News 7/17/12

Cloud-MDs announces plans to integrate its PM/EMR solution with DrFirst’s e-prescribing  software.

Aprima Medical Software releases Aprima Mobile, a smartphone app that provides physicians with access to to key functions and patient data in Aprima EHR.

CMS releases a guide for EPs to walk them through all phases of the Medicaid EHR program.

Greenway publishes a cool infographic that includes a ton of stats and an overview of the complete MU program. Even if you think you have MU all figured out, I recommend taking a second to check out the full graphic.

MGMA offers encouragement to practices interested in creating a social media presence, particularly Facebook:

Participating in social media takes considerable time and effort, so do your research before taking your practice online. And once you’re there, enjoy interacting with your community in another way. It’s a new avenue for sharing information and engaging with your audience outside the office walls.

I found that at least one of my doctors has a Facebook page (above) and an impressive 1,341 likes.

The Washington Post reports online ratings of physicians by patients are generally positive. Nevertheless, most doctors are leery of the more than 50 Websites that permit patients to post online reviews of their doctors.

E-mail Inga.

DOCtalk by Dr. Gregg 7/13/12

Clubbing EHRs Religion

Clubbing, EHRs, and religion: not exactly a triplet of terms that is commonly grouped. But, I see it almost everywhere I look in EHRdom these days. Lemme ‘splain, Lucy…

Taking each as they were writ:

Clubbing

Not the ear-popping, soulless electronic drum beating, Ecstasy-riddled type of clubbing. And, not the too-cute-to-be-believed, little white baby seal murder trade tool, either.

The kind of clubbing to which I refer is the kind that involves people’s predilection to form into Us vs. Them units. We club. We group. We team up and then we team up against.

Little boys do it in tree houses with “No Girls Allowed” signs. Sorority sisters and frat fellows do it. Bloggers do it. Facebookers do it. Republicans and Democrats love to do it. Tea Partiers do it with gusto. Sports teams do it, thrive by doing it. Nations need to do it, especially during an Olympic year or time of war, any war.

Steve Jobs and Apple did/do it best, having turned clubbing into an art form.

Clubbing and EHRs

Almost every EHR I’ve ever come across has a strong element of clubbing. “Our system is the smartest” or “Our system is the most physician-friendly” or “Our system is designed with you in mind, more so than any other system out there” or “Our system will get you the ROI the others only talk about” – these are all themes which seem to have become almost genetically encoded in the current EHR mindset.

Whether they are free or cheap, minimally draining or bank-bustingly expensive, pretty much every EHR company I’ve ever come across thinks they have the best system. Most of them also trash talk the other EHR systems – the opposing “clubs” – almost as much as they up talk themselves, not unlike opposing sports teams. (Take your pick for an example; Browns/Steelers and Ohio State/Michigan are my favs.) Most EHRs try to build more than brand loyalty; they sell a lot of laced Kool-Aid.

EHRs club… a lot.

Clubbing and EHRs and Religion

It probably doesn’t take much ‘splaining to see the connection with religiosity and EHR clubbing. Few things have brought more people together than religion. And few things have brought more people together to assail other similarly grouped people with a differing opinion more than religion. Few things have caused more good and more harm, throughout the entire course of human history, than religion. (This likely being the reason John Lennon tried to “Imagine”.) Religion doesn’t have to lead to harm; it just often gets contorted and ends up there.

Religion is sort of the pinnacle of clubbing… well, aside from Apple.

Clubbing EHRs Religion

In the first sentence, I placed commas between these words though I didn’t in the title. There’s a good reason for that: discussing “clubbing”, “EHRs”, and “religion” is not the same as “clubbing EHRs religion”. (To be PC, Punctuationally Correct, I should have an apostrophe after the “s” in EHRs, but I liked the way it looked without it!)

Face it. No EHR does “EHRing” that much better than any other. Most every single one that I’ve seen does some thing or things really well, maybe even uniquely well. Most every single one that I’ve seen also does some thing or things (usually things, plural) really, really poorly. None of them are worth religiosity. Few are even worth a club.

“Imagine” there’s no EHR religion. Imagine an EHR company telling you the full truth. Imagine EHRs working to build the best solutions and foregoing the paranoia that someone else might copy what you’re doing. Imagine EHRs learning from each other and getting best of breed capabilities shared across the sandbox.

Imagine EHRs remembering that jacked up prices and humongo corporate facilities are a part of the skyrocketing healthcare cost crisis. Imagine EHRs all remembering that we’re in healthcare, that caring is an integral part of what we do. (Many, maybe most, EHRs were started with caring at their core, but it seems as if that has gotten a little lost, a little contorted, in development.)

Imagine buying an EHR made as simple as choosing which type of paper you prefer. All paper works, but some is smoother, some is heavier grade, and some is just fine for the price. The nice thing with paper, though, is you can actually know what you’re getting before you buy. (Plus, I’ve seen very little clubbing in the world of paper, except perhaps for Levenger.)

CEHRR

I’d like to club the clubbing, club the religion, right out of EHRs. “Clubbing EHRs’ Religion” (CEHRR) is a new club I’m starting. I’ve got “I’m a CEHRR” (pronounce it “kûr”, as in “cur”, as in mongrel) t-shirts, coffee cups, and buttons plus a cool little clubhouse. It’s better than any other club. It’s the best club ever! Wanna join?

From the trenches…

“I do not feel obliged to believe that the same God who has endowed us with sense, reason, and intellect has intended us to forgo their use.” – Galileo Galilei

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 the Future exhibit for the American Academy of Pediatrics, and sits on the board of directors of the Ohio Health Information Partnership (OHIP).

News 7/12/12

Memphis Obstetrics & Gynecological Association (TN) selects MED3OOO’s InteGreat EHR for its 24 providers.

The 80-center MedExpress Urgent Care implements athenaCollector and athenaCommunicator.

Allscripts partners with biopharmaceutical services company Quintiles to jointly develop solutions that leverage de-identified longitudinal data to improve the drug development process.

South Hills Radiology Associates (PA) contracts with McKesson Revenue Management Solutions for billing services for its 14-physician practice.

Arthritis Associations of South Florida implements Anoto Group’s digital pen and paper technology to import clinical data directly into the practice’s NextGen EHR.

University Physicians (CO) expands its investment in GE Centricity Business to include payer contracting, document scanning, and integration with the hospital’s EMR.

The TriZetto Group names former Onlife Health CEO Chris Hunter SVP and president of Trizetto’s physician market group.

New payment methodologies may have helped primary care physicians increase their 2011 compensation by more than five percent. Also impacting physician compensation: the shift from private  practice to employment by integrated delivery systems and hospitals.

You may have read on HIStalk that I am taking a bit of vacation this week, so today’s post is a bit sparse. Back to the grindstone soon!

E-mail Inga.

News 7/10/12

From Deacon “Re: Michael Stearns. As a former e-MDs employee, I really don’t believe Dr. Stearns did anything that was listed in the email to e-MDs clients and on their Website. e-MDs is a good company that can’t get out of its own way, but Dr. Stearns was the least of their worries. He probably would have been a better CMO and working with product challenges than a CEO working on business challenges.” I’m sure I am not the only one surprised by the seemingly swift removal. Just one week earlier, the company hosted its annual user conference and symposium and posted photos (now removed) on Facebook showing Stearns to be large and in charge.

HHS announces the selection of 89 new ACOs, bringing the total number of organizations participating in Medicare’s shared savings initiatives to 154.

Southwest Community Health Center (CT) selects NextGen EHR, PM, and electronic dental record products for its 12 location FQHC.

CMS issues a proposed rule that would increase Medicare payments to family physicians by about seven percent and by three to five percent for other primary care providers for the 2013 calendar year. The same proposed rule includes new hardship exemptions and an informal review process for the e-prescribing program and recommendations for increased alignment between the PQRS reporting program and the MU use program.

The AMA offers advice for physicians who wish to remain in private practice but also want to facilitate better care coordination by becoming part of larger clinically integrated organizations. Critical elements for success include connectivity to other providers and access to data from EHRs and claims databases.

The 10-provider OrthoKC (KS) contracts with SRS for its EHR.

The California Primary Care Association and Arcadia Solutions develop Health Home Accelerator, a program to help primary care practices transform their organizations into a Patient Centered Medical Home and earn NCQA recognition.

Manet Community Health Center (MA- above) and Community Health Programs (MA) select athenahealth’s athenaClinicals, athenaCollector, and athenaCommunicator for their FQHCs.

E-mail Inga.

From the Consultant’s Corner 7/6/12

Centralizing Patient Access and Revenue Cycle Holds Great Promise

For healthcare execs, it’s like the search for the Holy Grail: finding a system that seamlessly supports patient access and revenue cycle management for both inpatient and ambulatory operations. The concept of a single consolidated patient statement covering both hospital and professional services not only reduces cost of collections, it is a major driver of improved patient satisfaction.

That prize is now within reach, as more application vendors have focused significant development resources to more closely integrate patient scheduling, registration, and billing functionality. But major obstacles still remain — often as much on the human side as with the technology.

Many CFOs call this kind of centralized approach the “single business office,” and there’s no argument about the major benefits it delivers. We have worked with several clients to implement a “one call does it all” model for patient access. In this model, a patient can schedule coordinated appointments across a variety of specialties and service locations.

As physicians and hospitals continue to work more closely together, several of our clients who have implemented centralized patient access units are now continuing their push towards centralization by developing a single business office capable of supporting professional and hospital services. These organizations will be well positioned to support the changes facing our industry. A common example is the ability to support bundled payment programs for organizations creating an Accountable Care Organization.

The common benefits an organization can expect from centralizing functions such as patient access or billing operations include:

• Improved patient satisfaction and care quality. Patients enjoy the benefit of making one call rather than multiple calls in which they repeat the same registration and demographic details over and over again. What patient wouldn’t love the convenience of one-call scheduling compared to spending hours on “hold”? Additionally, a single consolidated patient statement covering inpatient and professional services is easy to understand and more efficient for patients to respond to.
• Reduction in call volume. Patients aren’t the only ones who benefit from making fewer scheduling calls. Healthcare organizations need fewer staff to take those calls as well.
• Cleaner claims. Consolidating registration operations enables greater control over the quality and consistency of data capture, which reduces registration related denials.
• Accelerated self-pay payments. Patients who receive only one consolidated bill are more likely to pay it faster because it’s easier to understand. They don’t have to puzzle over separate bills from the hospital and specialists. In addition, by centralizing patient access and billing, a healthcare system can cut costs and reduce staff and the data captured is more consistent and of higher quality, resulting in fewer denials down the road.

Competing governance structures are perhaps the biggest obstacle to achieving the benefits of centralization. Most hospitals and their allied medical groups are governed separately. In many organizations, doctors don’t want the hospital to see sensitive financial data, and vice versa.

Secondly, implementing a seamless system uniting patient access and billing is a big job. The codes and fee schedules in ambulatory care differ greatly from those used for inpatient procedures. Plus there’s the expense and disruption of doing the system overhaul. It takes courage and leadership to oversee such a project. Fortunately, though, courageous leaders are rising to the occasion more and more often because the long-term benefits of centralization far outweigh the challenges.

Brad Boyd is vice president of sales and marketing for Culbert Healthcare Solutions, a professional services firm serving healthcare organizations in the areas of operations management, revenue cycle, clinical transformation, and information technology.