News 12/15/11

The Orthopaedic Group, a 36-provider group in Mobile, AL, replaces its legacy EHR with SRS EHR.

Emdeon and HHS announce a program through which Emdeon will donate Emdeon Clinician EHR licenses to 100 New Jersey healthcare providers practices in medically underserved areas. License fees will be waived for one year from the date a qualified provider contracts with Emdeon. I found this demo of Clinician from this year’s HIMSS conference.

athenahealth CEO Jonathan Bush speaks out in The Hill’s Congress Blog, calling for greater transparency and accountability in the Meaningful Use incentive program. Bush points out that the current program includes no verification process to prove physicians are actually using HIT in a meaningful way. He argues that the lack of verification could potentially lead to billions of wasted taxpayer dollars and “enormous disparities between what physicians and hospitals are able to do with the EHRs and their actual ability to improve care.”

The Maine REC (MEREC) reaches its enrollment target of 1,000 primary care providers. MEREC, by the way, does not charge for its services, and, the statewide HIE will not charge small practices a connection fee for the first year.

The New England Chapter of HIMSS names practicing physician Daniel J. Nigrin, MD (Children’s Hospital, Boston) Clinician of the Year. Nigrin is also CIO at Children’s and a faithful HIStalk/HIStalk Practice reader.

The White House announces that more than $2.9 billion in healthcare fraud has been recovered in 2011, which represents a 167% increase over 2008.

In article highlighting HIPAA privacy, The Boston Globe profiles Leon Rodriguez, director of the Office of Civil Rights. Also getting a mention: Massachusetts eHealth Collaborative CEO Micky Tripathi and his recent HIStalk Practice post, which details his organization’s handling of a patient security breach earlier this year.

E-mail Inga holiday greetings.

News 12/13/11

AthletiCo Physical and Occupational Therapy (WI/IN) selects NextGen Ambulatory EHR/PM for its 50 physical and occupational therapy facilities.

HHS’ Office of Inspector General releases an advisory opinion regarding the exchange of EHR data for patient referrals. At issue: whether a vendor can facilitate a (presumably nominal) charge from a referring doctor to a specialist for a patient’s clinical record, without violating the anti-kickback statute. In reading the advisory opinion, it appears the vendor will not only facilitate the charge, but also keep a portion of the fee. OIG’s verdict: the proposed“coordination” service would not violate the anti-kickback statute. At the vendor’s request, the OIG does not name the vendor, although it sounds a lot like athenahealth to me (unverified.)

Danbury Radiological Associates (CT) selects ADVOCATE to provide billing services for its 20 physicians.

Quest’s Care360 EHR is named the top standalone e-prescribing platform by Black Book Rankings. Practice Fusion earned top scores for its EHR-based e-prescribing module.

e-MDs clients Drs. Mark Woodruff and William Weeks of Southwest Family Physicians are among the first providers in Nebraska to attest and receive Medicare payments for their meaningful EHR use.

The Chicago Health Information Technology REC says it’s on target to reach its enrollment goal of 1,486 primary care providers by the end of the year.

Altos Solutions will extend preferred access to its OncoEMR and OncoBilling platforms to members of the Innovatix non-acute care purchasing organization.

The California Health Information Partnership Services Organization (CalHIPSO) partners with CDW Healthcare to provide technology services and solutions to practices implementing EHRs.

DrFirst embeds technology from Atlas Medical into its Rcopia e-prescribing solutions, allowing Rcopia users to order tests and receive reports from any diagnostic testing facility on the Atlas iOn Interoperability Network.

Dermatology-specific EMR Encite, Inc. integrates NetHealth’s Quality Report System into its product to automate PQRS reporting.

An employee hired to purchase and maintain the IT systems at Wasatch Internal Medicine (UT) faces second-degree felony theft charges for stealing nearly $350,000 from the clinic. Over a 2-1/2 year period, the clinic paid Eric David Christensen almost $400,000 to purchase 51 PCs, warranties, and servers. Results of an audit uncovered that only three computers had been supplied to the office and none had warranties. When confronted, Christensen admitted he had been overcharging the clinic and had falsified records to cover up his actions.

A former physician with Fletcher Allen Health Care pleads guilty in US Court to unlawfully obtaining the private medical information of another person. Apparently Joshua Welch was having a sexual relationship with a woman who was not his patient and wanted to ascertain if she carried a sexually transmitted disease. He faces up to one year in prison and a $50,000 fine.

Overlake Imaging Associates (WA) selects Zotec Partners as its outsourced billing provider.

CMS posts the PQRS measures for 2012, including detailed specifications and release notes on the individual quality measures and measures groups. I found the release notes gave a pretty quick summary of what measures have changed and how.

On EHRtv, Medicomp CEO David Lareau talks Quippe with EHRtv’s Eric Fishman. He discusses the multiple way different EHR vendors are incorporating Quippe into their platforms.

Adirondack Region Medical Home Pilot Program, with implementation support services the Massachusetts eHealth Collaborative, earns Level 3 NCQA recognition for 29 of its 31 primary care practices.

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News 12/8/11

From Wednesday’s HIT Policy Committee meeting comes the following facts and figures:

• Over 154,000 Eligible Professionals have registered for Meaningful Use through the end of November, including 115,000 in Medicare’s program and 38,000 with Medicaid’s.
• Medicare has paid EPs almost $183 million; Medicaid has issued an estimated $237 million in incentives.
• The number of EPs that have registered is less than 30% of all EPs.
• Only 21, 425 EPs have received payments through the end of November. That’s about 14% of registered EPs and 4% of all EPs.
• At the time CMS crunched the numbers, 21,308 EPs had attested; 444 were unsuccessful.
• Drug formulary, immunization registries, and patient list are the most popular menu objectives.

The numbers leave me with a number of questions, including why payment appears to be so slow (almost half the total payments were not made until November.) I’m also curious why 444 EPs failed the attestation.  If you are in the know or have a theory, please share.

Anthony L. Jordan Health Center (NY) selects Phytel’s Atmosphere platform for patient outreach, appointment reminder, performance benchmarking, care coordination, and patient education.

Costco, in partnership with Allscripts reseller Etransmedia Technology, announces a nationwide launch of Allscripts MyWay EHR and PM, following sales success and high demand in select test markets. Costco is offering the MyWay package for as little as $499 a month, which includes hosting services, support, training, implementation, and unlimited claims processing.

Weight loss franchise company Pounds and Inches Away selects eMedical Fusion’s PM solutions, which are targeted at cash, hybrid, and concierge practices. eMedicalFusion also announces the availability of EMR interfaces with Amazing Charts and Eclipse.

Patient check-in company Phreesia releases a study of referral trends in physician offices, finding that 50% of new patients are referred by family and friends. I’m sure that individual practices find it beneficial to understand their own referral patterns,  but does anyone really need aggregated referral information, given variations between primary care providers and specialists and across geographic regions? My guess is that Phreesia’s primary motive for compiling and publishing this information to get the attention of pharma companies, payers, and others that might want more to incorporate their own market research into Phreesia’s check-in system.

On the other hand, who doesn’t want to know about wait times? The nationwide average for wait times to see a physician is 21 minutes. Patients in Wisconsin have the shortest average wait time (15 minutes) and Mississippi as the longest (25 minutes.) Wait times for primary care providers average six minutes less than for specialists. I’m not sure what one does with this data unless you’re looking for a reason not to move to Mississippi.

Maryland Health Care Commission adds OmniMD to its SelectVendor Product Portfolio.

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From the Consultant’s Corner 12/6/11

Clinical Integration: The Right Time, the Right Thing to Do

“Uncertain” doesn’t even begin to describe the future of healthcare in the US. We all know that the Patient Protection and Affordable Care Act is law, but it’s facing public resistance and an upcoming Supreme Court challenge. What’s more, there’s little doubt that ongoing budget talks in Washington will bring big changes to Medicare and Medicaid. We fully expect that the push toward performance-based reimbursement will only get stronger.

Now steps the just-released Accountable Care Organization (ACO) final rule into this already-confusing swirl step. The rule reflects the comments of thousands of physicians in provider organizations across the country, and is intended to empower them to join the trend toward clinical integration.

Although ACO participation is voluntary, most of the clients we speak with are convinced that this kind of system represents the future of medicine—and not just for Medicare patients under Medicare rules. Physicians—whether rural or urban, independent, or employed—will likely climb on board with the idea simply because it’s the right thing to do for patient care. Clinical integration across patient care settings is one of the best ways to enable providers to reach out to patients to offer better, more proactive services.

Under the new ACO rules, clinical integration can be accomplished in a number of different ways. Overall, the goal is to align providers and institutions with mutual, patient-centered objectives.

Though financial integration is one part of the picture, it’s definitely subordinate to the achievement of quality care. At their core, the rules require a commitment on both sides to the concept of aligning incentives for quality care—with the understanding that cost reductions will follow improvements in quality. They also require participants to recognize the undeniable role of IT in making it all happen.

Whether they’re headed by a physician chief executive officer (CEO) or a lay CEO, and whether they involve employed physicians or independent physician partners, all ACOs should share these four key characteristics:

• Common mission, vision and values
• Mutual respect and willingness to share risk
• Focus on the patient experience
• Commitment to quality care

Fortunately, some of the historical obstacles that have barred providers from working with large healthcare systems and payers are disappearing. For example, recent regulations released by the Centers for Medicare and Medicaid Services (CMS) significantly relax federal anti-trust laws. Everything is pointing in one direction: now, more than ever, is an opportune time for clinical collaboration.

For physicians, relationships with larger organizations make sense. They allow: easier access to the expertise inherent in the clinical programs of larger organizations; greater payer contracting experience; and the ability to leverage economies of scale. And let’s not forget information technology (IT) resources, which will play a huge role in the future of population management and coordinated care.

Clearly the pressure is on for providers and other healthcare stakeholders to align their mutual interests in order to cut the waste from our fragmented healthcare delivery system. With everyone on the same team, we can redefine the current ineffective, poorly coordinated, and unnecessarily costly healthcare system.

ACOs—together with other similar initiatives like patient centered medical homes, bundled payments and outcomes-based reimbursement—will become the foundation for delivering high-quality, cost-effective patient care for everyone. Ultimately, it doesn’t really matter whether ACOs start with Medicare or not. It doesn’t really matter whether the “ACO” moniker stays or goes. The concept of clinically integrated accountable care is here to stay.

So it’s up to providers to take the lead, developing clinically integrated organizations motivated by a common goal to improve access to quality, lower-cost care for all patients.

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 12/6/11

Greenway Medical Technologies selects Dell to as a cloud-based hosting partner for its PrimeSUITE EHR/PM solution.

The Alaska Medical Association makes DocBookMD available for free to its member physicians. The mobile application facilitates secure communication and the sharing of clinical information between providers.

The 88 providers at Core Physicians (NH) successfully attest for the Meaningful Use of their NextGen EHR.

CMS releases what it calls a “comprehensive tool” to guide eligible providers through the Meaningful Use program. The online resource covers everything from background on the MU program to eligibility measures, attestation, and payment. I agree that it is comprehensive and found it easy to navigate; however, I find it curious that it’s just now being released by CMS.

The non-profit Doctors Helping Doctors Transform Health Care officially launches December 1. The organization supports healthcare transformation, initially through the greater use of HIT, and is supported by unrestrictive grants. The website includes various blog posts and videos that feature lessons learned and best practices from physicians who have already adopted HIT. Janet Marchibroda, founding CEO of the eHealth Initiative, serves as the organization’s executive director.

As Mr. H so aptly put it, this weekend’s post by Micky Tripathi should be “mandatory reading for just about everybody.” In case you missed it, Micky shares how his organization handled a patient data breach. It’s unbelievably well-documented and includes a step-by-step account of how his organization addressed the breach. A couple of readers have called it the “HIStalk Post of the Year.” Even you über-busy types will thank me (and especially Micky) for taking two minutes to review the lessons learned at the end of the piece.

gloStream selects DiagnosisOne’s smartConsult clinical support solution to integrate integrate into its gloEMR offering. More on DiagnosisOne in this overview video.

The Michigan Center for Effective IT Adoption (M-CEITA) announces that over 3,724 Michigan providers have committed  to work with it on their adoption of EHRs.

CureMD Healthcare wins an eHealthcare Leadership award in the category of Business/Process Improvement Applications or Products.

A survey by the Optum Institute for Sustainable Health suggests that many physicians are still unsure if they will participate in ACOs. Furthermore, a significant number of physicians claim they are not even familiar with ACOs.

A patient sues his dentist after the dentist fines him $100 a day for posting negative reviews of his treatment. Before receiving treatment for an infected cavity, the patient was compelled to sign a privacy agreement. The patient later posted notes on two consumer websites, calling the dentist a “scammer” and warning others to “avoid at all cost.” The dentist then began invoicing the patient $100 for each day the review stayed online. The patient is asking for the privacy agreement to be declared null and void and for the dentist to be barred from presenting such agreements to future patients. The patient also wants to be refunded the $4,766 he paid for his treatment.

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