News 2/3/11

Microsoft announces new encrypted e-mail functionality that will allow users of the Quest Diagnostic Care360 EHR to transmit clinical information directly to patients. An encrypted copy of a patient’s clinical data is also automatically saved to  patients’ HealthVault account. If my doctor were to automatically download my records into a PHR, then I might actually consider using one. However, I predict patients will continue to resist HealthVault or similar technologies until most of their providers offer similar uploads.

Azalea Health Innovations partners with DrFirst to launch Azalea eRx. The electronic prescribing solution is available as a standalone product or integrated with both Azalea PM and Azalea Labhub.

MDBlackBox introduces a free, on-demand PM/EMR suite. I looked over their website and apparently the company offers some “pre-paid items,” though I never found a link that identified what those items were. There is a contact listed for “Business/Advertisement” so I assume the product has ads imbedded into the application. No demo or screen shots available, so I suppose the company is still ramping up.

Apello Technologies introduces Apello Physicians Network, a new iTunes app for doctor-to-doctor communication. The mobile app facilitates doctor-to-doctor sharing of patient data using a combination of tools including text messaging, voice memos, and fax.

eClinicalWorks is hosting a few road shows in coming weeks, showing off their new Version 9.0 and touching on the 25 requirements of Meaningful Use. Details here.

Physician Oncology Services and Vantage Oncology merge to form a network that includes 40 radiation oncology centers across 13 states and over 80 physicians.

A big welcome to Medicomp Systems, HIStalk Practice’s newest Platinum sponsor. Medicomp offers a variety of EMR tools, such as the MEDCIN clinical knowledge engine and the CliniTalk voice-to-data physician documentation system. They are also the terrific folks rolling out the red carpet (literally) for the HIStalkapalooza event at HIMSS. They seem like a very fun bunch and have been hugely supportive of all the wacky ideas we’ve dreamed up for the party. Medicomp will be introducing a new product or two in the coming weeks and we look forward to hearing the details and sharing with readers. Thanks Medicomp for supporting HIStalk Practice and for hosting a sure-to-be-fabulous party!

If you are a physician attending HIMSS, there’s a new Physician Executive Forum option this year. The track is designed for physician leaders in hospitals or the ambulatory environment, particularly those responsible for helping their organizations with such HIT issues as Meaningful Use and ICD-10 conversion.There’s no additional fee if you are already attending HIMSS. HIMSS is also offering an all-day Physicians’ IT Symposium ($285) on Sunday the 20th which will focus on achieving Meaningful Use.

MGMA says its membership grew almost 5% last year and now includes 22,500 professionals. Members lead 13,600 organizations and their 280,000 physicians provide 40% of healthcare services in the US.

D&H Distributing partners with gloStream to serve as a VAR and provide practices with a local support option.

Concierge medicine with a twist: the 31-physician One Medical Group offers a low-cost, concierge-style practice for a mere $150 to $250 year. In addition, the practice accepts a variety of insurance plans, including Medicare. Like a traditional concierge practice, patients can e-mail their physicians at no charge and are usually able to schedule same-day appointments. The physicians typically see about 16 patients a day, compared to the national average of 25. To keep overhead low, the practice relies on a number of automation tools including online appointments and prescription refill requests. One Medical Group was founded by Epocrates co-founder Dr. Tom X. Lee and has offices in San Francisco and New York City.

E-mail Inga.

News 2/1/11

NCQA’s new patient-centered medical home standards reinforce federal Meaningful Use incentives for primary care practices to adopt HIT. The PCMH 2011 calls for medical practices to be more patient-centered and includes Meaningful Use language embedded into evaluation standards. NCQA believes that practices meeting PCMH 2011 requirements will be well prepared to qualify for Meaningful Use and vice versa. Download here.

The 170-physician Florida Woman Care adds athenaClinicals EHR and athenaCommunicator. The practice is already an athenaCollector client. I also see from athenahealth’s blog that Dr. Catherine F. Vanderloos of Shreveport, LA was among the early recipients of a $21,250 EHR incentive check.

Amazing Charts releases AC OnCall, an app that gives providers access to their Amazing Charts records from an iPhone, iTouch, or iPad. Users can download the app for free for three months or pay a one-time fee of $24.99.

Delta Radiology Medical Group (CA) signs a three-year billing services contract with Zotec Partners.

Doctors Urgent Care (WV) installs Benchmark Systems’ EMR and PM system for its three urgent and primary care practices.

Most doctors want to share patient information electronically with other providers, according to a new Markle survey. Almost half of doctors would also like to share records with patients electronically and 65% believe patients should be able to download their personal health information online. PHR adoption continues to be slow, with only 10% of the public claiming to maintain one. But, that’s up from 3% in 2008.

Michael Last Internal Medicine chooses the Waiting Room Solutions Internal Medicine EHR and PM product.

Holy Name Medical (NJ) selects Aprima’s EHR/PM software as a recommended and subsidized solution for its affiliated physicians.

AMA announces it is working with Covisint to help physicians receive reimbursements from CMS’s PQRI program. AMA members are eligible for discounts for the Covisint DocSite, a web application for submitting data for 2010 PQRI reporting.

Epocrates looks to raise $75 million in its IPO, which is scheduled for February 2. Epocrates is seeking listing on the NASDAQ exchange under the symbol EPOC.

AMA spent more on lobbying efforts last year than any other healthcare group. AMA shelled out almost $22 million, which was a nine percent increase over 2009. AHA was also a big spender, with almost $18 million in expenditures.

Men and the chronically ill are most likely to support remote monitoring and virtual visits. Nearly half of the 1,000 adults in this survey are receptive if it saves time and money; 23% said they would never consider a remote visit with a doctor.

Doctors report that one in 18 patients are considered difficult and more likely than others to stay sick. “Difficult” patients were defined as those more likely to have worse symptoms two weeks after their visit. Physician experience makes a difference: doctors with less than 10 years of experience report that 25% of visits are difficult, compared to just 2% of visits for physicians with more than 20 years experience.

The Florida Academy of Family Physicians recommends Ingenix CareTracker as a PM/EHR solution to its members. FAFP members are eligible for discounts on monthly subscription fees and implementation services for the product through the HIT distributor CareTracker Partners.

Providers can buy insurance to protect themselves from financial losses associated with data breaches. Agents see small group practices as good targets since most offices lack internal resources to manage security concerns. It’s pricey though: $5,000 a year will get you $1 million of protection for up to five physicians. Insurance covers fines, patient notification costs, credit monitoring, investigation, legal defense, and even PR-related costs to rebuild the practice’s reputation.

E-mail Inga.

News 1/27/11

From: Maybe Confused “Re: Certified EHRs. I understand that to qualify for Stage One Meaningful Use you only have to use five of 10 objectives on a menu set. Does that mean my EHR can be certified for just those five components? Or do all 10 objectives need to be certified? Confused.” I did a bit of digging and found a similar question on ONC’s FAQ section. Bottom line: you must possess EHR technology that meets ALL certification criteria, whether you use all of them or not. That could be a single EHR product with complete certification, or, multiple products with modular certification to cover all requirements. And, I agree; it’s quite confusing.

First we learn that EHRs may not improve care. Now researchers say that pay for performance programs have no effect on patient outcomes. A study out of the UK finds that paying doctors financial rewards to meet targets for improving patient care made no discernable difference to the health or treatment of people with high blood pressure. One researcher concludes that the government and private insurers “are likely wasting many billions on policies that assume that all you have to do is pay doctors to improve quality of medical care.”

Baptist Health South Florida selects IOS Health Systems’ Medios EHR for its Physician EHR Donation Program. I believe “Physician EHR Donation Program” is just a clever name for the hospital’s initiative to subsidy EHR for their affiliated physicians. Medios will also provide a connection to the hospital’s Siemens Net Access System.

Citing tight economic conditions, the ONC extends the amount of time it will cover most of the costs for RECs from two to four years. With the original four-year grant program, RECs would have been responsible for only 10% of costs during the first two years and ONC would pay 90%. In the final two years, that ratio would have switched. The ONC now plans to pay of 90% of costs for four years.

PrimeCare (FL) selects Doctors Administrative Solutions (DAS) as its EHR vendor of choice. PrimeCare will implement DAS’s personalized version of Aprima Medical Software EHR in 12 of its owned practices.

EMR vendor gloStream offers practices a full refund on software and services if physicians aren’t back up to their usual full patient load within 15 days of the implementation completion. As Mr. H mentioned in HIStalk yesterday, the offer sounds great but be sure to read the fine print.

Nuesoft Technologies updates its brand with a new set of logos and updated color schemes. They are looking for feedback here.

Healthcare Administrative Partners hires two new managers for its billing, coding, and medical practice management consulting business. Former Advisory Board product manager Yukki Lam will serve as a practice manager; former NextGen and Siemens Healthcare analyst Carol Smith will take over as Director of Data Analysis.

Office Ally says over 340,000 providers now use one or more of its products, following a 36% increase in users in 2010.

Need a free web-based patient appointment reminder tool? HealthCollaborate releases a free module to that sends automated appointment reminders via email or text messaging. In looking at their website I didn’t see any sort of “catch” for the service, but did note the company offers a number of other services for a fee.

The publisher of The Wall Street Journal files suit in US district court, seeking to overturn a thirty-two-year-old court order barring public access to a confidential Medicare database. Publisher Dow Jones & Co. says access to the database is essential to rooting out fraud and abuse in the Medicare program. The AMA has long argued to keep the records secret, saying that to disclose how much money individual doctors collect would violate their privacy. Health-care advocates, law-enforcement officials and others argue that access to the data would expose instances of fraud, ease evaluations of the quality and cost of care, and help ensure the government is doing everything it can to protect taxpayer funds. I say it’s public funds and taxpayers deserve to know how the money is being spent.

E-mail Inga.

Intelligent Healthcare Information Integration 1/26/11

Root Beer & Hope Floats … But Not All EHRs

This week, a colleague from Georgia wrote me about his parallel EHR search. His group had also ended up choosing Peak Practice after an exhaustive search, a search they have also again begun, looking for its replacement. But, after a few nice words about following along here on HIStalkPractice, yadda, yadda, his next three sentences were perhaps the most telling:

“Anyway, we’ve been busy doing our own demos. Initially, I wanted to be very thorough and consider almost all that’s available. My partners are not as patient and I’m getting tired of it, too.”

He then asked about a few specific products: two pediatric specialty-specific (Office Practicum and PCC) and two more broadly focused (Greenway and athenahealth). He mentioned several more that he had “no desire to even look at” and finished with another telling statement/question:

“I know nobody can predict the future of mergers, acquisitions, and decline of once solid-looking products (Encounter Pro, and Clinician/PeakPractice, etc.) but do you have any insider information or gossip from the health IT industry about the stability of and future direction of [EHR vendors]?”

Boy, oh, boy, Dr. Bu, are you feelin’ me, or what?!

To top it off, on that very same day, a market analyst at Software Advice, which provides software selection services for multiple industries, wrote me and I quote:

“In short, the EHR market has accelerated as a result of government subsidies. But vendors are having a tough time keeping up with the growth. As a result, we expect to see major consolidation in the market. Some will get acquired, others will just get left behind.”

Ain’t that the truth? The CEO at Software Advice, Don Fornes, had recently written a good piece on EHR Vendor Viability. In it, he notes that it’s not all about size, that execution and corporate management will be key. He further notes how tough it is for providers to assess the financial viability of EHR vendors and suggests that we could use a good A.M. Best for EHRs. Of course, he offers their Guide to Assessing Medical Software Vendor Viability, which, I promptly downloaded – also, “of course.” (Obviously they are trying to promote their software selection service, but at least it’s free to providers).

This line from the very first page started the old smoke drifting up from my ears again: “Or let’s say the vendor doesn’t go out of business, but they get acquired by another company. In this case the acquiring vendor informs you that they will ‘sunset’ the product and cease support within two years.” I couldn’t tell whether their guide was written before or after my birthday last year, the day I learned about the sunsetting of my EHR, but I sure wondered. It seemed as they had written it directly at/to me!

While I enjoyed reading what Don had written and what their Guide said, it still left me with same sour after-aroma that Dr. Bu and I now smell (i.e., having lived through three acquisitions of our chosen product, we can now only to watch it rot like a pumpkin in the sun after being sliced from the corporate vine). And Don’s article, while informative about the current state of the industry, only heightened my sense that rotting pumpkin aroma will be spreading from more EHR vines soon.

So, when it comes to concerns about the longevity potential of my next EHR and its vendor’s financial viability, unless I want to pay some consultant fees which I can’t afford, I’m left to a few choices:

1) Go with what my VAR (the original source of my current EHR) chooses and hope they’ve done good homework;

2) Go with one of the choices of my local REC and hope they’ve done good homework;

3) Try Software Advice’s “free FastStart Consultation” and hope they’ve done good homework;

4) Await the “A.M. Best for EHRs” (which may never come) and hope they do good homework; or,

5) Look for guidance from my Higher Power and hope I do good homework.

Best I have right now, Doc Bu. (I do recommend a good nose plug, just in case nobody does good homework. And naps. Naps are good. EHR hunting IS exhausting.)

From the trenches…

“Hope is the feeling that the feeling you have isn’t permanent.” – Jean Kerr

Dr. Gregg Alexander, a grunt in the trenches pediatrician, directs the “Pediatric Office of the Future” exhibit for the American Academy of Pediatrics and is a member of the Professional Advisory Council for ModernMedicine.com. More of his blather…er, writings…can be found at his blog, practice web site or directly from doc@madisonpediatric.com.

News 1/25/11

From Tina Goodman: “Re: Weno Healthcare. OpenEMR was removed because Carol Bean, at ONC said we could not share customers with e-community and testing/certification. Her verbal and written warning was that is was a significant issue and we must have ‘clean lines.’ Then they approved Surescripts and another company that did not have ‘clean lines.’ We have been denied a fair process and I have all the evidence to support our compliance.” Goodman is CEO for Weno Healthcare, which was recently denied approval as an ONC-ATCB. I noted last week that Weno’s OpenEMR product was no longer offered on the Weno Web site and Goodman provided this explanation. I have asked Carol Bean, ONC’s division director for certification and testing, for a comment on the subject, but haven’t heard back.

Cardiac Science Corporation completes certification for its HeartCentrix monitoring solution to run with Allscripts Professional EHR.

Louisiana Medicaid issues an EHR stimulus check payable to Winn Community Health Center, making it the first FQHC to receive funds. The clinic was initially established with the help of a $1.3 million ARRA grant. Winn Community runs SuccessEHS as its EHR.

Billing service Broadleaf Health (CA) selects Kareo’s medical billing software.

Billing and practice management service provider AdvantEdge Healthcare Solutions appoints J. Paul O’Haro as COO. He’s the former president and CEO of CompOne Services and also spent time at Per-Se.

Digital Assent secures $2 million in Series A equity financing. The company is the creator of  PatientPad, a self-service check-in and patient education tool that facilitates the collection of patient information, insurance verification, payment collections, and the signing of consent forms.

A new study out of Stanford University suggests that EHRs provide no clear improvement in care quality in the outpatient setting. Findings were based on over 250,000 outpatient visits between 2005 and 2007. Of 20 indices of care quality analyzed, only diet counseling for high-risk adults showed significantly better performance in EHR-related visits compared to conventional record keeping. Critics contend the findings may be irrelevant to today’s current EHR systems, which include more clinical decision support tools.

Cumberland Consulting Group promotes Matthew Good and Michael Worner from principals to partners. Good is a former consultant for Ernst & Young and is currently managing an EMR implementation for more than 550 physician practices. Worner is a former consultant with CSC and analyst with SAIC.

The new FAIR Health database, created under agreements with the New York attorney general’s office, is set to launch by late January. The database will be designed to show what is considered a "usual, customary and reasonable" payment rate for physician services and serve as a fair and transparent source for evaluating out-of-network reimbursement.

HIStalk Practice has just hit a new milestone with 1,000 confirmed e-mail update subscribers. When Mr. H suggested we start HIStalk Practice two years ago, I thought it was a terrific idea – until I realized he wanted me to run it. However, he persuaded me to give it a go and it’s all turned out better than I ever expected. Thankfully we’ve had supportive sponsors from the start, as well as a steady flow of new ones. Dr. Gregg Alexander has been a great addition with his regular from-the-trenches insights. Thanks, readers, for stopping by and for continuing to send new friends our way.

South Florida Health Technology REC selects Greenway’s PrimeSUITE 2011 as a pre-qualified EHR solution. PrimeSUITE has been selected as a preferred product with at least nine other RECs.

Speaking of Greenway, please join me in welcoming them as HIStalk Practice’s newest Platinum sponsor. A long-time HIStalk sponsor, Greenway decided to extend the love over to the Practice site. Greenway’s been in the EHR/PM business since its 1998 founding by W. Thomas Green Jr.  the company’s current chairman of the board. Its core product is PrimeSUITE, which is used by more than 23,000 healthcare providers in 31 specialties. PrimeSUITE just won two 2010 Best in KLAS awards in the ambulatory EMR and practice management categories and PrimeSUITE EHR has earned ONC-ATCB 2011/2012 Complete EHR certification. Other Greenway solutions include PrimeSpeech, PrimePatient, PrimeExchange, PrimeResearch, PrimeMobile, PrimeRCM, and PrimeEnterprise. Give their ad  a click to learn more. A big thank you to Greenway for supporting HIStalk Practice.

NextGen is offering a webinar demo of its Patient Portal, version 5.6 SP1 on Wednesday, January 26th. Details here.

New Jersey says it’s serious about accountable care organizations, approving legislation to enable the formation of five ACOs across the state. New Jersey lawmakers also agree to pay bonuses to participating providers based on the anticipated savings from reduced medical costs and improved patient health.

E-mail Inga.