News 8/8/13

More than four in five clinicians use a smartphone every day and nearly half of physicians use a combination of a smartphone, tablet, and laptop/desktop routinely in a professional capacity. The Epocrates-prepared report predicts that 90 percent of physicians will use smartphones by next year and almost as many will have adopted tablets. The top task on tablets and computers: EHR, notes, and e-prescribing.

Precision Billing and Consulting Services will implement the CureMD platform for billing and practice management for its 400 physician clients.

BCBS of Michigan reports “strong evidence” of cost and quality savings from its PCMH project, which includes over 3,017 physicians and 994 groups. BCBS documented savings of $155 million during the first three years by avoiding hospital admissions and readmissions, ED visits, and through increased use of generic drugs and fewer radiologic studies.

The 15-physician Puget Sound Institute of Pathology (WA) contracts with McKesson Business Performance Services for RCM services and strategic planning.

Aprima PRM 2014 EHR/PM v. 14.0 earns Meaningful Use Stage 2 certification as a Complete EHR.

TrustHCS joins Greenway Medical’s online marketplace to offer PrimeSUITE customers access to its coding and ICD-10-readiness solutions.

Patients who have used EMRs through online portals express significantly more satisfaction with their physicians, believe they receive better quality of care, and engage in clearer and more responsive communications with their physicians.

Boulder Community Hospital Physician Clinics select Wellcentive’s Advance platform to facilitate care coordination in support of its PCMH implementation and as part of its comprehensive primary care initiative.

In 2012, Medicare paid physicians participating in the Primary Care Incentive Payment Program more than $664 million. The PCIP program pays primary care professionals a quarterly bonus of 10 percent if their primary care billings comprise at least 60 percent of their total Medicare allowed charges.

The AMA notifies CMS of additional problems with the Medicare Physician Compare website, including issues with the search function and inaccurate practice demographics. The AMA claims that problems with the current design make it difficult for users to identify a physician’s location, hospital affiliation, board certification, and other practice information.

Email Inga.

News 8/6/13

From Caymus: “Re: Aprima user group meeting. I just go back from Aprima’s national conference, which had almost 750 attendees from about 500 practices. MGMA’s Rosemarie Nelson was the keynote speaker and was very impressive. In talking to other attendees the general consensus is that people are happy with where Aprima is heading. Interestingly there were very few former Allscripts MyWay users, but that may change next year once more practices have transitioned.” We always like updates on interesting industry conferences so thanks for the update.

CCHIT designates eClinicalWorks V10 compliant with the ONC 2014 Edition criteria and certifies it as a complete EHR.

An employee of the Rocky Mountain Spine Clinic (CO) who was hoping to do some work from home is fired after misappropriating PHI on 532 patients. The billing department employee created a document that included patient names, insurance company information, and patient surgeries and emailed the file to her personal email account. The clinic later fired the employee, notified affected patients, and filed a police report, but did not press charges since the theft was a “mistake” resulting from “bad judgment.”

ONC releases its user guide to EHR contract terms.

The 210-physician Faculty Practice Plan of Howard University (DC) contracts with CHMB to provide IT project management, application hosting, and support services as the practice transitions to Allscripts EHR and PM.

Physician offices cut 700 jobs in July, a decrease of only .03 percent but the first decline since June 2012. Overall healthcare employers eliminated 6,843 jobs, the highest monthly total since November 2009.

E-mail Inga.

News 8/1/13

Allscripts adds integration with Spaulding webECG, allowing the app to be launched from within Allscripts Enterprise EHR to support physician orders and access to ECG reports.

NextGen reseller TSI Healthcare will integrate PatientPay with NextGen PM.

HealthTronics will integrate SampleMD’s eCoupon and eVoucher solutions from OPTIMIZERx Corp. within its UroChartEHR and meridianEMR platforms.

Hallmark Health System (MA) selects athenahealth’s athenaClarity to proactively manage its patient population and engage in new reimbursement contracts.

LiquidEHR, which offers an EHR/PM platform for the eye care industry, partners with DrFirst to offer users integrated e-prescribing functionality.

3M Health Information Systems introduces Patient-focused Episodes software, an analytics program that considers the costs and outcomes of longitudinal care. PFE defines over 500 episodes of patient care across inpatient and outpatient encounters and analyzes provider costs, resource use, and performance across episodes.

Capterra publishes an infographic that is interesting to dissect, though perhaps not so useful to providers except to narrow the EHR field. The graph displays the top 20 “most popular” EHRs based on a combination of the number of customers and users and “social,” which I assume means social media presence. I don’t see why social media presence would be important to anyone looking to buy an EMR, but I suppose the list is meant to be more of a popularity contest than a hardcore look at customer satisfaction, product usability, or other factors more relevant to product selection. Regardless, what I do like about the graph is that it offers a nice visual to quickly grasp which products serve a relatively smaller number of customers with many users (Epic) versus relatively more customers/fewer users (athenahealth, AmazingCharts.)

Greenway Medical will provide its PrimeSUITE customers access to PatientCo’s patient financial engagement  platform.

E-mail Inga.

News 7/30/13

Zotec Partners signs a definitive agreement to acquire Medical Management Professionals , a subsidiary of CBIZ, for $200 million, making the new entity one of the largest RCM services firms in the US.

CMS reports that the number of physicians opting out of Medicare has tripled since 2009 because of low reimbursements, displeasure with the government’s involvement in medicine, and patient privacy concerns. Despite the growing trend, the overall number of physicians who had previously accepted Medicare and opted out in 2012 is  relatively small at 9,539. AAFP claims the number of family doctors accepting Medicare patients last year was 81 percent, down from 83 percent in 2010.

The California Academy of Family Physicians will provide its members with tools and transformation expertise from Arcadia Solutions to help practices migrate to a PCMH model.

In case you missed it, over the weekend Dr. Gregg shared the story of a blogosphere encounter with another physician whose group recently went live on EMR. Dr. Gregg relayed this anecdote about the other physician’s implementation:

That day – go-live Day One – with no schedule adaptations, the partners were also up and running, most having documented all of their first day’s encounters on the system. Not just one or two patients, but all of them.

I asked Dr. Gregg to give me his opinion on why the practice was so successful so quickly. He points to the software (ElationEMR), which Dr. Gregg tells me is “probably more intuitive than any system I’ve seen.” He notes it does have a few “holes” but it’s only $149/month with no up front fees. I’d never heard of the software but always find it  fun to learn about new programs that seemingly live up to their hype. Dr. Gregg and I have no financial interest, by the way. Just the regular ole nerdy interest.

ONC head Farzad Mostashari, MD and MGMA Healthcare Consulting Group’s Rosemarie Nelson will provide keynote addresses at this week’s Aprima 2013 Annual User Conference in Dallas. On August 3, attendees will make fleece blankets for ICU patients at The Children’s Medical Center of Dallas.

CareCloud reports it signed 150 new medical groups in the second quarter, with more than half selecting CareCloud’s integrated EHR/PM applications.

Though the end of June, 305,778 EPs have been paid more than $595 million in EHR MU incentives.

Walgreens announces a rebranding of its 370 retail clinics, including a name change from “Take Care Care Clinic” to “Healthcare Clinic.”  I bet Walgreens paid millions to advertising gurus to come up with that catchy name.

E-mail Inga.

DOCtalk by Dr. Gregg 7/26/13

The Kicker

Blogging sometimes seems like an extended version of tweeting. You blast out your thought(s) du jour to a largely unknown crowd and respond to those folks who happened to read and whose buttons you happened to have pushed. Blogging just involves longer thought trains than tweeting. It’s sort of the interim step between being a full blown (i.e., real) writer and a tweeter.

But sometimes it gets bigger than that. Sometimes, through the interplay of commentary, you learn something cool or you connect with someone you might otherwise never have met. That’s the really fun part — the kicker — to being a part of the blogosphere.

I got just such a kicker recently. Actually, I got a double kicker, though not through my own blog ramblings this time, but rather via the “Comments” section on another.

Those comments were left by Dr. Andrew Schechtman. He shared a bit of his group’s experience as they searched for an EHR. I found his comments on this — and on the current state of affairs of EMRs/EHRs — to be well written and insightful. He seemed a bright light, so I looked for and found him on LinkedIn. I sent a message asking him to chat. We connected via Skype shortly after.

I’m in Ohio; Andrew is in the San Francisco Bay area. I was in a tee shirt and at home as it was later evening for me and I had just hung up from a two-hour conference call. I was tired and hadn’t even had a chance at dinner yet.

Andrew came onto the video call with his stethoscope still draped across his neck. In dress shirt and tie, he closed his office door and said he was just wrapping up patients. I wasn’t sure how this would go since I was beat and his brain was probably still processing the day’s patients and workload.

We started off with the obligatory ”how do you dos” and the “here’s where I come from” stuff. But it didn’t take long to forget my fatigue (and my stomach growls) as the conversation turned to deeper stuff. (Well, “deeper,” if you call HIT “deep.”)

What I found most enjoyable was the demeanor that Andrew exuded. He was an obvious geek, yes, but not in an outwardly obvious way. He was calm, easygoing, considered, and pleasant. He had a good sense of humor and laughed gently. I would wager that his patients would say, “He has a good bedside manner” – confident, but not cocky; caring without being overbearing; lightly delightful.

(Sorta sounds like a man-crush, doesn’t it? Ack. It’s not intended that way; he was just an impressive fellow.)

The first kicker for me (from participating in the blogosphere commentary) was meeting this enjoyable fellow a half a continent away. The second kicker was something he told me while we Skyped.

Andrew was describing his experience with looking at EHRs from various vendors. All the same stuff you hear: too cumbersome, too little “stuffings”, too expensive, too much resistance from his partners, etc. At one point, he had actually adopted one of the better known “free” EHRs and started documenting his encounters even though the rest of the group was still on paper. (He documented digitally and then printed his notes out to stick in the group’s paper chart folders!) But then he started talking about the EHR that he eventually adopted for his group.

He said they had looked at ElationEMR back in 2010 and decided to walk away from it (seeing it as one of the “too little stuffing” EMRs at the time.) About a year later, just as they were just about to go with one of the more widely adopted EHRs – one of the biggies – they decided to give ElationEMR one more look. So much had changed in this startup system, in lots of good ways, that they opted to put their faith in the newbie.

They adopted and implemented. Andrew got the front office up and running with minimal training. In fact, pretty much the entirety of the staff’s training consisted of a little seven-minute Camtasia video he created. (He granted me permission to share it with you, FYI.)

The staff was up and running. Period.

On live day one, after similar minimalistic training, he challenged his partners to “just do one or two patients with it today.”

That day – go-live Day One – with no schedule adaptations, the partners were also up and running, most having documented all of their first day’s encounters on the system. Not just one or two patients, but all of them.

Let me repeat that: not just one or two patients, but all of them.

No downtime. No reduced numbers to accommodate training and workflow adaptation. No major fuss or muss.

That was a real kicker for me. How many EHRs can really and truly be incorporated into a busy practice’s workflow with such little disruption? It’s nice to know it is possible.

Nice to meet you, Andrew, and thanks for the inspiration.

From the trenches…

“The sad thing is he’s a good kicker. He’s a good kicker. But he’s an idiot.” – Peyton Manning (on Mike Vanderjagt)

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).