decided to stay in San Diego and open a hair salon.

Dear Emdeon: please send me a pair of the lime green shoes.

Thanks Capario for displaying your HIStalk sign!

Sadly I missed out on NextGen’s chair massage.

My favorite booth. Cool couches, open, and welcoming.

If I hadn’t just had my picture taken in a boa at Greenway’s party I would have donned a fun get-up and taken advantage of Trizetto’s photo booth.

I don’t recall what Emdeon was giving away but a crowd of folks were hoping to win something big.

Nothing draws more people than a drawing for $1,000, courtesy of MGMA and their sponsors.

I intentionally went light on swag, but I am optimistic I will get an email from someone saying I won an iPad mini.

I have the best story to go with this tee shirt, and I will share it tomorrow. For now let’s just say that the CEO of CompuGroup Medical rocks.

Happy travels if you are heading home Tuesday. If you are still in San Diego tonight, I’ll be the one with swollen feet and flats.

Email Inga.

From MGMA 10/8/13

Fun, fun, fun in San Diego Monday night!

I recruited an enthusiastic friend and we hit seven parties and still managed to get back to our hotels at a decent hour. We started at Practice Insight’s event at the Marriott’s Marina Kitchen. Above is the amazing view we enjoyed while sipping on wine and eating maple-smoked bacon on a stick (kind of like a lollipop – totally decadent.) As we looked at the harbor we fantasized about moving to San Diego and its seemingly perfect climate.

We cut short our day-dreaming to head to CareCloud’s party, which was also at the Marriott. The outside venue was near the pool and spilled onto the lush green lawn. CareCloud offered chair massages, which seemed to be a big hit. I noticed that CareCloud also brought along a few demo stations to show off their product, which actually seemed like a pretty smart thing to do. The crowd was definitely larger than I anticipated and the location was perfect.

Of course I noticed that the CareCloud ladies working registration were wearing some hot shoes.

We jumped into a pedicab (which is much more fun than a regular cab) and headed to GE Healthcare’s party at the Hard Rock Hotel. Yet another beautiful venue and the fire pits offered the perfect amount of heat. We snacked on some tacos, had a glass of wine, and chatted with a few GE folks. Compared to CareCloud’s large event, GE’s seemed more exclusive, which of course made us feel quite special.

Next we headed to the Solamar Hotel, where both Ingenious Med and athenahealth were hosting parties. Ingenious had taken over the Jsix restaurant, which had a nice bar and lots of friendly Ingenious employees greeting everyone.

We then took an elevator up to the Solamar’s pool bar to athenahealth’s party. The athena folks know how to have fun and Jonathan Bush was his typical boisterous self and talking to everyone about everything. We snacked on some yummy appetizers, had another glass of wine, and chatted with several folks in the large and happy crowd. I really would have loved to stay longer and listened to Jonathan address the crowd, but we had other parties calling.

We strolled to the Greenway party, which had a roaring 20’s theme. The photo sessions in the back room were a big hit and we put on a couple hats and boas and got our picture snapped. It’s a great souvenir and a fun idea. We also got to keep our long pearl necklaces and mustaches on a stick. Mustaches on a stick make me happy.

Finally, we jumped in a cab and headed to Vitera’s event on the USS Midway. The ship was by far the coolest venue of the evening. Its size is amazing (apparently holds 4,000 people) and a few dozen planes are permanently parked inside the hangar. Vitera had a fireworks display and a great band with several female singers. Lots of people were dancing, including Vitera’s CEO Matt Hawkins. The party was really over the top on several levels. If/when HIMSS ever returns to San Diego, I am voting for the Midway as the site for HIStalkapalooza.

Finally, we jumped in another pedicab, rubbed our tired feet, and headed to our hotels. Thanks for all our hosts for the hospitality, the great drinks, and yummy food!

On Tuesday’s agenda: a couple of sessions and lots of time in the exhibit hall.

Email Inga.

From MGMA 10/7/13 Afternoon Update

I am about to head out to a few parties but first want to share some of the highlights of my day.

George Will was the morning keynote speaker. Since he is known primarily for being a conservative political commentator I was quite surprised and disappointed that he made no more than a passing mention about the current government shutdown. He focused more on the poor state of our economy, how we got here, and what might happen if things don’t change. He ended on a somewhat optimistic note, saying that Americans are “thrifty industrialists” and we will eventually figure things out. Will is quick-witted, tells some good stories, and offers some logical arguments to support his opinions. I am not sure I agree with all his opinions and wished he offered more concrete suggestions for fixing our current problems, but all in all I enjoyed his presentation.

Next I sat in a standing room only session on EHR and risk management led by the consultant Nancy Babbitt. She offered some solid suggestions for ways practices can tweak the use of their EHRs (and other technology) in order to mitigate risk and provide better customer service. I didn’t notice anyone leaving early so I’d say the crowd valued what she had to say.

Speaking of standing room only, I noticed this tweet from someone complaining about not being able to get into a couple of sessions. Don’t know if Melissa was just having bad luck or if overcrowding is a widespread issue.

After the EHR risk session, I stood with the crowds for 45 minutes until the exhibit hall opened. I am pretty frustrated with the limited exhibit hall hours and have heard other attendees expressing similar disappointment. I think hall is open for a total of about seven hours, including the reception last night and during an extended lunch hour today and tomorrow. I have to believe the vendors would also like more face time with attendees. I realize the goal is limit the competition between sessions and the exhibits but given that there are 360 vendors, seven hours is not enough time to explore things, much less schedule any one-on-one meetings. Today I had only about 30 minutes in the hall before having to head out for other meeting.

While waiting for the exhibits to open, I did have time to check out some of the fashion on display. Here are some sandals I thought looked reasonably comfortable and also cute. Bonus points for the purse.

Once I made it into the hall, I ran into Maria from athenahealth. That girl always brings her A game when it comes to shoes.

Thanks VersusTech folks for the picture of your HIStalk sign in your booth. I’ll be by tomorrow to check it out.

Best session of the day for me was a discussion on IT in Healthcare, which included panelists Stephen McCallister, Waco Hoover, Rosemarie Nelson, and a strangely dressed female; MGMA’s Derek Kosiorek moderated.  (Rosemarie – I’m still waiting for my free glass of wine.)

Official attendance, according to MGMA: 4,600. I also learned the official theme of the conference is “meeting practice success face-to-face.”

I’m off to check out the after-hours party scene. Look for details on the escapades tomorrow!

Email Inga.

From MGMA 10/7/13

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The MGMA13 crowds arriving Sunday were greeted with chamber of commerce weather: clear skies and a high of 86 degrees. I’m not sure how many folks come early for the pre-conference sessions but I wouldn’t be surprised if a few attendees played hooky and basked in the sun yesterday afternoon. Today’s high is a more seasonal 75 degrees – still pretty darn nice.

I arrived early afternoon and I grabbed a bite to eat at an outdoor cafe before heading over to the convention center. I arrived too late for the opening speaker (former Blue Angels pilot John Foley), but by all counts he provided a motivating message on leadership.

The doors to the exhibit hall opened at 4:30 and the crowds immediately poured in. Instead of a traditional opening reception, MGMA hosted the two-hour reception inside the exhibit hall. Given that the exhibit hall is only opened a total for seven hours through Wednesday I guess it was an efficient way to allow people to socialize and see exhibits.

The food looked fine with a mix of Mexican, Italian, and assorted finger foods. Not surprisingly, the lines at the bars were longer than the food lines.

Thanks to all the HIStalk sponsors displaying their desktop signs. If you see one, please tell the vendor thanks for supporting HIStalk!  Vendors with HISalk signs included Aprima, Emdeon, Iatric, Culbert Healthcare, Quest, Versus, Ingenious, and AdvancedMD.

Overheard in the exhibit hall: “I am spending $3,000 to be here so I need to show my doctors that I found something that was worth my while for being here.” Wish I could have listened in more to learn what her game plan was.

MGMA rolled out a new brand which it says “signifies the Association’s strategic direction and capitalizes on MGMA’s current work to serve members.” I am sure there will be more said in the opening session but it appears the MGMA-ACMPE name has

been dropped in favor of “MGMA.”

Availity gets an early vote in the cool booth category. Very open and comfy couches to sit on while listening to presentations.

NextGen had a smaller booth this year. Last year they had a smaller booth than the previous year so I guess they are on a “less is more” kick. GE, which didn’t exhibit last year, is in a back corner, while Vitera, athena, Greenway, Pulse, and Allscripts all have big booths that drew decent crowds during the reception.

Several vendors appeared to be no-shows.

I won a $5 Starbucks gift card from the Emdeon folks when I played their stacking game. It wasn’t too hard so it’s worth a couple of minutes of your time if you enjoy a free cup of coffee.

My Monday agenda includes a keynote session with George Will (I am sure he will have a comment or two on the government shutdown), two or three educational sessions, and another stroll through the exhibit hall. I have lined up the evening party schedule to ensure the maximum number of events before my feet give out.

If you are at MGMA, drop me an email with your impressions.

DOCtalk by Dr. Gregg 10/4/13

Well, Tit My Tat

TIT: Meaningful Use implementation has become “detrimental to the very patient population it is designed to engage and empower.” (From EMR & HIPAA – Mandi Bishop)

TAT: Since its onset, MU has stirred a bazillion more providers and provider organizations out of their entrenched paper bunkers than all the glam and glitz and overpromises of the entire EHR industry. Patients can’t see the rewards of MU implementation until providers are truly using meaningfully. (They’re just starting to do so.)

TIT: EHRs, with all their required clicks and dropdowns and menus and pop-ups take sooooo long to navigate; they take up too much provider-patient time.

TAT: Try and document to the same degree with paper charts – making the output legible, mind you – and retrieve the same info you can via even a poorly designed EHR. How long did it take your staff to find the paper chart you needed? How long did it take to look up those drug-to-drug interactions in that ten-pound PDR? (Could you even read the tiny print?) How many times do you require patients to fill out those same, stupid paper forms and how long does that take?

TIT: Getting patients to understand the patient portal, plus getting them enrolled, takes an enormous amount of time away from patient care.

TAT: Getting anyone to do something new takes effort. If you’re providing them a quality patient portal that gives them self-care value, aren’t you actively engaged in patient care as you help them engage? It’s like teaching someone to ride a bike; it takes some time at first, but once they’re off on two wheels, they won’t need you anymore and will be wheeling happily away to a happier, enabled future.

TIT: Referring a patient – finding the provider’s HISP address and sending the Summary of Care document via Direct – takes so much time and even then the system doesn’t always work right.

TAT: Go ahead. Refer a patient the old-fashioned way. Send them without supporting documentation. Send them with minimally legible paper records via fax or snail mail. Send them with paper records tucked under the patient’s arm (still just as minimally legible.) It may save you time, but what about all the redundant discovery time it takes the specialist to discover what he/she doesn’t get from you or that he/she cannot decipher in your records? Duplication and redundancy and repetition and reiteration and replication and recurrence of effort is such a waste. Plus, the specialist probably charges a lot more for their time, thus the healthcare system as a whole just spent more money covering this superfluous labor. Talk about not working right.

TIT: MU has stalled the innovative spirit of the EHR industry.

TAT: Have you seen the number of new EHRs, new HIT tools, and the new developments in many legacy systems of late? Could innovation have been faster without MU? Maybe, but if the marketplace was still where it was back in 2009, would the industry be growing with just a 17-20% provider adoption rate?

TIT: Lots of providers are starting to balk at moving forward with MU – 17 percent by some accounts. MU has just become too cumbersome.

TAT: Turning that around a bit says that 83 percent of providers are still planning on MUving ahead. Let’s see then…17 percent using an EHR/EMR versus 83 percent trying to use one and do so with some connected purpose…? And some people say MU hasn’t made much difference?!?

TIT: MU isn’t right for everyone.

TAT: What is? How can you design anything, especially something on such a grand scale, which works well for everyone? Hector’s pup, even the iconic iPad isn’t right for everyone.

TIT: MU penalties will hurt those who don’t adopt.

TAT: Yep. Haven’t seen anything that’s worthwhile that doesn’t have some pain associated with its birth.

From the trenches…

“We’re still in the birth pangs of this giant HIT baby we’re all trying to deliver.” – Dr. Gregg

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 (OHIP).