News 10/19/10

SRS lands a big contract with the 242-provider Illinois Bone & Joint Institute (IBJI). IBJI selected the SRS Hybrid EMR following a 30-day, multi-site pilot installation.

West Virginia launches an e-prescribing initiative that will allow Medicaid providers to electronically forward Medicaid and commercial prescriptions to pharmacies. The WVeScript service is offered free of charge and uses  the Surescripts e-prescribing network.

When adverse drug event reporting tools are incorporated into an EHR, physicians are more likely to participate in the reporting process. These findings are based on a pilot study with 26 practicing physicians testing an EHR-based tool that automates adverse drug reporting to the FDA.

The AMA adds Quest Diagnostics Care360 EHR as a Web-based EHR alternative on the AMA’s online platform.

Nice use of EMR: physicians at the University of Texas Medical Branch pull data from their EMR to examine blood lead levels in children. Data from 2006 to 2008 indicated that blood lead levels in 1-2 year old children were higher among children living on Galveston island than in other regions. In part driven by these findings, the UTMB worked with the city to reduce city-wide lead levels. More current data, collected during routine office visits, indicates blood lead levels have declined and are in line with state and national averages.

GE Healthcare says it has successfully linked its Centricity EMR with several non-GE inpatient systems, allowing for the sharing of clinical patient data.

American Medical News weighs the pros and cons of cloud computing for physician offices. Pluses: it’s usually less expensive, provides a virtually maintenance-free infrastructure, and is highly accessible from anywhere. Potential concerns include unreliable speed, less control over downtime, and uneasiness because data is stored off-site. A third of the industry is using some type of cloud-based application, so I’m thinking the clouds don’t need to be feared.

Look for some field reporting next week when I travel to MGMA in New Orleans. If you have any suggestions for sessions, exhibits, or quick shoe shopping, send me a note. Whether you are MGMA-bound or not, you’ll enjoy reading our Vendor Executives post this week, which features several industry execs and their predictions for the hot topics that attendees will be discussing (hint: Meaningful Use is just one of many.) Also this week: our annual HIStalk/HIStalk Practice MGMA exhibit guide, which highlights some of the cool things you can check out when stopping by our sponsors’ booths.

I love when vendors promote good causes, so of course I’m happy to mention Sage Healthcare’s support of Breast Cancer Awareness during MGMA. Sage will install a 6’ X 8’ Wall of Hope for attendees to share their personal stories battling breast cancer. For each story posted, Sage will make a donation to breast cancer research. I’ll be stopping by to lend my support (though thankfully I don’t have a personal story to share.)

Here is something to ponder: if physician finder/physician rating services cannot reliably remove information on deceased doctors, should the overall accuracy of the sites be questioned? The question was first posed by blogger Barbara Duck, who found several listings for one of her former and not-so-recently deceased physicians. The physician data manager for HealthGrades says they’d like more physician involvement to make sure data is correct, saying, “We’re trying to make sure that the physician is responsible for their Web presence.”  (Who knew there was Internet in the afterlife?)  Perhaps these sites need a big “Buyer Beware” stamp so patients won’t immediately assume that just because it’s on the Web, that a particular physician will take a specific insurance, has a current license, or even has a pulse.

E-mail Inga.

News 10/14/10

From: Thoroughbred “Re: New KLAS report. Evan Steele must carry some clout with KLAS. They just released a report that rates ambulatory EMRs by specialty.” Last week Evan submitted a Readers’ Write piece calling on KLAS and other analysts to provide ratings by specialty. Turns out that KLAS agrees with Evan, saying they’ve been working on this report for several months because they recognize that different specialties have different functional needs. SRS, by the way, scored quite well, taking top honors for cardiology, ophthalmology, and orthopedics. Greenway was the highest rated product for ENT and OB/Gyn. Praxis earned the top scores for family practice, Amazing Charts for family practice, and athenaclinicals for pediatrics. EpicCare Ambulatory was the highest rated product for multi-specialty groups. Providers can download the full report for free.

While the US continues its struggles with healthcare automation, our neighbors to the north are having issues of their own. Officials are concerned that fewer than 40% of Canada’s primary care doctors have access to EHRs, prompting the Canadian Medical Association to ask the government to allocate more money to the cause. Though the government has already spent millions trying to build an electronic health record system, CMA officials say most of the funds have got to systems and IT architecture, rather than to doctors’ offices, hospitals, labs, and pharmacies. The CMA is calling for an additional $423 million over five years in order to boost the number of doctors using EMRs.

Speaking of Canada, I’d love to connect with someone who is familiar with both the US and Canadian EMR markets. I’ve reached out to a couple of folks over the last year but no luck connecting with anyone so far. If you or someone you know is well-versed on this topic, drop me a note.

The Rhode Island Quality Institute (RIQI) awards REC pre-qualified EHR status to Allscripts, NextGen partner Blackstone Valley Community Health Care, Inc., Ingenix,  NextGen, and Polaris Medical Management. In addition, RIQI is in final contract negotiations with: GE Healthcare, eClinicalWorks, and athenahealth. The REC also names 12 vendors pre-qualified technical service consultants.

Sage Healthcare’s SVP Tony Ryzinski authors this piece outlining 14 points for successful EHR implementations. The vendor-neutral tips emphasize putting the right leaders in place, minimizing distractions during the transition, and focusing on successes.

Sales reps take note: nearly half of physicians require or prefer an appointment with medical industry sales reps before meeting one-on-one, according to this SK&A survey. Twenty-three percent of doctors refuse to see reps at any time at any of their locations. When a practice is owned by a hospital or health system, physicians are less likely to allow access without an appointment.

Centice Corporation introduces the PINPOINT Rx system, designed to help physicians and pharmacists identify medications. The device captures the spectral signature of a drug and checks it against a known database.

The 200-provider Community Care Physicians implements mycareDOT patient portal, developed by RelayHealth.

North Texas Children’s Anesthesia commits to a three-year service agreement with billing service provider Zotec Partners.

Skyscape partners with the Massachusetts Medical Society to offer a mobile version of Journal Watch. Journal Watch provides summaries and commentaries on recently published medical information across 13 different specialties.

E-mail Inga.

News 10/12/10

The AMA introduces an online tool to help physicians practices analyze and adjust office fee schedules.  Practice Analysis Tools for Healthcare (PATH) allows users to upload fee schedules electronically and compare rates with national averages, gauge compliance with fee rules, and generate reports suggesting fee adjustments. AMA is offering PATH for $199 through the end of the year.

Western Rehabilitation Health Network selects ChartLogic as the preferred EHR for is 115 member locations. ChartLogic was one of the first EHR to to earn ambulatory certification by an ONC-ACTB body (The Drummond Group.)

On September 28th, The University of Virginia Health System launched EpicCare at over 140 outpatient clinics. Prior to going live, the clinics converted and loaded more than 1.8 medical record numbers, 3.3 million radiology results, 18 million document images, and 30 million lab results.

Sansum Clinic (CA) will deploy Medi-Span to its 150 affiliate physicians, giving providers drug information and medication decision support at the point of care.

Aprima Medical Software adds eHealth Technologies as its latest reseller.

Henry Schein Medical Systems announces an expansion of its MicroMD EMR solutions to include specialized clinical content that can be customized for rapid deployment.

Midmark Corporation and SuccessEHS announce the integration of the Midmark IQspiro digital spirometer with the SuccessEHR (formerly CareRevoloution) PM and EHR solution.

For those keeping track at home: HIStalk Practice traffic grew 11% in September compared to a year ago. YTD, views are up an average of 21% compared to 2009. If you are interested in joining a great group of sponsors, drop me a note. And if you are not on our e-mail subscriber list, sign up on the top right. Thanks for reading and thank you sponsors for your fantastic support.

The Ohio State Medical Association (OSMA) publishes a toolkit advising physicians of best practices when it comes to social media in the medical office. The guide includes tips for physicians and their staff to stay within legal and ethical boundaries when using social media tools.The toolkit also provides some handy resource documents, including a  sample “Prohibited at Work” form outlining social media do’s and don’ts for office staff. And of course it addresses the age-old question: should  I “friend” my patients?

Here’s a new social media trend that OSMA may not have covered. Health care providers are trying to attract new patients using tools such as Groupon and Living Social, which offer e-mail subscribers up to 24 hours to purchase services or products for 50 to 90% discounts. So far most of the healthcare deals are for services not traditionally covered by insurance, such as eye exams and teeth-whitening.  I personally love the Groupon concept for restaurants, and even purchased one for a facial. However, it’s probably not a great way for an orthopedic surgeon to find more knee replacement patients.

For practices needing patient-center medical home resources, you might check out TransforMed’s Delta Exchange, an interactive, provider-only online community. TransforMed, which is a subsidiary of AAFP, offers Delta Exchange members a variety of resources including information on medical homes best practices, interactive webinars, and several forms and templates for streamlining office processes.

Physicians are still not embracing e-mail as a way to communicate with patients according to this recently release study. The report, which was based on a 2008 survey, finds that only 35% of physicians are equipped for email and less than 20% of those regularly e-mailed with patients. That translates to an overall e-mail communication rate of less than 7% for all  all office-based physicians  Reimbursement and privacy concerns were among the top reasons for doctors’ reluctance to embrace e-mail communication with patients.

E-mail Inga.

Intelligent Healthcare Information Integration 10/11/10

About a week ago, I asked the wonderful Mr. H and the wonderful and lovely Inga to post a piece I wrote about the impending death knell of my chosen EHR, Peak Practice. While they are sensitive to their sponsors (though vendor neutral) and almost fanatically conscientious about their reporting reliability before posting such a “rumor,” typically seeking firm confirmation before such stories go live, they decided to run the story based upon our longstanding good relations and my assurance that my sources were impeccable. (Plus, I begged like a bratty three year old because this was my “Right EHR,” as I mentioned, and I was mad as heck to lose such a technologically-sharp and future-friendly tool!)

Thus, they ran the piece at my bequest. (Thanks, again, guys.) The official Peak sunset announcement was reportedly going to come out that same day, but, as you may have noticed, there’s been a Mormon Tabernacle-sized choir of crickets chirping since that post.

True, the vendor has not denied it. Also, true, I’ve had the story confirmed from multiple reliable sources since then. True, I’ve been told this was “the blog heard round the world” – or at least around the Peak Practice-related portion thereof. Third-hand true, I’ve heard that there have been lots of phones ringing off lots of hooks and lots and lots of lawyers making lots of unexpected overtime and lots of VARs wondering what they’ll do next for lots of clients who also happen to love – or at least, want to keep – Peak Practice. (I really feel for you lucky former MediNotes “e” clients who were migrated to Peak and who now get to go through yet another conversion – hoo boy.)

I’ve heard that I’ll get “upgraded” to one of the vendor’s other products. Don’t care what you say, guys: practically speaking, from a real world, workflow adjustment, staff frustration, conversion blues, and just, plain, personal preference perspective, none of what you’re offering looks like anything but a step down. One option runs dual databases, which provides no attraction. The closest would be the MyWay product, but the original vendor of that product seems to have done a better job advancing its technology, so if I were to go that way, why wouldn’t I go with them?

As I mentioned last time, it isn’t just the tool; the people, the corporate philosophy, the general “here’s how we deal with people” gestalt makes a huge difference to us small guys. Big companies sometimes seem to forget that talking corporation-to-corporation is a completely different language and doesn’t translate very favorably into the native trench grunt tongue.

I’ve been with this product for a long time and I’m pretty sure I’ve helped lots of people make lots of sales (and money) from my advocacy. I now know that some people appreciate that fact as I’ve had a slew of reach outs from multiple other EHR companies since last week’s piece. That makes an impression.

I have a distinctly different impression about the folks who now own my “Right EHR.”

Question: Is a new customer more important than keeping a current customer?

One of the wisest HIT people I know recently wrote me that “it is too bad that they won’t sell the product to someone else. They didn’t buy Eclipsys to bury a feared competitive product, but the result will be the same.”

The announcement is coming. The die is apparently cast. So, while the crickets seem to be chirping quite loudly right now, morning is coming, the crickets will fade, and the sun is about to rise on a new day – one which will no longer have a Peak.

From the soon to be Peak-free trenches…

“No quote today…I’m not feeling Peaked enough.” – Gregg Alexander

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 hisblog, practice web site or directly from doc@madisonpediatric.com.

News 10/7/10

Patients are concerned with the ability to communicate with their healthcare providers, according to a new poll. They say their experiences would be more satisfying if they could spend more time discussing health issues and would prefer having a single provider overseeing their care.

Carolina Family Practice and Sports Medicine apparently already understood the need for better provider-patient communication, having recently implemented Intuit Health’s patient portal.The portal allows patients to securely communicate online with their doctors, as well as pre-register, request appoints, and pay bills.

If you are looking for a great online resource for EHRs, I happened across this section on from the Maryland Health Care Commission (MHCC) Web site. MHCC developed the Physician EHR Portfolio as a tool for physicians evaluating and comparing EHRs. It includes product and pricing information (both ASP and client/server options) for about 30 products. Most vendors include screen shots and user references. MHCC also created pricing comparison tables that aggregate the per-year projected costs by vendor. FYI, the five-year cost for a four-doctor practice utilizing an ASP model ranges from $13,000 (total) for RxNT to $192,906 for EHS’s CareRevolution.

Fletcher-Flora Health Care Systems and Praxis Electronic Medical Records announce a partnership to interface Praxis EMR with the FFLex eLink IMR instrument management system. The integration will allow providers to import patient results from clinical lab instruments into the Praxis program.

MedInformatix combines its EMR and practice management platform with PhoneTree’s Patient Messaging, giving users the ability to issue automatic reminders and announcements based on data in the MedInformatix database. The integration is bi-directional and message tasks can be executed from both the MedInformatix and PhoneTree applications.

The e-MDs folks point out that both winners of the 2010 HIMSS Davies Ambulatory Care Award of Excellence are e-MD clients. The Diabetes Center (MS) and Miramont Family Medicine (CO) were individually recognized for leveraging their use of HIT to provide excellence in care. The Diabetes Center, by the way, was the first nurse practitioner-owned practice to be considered for a Davies award.

Yet another health system buys a large private practice. St. Joseph Mercy Health Systems (MI) purchases the 150-physician Integrated Healthcare Associates (MI). St. Joseph’s CEO says the healthcare reform bill played a role in prompting the merger, since care is being driven away from hospitals and back into doctors’ offices and outpatient centers. Personally, I think that is code for, “Accountable Care Organizations are on the way and we’re proactively lining up our team.”

We try to minimize the overlap between HIStalk and HIStalk Practice, but I wanted to point out some particularly insightful comments Mr. H made about hospitals buying up  primary care practices.  Mr. H points out that back in the 1990s, hospitals went on similar buying sprees, paying big money for practices — only to have doctors buy themselves back out a few years later. See here why Mr. H predicts history will repeat itself.

In addition to worrying about Meaningful Use and Accountable Care Organizations, industry consultants say physician offices should be prepping for the ICD-10 transition. The deadline is October 1, 2013, which means practices have less than three years to assess their needs, implement a transition plan, and make the switch. AHIMA says 59% of their members haven’t started to address the transition, which is estimated to cost more than $83,000 for a 1-10 physician practice. A couple of organizations estimate that the complete ICD-10 conversion process will take providers 966 days to complete, which means the planning process should have started January 8, 2010, in order to meet the October 1, 2013 deadline. In summary: there’s a new storm a brewing.

I’m sorry I couldn’t attend last week’s Xconomy Xchange in Boston featuring athenahealth’s Jonathan Bush and eClinicalWorks’ Girish Navani. Pediatrician Andrew Baumel, MD provided an overview on HIStalk Practice earlier this week, noting both leaders were forthcoming about their views and company strategies. He also mentioned a lack of fireworks (which of course would have been entertaining.) Xconomy filed its own summary, also noting frank talk “without (too much ) verbal bloodshed.” There’s such honor in HIT.

E-mail Inga.