DOCtalk by Dr. Gregg 10/14/12

Yawn … More HIT?

Maybe I’m shooting myself and the good folks of the HIStalk family in the collective foot, but I’ve been wondering recently: Are we starting to reach the point where HIT is becoming passé?

In this world of faster and faster obsolescence where all things cool are soon usurped by the next latest and greatest, it’s no surprise when something so recently “hot” joins the ranks of the has-beens. Even longtime “wow” leaders struggle to keep leading the leading edge. Gosh, golly, gee, even that paragon of new release fan-mania, Apple, seemed to lose a little of its “Whoa!-factor” with the latest release of the iPhone 5.

So, I suppose it’s no wonder that as the adoption of HIT picked up (along with the MU stimulus checks), it, too, seems to be succumbing to the fading rose phenomenon.

To wit, the other day I heard someone who had adopted an EHR for their office just a year or two ago make the comment (paraphrased):

“It seems like all this EHR stuff is mostly just an expensive version of my old paper charts. It’s probably been worth the effort, especially for the insights into our practice and patient care methods, but it should be more than this. I read HIT stuff these days, but it all sounds the same. Where’s all this information sharing and provider linking and population data enhancement stuff we were promised… that everybody’s still promising?”

While I assured him that many good folks are spending many long hours working to bring about all the interoperability and data connections he desires, I could see in his eyes that the luster and shine was off of the HIT apple for him. HIT had stopped producing a dopamine surge in his synapses and he was looking for a new digital fix to bolster the HIT feel good factor.

I’ve seen many cool new tools – and many wow-inducing products still in the developmental pipeline – but it appears that, at least for some, the current crop of HIT is more of a yawn than a new harvest of can’t-wait-to-get-it-let’s-get-in-line-early-dopamine-producing fun.

HIT has been around long enough that I suppose it may be time that we focus less on the cool new tools and toys and more upon what we can actually do with them. Compare it to how cool it was to download all those fun-looking apps on your latest tablet or smartphone. How many apps do you have that you never actually use and that have just taken up memory from a day or two after you got them? (If you’re like me, there’s a ton of them!) We still use the cool tools, but now it’s less about the “wow” of the tool and its apps; now it’s more about what we can do with them.

Maybe HIT has started to become less of a headliner and is becoming more of a stagehand. Maybe its focus is – and perhaps should be – shifting. That shift in focus, that reemphasis upon the reasons for which we’re actually doing all this (i.e., improving health and healthcare), should be a really good thing. At least, I hope so.

(To Inga and Dr. Jayne: I apologize if the strange image conjured up by that HIStalk “collective foot” comment offended your foot- and fashion footwear-related senses.)

From the trenches…

(Special and most sincere thanks to Mr. H for posting an announcement of the new asthma education-consumer engagement app I’ve been involved with developing. Please check it if you haven’t and you may find an iPad in your mail soon!)

“A new idea is delicate. It can be killed with a sneer or a yawn…” – Ovid

Dr. Gregg Alexander, a grunt in the trenches pediatrician at Madison Pediatrics, is Chief Medical Officer for Health Nuts Media, directs the Pediatric Office of Today! exhibit for the American Academy of Pediatrics, and sits on the board of directors of the Ohio Health Information Partnership (OHIP).

News 10/11/12

athenahealth will integrate Entrada’s voice services into its EHR and PM products.

Women’s preventive healthcare improves when providers use EHRs, according to a JAMIA-published study. Preventive care increases further the more sophisticated the EHRs.

The editor of iMedicalapps argues that Epocrates is at risk of becoming irrelevant. The top reason: Epocrates still lacks an iPad app.

Anesthesia Business Consultants and iMDsoft launch myAnesthesia for perioperative documentation.

The New York Times looks at how the proliferation of gadgets, apps, and Web-based information is impacting the care that physicians provide. While younger doctors in particularly embrace new tools to diagnose and treat patients, older physicians worry that human connections are at risk of being lost. A teaching physician at the San Francisco VA Medical Center shares what he says to his medical students:

“I tell them that their first reflex should be to look at the patient, not the computer.”

The two-year old physician networking site Doximity claims 100,000 verified members and use by over 15 percent of US physicians for secure doctor-to-doctor collaboration.

Cerner will embed Nuance’s cloud-based medical voice recognition technology into its mobile EHR products including PowerChart Touch. Cerner is also integrating Nuance’s PowerScribe 360 radiology reporting product with Cerner’s RadNet RIS.

E-mail Inga.

News 10/9/12

Aprima attempts to capitalize on last week’s announcement that the AllscriptsMyWay product  will not be enhanced to meet Stage 2 MU requirements. Aprima reminds MyWay customers that the software is based on Aprima’s PRM 2008 version and offers a no-charge license migration, as long as practices sign up for maintenance and support. Aprima also says that MyWay resellers can join Aprima’s  reseller network and offer their customers an upgrade option.

Allscripts, by the way, provided us with further clarification on their MyWay-Professional Suite upgrade program:

Could you clarify “free upgrade?” Is that a free license, a free conversion, or both?

This upgrade includes software, implementation and training. It will start in January 2013 and end in September 2013. The implementation will be facilitated by enhanced tools that make data conversion and interface activation seamless. This, coupled with tailored simulation learning and a hands-on weekend learning event, will prepare clients to take advantage of their newly upgraded software.

Does the maintenance fee change for MyWay clients once they’re on Pro?

The maintenance fees will remain the same as what is defined in a MyWay client’s current agreement.

And when you say “converged platform,” how is it different than the current Pro product?

We are launching a converged platform and the first step is to move our MyWay clients to this platform. They will experience many enhancements including mobility with Wand, our native iPad mobility solution, additional content including more specialties, and real time point of care/clinical decision support. In addition, the converged platform will be able to process ICD-10 codes and is planned to be certified for Meaningful Use Stage 2.

Allscripts is also said to be considering first-round bids for a leveraged buyout from PE firms Blackstone Group, Carlyle Group, and Silver Lake Management.

Physicians using EHR scored significantly higher on quality of care for four screening measures for diabetes, breast cancer, chlamydia, and colorectal cancer, according to a study published in the
Journal of General Internal Medicine.

Miami Children’s Hospital (FL) will deploy CareCloud’s RCM product for its 200 physicians.

Dr. Mehmet Oz of “The Dr. Oz Show” and Google Health’s Lisa Duncan are featured presenters at Practice Fusion’s Connect 2012 user conference next month.

A majority of clinicians believe electronic HIE will positively impact healthcare. Physicians say the biggest HIE barriers include the lack of interoperability, the lack of exchange infrastructures, and the costs associated with developing interfaces and exchanges.

Professional services company CBIZ acquires the assets of anesthesia billing company ProMedical, Inc.

Physician offices added 6,600 jobs in September, representing a 0.3 percent gain. Hospital jobs grew 0.2 percent with the addition of 8,000 workers.

Startup BetterDoctor launches its doctor-connect app nationwide after several months of beta-testing in San Francisco. The app matches patients to the “best” doctors based on specialty, location, and other consumer preferences and excludes any physicians in the midst of malpractice lawsuits.

Epocrates is asking readers for input on questions or topics for its annual survey of primary care physicians, cardiologists, oncologists, and psychiatrists. If you have any suggestions, let me know and I will pass it on.

E-mail Inga.

News 10/4/12

From Patrick Hall: “Re: Official e-MDs response. As of Oct. 1 of this year, e-MDs is pleased to report its continuing consistent pattern of year-over-year overall revenue growth. Compared to last year, e-MDs has a greater number of customers and employees, a larger number of contractors, as well as increased revenue. As a general rule, e-MDs does not comment on individual personnel changes that occur during routine business operations.” Hall is the EVP of business development ffor eMDs and we thank him for sending us this note in response to comments posted earlier this week from Adam Wright.

From San Antonio Rose: “Re: MGMA. Here’s are a couple recommendations for you. Download the MGMA12 app to your iPhone and bring your cowboy boots.” Cowboy boots: why of course! MGMA app: sounds like a great way to  figure out where I want to go when. Too bad it has been stuck on this screen for the last two hours. Maybe the download will finish by Oct. 21.

The 77-physician Optimal Radiology selects McKesson Revenue Management Solutions for billing, reporting, and collections.

The Ohio AFP and the state’s department of health pilot the PCMH Education Pilot Project, which aims to transform 50 primary care practices into PCMHs that will train medical students, primary care residents, and advanced practice nursing students. Participating medical students will receive up to $30,000 per year in scholarship funds in return for a commitment to practice at least three years in Ohio.

Seven percent of physicians plan to become cash-only or concierge practices within the next three years, which will likely exacerbate existing concerns about physician shortages and lead some patients to avoid routine check-ups and screenings.

Patients who have access to their doctor’s notes are more positive about their quality of care, even though physicians are less enthusiastic a note-sharing program. A year-long study of healthcare sites using OpenNotes software found that patients are more likely to understand their health issues, recall what the doctor tells them, and take prescribed medications when they have access to their visit records. Only a third of the doctors agreed that the program changed how well patients managed their care.

E-mail Inga.

News 10/2/12

From Adam Wright: “Re: e-MDs. They laid off 10 of their staff in operations and a couple of sales folks. Something is going on there.” Unverified. We asked e-MDs to comment but did not hear back. [Statement from e-MDs as of 10/3/12 ] “As of October 1st of this year, e-MDs is pleased to report its continuing consistent pattern of year-over-year overall revenue growth. Compared to last year, e-MDs has a greater number of customers and employees, a larger number of contractors, as well as increased revenue. As a general rule, e-MDs does not comment on individual personnel changes that occur during routine business operations.”

My company was “Acquired” today.. 15 years being the middle size guy who bought up small guys. Now we got gobbled bizjournals.com/pittsburgh/new…

— Susanne Bowyer (@2weety13) October 1, 2012

McKesson signs a definitive agreement to acquire MED3OOO. The companies say that once complete, the acquisition will complement the medical billing and PM offerings of McKesson Revenue Management Solutions and accelerate expansion into growth markets, including domain expertise, services, and technologies for building ACOs. I suspect McKesson also found InteGreat EHR superior to its warehouse of legacy EHR offerings, both in terms of technology and scalability for large practices.

PDX-NHIN, a pharmacy management solutions and services provider, will deliver medication histories from its electronic pharmacy record to Emdeon Clinical Exchange, giving providers real-time access to data for medication reconciliation.

Michigan Orthopaedic Institute selects SRS EHR for its 17-provider practice.

Florida International University incorporates the use of CareCloud Charts EHR into its masters program in Health Informatics and Management Systems. Speaking of CareCloud, the company wins an award for Product/Service of the Year in the South Florida Business Journal’s Entrepreneur Awards 2012.

The 90-physician Collom and Carney Clinic Association (TX/AR) chooses MModal Fluency Direct, a speech recognition solution for clinical documentation.

Capsite releases its 2012 Ambulatory EHR and PM Study. Some highlights:

• Epic holds 17 percent of the ambulatory EHR market, followed by Allscripts (15 percent), eClinicalWorks (nine percent), and NextGen (seven percent)
• Allscripts is the leading PM vendor with a 16 percent market share, followed by Epic (10 percent), GE (8 percent), and eClinicalWorks (seven percent)
• 40 percent of organizations are in the market for an EHR and most will buy within two years
• Only 27 percent of organizations intend to buy or upgrade their PM system
• 43 percent say they have successfully attested for Stage 1 MU; an additional 23 percent aren’t sure of their MU attestation status
• Almost half of organizations plan to join an HIE.

AAFP News Now explores an emerging struggle for practice owners and employed providers: how to allocate MU funds, shared savings, and new quality-based incentive payments. Unless addressed in an employment agreement, employed providers are entitled to their own MU incentives, even if they did not pay for the EHR. The advice: new employment agreements must address bonus opportunities, performance expectations, and the distribution of financial incentives.

E-mail Inga.