News 4/18/13

The HHS Office of the Inspector General publishes protocols for providers who wish to voluntarily disclose self-discovered evidence of potential fraud. The OIG notes that physicians and other healthcare providers that follow self-disclosure protocols “deserve to pay a lower multiple on single damages than would be normally required in resolving a Government-initiated investigation,” though the specific multiplier may vary depending on the facts of the case.

NextGen reseller TSI Healthcare recognizes Carolina Orthopaedic and Sports Medicine Center as its Circle of Excellence award winner in the practice management category.

HIMSS Analytics recognizes 54 Essentia Health (MN, ND, WI) ambulatory clinics for achieving Stage 7 on the Ambulatory EMR Adoption Model. The clinics run Epic.

Meditab Software introduces the AllergyEHR Shot Lab, which works with third-party EHRs to provide immunotherapy tracking and management.

The preliminary results are in from our 2013 HIStalk Practice Reader Survey. I’ll summarize the findings in a separate post, but I’m pleased to report that 91 percent of survey participants believe that reading HIStalk Practice has helped them perform their job better in the last year. Readers shared a number of good ideas to make the site even better and Mr. H and I will be weeding through those in the next few days. Thanks to all who took the time to participate.

GE Healthcare IT announces several new initiatives in support of customers at this week’s 2013 Centricity Live USER Conference in Washington, DC. Proposed programs include:

• The GE Centricity Productivity Award for practices that most embody GE’s vision of “connecting productivity with care”
• An expansion of the channel partner program to support small and midsize independent practices

The Wall Street Journal interviews athenahealth CEO Jonathan Bush, who discusses his company’s purchase of Epocrates, physician adoption of cloud-based services, his political family ties, and more. A couple of highlights:

The biggest obstacle to athena’s business success has been the fact that we’re totally unknown. And when we’re known, we’re not trusted because we’re too new, too young, too complicated. Everybody knows Epocrates and trusts them. And so the first benefit is that, is just that we can now be known.

I worked for my uncle George—41’s—campaign when I was a teenager and he has been an idol my whole life. Not at the same level as my dad, who also had a much bigger impression on me. But my uncle is very, very, very loyal, committed to his team, and I am that way as well

Children’s Mercy Hospitals and Clinics announces a telehealth program that will connect allergy patients in Wichita with providers in Kansas City. An RN will facilitate the remote visits and physicians will use a digital stethoscope to assess a patient’s ears, nose, and throat.

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News 4/16/13

Physicians should “pause before posting” online, according to recommendations from The American College of Physicians and Federation of State Medical Boards. In order to protect the patient-physician relationship and observe professional conduct, other recommendations for physicians include:

• Not friending or contacting patients through personal social media
• Texting patients only if  they consent, and then only with extreme caution
• Communicating electronically only with established patients that have given consent.

Most physicians support patient self-tracking to collect and share their health data. More than two-thirds of physicians report having at least one patient sharing health measurement data and three-fourths believe self-tracking leads to better patient outcomes.

SuccessEHS integrates its SuccessEHS 6.1 EHR/PM solution with four Welch Allyn medical diagnostic devices.

The Greater Miami Chamber of Commerce names CareCloud the 2013 Technology Company of the Year. CEO Albert Santalo accepted the award on the company’s behalf.

Practice Fusion launches Patient Fusion, which allows patients to schedule online appointments via the Web with any of the free EHR company’s 27,000 physician users and access their health records online. Mobile versions will follow.

Phreesia partners with EHR Integration Services to integrate its self-service patient check in technology with existing PM and EHR systems.

Athenahealth will provide developers access to APIs to connect to athenahealth’s physician network, including appointment data and anonymized billing and medical history. Possible apps could facilitate scheduling, data sharing between practices, and practice-patient communications.

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

Surescripts awards DrFirst the 2012 White Coat of Quality award for its Rcopia e-prescribing software.

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From the Consultant’s Corner 4/12/13

The Next Available Appointment Is…
By Brad Boyd

Have you ever gone to the doctor for a routine checkup, only to be told that you should really see a specialist to take a closer look at that issue you’re having? Perhaps you have frequent migraines or your asthma symptoms are getting worse. As you try to make the appointment, you are told that the only time you can see the specialist is in six weeks, on a Tuesday, at 10:45 a.m., because the doctor is not available any other time.

This situation is not only irritating for you—the patient—it is also aggravating for your primary care physician. When patients have trouble gaining access to specialists, it can mean delayed treatment, potentially compromised patient care, and more headaches for the primary doctor. I’ve observed that some primary care physicians cope with this problem by referring patients to specialists outside their network, which presents issues for both the physician and the network.

As healthcare organizations pursue clinical alignment and integration initiatives—such as Accountable Care Organizations and other value-based reimbursement strategies—I have found they focus on steps like implementing integrated information technology systems, standardizing medical management, and fostering greater physician alignment.

While these are important aspects of an integrated approach, what many organizations fail to realize is that they also have to address patient access issues. If patients have trouble getting in to see their doctor or specialist, there could be some pretty significant patient care, satisfaction, and revenue effects.

I’ve noticed this problem happens most often when academic institutions seek clinical alignment and integration with non-academic organizations, such as physician practices. In these situations, physician compensation in the academic medical center may not be aligned with productivity expectations. In other words, the compensation model for specialists doesn’t incentivize them to see large numbers of patients. They may limit the number they see, choosing instead to focus on research activities or other priorities.

Improving patient access and the overall patient experience requires a holistic view of the academic institution-physician practice partnership, taking into consideration governance, leadership, and management issues. I recently tackled this type of holistic assessment for one of my clients, an academic group practice. Together, we developed a patient access optimization program which we piloted across two departments.

The result was a 25 percent increase in appointment slots and a 14 percent growth rate in ambulatory revenues. Satisfaction scores also improved for employed and aligned practices as well as their patients because patient care was better coordinated across the health system. In addition, referrals to competing health systems went down substantially. Based on the success of the pilot, the organization is deploying a new standardized "patient care model" throughout the remaining clinical departments.

Spending time looking at patient access and figuring out ways to increase specialist availability can ensure that any clinical integration program you pursue is successful. By addressing this issue, you can make the road toward clinical integration a little easier and ultimately reach your goals in this effort.

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

News 4/11/13

Athenahealth files a lawsuit against CareCloud, a four-year-old PM/EHR company that athena claims is infringing on one of its patents. The 2001 patent addresses the way claims processing rules are injected into athenahealth’s billing workflow. Above is a 2011 tweet from Jonathan Bush. Several former athenahealth employees now work for CareCloud. Athenahealth’s director of communication was unable to comment on the lawsuit, but CareCloud CEO Albert Santalo provided us with this statement:

“To the best of our knowledge Carecloud is not infringing on Athenahealth’s 13-year-old outdated method and we won’t be making any additional comment at this time.”

Main Line Health (PA) implements eClinicalWorks EHR across 42 practices.

The Polyclinic (WA) selects Phytel’s Population Health Management solution and Verisk Health’s Provider Intelligence program for population health management.

CMS creates a fact sheet to help providers if they are selected for EHR incentive program audits. CMS notes that documentation supporting attestation responses should be retained for six years and should support all payment calculations, such as cost report data.

Arkansas Heart Hospital selects eClinicalWorks EHR for its physician clinics.

HIMSS Analytics recognizes the ambulatory clinics of NorthShore University HealthSystem as the first group of ambulatory facilities to reach Stage 7 of the Ambulatory EMR Adoption Model.

Clinical effort, teaching, and research are named as the factors that most heavily influence physician compensation in academic settings in an MGMA report on academic practice compensation. Other factors influencing compensation: department rank, specialty, and geographic location.

Intuit Health announces that seven million patients have now registered for the Intuit Health Portal, including one million in the last six months.

Athenahealth celebrates the fifth anniversary of its Belfast, ME location, which now employs 570.

Bankruptcy attorneys and physicians blame a weak economy, shrinking reimbursements, changing regulations, and rising malpractice and drug costs for a recent spike in physician practices filing for bankruptcy. The American Bankruptcy Institute reports at least eight filings by physician practices in recent weeks.

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News 4/9/13

From SensibleShoes: “Re: Walgreens. This is absolutely insane. Walgreens has no idea what they are doing but they just found a way to sell more of their drugs on their shelves!” Walgreens becomes the first retail store chain to to offer diagnosing and treatment for patients with chronic conditions. Walgreens officials say they are not trying to take over primary care but instead are offering patients more access points for testing and care management. The AAFP does not welcome the news, saying it’s difficult to manage care when patients are treated in various settings. I am sure that AAFP’s objections have nothing to do with the fact that the 300+ retail clinics are staffed by PAs and NPs and not FPs.

Baylor Quality Alliance (TX) selects Greenway Medical to participate in its EHR program, which aids community physician practices in the evaluation, selection, and implementation of EHR applications.

The producers of NPR profile several physicians in rural Missouri, most of whom lack the necessary funds to transition to EHRs. Many practices are turning to large health systems for financial support while older providers are choosing to opt out of EHRs and use paper records until retirement.

The Chicago HIT REC introduces LAUNCH, an extension of its EHR adoption and training assistance program and available to both primary care physicians and specialists.

American Medical News offers physicians some tips for buying an EHR the second time around. I agree that one of the first things practices should do before jumping into a new system is identify what went wrong the first time to avoid repeating mistakes. Providers then need to prioritize their buying criteria and commit fully to the sometimes painful implementation process.

The AAP and AHRQ develop a set of instructions for EHR vendors that defines functionality and more than 700 requirements that are considered essential to pediatrics.

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