Joel Diamond 10/19/11

All That’s Good About Healthcare

There’s a new book by Candice Millard about the life and assassination—or better yet, death by medical malpractice– of President James A. Garfield. It turns out that his doctors’ refusal to wash their hands before probing his wounds after his shooting contributed more to his death than the bullet delivered by Charles Guiteau, which missed the president’s spinal cord and vital organs.

This travesty occurred despite the tireless campaign of Joseph Lister, who demonstrated that simple hand washing could save lives by preventing infection. And here we are, 130 years later, looking at technology and financial incentives to convince physicians to perform this simple act.

Ahh, but I am much too cynical. It’s so easy to point out what is wrong with medicine today. Instead, I’d like to change my usual tone, and focus on what’s good (and oh, there is so much good.)

• Laparoscopic surgery
• Immunotherapy’s profound effects on the treatment of rheumatologic and inflammatory bowel diseases
• Breast implants
• Robotic-assisted surgery
• Routine options for organ transplant
• Breast implants
• Advanced imaging technologies
• Cameras that when swallowed take Ansel Adams- like portraits of your bowels
• Breast implants
• Insulin pumps and patient-controlled analgesia
• And have you seen those TV commercials with former coach Jimmy Johnson for Extenze?

For those of you who insist on maintaining a cynical outlook, it is true that medical science now allows Bubba to eat pork rinds and pizza while never moving from his couch except to procreate– treating his acid reflux with OTC Prilosec, popping daily Cialis to help with the inbreeding, chasing it with Prozac because he’s bummed at “The Jersey Shore” hair-product line that messed with his Rogaine-induced mullet, while ultimately getting insurance to pay for his gastric bypass so he can fit through the door of his double-wide trailer.

But the reality is that Prilosec and other acid-blocking medicines have virtually eliminated the surgical treatment for peptic ulcer disease. Viagra and similar medicines have allowed Senator Bob Dole to keep Elizabeth happy. SSRI medicines have allowed millions of American to lead productive lives while decreasing the horrible stigma associated with mental health treatment. Laparoscopic bariatric surgery has finally reversed heretofore incurable obesity and its costly and devastating sequelae of diabetes, sleep apnea, and coronary disease.

Extending the analogy, medical technology has fueled its fair share of cynics. Like the television Dr. Oz, stethoscopes and scrubs seem to be more a fashion statement, as young physicians favor ordering echocardiograms than listening to heart murmurs, and it’s infrequent that they actually come into contact with blood and guts. Non-peer-reviewed Google searches have supplanted careful review of Harrison’s Textbook of Medicine, and template driven EMRs often get mistaken for a careful review of symptoms.

But ready access to imaging and information technology has markedly improved the way that new physicians approach diagnostic dilemmas, and a standardized approach to history and physical acquisition (along with improved decision support) will continue to drastically alter patient outcomes

Finally, let’s get back to hand washing initiatives (finally) taking placed in hospitals across the country. Along with other seemingly simple interventions such as marking the correct site before surgery, these measures represent an organized attempt to bring quality on a massive scale to an industry previously ignorant of evidence-based best practices.

Oh yeah, did I mention the new hair-removing laser that I got on eBay? I can finally say goodbye to those uncomfortable Brazilian waxes.

 

Joel Diamond, MD is chief medical officer at dbMotion, adjunct associate professor at the Department of Biomedical Informatics at the University of Pittsburgh, and a practicing physician at UPMC and of the Handelsman Family Practice in Pittsburgh, PA. He also blogs on interoperability.

News 10/18/11

Medical billing company MedData, Inc. acquires Data Management, Inc., a provider of physician billing services to pathologists and EDs.

The Department of Pathology at the Medical City Dallas Hospital (TX) selects McKesson’s Revenue Management Services  for billing and revenue cycle management.

GE Healthcare announces that it is now a Meaningful Use partner in New York eHealth Collaborative’s REC program.

St. Paul Eye Clinic (MN) selects the SRS EHR for its 15 providers.

HealthStar Physicians (TN) will implement athenaCollector, athenaClinical, and athenaCommunicator for its 60-provider network.

The CalOptima REC announces its preferred EHR vendors, which will extend special contract terms and preferred pricing to COREC members. On the list: Comtron, Med A-Z, MED3000, Mitochon Systems, Office Ally, and SuiteMed.

athenahealth announces findings from its VaccineView program, which indicate that pediatricians are being under-reimbursed for certain vaccines nearly half the time, when the total cost to the physician is considered. VaccineView analyzes payment information for eight vaccines, based on data compiled in the athenanet network.

If you are a physician interested in increasing your online presence, Avvo is offering a free guide, “Being Influential Online: Social Media Tactics for Physicians.”  In addition to several how-to steps, the guide looks at physician liability, HIPAA, and SEO to increase online reach.

We published our annual HIStalk Must See Vendors for MGMA directory over the weekend. Please stop by the booths of these HIStalk and/or HIStalk Practice sponsors and show them some love and thanks for their support. Here are a few highlights:

• A couple of the vendors, Mediserve and Practice Fusion, are not actually exhibiting, but are available for personal meetings.  You can find their contact information in the guide. 
• Allscripts and its featured partners are hosting a bingo game and giving away a number of prizes.
• Culbert Healthcare Solutions is giving away an Apple iPad2.
• MED3OOO, which is formally launching Quippe, is giving away 100 iPads during 11 different demo sessions.
• NextGen is leading a presentation in the Healthcare Innovations Pavilion Monday (“Capitalizing on PQRS as a Stepping Stone Toward Accountable Care”) and sponsoring a concurrent educational session Tuesday (“Using Data and Leadership Alignment to Achieve PCMH Recognition”).

E-mail Inga.

HIStalk’s Must See Vendors – MGMA 2011

3M Health Information Systems
Booth 1300

3M Health Information Systems delivers software and consulting services to help organizations improve compliance, workflow efficiency and financial performance. We offer expertise in clinical documentation, remote and automated coding, ICD-10, dictation, speech recognition, and mobile physician technology to support the electronic health record and pay for performance initiatives.

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Acusis
Booth 1400

Acusis provides cost-effective, accurate outsourced clinical documentation solutions to hospitals, clinics, and physician practices. AcuSuite, Acusis’ web-based software application, manages the entire process and delivers meaningful clinical documentation within a tailored turnaround time of 24 hours or less while providing Higher Standards, seamless implementation, EMR integration, and highest customer satisfaction.

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ADP AdvancedMD
Booth 559

AdvancedMD is now part of ADP, a trusted company with $10B in revenues and 570,000 clients, including 45,000 physicians. The company provides cloud EHR and leading billing tools. Proprietary claims scrubbing produces 95%+ first-pass acceptance compared to the industry average of 70%. Clients receive automatic and offsite backup, as well as continuous updates to meet regulatory compliance.

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Allscripts
Booth 1317

Allscripts provides innovative solutions that enable a connected healthcare community. More than 180,000 physicians, 1,500 hospitals and 10,000 post acute care organizations trust Allscripts to improve patient care and deliver world-class outcomes. Check out our Client Outcomes Center at www.allscripts.com/i2o to learn more.

Allscripts Partner Booth Bingo

VISIT Allscripts (BOOTH 1317) OR ANY OF OUR Featured Partners DURING MGMA TO PICK UP YOUR BINGO CARD. Collect stamps AT ALL PARTICIAPTING BOOTHS and you could win ONE OF SEVERAL GREAT PRIZES! LIVE DRAWING IS TUESDAY AT 1:00PM AT ALLSCRIPTS BOOTH 1317.

No purchase necessary, open to MGMA Annual Conference attendee members only (sorry, no vendors). Game ends at 1:00PM on Tuesday, October 25, 2011. You must be present to win.

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AT&T
Booth 1643

AT&T ForHealth is a new area that will accelerate delivery of innovative wireless, cloud-based networking services and applications. AT&T believes that the use of technology and smart networks will help improve care quality and reduce costs for a healthier world. AT&T Inc. is a global leader in communications.

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Capario, Inc.
Booth 117

Capario provides revenue cycle management solutions that accelerate and refine critical reimbursement processing needs, including real-time transactions, electronic payer remittances, denial management and business-intelligence reporting. To learn more, visit www.capario.com.

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Culbert Healthcare Solutions Inc
Booth 1328

Culbert Healthcare Solutions is a professional services firm serving healthcare organizations. We specialize in helping group practices leverage clinical and practice management technologies to improve patient care and financial performance by implementing best practices. Stop by to find out how to win an Apple iPad2.

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eClinicalWorks
Booth 1145

eClinicalWorks provides ambulatory clinical solutions, including EMR/PM software, patient portals and community health records applications. With 55,000+ providers and 250,000+ medical professionals across all 50 states using its solutions, customers include small, medium and large physician practices, out-patient departments of hospitals, health centers, departments of health and convenient care clinics.

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Emdeon
Booth 1301

Emdeon is a leading provider of revenue and payment cycle solutions that connect payers, providers and patients to integrate and automate key business and administrative functions throughout the patient encounter. Stop by the booth to find out how to win a vacation on Emdeon!

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e-MDs
Booth 1728

Visit e-MDs at Booth #1728  to demo the new e-MDs Rounds® for the iPhone. The user friendly mobile app combines the power of e-MDs Solution Series™ with the mobility of an iPhone, allowing doctors to remotely and securely key in patient information from their EHRs via their mobile device.  Using Rounds®, doctors are able to view patient data and scheduling information, capture charges, view results, write prescriptions, and exchange messages internally with staff.

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Enovate
Booth 642

Enovate is a national provider of mobile and wall mounted clinical workstations for the healthcare environment. Enovate provides multiple solutions for medication delivery, computerized physician order entry, clinical documentation, and electronic medical records. Enovate – advancing health information technology For more information, call (877)258-8030 or visit www.enovateusa.com.

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Gateway EDI, LLC
Booth 717

Gateway EDI, a health care electronic data interchange provider, helps practices maximize revenue, increase cash flow and catch claims issues before they impact a practice. Over 90,000 physicians trust Gateway EDI to take the worry out of billing, so they can focus on patient care. For information, visit www.gatewayedi.com.

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GE Healthcare IT
Booth 501

GE Healthcare provides transformational medical technologies and services that are shaping a new age of patient care. Our Centricity solutions support the vast information needs of our customers with enterprise-wide and departmental clinical systems; industry-leading imaging management solutions and best in class practice and revenue cycle management tools.

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Greenway Medical Technologies
Booth 517

Greenway Medical Technologies provides innovative EHR, ambulatory healthcare and clinical research business solutions to more than 33,000 healthcare providers nationwide, in 30 specialties, by enhancing the delivery of patient care through advanced health IT software and on-demand services that allow physician practices to function at their highest level of efficiency.

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Kareo
Booth 1716

Kareo – an MGMA "newbie" but a veteran in making medical billing software easy to purchase, learn and use.  Kareo’s  web-based software powers thousands of small medical practices in the U.S. We are leading our industry in the shift from traditional software to cloud computing (a.k.a. Software-as-a-Service) with the sole aim of helping doctors get paid by taking today’s complex healthcare system and making it easy. This allows doctors to spend less time worrying about their business and more time caring for patients and saving lives.  Visit Kareo @ booth 1716 and learn more about their refreshing and smart way to manage scheduling, eligibility, claims processing, patient billing and complement an EHR strategy.

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Ingenious Med
Booth 1609

Ingenious Med is an industry-leading mobile platform optimizing healthcare performance and revenue. The application automates the activities of physicians through charge capture, documentation, coding and compliance, improved quality of care and digital communication. With more than 9,000 users in 800 facilities nationwide, the award-winning functionality optimizes performance, efficiency and revenue.

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Lippincott Williams & Wilkins/Wolters Kluwer Health
Booth 200

Lippincott Williams & Wilkins, a Wolters Kluwer Health company is a leading international publisher of medical books, journals, and electronic media.  Visit booth #200 to browse our comprehensive product line and learn about the fastest, most affordable evidence-based tool at the point-of-care, 5minuteconsult.com.

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MedAssets
Booth 935

MedAssets works with healthcare providers to improve financial and operational performance. MedAssets further enables customers to deliver high quality, affordable healthcare through a comprehensive suite of evidence-based technologies and services, and developing best-practice solutions that effectively optimize revenue, secure reimbursement, reduce waste and aggressively manage total costs.

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Medicomp Systems
Booth 459

Medicomp is an inventor of tools that enable clinical usability at the point of care.  The MEDCIN and Quippe clinical knowledge engines and components are used daily by more than 100,000 clinicians to improve patient care, documentation, and compliance.  Our tools provide actionable, patient-specific, problem-oriented views of all clinical data for a patient. For more information, visit www.medicomp.com.

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MediServe

To schedule a meeting:

David C. Erickson
VP & GM
MediServe
480.299.3416
Davide@Mediserve.com

MediServe is a software development company dedicated exclusively to rehabilitation and respiratory care providers.

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McKesson
Booth 725

McKesson delivers solutions across all care settings; providing physicians with more products, services, and resources than any other healthcare company  including revenue management and practice management solutions as well as ONC/ATCB certified EHR systems for meaningful use. See how our solutions can prepare you for ANSI 5010 and meaningful use.

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MED3OOO
Booth 1109

MED3OOO, healthcare management and information technology, offers solutions for medical practices, clinics, hospital systems and hospital-employed physicians with RCM, ASP PM/EHR systems, and ACO strategies. Visit our booth for a demonstration of our intuitive browser-based InteGreat EHR, enhanced with Quippe®, creating the first “EHR with Physician Intuition," and allowing physicians to create templates on-the-fly.

MED3OOO will be giving away 100 ipads to those who “win” a spot at one of 11 demo sessions held during the following times:

· Sunday: 2, 3, 4 pm

· Monday: 10, 11, 12, 3, & 4

· Tuesday: 10, 11, 12

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MedAptus
Booth 1401

With the most powerful yet easy-to-use Intelligent Charge Capture technologies available, MedAptus enjoys enterprisewide adoption at many prestigious, academic healthcare organizations. Our full-scale Professional and Facility offerings increase revenue, re-engineer archaic processes, enhance EMR investments and save busy providers time.

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Medicity
Booth 617

Medicity created iNexx to give physician practices the flexibility to select and download low-cost, certified EHR modules and other apps that fulfill meaningful use requirements and solve the practice’s specific workflow challenges – all within a professional social network that powers unprecedented patient-centered care collaboration.

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NextGen Healthcare
Booth 1035

NextGen Healthcare is a leading provider of integrated electronic health record and practice management systems, connectivity solutions, and billing services designed to serve the needs of ambulatory practices and hospitals of all sizes and specialty areas. Our award-winning, certified solutions help improve care quality and increase operational efficiencies.

NextGen is also participating in the following sessions:

Healthcare Innovations Pavilion Education Session
Session HIP8: Capitalizing on PQRS as a Stepping Stone Toward Accountable Care
Monday, Oct. 24, 9:45-10:05 am
Lora Baker, manager, PCMH/ACO/PACE products, NextGen Healthcare

Concurrent Session
E4: Using Data and Leadership Alignment to Achieve PCMH Recognition
Tuesday, Oct. 25, 1:45-3:00 pm
Jen Barrera,  SVP, Strategic Development and Dr. Tamarah Duperval-Brownlee, M.D., MPH, FAAFP, Chief Medical Officer, both from Lone Star Circle of Care, Georgetown, Texas

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Nuance
Booth 1527

Nuance’s Dragon Medical is the most widely used speech recognition system in medicine today. Dragon Medical reduces transcription expense, delivers results rapidly, and heightens clinician satisfaction by making EHR systems easy to use, which accelerates the adoption of clinical information systems so provider organizations maximize the return from IT investments.

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Practice Fusion

To schedule a meeting:

Liz Meyerdirk
Senior Director of Business Development
lmeyerdirk@practicefusion.com
415-992-5578

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Sage
Booth 1116

Sage provides end-to-end clinical and financial technology solutions so physicians and medical professionals can focus on patients instead of paperwork. Serving more than 400,000 healthcare professionals including 80,000 physicians, Sage is physician-focused, patient-centric. To learn more about Sage solutions for EHR, practice management, patient engagement and reporting, call (877) 932-6301.

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SRSsoft
Booth 1200

Leader in productivity-enhancing EHR technology for high-performance specialty practices—with a successful adoption rate unparalleled in the industry. Offered via the Unified Desktop™, the robust SRS EHR, SRS CareTracker PM, and SRS PACS increase speed and efficiency, free physicians’ time, boost revenue, slash overhead, and enhance patient care and satisfaction.

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ZirMed
Booth 635

ZirMed is a nationally recognized leader in delivering revenue cycle management solutions to over 100,000 healthcare providers.  ZirMed leverages the power of technology to cure administrative burdens and increase cash flow.  ZirMed solutions include eligibility verification, credit/debit/check processing, claims management, electronic remittance advice, patient statements, e-commerce, and lock box services.

DOCtalk by Dr. Gregg 10/14/11

The Future Comes at a Cost

I’d like to join the choir, just for a minute, to sing the dirge of the funereal march for Steve Jobs. Whatever issues folks may have with Apple or iTunes or even Mr. Jobs himself, it is undeniable that he changed our world in an uncommonly broad-sweeping way. I’m not so sure the Edison or Da Vinci comparisons fit, but he was certainly an inspirational powerhouse for our age and a true visionary. Such visionaries are rare, wonderful creatures. Steve’s vision helped us all see the future more clearly.

Speaking of the future, I’ve been underwater preparing for this year’s “Pediatric Office of the Future” (POF) annual exhibit at the American Academy of Pediatrics – National Conference& Exhibition. (Pardon me a minute while I crow.) Its growth has been phenomenal – over 500% in five years – and now features tech tools for all three “offices” where pediatricians work: outpatient, inpatient, and mobile. With 31 sponsors, including some of the biggest companies in HIT and/or the US, we’ve added loads more space and oodles more “toys” including telemedicine, robots (yes, plural), hospital gadgets, patient engagement & education, “personal HIE,” after-hours support, social media savvy, mobile gizmos, an additional “Hospital of the Future” booth, the new “Mobile” zone, and on and on. It should be a great show.

One of the coolest things we were able to add this year is the new Tech Talk Theater, featuring experts giving 15-minute “hit-and-run” talks at the top and bottom of every hour each day during the exhibition.

Of course, all this comes at some cost. Not to the attendees and not to our many generous sponsors. Well, OK, attendees have to pay to come to the convention and sponsors, well, they sponsor. But, the cost to which I referred is the cost to your humble narrator. And that cost is one which I think many of my colleagues will also have to pay in the near, if not immediate, future.

While HIT wonks and gurus are mostly focused upon getting docs digitized these days, one of the associated facets of going electronic involves meeting those digital demands and exploding expectations from increasingly savvy “e-patients.” To wit: social media.

I admit to being a bit behind in social media savoir faire: I infrequently Facebook, don’t DIGG, find much of YouTube blatantly bland, and am mindlessly missing something in my Motorola Photon’s Motoblur. I am LinkedIn, have Tweeted a tad, and have a practice web presence. (I’ve not implemented a patient portal yet as I didn’t like the existing interface of the one from my dying EHR, though I am looking forward to that functionality in my next system – still TBD.)

So why do I say that social media sense is a cost which my colleagues must soon bear? Two main reasons…

Number one: a great colleague sort of forced me to get friendly with Facebook and YouTube and to become even more of a Tweeter (more of a Twit?) by setting up such sites for the POF and then handing me the reins. He had done some of the basics, but he’s maybe even less social media literate than I, and it took a fair amount of doing to bring them to some sense of life. The learning curve is not steep, but it takes time. And time is one of the least available resources most docs have. (My efforts here and here. I’m sure they are amateurish, but it’s my beginning. Oh … and Tweets are from @PedsOfficeFutur.)

Number two: I have been happily watching the development of an amazing new tool, HealthTap. This very clever physician-patient facilitator platform is phenomenal. Not only does it help you reach your patients, expanding your educational outreach and practice marketing power, but it also provides immediate access to thousands of colleagues across all specialties whose real world experience and expert insights are like a multitude of mini curbside consults at your fingertips, on demand.

I’ve found these experiences enlightening – and powerful. I want to do more with all of them. But engaging with these social media tools in order to engage with patients and colleagues comes with the aforementioned cost: the cost of time (and some pre-mastery frustration.)

With all of the demands upon a physician’s time these days, from going electronic to getting social and then to all of that actual patient care and practice management stuff, it gets a mite overwhelming, even for a staunchly geekoid guy like me. I admit to some moments of aggravation and annoyance as I try to become knowledgeable about tools with which many of my patients and their parents are already quite adept. I’m guessing my colleagues have had, or will soon have, similar SMS (“Social Media Stress”) as we move beyond “going digital” into that great new future towards which we strive, where technology is merely background noise that is taken for granted in our day-to-day chores, not a focus of our daily duties.

That’s the future envisioned and so admirably enabled by Mr. Jobs. Personally, I look forward to it, regardless of the cost.

From the trenches…

“Being the richest man in the cemetery doesn’t matter to me. Going to bed at night saying we’ve done something wonderful, that’s what matters to me.” – Steve Jobs

(Rest, Steve. Well done.)

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 10/13/11

PedsPal, the physicians group purchasing program for Cook Children’s Health Care System (TX) collaborates with athenahealth, Microsoft, Sanofi Pasteur, and Merck to establish the use of 2D barcodes on vaccines. The technology will allow physicians using athenaClinicals to scan a vaccine’s barcode and have the information automatically added to a patient’s chart.

The employed physician group of Lehigh Valley Health Network (PA) selects Phytel’s care management tools for its 487 physician practice.

Hospitals and health systems continue to employ more physicians, with 70% planning to hire more over the next 12-18 months. Once employed, the majority of hospitals are linking quality outcomes to physician bonus compensation and providing non-monetary compensation in the form of IT and EHRs.

A reported 56 million US adult consumers have accessed their medical information on an EHR maintained by their physicians. That’s about 24% of the adult population, which definitely sounds much too high to me.  Regardless, consumers most likely to access their EHRs online include those that are younger, more educated, and more likely to use the Internet and own a smartphone.

Facey Medical Group (CA), a 150-provider multi-specialty group, engages LancetHealth to provide data analysis and BI consulting services.

On tap next week: HIStalk’s Must See Vendors for MGMA 2011. Our annual guide will include details on a number of giveaways (lots of iPads!) and contact information for several of our vendor sponsors who are attending but not exhibiting. I’ve already been invited to one party, which means I’m that much more excited to head to Vegas.

Kareo names Bob Nichols to its National Advisory Board. Nichols is president of Medical Billing Services & Solutions.

Healthcare Information Xchange of New York announces that it has successfully connected its HIE to athenaClinical EHR.

RepuCheck introduces technology that sounds promising because it offers a solution for practices needing  to increase new patient referrals. However, I’m not sure that RepuCheck’s Review Buildr quite hits the mark. The online tool includes various alerts to remind front-staff to encourage satisfied patients to complete online reviews. The program also offers back-end analytics. The objective is to increase the number of positive patient reviews, but simply reminding staff to remind patients doesn’t sound like a very effective strategy. Maybe I am missing something.

E-mail Inga.