News 2/28/13

McKesson names the Bread of Healing Clinic (WI) the company’s first recipient of its Practice Choice EHR software as part of the McKesson Give Back initiative.

iSALUS Healthcare launches a new version of its OfficeEMR which includes a patient timeline that converts discrete patient data into a visual format with drilldown functions.

More than three quarters of patients served by safety-net clinics express interest in electronically communicating with their providers, according to a UCSF study. Many community clinics, however, do not offer patient portals or secure messaging systems that support electronic communications with physicians.

Cymetrix, an RCM and consulting  provider for physician offices, acquires the healthcare analytics firm CareClarity.

Practice Fusion buys 100Plus, a start-up firm co-founded by Practice Fusion CEO Ryan Howard that provides personalized health predictions based on data analytics.

A Nuance Communications’ survey finds that 80 percent of US doctors believe virtual assistants will change how they interact and use EHRs and will benefit patients by making them more engaged in their own healthcare. Providers also predict the use of virtual assistants will provide accurate and timely information to support care and will improve alerts on missing information in records.

Evolution Health will deploy Greenway Medical’s PrimeSUITE platform across is national network of house call providers.

Only sixty percent of physicians say they are willing to participate in ACOs, with more primary care providers willing to participant than specialists. More providers are interested in being part of an Medicare ACO than ACOs led by other payers.

e-MD clients attending HIMSS can participate in a free User Group Meeting on Thursday March 7 at the Hilton New Orleans. The event is sponsored by Gateway EDI and NHXS.

E-mail Inga.

News 2/26/13

Memphis Obstetrics & Gynecology Association goes live this week on MED3OOO’s InteGreat EHR.

Medical practice plaintiffs who filed a class action lawsuit against Allscripts for its decision to not enable the MyWay EHR for future MU stages or ICD-10 will learn Tuesday whether they can continue with their suit or will instead be forced to accept binding arbitration. If the complaint is certified as a class action, Allscripts will be required to provide the names of all MyWay customers to the plaintiff’s attorneys, who say all 5,000 MyWay physician users would then be automatically included in the suit. Attorneys for Allscripts have filed a motion to block the suit, arguing that the doctors signed a contract requiring their differences to be settled by binding arbitration.

The Westboro, MA paper profiles a new mobile app from eClinicalWorks that will be offered free to consumers and eCW’s physician customers. It can send patient reminders to smartphones or computers, allow patients to access their medical records and lab results, and allow patient-provider messaging, including refill requests.

The medical director of HealthInsight Utah reports that use of specific HIT tools has enabled Utah Beacon Community providers to achieve a 10 percent improvement in hypertension levels for 2,000 patients. Some of the HIT tools used the development of registries, patient lists, and reminders; the creation of templates that capture data accurately and alert staff of particular requirements; the use smart clinical support tools that include reminders, alerts, and flow sheets; and, the addition of medication adherence assessment options within EHR templates to prompt providers to review e-prescribing lists and determine if patients are filling their medications.

The Maryland State Medical Society introduces the Center for the Private Practice of Medicine, which will provide resources to help independent physicians stay in practice, including assistance with HIT, office management, billing, and related tasks.

Curious: a study published in the Canadian Medical Association Journal finds that people of high socioeconomic status are 50 percent more likely to be able to schedule an appointment with a primary care provider than those of low socioeconomic status, even though Canada’s universal healthcare system pays physicians the same for either group. Researchers blame discrimination.

Greenway Medical announces that its PrimeSUITE EHR platform has achieved PCMH 2011 Prevalidation status from NCQA.

Rose Marie Nelson of MGMA Health Care Consulting Group discusses the need for population health management tools to effectively manage patient populations and qualify for reimbursement incentives. She notes that EHRs alone may not offer all the required functionality to identify and proactively manage and report on multiple unique populations. Duly noted. Nelson gave me the name of a couple PHM products that I will check out next week at HIMSS.

Another emerging HIT requirement for physician offices are tools for shared decision-making that include feedback loops that allow providers to verify whether or not patients follow through on recommended actions (tests, specialist consults, etc.)

New federal legislation is making physicians a larger target for healthcare fraud investigations. Of the 2,309 civil and criminal healthcare fraud cases opened in 2012, 21 percent involved physicians, compared to 15 percent in 2010.

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News 2/21/13

Kareo launches a free application, cloud-based EHR that can be used as a standalone application or integrated with the company’s PM and billing services. It was developed using technology acquired from Epocrates, which exited the EHR business a year ago. Kareo notes that the EHR is “advertisement free” and says it will provide support and updates at no charge. The company hopes that the free EHR offering will attract more clients for its PM and billing service products.

Kareo also announces the appointment of Tom Giannulli, MD (Epocrates) as CMIO.

The Rhode Island REC introduces an EHR adoption program for specialists that allows specialty practices to receive the same assistance and benefits previously only available to certain primary care providers.

Over time more patients will rely on doctor rating Websites to find physicians, predict researchers from the University of Michigan. A poll of parents reveal that insurance, location, referrals, and provider experience are the most important factors when selecting a pediatrician. Parents under the age of 30, however, were twice as likely as older parents to also consider online ratings.

“Data suggest that younger families are more likely to rely on online ratings, which means over time we’d expect the use of these Websites will keep increasing.”

Up to 17 percent of physicians are planning to change EHR vendors by the end of the year, according to a Black Book Rankings poll. Key findings include:

• Vendors are blamed for being too busy selling and implementing systems while development issues are left on the back burner.
• Users complain of unmet needs and MU is blamed for creating an artificial market for dozens of immature EHR products.
• The majority of practices considering a switch say their current solution does not meet the individual needs of the practice; that their practice did not adequately assess its needs before selecting an EHR; and that the design of their EHR is not suited for their practice specialty.
• Specialties least satisfied with their EHRs are nephrology, urology and ophthalmology
• Specialties most satisfied with their EHRs are internal medicine, family practice, and general practice.

Greenway will integrate the Physicians Interactive eCoupon voucher and coupon distribution system into its PrimeSUITE solution.

CareCloud reports it concluded 2012 with its 12th quarter of consecutive revenue growth, expansion into 45 states, management of more than $1.5 billion in annualized A/R, and inclusion of more than 4.5 million patients on its platform.

Healthpac will embed PatientPay’s online bill management services into its practice management system.

Surescripts awards e-MDs the 2012 White Coat of Quality for upholding high quality e-prescribing standards.

MGMA-ACMPE releases DataDive: 2012 Procedural Profile Module, a Web-based tool that allows users to develop an organizational profile which can then be benchmarked against peers using national MGMA data. The goal is to help practices better understand patient demand and and future workload.

E-mail Inga.

HIStalk Practice Interviews Wyche T. Green, III, President and CEO, Greenway Medical Technologies

Wyche T. Green, III (“Tee”) is president and CEO of Greenway Medical Technologies of Carrollton, GA.

Tell me about yourself and the company.

Greenway is passionate about creating a smarter healthcare system; a system that embraces the electronification that is taking place today in which the provider and the consumer can thrive and that eventually leads to improving population health. The current healthcare system is closed and not very innovative. I believe it’s changing and I think about the day when data captured on each one of us in a smarter system will actually assist in improving the care we receive and the care that the next generation will receive.

We’re building platforms that enable providers to embrace electronification, embrace the consumer, and begin this quest of improving population health.

I have never considered our company as strictly an electronic health record company. It just happens to be a component of what we do. We provide ambulatory solutions that connect to enterprises and hospital systems. You will see very soon that components we offer such as PrimeEXCHANGE around interoperability, the communication portal PrimePATIENT and the data intelligence within PrimeDATACLOUD alone can service communities of health in their own right to solve community issues that may or may not utilize the core of our PrimeSUITE EHR. If you think about the struggles of the establishment of HIEs, PrimeEXCHANGE currently supports more than 5,000 connections allowing widespread provider access to ride a platform that can exchange with systems like Epic, Cerner, and Relay Health, and more than 600 hospitals, labs, HIEs, and registries.

The collective power of these platforms and solutions enable physicians, leaders and patients – in communities large and small – to create a smarter healthcare system where everyone benefits. As healthcare rapidly evolves, our culture is committed to providing these powerful tools to successfully navigate change. As the healthcare system realizes our common goal of unlocking, assessing, sharing and applying decision-making information, population health will certainly improve. That’s what we stand for.

We started the company in 1998 in Carrollton, Georgia where we remain headquartered today. We have grown from a closely-held investor base to trading as a public company listed on the NYSE. A lot has changed over the last decade but our mission and passion to create a smarter healthcare system endures.

Who are your most direct competitors and what factors are causing them to increase or decrease in influence?

For me, for Greenway, it’s changed. I think it is shortsighted to consider that your competitors come from within your direct market. We’re pushing for significant and meaningful change in how we manage healthcare, but sometimes there are forces that impede or slow that change. Today, the industry is faced with an economic issue with how we pay for healthcare services.

We are moving from production medicine to value or outcomes-based medicine. Innovation is playing a major role in that transformation. Greenway is driving innovation to enable that transformation. But today, the majority of the system is still built around fee for service. How long will that take to change? Those are the biggest competitors in the industry today.

Everybody talks about product usability and ONC seems interested in transparency in that area. What efforts does the company make in terms of usability and how do you see market demand affecting that?

For Greenway, it’s focusing on solving customer issues and creating value for them. That is the key. We are working on usability innovations that may not make it into the mainstream for years to come, but customers have real issues today and we are crafting powerful solutions for them. They will face new issues tomorrow. We will continue to create and deliver more innovation to answer this unending call. That’s something we are acutely focused on.

So usability translates into customers issues. If providers can’t use your technology at the point of care, how will we get to a clinically-driven revenue cycle? Greenway has invested a tremendous amount of energy with subject matter experts across the more than 30 different specialties we currently serve and provide templates to optimize the workflow at the point of care. This way aspects like clinical decision support and payer-based care plans that are ultimately going to be important to the consumer, are done inside these provider workflows. Again, focusing on customer issues and creating real value for them is the priority, and usability will advance our providers ability to successfully adapt to this changing landscape.

How has life changed since becoming a publicly traded company?

Primarily it has given Greenway a debut on a much larger stage to tell our story. We are now able to tell our story from the New York Stock Exchange, the center of capitalism. That is a big arena to communicate our message of positive change around the creation of a smarter healthcare system.

Greenways awareness continues to accelerate and add momentum to our purpose. Larger organizations are having conversations with us about how we can solve their issues in innovative ways. How we can solve community issues through PrimeEXCHANGE, through PrimePATIENT, through PrimeDATACLOUD. We are having these discussions.

People are beginning to understand that Greenway creates powerful ambulatory platforms and solutions, not just an electronic health records. Which is what we’ve been all along. Now stakeholders better understand the value of what our platform is capable of.

Everybody’s talking about Big Data and analytics. What do you offer and what will you need to offer as business models and requirements change?

The key is again our cloud-based portal PrimePATIENT that includes the HealthVault PHR, Blue Button functionality and other scalable integrations. Platforms that allow communities to solve issues in their area as it relates to how patients interact with each other and with providers. Issues with how I exchange information across my community from systems that might not be Greenway.

PrimeEXCHANGE also gives us this capability. Our PrimeDATACLOUD platform allows us to share clinical, financial and administrative data across multiple settings and allows different analytic engines to pull data to run different types of analysis. One thing is for sure, no community is alike. We believe one size fits one, not one size fits all. We have to define in each community what the value–based system is going to be and what data and analysis is essential.

In some areas of the country, we have a tremendous variation on how you keep score. That can be very confusing for providers. To be able to create the flexibilities of different types of analytics that can be run based on what that community has defined as what’s important to them and their stakeholders. That flexibility is critical in healthcare.

I heard somebody describe it in a way that we’re playing in a soccer game with 12 people, but there are 50 referees. That’s so true. So creating innovative platforms that allow the communities to drive what they deem is valuable, what they deem as outcomes, we’re able to do that with these portal, interoperability, and data intelligence platforms.

You offer PrimeRESEARCH that connects life sciences companies with physician practices. Is that a significant demand, and do you see that as a competitive differentiator?

Yes, it’s a major differentiator. It’s very much about creating a smarter system. Where is most of the care in this country delivered? It’s delivered in ambulatory environments and communities. Why wouldn’t we want life sciences and research connected, or research and providers connected at this intersection?

There is an abundance of useful and relevant information in our systems that need to be unlocked and used properly. When leaders, providers, and communities can leverage the exacting information they need to improve their efforts, we are making big steps in creating a smarter healthcare system. This is something that has not been done in this country on any type of scale. We’re doing it for the first time.

We’re in 43 different clinical trials today for providers who haven’t really participated in any type of research since medical school. Now they’re offering solutions, offering information, they’re being educated in ways that they haven’t been in many, many years. I believe as more and more of the consumer mindset emerges in healthcare, we’re going to demand access to this type of information. It’s going to be done in that patient-to-provider relationship.

Right now we can query our network of customers to securely identify relevant patients that match a given study. We support the practices to enroll patients, collect study data, and provide remote monitoring that becomes another source of provider revenue. I see that early Stage 3 proposals include a core measure seeking the ability of EHRs to query enrollment systems so providers can seek out available studies. We’ve already eclipsed that task but I’m glad that policy is catching up to the importance of ambulatory platforms and clinical studies.

Some are calling for EHRs that are open and that allow the use of third-party apps to add or change functionality. How would you summarize the state of openness of the EHR market and Greenway’s interest in incorporating that capability?

We offer the most open platform in the market today. Our advanced application programming interface has allowed innovation to explode in this industry. We have more than 100 different relationships in various stages of development or currently operational on behalf of our customers and their communities.

We launched our Greenway Marketplace API a year ago during HIMSS12, so the doors are open for others to collaborate and innovate with us. This year in January we announced more innovations around web services to accommodate all partner platforms along with encryption and connection advancements.

If you look at the range of cloud-based and integrated solutions coming together they reach across clinical, financial and administrative needs. Isabel Healthcare, for example, is a Michigan-based company that has developed a comprehensive diagnosis decision support solution. Krames Staywell out of Illinois specializes in patient education materials. codeHERO brings charge capture to a wide variety of remote technologies, and another company we work with, DMEhub, coordinates the electronic prescribing of medical equipment and devices. You can see the unlimited potential here.

We understood and our partners have come to understand that the annual or relegated software releases are too slow and we needed to unlock the velocity of innovation. It’s not about where the data comes from, it’s about data liquidity. That’s a term we have used for a decade. Unlocking useful and relevant data so it flows to the right people at the right time in the right places, securely and safely. I believe others are seeing why this is important in what historically has been a closed, isolated market locked within four walls, but the rules of the road are changing.

How will the EMR industry look different in five years than today?

The industry is going to continue to evolve and we will continue to innovate. I think you’ve touched on some of those aspects in your questions around research, open development, usability, and data. Also consumers are changing their habits on how they access information to seek the best care. The makeup of our customers is changing. We have customers like Walgreens. Who thought that Greenway’s ambulatory platforms would be serving an organization like Walgreens? Walgreens is stepping in to fill a void within primary care and Greenway is a strategic partner in that.

We are also working with the Evolution Health division of Emergency Medical Services Corporation to provide house call medical services to mobile providers. We are working with physician affiliates of Hospital Corporation of America and launching a community outreach and EHR adoption program with Baylor Quality Health Care Alliance.

We are beginning to see larger and larger health systems begin that dialogue with us because they understand how innovative this platform is and they understand the value it brings to their customers. This is exciting!

But make no mistake, with the current economic landscape and the healthcare reform that’s hitting this country, coupled with a short supply of primary care physicians coming out of medical school, drastic changes in healthcare payment and delivery are ahead. With all of that change, with all of that disruption, come incredible opportunities for organizations that are innovative enough and can drive value on behalf of their customers.

News 2/19/13

The CalHIPSO Regional Extension Center launches service offerings that include Meaningful Use tracking, EHR readiness, and eligibility registration attestation.

DeKalb Health (IN) selects e-MDs Solution Series for its 19 providers.

RCM provider MediGain acquires ASC Billing Specialists, a PM and A/R management company specializing in ASCs.

Telligen Iowa HIT REC achieves 100 percent of its goal of 1,200 providers live on certified EHRs with active quality reporting and e-prescribing.

Researchers from Indiana University devise an artificial intelligence (AI) framework that may outperform physicians in making cost-effective clinical decisions that result in good outcomes. The researchers used EHR data to compare real outcomes and costs associated with 500 cases with the hypothetical models generated by computer algorithms. The results indicate that AI could improve patient outcomes by 30 to 35 percent.

gMed releases gGastro+, a gastroenterology-specific EHR with integrated endoscopy reporting, a patient portal, and practice maintenance.

Vitera says its v8.10 release includes enhancements to Intergy EHR and PM, Practice Analytics, and Practice Portal.

CMS hosts a 90-minute call February 19 at 1:30 EST to discuss avoiding the 2014 eRX and 2015 PQRS payment penalties.

Michigan lawmakers introduce legislation that calls for the creation of a single universal prior authorization form for prescription drugs.

Covisint reports that its customers have earned more than $30 million in incentives using its DocSite PQRS solution.

Patient-centered medical homes deliver slightly better care in terms of patient satisfaction and preventive care, but may not result in cost savings according to a study published in Annals of Internal Medicine.

MedCity News categorizes the three types of organizations buying EHRs in 2013 as 1) small provider organizations purchasing their first EHR; 2) practices switching EHRs as part of a merger or acquisition by another organization; and 3) providers that are disgruntled with the current EHR and looking for a replacement.

E-mail Inga.