News 3/29/12

NextGen enters into a reseller agreement with Nuance, giving NextGen the opportunity to sell Dragon Medical speech recognition software directly to its Ambulatory EHR clients.

Speaking of NextGen, I see they are hosting their fifth annual NextGen Cares Golf Tournament April 23rd in Horsham, PA benefiting the Jayne Foundation.

Online physician networking site Sermo names former Revolution Health president Tim Davenport CEO. Davenport replaces Sermo founder Daniel Palestrant, who left the company in January to run Par80, a start-up focused on improving the patient referral process.

The Centricity Healthcare User Group hosts its annual meeting April 20-21st in Las Vegas. CHUG is not an official organization of GE Healthcare and the group limits its membership “to well-behaved licensed Centricity EMR users, GE Healthcare employees, and a few very polite consultants and vendors of products supporting Logician.”  I wonder if CHUG expects everyone to remain “well-behaved” and “very polite” while visiting Sin City.

Greenway Medical makes its PrimeMobile clinical and financial application available for Android smartphones and table devices.

Cool-sounding technology: Giffen Solutions launches MexCom, a smartphone app that will record, transcribe, and archive conversations. The app also allows physicians to access a patient’s health profile when a patient calls and to e-prescribe.  I didn’t see anything on their Website to suggest it interfaces with a practice’s EMR but otherwise the functionality looks handy.

The American College of Osteopathic Family Physicians names MDdatacor its vendor of choice  to offer the College’s Medical Home Quality Markers program. The program will use MDdatacor’s technology platform for patient data management and reporting  for members seeking PCMH recognition from NCQA.

A physician with Northwestern Memorial Physicians (IL) resigns earlier this month, blaming the practice for “technology troubles, billing errors, and lack of adequate office staffing.” Northwestern, which utilizes Cerner, rejected the resignation, claiming that Dr. David Vigder breached his employment contract and improperly engaged in talks with the practice’s chief competitor, NorthShore University HealthSystems’s Medical Group. Vigder responded through his attorney, providing details of the “severe computer problems” that made communication with specialists difficult. Northwestern has subsequently responded to Vigder with a lawsuit.  Stay tuned.

In an interview on Fox Business, athenahealth CEO Jonathan Bush discusses the need to get doctors to believe in the Cloud; he also shares impressions on the healthcare reform debate.

TransforMED, the AAFP subsidiary dedicated to helping organizations adopt the PCMH model of care, expands its leadership team and staff. In addition to the hiring of several project managements and practice enhancement facilitators, TransfoMED names Barbara Doty, MD and Laura Knobel, MD to its board of managers and  promotes Diane Cardwell to VP of healthcare solutions and Dan McKean to VP of business development.

Two practices within the University at Buffalo School of Medicine select PatientKeeper Charge Capture, which will be integrated with UBMD’s GE Centricity Group Management PM product.

CalOptima REC reaches it 1,000 member enrollment goal for primary care providers.

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News 3/27/12

The 38-provider St. Cloud Orthopedic (MN) selects SRS EHR.

A Maine public radio station profiles EMR adoption by solo physicians, including internal medicine physician Dr. James Raker. Raker adopted an EHR last year to “keep up with the industry” but feels they are more time-consuming than paper and do “nothing” to help patients. Raker also notes that an EHR conversion can be a daunting task for a solo physician and is one reason many are electing to join larger groups or seeking early retirement. Family physician Dr. Paul Wooden adds that EHRs make it challenging to give patients the attention they deserve and make visits less personal. Despite those negatives, Wooden finds EHRs helpful:

“They excel in terms of data capture, of making records available, keeping track of medication lists, allergy lists. They have the ability to check a patient’s allergy list based upon medicines that are prescribing, so that’s a real benefit.”

American Medical News provides some tips for physicians and small practices to ensure that a lost mobile device does not result in a data breach. The suggestions are targeted to providers who don’t have the benefit of a health system or large practice to manage their device security and include:

• Selecting a device that offers encryption tools or security apps
• Using a passcode lock
• Adding remote wipe capabilities
• Enacting required login to any applications that carry personal information.

Former Carefx Chairman and CEO Andrew Hurd is appointed president and CEO of Epocrates. Hurd takes over for Peter Brandt, who will step down as interim president and CEO and assume the role of vice chairman of the board of directors.

Through the end of February, the EHR Incentive program paid EPs and hospitals almost $3.9 billion. Here’s how that breaks down for EPs:

• Medicare payments of over $636 million to 35,341 EPs, including 31,650 MDs or osteopaths.
• $511 million from state Medicaid programs to 24,443 EPs.
• Total payments to EPs: almost $1.2 billion.

February, by the way, was the biggest month ever for EP incentive payments: $326 million to 17,285 EPs.

TRA Medical Imaging (WA) contracts with Zotec Partners to manage the billing operations for its 52 physicians.

CMS informs physicians who were not deemed “successful electronic prescribers” in 2011 that they may contact the agency’s QualityNet Help Desk, should they have questions about this year’s 1% Medicare payment adjustments that will be imposed for failing to meet 2011 e-prescribing requirements. Though the e-prescribing incentive program does not have a formal appeals or review process, CMS has agreed to review concerns to identify any unusual or extenuating circumstances that may warrant further consideration.

US Representative Nancy Pelosi participates in a ribbon-cutting ceremony for Practice Fusion, which recently moved into a new building after completing a $1 million renovation. Pelosi  said that the rapidly growing Practice Fusion exemplifies the kind of innovation that lawmakers had in mind when they passed the Affordable Care Act. Am I the only one who doesn’t quite get the connection between the Accountable Care Act (not ARRA) and Practice Fusion’s growth?

E-mail Inga.

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From the Consultant’s Corner 3/23/12

Now Is Not the Time to Delay Your ICD-10 Preparation

That sound you hear is an entire industry collectively groaning and sighing. Why? Because the Department of Health and Human Services (HHS) is taking steps to postpone the date when “certain health care entities” must start using the ICD-10 diagnosis and procedure code sets.

Many of those who’ve already started down the path to ICD-10 conversion are groaning in frustration over the proposed compliance delay. You may want to listen to them. The sighs of relief coming from procrastinators should be your wake-up call to keep pushing full steam ahead toward ICD-10 compliance.

It’s like when the college professor gives you an extra two weeks to finish an important term paper. The procrastinators take their feet off the gas, while the A students keep preparing diligently. The latter is exactly what your organization should be doing with regard to ICD-10.

I often compare the ICD-10 transition to pulling off a Band-Aid. It’s going to hurt no matter when you pull it off, so you might as well face the pain sooner rather than later.

Let’s face it. Balancing many priorities — including governmentally-led programs such as achieving Meaningful Use (MU) and 5010 — have been a tall order and an all-consuming task for most healthcare providers, vendors, and consultants. Simply keeping up with the various phases of MU has robbed most providers of the time and resources needed to do ICD-10 impact assessments and project plans. Many of the payers, IT vendors, and clearinghouses are likewise playing catch-up. So while a few major stakeholders have made steady progress toward ICD-10 implementation, most have not.

Lately there’s been talk of a dual track, where some organizations need to meet the original Oct. 1, 2013, deadline for ICD-10 compliance while others get an extension. In a word, that would be disastrous because it would add an extra layer of confusion. Determining which healthcare entities are using ICD-9 and which are using ICD-10 after October 2013 would be difficult at best. But that may be the situation in which we’re placed, so we need to be prepared.

If HHS does decide to grant you a few more months to get ready for ICD-10, don’t squander that time. Put it to good use by continuing to consult with your physicians, payers, and vendors. If they’re behind schedule, hold them accountable. Don’t forget that hospitals and practices have the most to lose from being behind the curve on ICD-10. There can be major disruptions to cash flow, so now’s the time to refocus and get cracking.

You can start by asking yourself these questions:

• Have we done an ICD-10 impact assessment?
• Do we have a project plan and a conversion team in place – one where the roles are clearly defined?
• What are the budgetary requirements which need to be planned for?
• Do our IT partners currently have the development bandwidth for ICD-10 conversion?
• Are our payers and clearinghouses making good progress or dragging their feet?

If the ICD-10 deadline does get pushed back, that doesn’t mean you can start lounging in a hammock. Getting ready for this new coding system is a huge undertaking. Hospitals and practices that use this extra time wisely will have far fewer headaches when the real deadline arrives.

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.

News 3/22/12

EZ DERM announces that its EHR iPad app now incorporates Nuance Communication’s medical speech technology for app interaction, navigation, and clinical documentation.

RCM provider MD On-Line acquires MD Technologies, a provider of RCM products and the Medtopia Manager PM system.

Practice Fusion forwarded me an email that reminds its customers that lab integration is available at no cost and that connections are currently available with 16 regional and national reference labs. Assuming it all works as advertised, free integration to that many reference labs is impressive.

The American Academy of Pediatrics updates its Child Health Informatics State Resource Map, which provides a snapshot of HIT activities in each state, including contact information for RECs. The AAP also offers an EMR Review Site where pediatricians can read reviews and provide comments related to the performance and features of specific EMRs. Both tools look quite handy and do not require a subscription to access; however, I could not find more than one or two reviews for each of the EMRs listed on the Review Site.

Paul Grundy, MD is one of four NCQA 2012 Health Quality Award honorees for his early championing of the patient-centered medical home model. Grundy is president of the Patient-Centered Primary Care Collaborative and global director of IBM Healthcare Transformation.

Waiting Room Solutions announces multiple new clients for its EMR solution including Integrative Health and Hormone Clinic (IA), Healthcare One (OK), Lynda J. Wright, MD (ME), and Orlando Executive Health (FL).

Holy Name Medical Center (NJ) names PriorityOne Consulting a preferred vendor to assess the IT infrastructure of its affiliated physicians’ offices and assist practices with the adoption of Aprima EMR.

Three Hoag Orthopedic Institute (CA) physicians will be the first to participate in a new automated bundled payment model for knee replacement surgery.  The Bundled Payment Initiative, which pays a set, comprehensive fee for a given episode of care, is a collaboration with Aetna and the Integrated Healthcare Association.

The Wall Street Journal profiles Colorado’s Westminster’s Medical Clinic, a small practice struggling to make ends meet. After losing money in 2010, the three-doctor group joined a medical home project in hopes of improving its bottom line; in 2011 the practice profited just $29,261. The physicians sell dietary supplements to augment their income and are now considering charging patients a monthly fee to offset the costs of its online portal and on-line consults. Meanwhile, the physicians work demanding hours, leading one of the doctors to say the situation was “just too much” and that his life was “insane.” I’m sure he has thousands of peers who would concur.

E-mail Inga.

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News 3/20/12

The 38-provider OrthopaedicCare (PA) selects GroupOne Health Source to implement its eClinicalWorks EHR.

Central Virginia Health Network will offer Phytel’s Atmosphere platform, including Phytel’s Insight and Coordinate modules, to the network’s 300 community physicians.

Athenahealth will hire 80 people to work at its Belfast, ME office, raising its headcount by 20%.

The Dean McGee Eye Institute (OK) selects ifa united i-tech to provide its EMR v6 solution.

Gateway EDI finds that 56% of practices report moving forward with ICD-10 preparations, despite the potential delay of the implementation deadline. An additional 33% of practices have not begun planning and 11% are postponing preparations until a new deadline is announced.

AMA Board of Trustees Chair Robert M. Wah, MD provides commentary on EHR following his recent participation at HIMSS. In addition to providing an overview of some of the meeting’s highlights, he offers some thoughtful remarks on the role of technology in providing care and the role of physicians in deploying technology:

The use of technology must be seen as a way to improve care for our patients and not seen as a technology program or project. It is also clear that physicians must be involved in this process from the beginning of development and through deployment of new technologies.

One of the thirteen recently fired Everett Clinic (WA) employees speaks out about the incident that led to her dismissal. RN Kathleen Crossler was fired after a new electronic monitoring system tagged her for violating patient privacy rules after looking up her husband’s lab results – at his request. A clinic representative notes that the organization’s confidentiality agreement states that employees cannot look at files even if they are asked by friends or family to check medical information. The 65-year old Crossler intends to appeal her termination.

Essentia Health (MN) rolls out its MyHealth portal, giving patients access to lab results, immunization records, and appointment requests.

The top two ways to describe patient engagement, according to healthcare organization leaders participating in a National eHealth Collaborative study: patient uses educational material and online resources to learn about better health or their own health conditions, and, patient uses tools and resources to management his medical record and other health data. The proposed Stage 2 MU regulations include several facets of patient engagement, though there isn’t agreement on what it means to “engage” a patient.

Joslin Diabetes Center (MA) announces plans to offer telehealth services nationwide using the American Well communications platform integrated with the practice’s NextGen EHR.

Practices that adopt the PCMH model of care experience higher morale and job satisfaction rates among physicians and staff members, according to a study published in the Archives of Internal Medicine. However, the model also leads to an increase in physician burnout. Researchers attribute the morale boost to providers’ ability to offer better access to care and increased communications; the increased workload associated with the PCMH model is blamed for the burnout.

The local paper interviews Girish Kumar Navani, CEO of the Westboro, MA-based eClinicalWorks, which has grown in its 13 years to a $200 million company serving over 60,000 physicians and employing 2,000. Girish summarizes the success of the company under his leadership as follows:

Being a good businessman is intuitive. In a way, it means doing what your heart tells you to do. You have to believe in doing what your sense of ethics tells you to do. And you have to let your decisions be driven by treating people the way you would like to be treated. I am an avid football and Patriots fan, and I look at it like this: I may be the quarterback, calling the plays, but I am still huddled with the same 11 guys. I am still on the field — the quarterback doesn’t make calls from the sidelines.

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