From the Consultant’s Corner 3/12/13

Bringing the Outside In: Two Ways to Capture External Data in Your Business Intelligence Efforts
By Brad Boyd

The term “business intelligence” has been tossed around for years as a way to describe the process of capturing, analyzing and interpreting data—and then using it to make organizational decisions.

Many of the healthcare organizations I work with have engaged in business intelligence activities for a long time, focusing on collecting and leveraging internal data and information. However, as the industry shifts from volume-based reimbursement to value-based reimbursement, I believe the need for data will shift as well. Moving forward, organizations will discover an exponential increase in their data requirements—not only internal data, but also external data from other healthcare providers, payers, and others.

In my opinion, organizations must figure out how to integrate external data and incorporate it into current business intelligence efforts. The big question is: What’s the best way to do this?

I advise one of two main approaches. The first one involves bringing external data into your organization a little bit at a time. For example, you could import data into distinct buckets within an existing data warehouse, and access that data through a variety of reports. If a clinician, administrator, or other staff person wants to see the data, he or she could ask for a report to review.

Although this approach is cost effective and requires minimal resources to set up, it doesn’t provide a seamless integration between external and internal data. External information is accessible from a segregated reporting perspective, but isn’t available in an integrated way through the EHR or other IT systems.

In fact, the whole process can be rather clunky, given that you could quite possibly have to leave one source of data to view another. In certain situations, this could be very frustrating. In addition, it fails to provide a comprehensive view of both internal and external data.

If this approach seems too time-consuming and cumbersome, I would think about marrying external and internal information upfront, storing them both in IT systems right away. Engaging in this type of wholesale move provides quicker, more streamlined access to comprehensive data for individual and population health management.

However, I have to caution that this avenue is much more costly and resource intensive. It involves updating and reworking your current IT solutions and your business intelligence strategies. Given all of the other competing priorities in your organization—ICD-10 and Meaningful Use, for example—pursuing this type of large-scale integration may not be feasible.

Whether you choose to absorb external data incrementally or all at once, there’s no question in my mind that you will need to gain access to it and share it across your organization. The current healthcare environment demands it.

I highly recommend that all healthcare organizations start seriously thinking about the best ways to incorporate external data into their business intelligence efforts. It’s essential to weigh the pros and cons of different approaches and map out a strategy. Otherwise, you may be left unprepared for the data-enriched, value-based future of healthcare.

Brad Boyd is vice president of sales and marketing for Culbert Healthcare Solutions.

News 3/12/13

HHS announces its 2013 HIT implementation goals, which includes having 50 percent of physician offices online with EHRs by the end of 2013.

Satisfaction and usability ratings for certified EHRs fell 12 percent from 2010 to 2012, according to an American College of Physicians survey. The percentage of clinicians who would not recommend their EHR to a colleague increased from 24 to 39 percent, while the percentage of clinicians “very satisfied” with the ability of their EHR to improve care fell six percent.

HIMSS names eClinicalworks customer Unity Health Care (DC) a winner of the 2012 HIMSS Community Health Organization Davies Award based on excellence in implementing EHRs. eClinicalWorks also announced that Coastal Medical (RI) is adding eCW’s Care Coordination Medical Record to advance its ACO-related objectives.

EMR vendor CureMD acquires Practice Services, a New York-based medical billing services company.

Athenahealth proposes an HIT Code of Conduct that calls EHR vendors to adhere to five principles related to data portability, patient safety, provider freedom of choice, and MU:

• Empower data portability and provider choice
• Build a true nationwide information backbone
• Protect patients
• Prevent fraud
• Drive Meaningful Use

Athenahealth also announces that Cerner has certified the athenaNet suite for interoperability with the Cerner network.

e-MDs launches a cloud-based EHR/PM solution and introduces Solution Series 7.2.2, an updated version of its client-server suite of EHR/PM products.

The NCQA awards SuccessEHS client Scenic Bluffs Community Health Centers (WI) the highest level of recognition from its PCMH program and recognizes four Scenic Bluff providers with NCQA 2011 PCMH Level 3 recognition.

The average physician could lose $43,743 over five years with EHR adoption, according to a study published in Health Affairs. Of 49 community practices surveyed, 27 percent could have positive ROI. Practices using their EHRs to increase revenue by seeing more patients or by improving billing processes were more likely to realize a positive return; practices continuing to keep paper records were less likely to realize savings.

Vitera Healthcare releases a hosted version of its Medical Manager practice management platform.

Only one-third of physicians believe their patients should have full access to their full health record, though 82 percent want patients to actively participate in their own healthcare by updating their EHRs, according to an Accenture survey. More than half of the surveyed doctors believe the introduction of EHRs has has improved the quality of patient care.

NexGen unveils NextGen Population Health to assist providers in meeting  PCMH and ACO goals.

E-mail Inga.

DOCtalk by Dr. Gregg 3/10/13

Imagine (Healthcare’s Future Rendition)

Imagine there’s no “healthcare”
It’s easy if you try
No offices to call on
At most, maybe by Skype

Imagine all the patients
Healing their own way
Ay-hay

Imagine no insurance
It isn’t hard to do
Nothing to bill or cry for
And no copayments too

Imagine all the patients
Healing ills with ease

You-hoo-ooh
You may say it’s not easy
And you’re not the only one
Tech one day’ll make it simple
And the world will heal as one

Imagine self-diagnoses
I wonder if you can
No e-patient anger
A healinghood of man

Imagine direct admissions
Access in your hand
Hospitals stays and surg’ries
App-arranged and planned

Imagine all the patients
Directing their own care

You-hoo-ooh
You may say it’s not real now
But tomorrow soon will come
Tech one day’ll make it easy
And the world will heal as one

Imagine health’s best practice
In everybody’s hands
Personal genomics
By tricorder scans

Imagine all the patients
Engaged in their own health

You-hoo-ooh
You may say it can’t happen
Outpatient care won’t go ‘way
But med’cine as we know it
May just have seen its day

Imagine taking healthcare
To new heights unseen
People and their health-ness
With nothing in between

Imagine all the patients
Providers of their own

You-hoo-ooh
You may say I’m a dreamer
But I’m not the only one
I hope some day tech will help us
And the world will heal as one

From the trenches (and with full props – or, perhaps, apologies – to J. Lennon)…

“It’s just that the translations have gone wrong.” – John Lennon

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 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.

E-mail Inga.