DOCtalk by Dr. Gregg 5/22/14

HIT Curveballs

As is said: _hit happens. We’ve all heard that phrase (usually the full, four-letter version). It’s a nice, short summation of the inevitabilities of life. No matter what you do or how you plan, life will always throw you curveballs. No matter how well read you are, no matter how highly educated, no matter how credentialed, no matter how exquisitely trained, no matter how closely or loosely you choose whom to trust – everybody gets thrown off stance by an unexpected curveball every so often. (Sometimes, you may even get sliders, knuckle balls, or those throw-you-for-a-real-loop spitballs!)

If you do all the homework you can – study up on types of pitches, watch hours of film on pitchers and their styles, spend innumerable hours in the batting cage, rip yourself with hours on the Nautilus – you’ll still get a ball that you just weren’t expecting. Whiff. Swing and a miss. Steeee-rrrrrr-iiiike!

In the land of HIT, it happens all the time – to vendors and consumers alike. Vendors may not like it any better than their customers, but there is a bit of a difference. HIT vendors get many of their curveballs from regulations, or sometimes from their own poor planning or development. HIT consumers, on the other hand, can get just as many curveballs from regulations, but they can also get really brushed back by those curveballs thrown by HIT vendors. (Vendors rarely get stressed by any consumer pitches, but consumers can’t avoid dealing with HIT vendor pitches.)

Another important difference is that, pretty much across the board, HIT vendors are in this space to make money off of HIT. Consumers, on the other hand, are trying to use HIT to accomplish tasks like delivering healthcare and getting reimbursed for the care they provide.

When a HIT consumer gets a curveball from their HIT vendor, it can really cause the home team strife. It isn’t like the consumer is a reseller; they can’t just find a replacement product to hawk. And, they get no value merely from owning (or leasing) the HIT product. The consumer relies upon HIT tools as critical underpinnings for their mission: to deliver health care. The consumer trusts their HIT to provide the information necessary for medical decisions. They use it to document their efforts and to obtain reimbursement for said efforts. Increasingly, they use it communicate with those for whom they care.

HIT has become central to the mission of healthcare, having become a key member of the care delivery team. If the tools don’t work, if something changes to cause them to work less efficiently, or if they develop “future unfriendliness,” then the care delivery process becomes threatened. That is an unacceptable pitch, for any healthcare team, big or small.

When a provider decides to invest in a HIT tool, it is far more than just a product purchase. Yes, it is an investment of money, but perhaps even more significantly, it’s an investment of time, energies, workflow construction, staff training, sometimes patient orientation and training, and more. The entire healthcare delivery system for that provider office is impacted by these tools. When one of the chosen HIT vendors throws out a curveball – via acquisition, merger, business failure, or product development redirection – the swing-miss impact is felt throughout the practice, from their figurative fingers to their metaphorical toes.

The impacted providers must now either:
(a) hobble along with their lame duck tool for as long as they can,
(b) find a replacement tool into which they can invest even more time, money, energies, workflow construction, etc.,
(c) pull out what’s left of their hair and go back to reliable, old pen-and-paper and suffer the MU consequences, or
(d) find an ACO to wash away all their operational and financial woes.

Being at the plate when one of these vendor pitches comes past is thoroughly frustrating. Whoosh. Whiff. Steeee-rrrrrr-iiiike!

(And there’s no ump with whom to argue the ruling.)

From the trenches…

“Baseball is a game where a curve is an optical illusion, a screwball can be a pitch or a person, stealing is legal, and you can spit anywhere you like except in the umpire’s eye or on the ball.” – Jim Murray

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).

News 5/20/14

HHS representatives weigh the pros and cons of a new program that will use Medicare data to alert public health officials to the potential needs of vulnerable patients during a disaster. HHS tested parts of the program in three states, and is looking to take it nationwide. Critics are concerned about the security of patient data, but ONC head Karen DeSalvo, MD has said the program protects patient privacy and that its benefits outweigh its risks.

The VA’s troubles continue with the resignation of Undersecretary for Health Robert Petzel, MD. In accepting Petzel’s resignation, VA Secretary Eric Shinseki said, “As we know from the veteran community, most veterans are satisfied with the quality of their VA healthcare, but we must do more to improve timely access to that care.” That statement seems questionable given the fact that at least 40 veterans died waiting for appointments at a VA facility in Phoenix, which has also been accused of maintaining a secret waiting list.

In other health data news, the Colorado Rural Health Center launches the Health Awareness for Rural Communities Data Bank to enhance access to streamlined data sharing and collaboration for rural healthcare providers, communities, and other interested stakeholders. The data bank is a collection of over 100 population health measures, as well as demographics, indicators, and projects from the state’s 47 rural and frontier counties. It’s refreshing to hear of big data projects like these that boil patient health information down into usable and hopefully effective population health management tools.

Business administration costs, not physician salaries (as highlighted by the recent release of Medicare physician payment data), are the real cause of skyrocketing healthcare costs, according to a New York Times article. It points out that healthcare is staffed by some of the lowest and highest paid individuals in any industry, with the compensation of health insurance executives topping over $583,000, general physicians reaching $185,000, and EMTs reaching just over $27,000. Perhaps the most telling statement in the piece comes from Abeel A. Mangi, MD cardiothoracic surgeon at the Yale School of Medicine: “Most doctors want to do well by their patients. Other constituents, such as device manufacturers, pharmaceutical companies and even hospital administrators, may not necessarily have that perspective.”

Physicians interested in the transparency of their payment data – Medicare or otherwise – may want to comment on the CMS Open Payments Program, which in September will publish payments that drug and device manufacturers have made to physicians. Those physicians interested in reviewing their open payment data must register with the CMS Enterprise Portal by June 1 for the opportunity to correct any  data discrepancies beginning in July. Physicians who have been less than pleased with the opaque nature of the Medicare physician payment data may want to go over this particular set of information with a fine-toothed comb, if only to equip themselves with explanations for their pharma and med device ties when the media come calling.

Scott Gottlieb, MD gives his two cents on the publication of open payment data: “Washington has little faith in American physicians, and sees a need and a license to regulate just about every aspect of medical practice, even trinkets doctors receive. There’s a clear view that doctors can’t be trusted to have any financial interactions with drug and device makers, no matter how small or simple these transactions. A free mug is as likely to influence a physician’s judgment as a $50,000 consulting fee.”

The National Committee for Quality Assurance recognizes Heritage Valley Medical Group (PA) physicians for their use of evidence-based measures in diabetes care. Ninety-three percent of the group’s 125 employed physicians met the standards for NCQA’s Diabetes Recognition Program. The group participated in the program after a community health needs assessment found that diabetes care was a top concern.

Oncologists list the pros and cons of moving from independent practice to hospital employment. The downsides seem to outweigh the benefits, with one physician venting that, “You don’t make decisions anymore. If you are a physician and you want to buy a widget, you have to go and get permission. It requires an act of Congress.” Loss of autonomy, “having a million different bosses,” longer wait times for on-site lab results, and higher patient copays were also mentioned.

Solo neurologist Robert Steg, MD explains the reasons why he closed his solo neurology practice, citing the requirement to move to a cost-prohibitive EHR as the final straw. The “Near future” category in the chart above ties into his EHR concerns, since Steg’s inability to purchase one would have prevented him from operating within the hospital’s ACO, and gaining referrals from its network.

In additional ACO news, HackensackUMC Mountainside (NJ) announces the formation of Mountainside Medical Group, a network of physicians employed by the hospital. The rise in hospitals creating physician groups  (not to mention investing in urgent care and retail clinics) may seem counterintuitive, but actually plays into the business model of ACOs and their need for coordinated care between physician and hospital networks.

The local paper takes a deep dive into the world of physicians, EHRs, HIE, and Meaningful Use in Michigan, which in 2013 saw  48 percent of its office-based physicians on an EHR. Michigan’s numbers are on par with the national average, according to the ONC. The state’s physicians are likely similar to many others in that the plethora of EHR vendors, and implementation and maintenance costs,  have left many unsure of which way to turn in terms of achieving interoperability to drive HIE efforts.

Tenet Healthcare (TX) announces that it will double the number of its nationwide MedPost Urgent Care centers by the end of the year. Kyle Burtnett, senior vice president of Tenet’s outpatient services, says the move is part of Tenet’s broader strategy to grow its portfolio of outpatient facilities, as well as to expand into “faster-growing, less capital intensive, higher-margin businesses.”

Even public health departments are getting in on the urgent care action. The Rhode Island Department of Public Health announces it will allow CVS to open MinuteClinics in seven of its pharmacies to provide more accessible and convenient care to consumers via a trusted brand name. MinuteClinic is the first retail clinic provider to achieve three consecutive accreditation awards from The Joint Commission. Primary care physicians have expressed their concern, however, commenting that the proposed clinics may erode their practices and further threaten an already beleaguered business model. The health department has incorporated those concerns into 22 stipulations the clinics must meet to set up shop. The guidelines also mandate that the clinics use the state’s EHR.

Athenahealth CEO Jonathan Bush releases his new book, “Where Does it Hurt? An Entrepreneur’s Guide to Fixing Health Care,” amidst continuing debate around the valuation of the company’s stock. While the book has yet to hit the best seller lists, the company got a bit of an uplift recently from analyst Mohain Nadu, who explained that because of athena’s cloud technology advantages, the company can introduce new services and technology much faster than a traditional software vendor. Perhaps Nadu was obliquely referring to Epic, which hedge fund manager and stock naysayer David Einhorn recently called out as one of athenahealth’s biggest threats. It goes without saying that Epic is neither public nor based in the cloud, and for what’s it worth trailed behind athenahealth in the 2013 Best in KLAS Overall Software Vendor award.

My Medical Inventory offers a new Web-based tool to help physicians better manage medical supply inventory. Julio Guerra, MD developed and tested the software in his practice, ultimately deciding to commercialize it based on positive feedback from his office staff.

GloStream introduces GloComplete, a revenue cycle and practice management service that incorporates the company’s EHR and practice management solutions. The company already has 40 practices and 120 physicians using the new tool, and expects an overall growth of 30 percent by the end of the year.

Valence Health launches the Valence Partner Network, a group of health services firms that will offer integrated solutions to Valence Health clients, including more than 30,000 physicians. Founding network companies include Aldera, Dubraski & Associates, Emmi Solutions, Limeade, Navitus, and Warbird Consulting Partners.

IBM announces that Modernizing Medicine is one of three partner companies that will release “Made with Watson” apps this year. The company offers specialty EMRs and is developing an iPad app that will guide physicians through a patient encounter to provide evidence-based medicine suggestions.

Readers Write: Technology Could be Great Equalizer Under ICD-10

Technology Could be the Great Equalizer under ICD-10
by Tom Giannulli, MD, MS

As an internal medicine physician, I get the best of both worlds. I have relationships with my patients like a family practice provider, but I get to treat more complex conditions and deal with challenges like a specialist. I love what I do, and I am not the only one. Recent studies show that many providers love their specialty and would choose it again. In the Physicians Practice 2013 Great American Physician Survey, nearly 80 percent of physicians said they were fairly happy with their choice of specialty. In addition, given the chance, they would roughly do everything the same way again. However, we are all practicing different kinds of medicine, and we face different kinds of day-to-day challenges.

The switch to ICD-10 is no different. I have no doubt that come Oct. 1, 2015, we’ll all wish we were practicing in a simpler specialty like physical therapy, which uses a small handful of codes.

It is too late to change specialties, but it isn’t too late for physicians to change their attitudes about technology. Now is the time for them to get over whatever is holding them back and embrace what technology can do for medical practices. The recent ICD-10 delay has actually given practices a little more time to prepare properly.

One of the main reasons for the delay was the concern about physician practice readiness. When a recent MGMA survey evaluated preparedness around ICD-10, more than 90 percent of respondents indicated they were concerned about changes to clinical documentation, coding, staff productivity, and changes to clinical productivity.

The right technology could be the solution, and now practices have adequate time to choose those solutions and implement them effectively. Consider the five ways that technology can simplify workflow for physicians and help a practice prepare for ICD-10:

1. Billing and practice management software should be able to run an ICD-9 top codes report. This eliminates the need for your staff to dig through claims to identify top codes, speeding the process of code mapping.
2. Software vendors should be preparing the systems to submit claims to payers so that practices don’t have to connect with each payer or clearinghouse individually.
3. The EHR should offer tools to help ensure the most complete and accurate documentation possible. With click-to-pick menus and customizable templates, physicians can more easily get documentation up to snuff for ICD-10.
4. Eliminate the possibility of a 10-page superbill. For complex specialties, ICD-10 could easily mean a superbill that is three or four times the length of what practices have now. Not only does the practice have to update the paper form, but healthcare providers will have to wade through and complete it by hand for each visit. An EHR allows providers to complete a superbill by clicking and picking the codes. It can even suggest codes based on the notes and auto-fill codes based on entering the first few characters. With an integrated billing system, physicians can send the electronic superbill with the click of a button.
5. Access code-mapping crosswalks. Software should offer users a crosswalk so when an ICD-9 code is entered, the equivalent ICD-10 code can be easily found. It doesn’t entirely replace having access to coding handbooks, but it can often make things faster and easier than doing it by hand every time.

There are a lot of reasons to consider implementing an EHR, and even more to choose a solution that offers integrated billing, practice management, and EHR. The change to ICD-10 is just one of those reasons, and certainly one of the best. According to the MGMA survey, more than 80 percent of practices know they need to upgrade their EHR or practice management systems to make the change to ICD-10. Don’t wait. By choosing the right software now, practices may able to mitigate some of the challenges and achieve a successful transition.

Tom Giannulli, MD, MS is CMIO at Kareo of Irvine, CA.

News 5/15/14

Black Book Rankings announces that Kareo ranks first among small physician practices for integrated EHR and billing systems. The firm also recognizes Modernizing Medicine as the top dermatology EHR for all practice sizes.

CMS reminds Medicare EHR eligible professionals that 2015 hardship exception applications are due July 1, 2014.

The ONC approves the American National Standards Institute for a second three-year term as ONC-Approved Accreditor for its HIT certification program. It’s hard to believe the certification program has only been around since 2011, and fully operational since 2012. It would be interesting to see how much money vendors have spent on certification since the program’s inception, and how that value compares to incentive money providers have received for Meaningful Use attestations.

New Jersey-Health Information Technology Center Meaningful Use Director Bala Thirumalainambi sends a tweet congratulating Seema Rao, MD (NJ) on successfully attesting in the earliest possible 90-day period to Meaningful Use Stage 2. Rao, one of only a handful of physicians nationwide to attest thus far, is a solo practitioner who had most of her patients on a patient portal from the day she implemented her Practice Fusion EHR.

North Carolina’s HHS signs a data use agreement with the NCHIE as part of a House bill that requires hospitals to submit the demographic and clinical data of Medicaid patients to the HIE, allowing DHHS to monitor services and patient safety.

Athenahealth finds itself in the same “quagmire” as Facebook and Tesla, with its fundamentals “severely out of wack” when compared with its value, according to SeekingAlpha.com. The three companies, “valued solely on the basis of being able to grow extremely aggressively,” are going to get snapped back to company basics and thus more realistic valuations. Athenahealth is a bit of a different beast than the other two businesses, however, since it finds itself in a crowded marketplace fueled by MU incentive dollars, destined for further consolidation.

EClinicalWorks announces at its Health Center Summit that more than half (580 of 1,147) of Federally Qualified Health Centers use its products, four of them being Davies winners.

The Corporate Whistleblower Center urges healthcare accounting or Medicare coding “insiders” to contact them with proof of fraudulent Medicare bill upcoding because “the reward potential for this type of information can be enormous.” A quick perusal of the center’s website reveals it to be affiliated with the consumer advocacy group America’s Watchdog. Based on their domain names, both groups seem to be for profit. Physicians should be wary of working with an organization that highlights the ability of whistleblowers to “Get Rewarded for What you Know.”

Speaking of whistleblowers, Boulder Community Health (CO) investigates stolen patient records for the third time since 2008. The records of at least 30 victims have been mailed to the center by an anonymous whistleblower, who seems to be using the covert correspondence as a means to highlight the “the easy access that the hospital and their partners provide for someone with bad motives.”

Integrated Medicine Alliance (NJ) is featured in the local paper for its patient-centered medical home business model, which comprises eight primary care practices and three urgent care centers, all within 10 miles of each other and all on the same Vitera Intergy EHR from Greenway. IMA also employs eight care coordinators as part of its PCMH efforts.

A Texas-based pain management clinic selects PPJ Enterprise subsidiary Professional Billing Service to provides its billing, collections, and practice management services. Based on previous statements from PPJ Enterprise’s CEO, it seems likely the company initiated the sale thanks to exhibiting at an industry trade show. Mr. H (and likely many other busy providers) might find the plethora of healthcare IT events nearing comical proportions, but vendors obviously still finding benefit in participating.

A local paper reports that HealthSpot is well on its way to installing more of its private telemedicine kiosks in pharmacies and public buildings for easy access to physicians via a recent investment of $18.3 million from 27 investors. Physicians that see patients via the kiosks are pleased with the technology, but think it is a good diagnostic fit only for certain conditions. HealthSpot is focusing on the public areas of pharmacies and retail clinics right now. It seems these types of kiosks would lend themselves well to population health management initiatives if they were placed in truly public areas like community centers, libraries, and churches.

The California Urological Association designates Acentec a business partner for its member physicians seeking HIPAA compliance and IT management services. CUA’s 475 member physicians represent 52% of the state’s board-certified urologists.

NextGen receives the Surescripts White Coat of Quality Award for the third time. “Receiving the White Coat of Quality Award again underscores our commitment to not only applying best practices to the use of e-prescribing technology, but also to continuous quality improvement and training of prescribers,” says Sarah Corley, MD chief medical officer at NextGen. Surescripts also awarded this year’s designation to 50 other entities including software vendors and health systems.

CureMD announces the latest version of its EHR and practice management solution. As with many EHR companies looking to differentiate their products from the crowded marketplace, CureMD designers say their focus on usability and accessibility make this iteration ideal for tablets.

The Advisory Board Company says in its earnings call that it paid $25 million to acquire HealthPost, a physician finder and appointment scheduling site that will be rolled into the company’s Crimson analytics offerings used by 1,400 hospitals. HealthPost has $1 million in annual revenue, and is break-even on the P&L side. According to Advisory Board Chairman and CEO Robert Musslewhite, “HealthPost is a cloud-based ambulatory scheduling solution that enables health systems to reduce referral leakage and track new patients by using it. It does it with what we felt like was a market leading SaaS technology that enables physicians and consumers to identify the right provider of care, based on certain criteria, especially in terms of geography and it makes it a very easy one-click appointment booking experience for either the provider or the patient. So we’re excited about it. In terms of how we’re going to roll it out, it’s still TBD. I imagine we will have a program launch coming from it, then more news on that down the line.”

Not sure what to call your next academic medical event? This handy flowchart from PHDComics might help.

News 5/12/14

Secretary of HHS nominee Sylvia Mathews Burwell says fixing problems that still plague Healthcare.gov will be her top priority if confirmed. The first of her two confirmation hearings provided a glimpse of the stark difference between Burwell and former HHS head Kathleen Sebelius, who continues to gain no personality points when she refuses to attend a recent HHS budget meeting.

The Texas Health and Human Services Commission notifies Xerox that it is terminating the company’s Medicaid claims administration contract after Xerox employees approved thousands of requests for braces that weren’t medically necessary. THHSC chooses Xerox subcontractor Accenture to take over the contract until rebidding begins.

Xerox fares slightly better in Colorado. The state’s Department of Healthcare Policy and Financing signs a $16.6 million, five-year contract with Hewlett Packard for the implementation of a new Colorado interChange Medicaid Management Information System. The HP claims system beat out Xerox, Meridian, and Molina Medicaid Solutions in the bidding process due to its “adaptability,” and the hope that its cloud platform will evolve with technology over the coming years.

CMS announces plans to restructure its Quality Improvement Organization program, which provides “boots on the ground” technical assistance via independent organizations to improve care delivery at the community level.

Justin Barnes, VP of industry and government affairs at Greenway, announced late last week that he’s leaving the company at the end of May. He tells HIStalk Practice that he’ll stay busy over the summer with plans to start two companies (one of them in healthcare IT, with a nod toward consumerism, interoperability, and patient engagement), join a tech incubator, and continue his involvement with government issues in an unstated capacity. He says his Greenway departure is friendly and unrelated to its November 2013 acquisition by Vista Equity Partners or the April 2014 departure of Greenway President Matt Hawkins.

David B. Nash, MD, dean of the Jefferson School of Population Health at Thomas Jefferson University, outlines the benefits and challenges that will come with the launch of Medicaid ACOs in New Jersey later this year.

AllMeds Specialty EHR v10 achieves ONC HIT 2014 Edition Complete certification, which designates it as capable of supporting eligible providers in meeting Meaningful Use Stages 1 and 2.

Modernizing Medicine announces that its Electronic Medical Assistant v4 achieves ONC HIT 2014 Edition Complete EHR certification and that its EMA Mobile v4 achieves ONC HIT 2014 Edition Modular EHR certification.

Desert Valley Radiology (AZ) selects McKesson Business Performance Services to assist its six locations with revenue cycle management, transition to ICD-10, and quality reporting.

The Massachusetts House passes votes to eliminate a law that would have required physicians to demonstrate EHR competency or Meaningful Use certification as a condition of earning or renewing their medical licenses after Jan. 1, 2015. The House voted to delay from 2017 to 2022 a requirement that all providers use EHRs that are connected to the state HIE.

Enable Healthcare announces that its network of physician practices can access CompanionDx pharmacogenomic testing results through their EHI EHRs. It is slightly amusing that EHI’s president cites intelligence as one of the favorable characteristics of the CompanionDx team. You have to wonder about who they’ve tried to partner with in the past.

MModal opens a “state of the art” India Technology Centre in Bangalore to grow its presence in the clinical documentation space, and to help technology professionals in the “Silicon Valley of India” expand their careers.

Emmi Solutions offers the “Introduction to ACOs” Web-based interactive learning program to help patients understand the role their physicians play in an ACO, as well as the benefits of participation.

TelaDoc acquires AmeriDoc in an effort to support its growth into new markets. TelaDoc CEO Jason Gorevic’s comment that the “positive impact of telehealth on our health care system has fueled rapid adoption across all market segments” is an interesting one given the cold shoulder some states have shown telemedicine thus far. It will be interesting to see how the combined assets of the private companies weather the storm of future state regulations.

Physicians offer differing opinions on CrowdMed, a San Francisco-based startup that “isn’t out to replace [the] family doctor, but instead take advantage of the reach of social media to tap into an age-old medical practice: seeking second opinions.” Some, like Professor Amin Azzan, MD see it as an interesting tool to incorporate into his curriculum at the UC Berkeley/UC San Francisco Joint Medical Program. Concerns of other physicians include the credibility of advice-givers, and security of medical information uploaded to the CrowdMed website. Given the burgeoning popularity of online patient communities such as Patients Like Me, the potential for CrowdMed’s success is probably better than the average healthcare startup. The company makes no mention on its website of selling de-identified patient data, as Patients Like Me does, but instead is focusing on charging consumers directly for its investigative services. The validation of advice from third parties will likely be of benefit to the average patient scouring the Internet for answers, but the receptivity of physicians to crowdsourced treatment suggestions is questionable.

Vertical Systems Reseller says EHRs have the highest reseller profit potential in healthcare IT as well as the greatest appeal to healthcare providers.

A chat with Dominic Mack, MD, executive medical director of the Georgia Health Information Technology REC (GA-HITREC)

Dominick Mack, MD, who in addition to his GA-HITREC role is also co-director of the National Center for Primary Care at Morehouse School of Medicine, has helped the REC implement EHRs at over 4,000 physician practices and 56 critical access and rural hospitals. Of those, nearly 70 percent have attested for Meaningful Use.

The HIMSS 2014 Regional Extension Center Survey offers interesting statistics about the sustainability plans of RECs around the country. What are GA-HITREC’s plans?
Georgia was awarded $21 million and the money has, thankfully, not run out. We are, however, already looking at lines of services including membership services, privacy and security, technical consultation, patient-centered medical homes, and work with the HIE.

What will GA-HITREC help providers focus on once Meaningful Use Stages 1 and 2 are met?
We are looking to help providers with HIE connectivity, including interoperability and data analytics.

What will have the biggest impact on GA-HITREC moving forward?
We hope to help providers who need it the most – small practices and hospitals in rural and underserved areas. As a mission-based institution, we believe we are uniquely positioned to assist these practices.

What are your top IT priorities?
They include helping smaller practices successfully meet MU and PCMH criteria; providing added services that help smaller practices and hospitals become successful and competitive in an environment of new practice models such as ACOs; and helping practices with interoperability and the exchange of health information for better patient coordination and care.

Expenditure figures among RECs surveyed vary from $5 million to $20 million. Does that line up with GA-HITREC’s experience, or do those numbers seem high?
That sounds right.

Based on the survey results, are you surprised RECs aren’t paying more attention to securing PHI?
I think they are aware of the needs around that, but they have to balance their focus between program objectives and add-on services. Also, the cost of providing services and other needed resources is a big factor when providing these services.