Monday Morning Update 1/18/16

Top News

The New York Times takes public the recent OCR clarification for providers whose patients request copies of their medical records. An American Hospital Association SVP says the guidelines are “a helpful reminder,” the need for which she didn’t mention – that most of AHA’s members do everything they can, including citing non-existing policies or legal requirements, to avoid giving patients copies of their own information.

The statement was welcome, but areas of concern might be:

• The law was already in effect and was being widely ignored by doctors and hospitals, with no announcements of any resulting fines or enforcement actions.
• Patients will need to understand their rights and how to complain to OCR, which 99.99 percent do not.
• The effort required to file a complaint – and the potential for disrupting the provider relationship for doing so — will discourage most people from notifying OCR even if they know how.
• Providers still have a ridiculous amount of time to provide records that are most likely stored electronically.
• Many hospitals use release-of-information companies to handle patient records requests, allowing those companies to bill high per-page charges. It’s not clear to me whether that practice will be abolished since OCR’s requirements affect providers, not third parties.
• It would be nice if insurance companies, which have a lot more clout with providers than patients, would accept and manage records requests of their insured patients.
• OCR will have to respond to an increasing volume of complaints, which given their lack of response to a complaint I filed in July 2015 for exactly this situation from either the hospital or OCR, seems unlikely.
• OCR hasn’t done much to stop HIPAA violations, rarely using its power to levy fines.
• The only positive outcome for a patient who files an OCR complaint is finally getting the records, probably after a long delay in which their clinical value has been greatly reduced.

Reader Comments

From MU Later: “Re: your comment that CMS might be disappointed by how ONC has run Meaningful Use. ONC does not manage the program – that is solely done by CMS. ONC provides certification parameters and feedback to CMS, which is free to do whatever it wants.” I admit that I incorrectly think of ONC as being in charge of Meaningful Use since I’m not all that knowledgeable about the inner workings of ONC, CMS, and HHS or how much of ONC’s effort involves MU. Reading about the initial implosion of Healthcare.gov and the political differences between federal “agencies” and “offices” with their sometimes dueling fiefdoms and competing CIOs made me glaze over.

From Pustular Exudate: “Re: CareCloud. Of the 10 leadership positions listed on their website, nine are held by men. The one female is the head of HR.” CareCloud’s executive team is therefore 90 percent male, compared to Cerner (80 percent), McKesson (78 percent), Allscripts (92 percent), Athenahealth (90 percent), Meditech (62 percent), and Nordic (54 percent), just to list a few companies that I chose randomly.

From Gettin’ Jiggy: “Re: Becker’s Hospital Review. I wondered who is doing those clicky, empty stories. New grads, that’s who. Checked their LinkedIn employee list.” Reviews on Glassdoor say things like, “This is not journalism … editors suggested that writers rerun quotes and portions of old features and cobble them together to create new content” and “recapping real reporters’ healthcare news to spit out on our sites … working on a feature story with some sort of catchy, click-friendly title like ‘7 Ways to Make More Money.’” They are the industry’s Buzzfeed, cranking out click-baiting headlines and mindless lists from content reported better elsewhere, read by folks who can’t resist the temptation of journalistic junk food. I can’t fault it – it apparently has quite a few readers and its employees say it makes a fortune for the owner.

HIStalk Announcements and Requests

Two-thirds of poll respondents aren’t interested in company funding announcements. New poll to your right or here: what impact will providers see from CMS’s planned changes to the EHR incentive program?

Mrs. Perez is a new teacher in the gifted program of her Florida school and reports that her students are using the portfolios we provided via her DonorsChoose grant request to organize and present their materials when they attend their gifted class. She isn’t allowed to send photos that include student faces, but was nonetheless creative in having them pose with their “thank you” signs attached to their brand new portfolios.

Ms. B checked in from her Illinois kindergarten class, for which our grant provided STEM exploration kits. She provides some background: “Thank you for providing my little scholars with the opportunity to experience the STEM activities from this proposal. You may say, ‘why linking monkeys?’ Well, just look at the joy on my students faces when they’re using the linking monkeys to learn the standard of number representation… What about the classifying chart? My scholars love to size up the various pictures and debate on who has it correct. Is a bus larger or smaller than a ball?”

Recruitment and consulting firm Healthcare IT Leaders donated $1,000 to DonorsChoose to secure a presenter spot at my CIO lunch at HIMSS (contact Lorre if you would like to do the same or to volunteer as a CIO attendee). I’ve exhausted the matching funds from my anonymous vendor executive, but I was still able to use dollar-for-dollar matching funds from third-party foundations to fund these teacher grant requests from their donation:

• Five tablets and three headsets for Ms. Johnston’s elementary school class in Aurora, CO
• Math manipulatives for Ms. Krieg’s fourth grade class in Round Lake, IL
• Math center games for Ms. Yoder’s first grade class in Jacksonville, TX
• A library of 13  literacy and numeracy DVDs for Ms. White’s kindergarten class in Phoenix, AZ
• Two Osmo gaming systems for Mrs. Jochum’s elementary school class in Norfolk, NE
• Math games for Ms. Medel’s fifth and sixth grade classes in Indianapolis, IN

My new dentist offers a $400 per year plan for patients without dental insurance that includes two cleanings, a whitening treatment, annual exam with x-rays, and a 30 percent discount on other services. I was running the numbers to decide whether I’d be better off dropping dental insurance and paying him directly when I realized that the most valuable contribution of insurance companies is to negotiate pricing in their contracts. His list price for a filling is something like $240 vs. the insurance-negotiated price of just over $100, so his 30 percent member discount would leave me paying $168 ($240 x 0.7) vs. $40 with insurance ($100 x 0.4 since insurance covers 60 percent of the negotiated price). I’m back to my never-ending question – why do providers charge so much more for cash-paying patients as a “cash surcharge” rather than a “cash discount?” Maybe it’s naive to think that they should offer the same rate to everyone, but that’s how it seems to me. It’s easy to understand why ever-expanding big health systems are increasing prices through pricing power rather than decreasing them through efficiency – because they can.

HIStalkapalooza

About 900 folks have signed up to attend HIStalkapalooza, so the window will soon close on your opportunity if you aren’t one of them. Barry and Jennifer will host again, the red carpet is set, and at least three HISsies winners will appear on stage. The good news is that unless I get swamped with additional requests, I’ll be able to invite everyone who signs up, same as last year. 

If you haven’t attended previous HIStalkapaloozas and are wondering why so many people rave about the band, here’s a video of Party on the Moon, who fills the dance floor literally from their first note to their last. As a music snob, I’ve never seen anything like them, which is why I keep bringing them back. They love the HIStalkapalooza crowd and are rewarded with reciprocation.

Last Week’s Most Interesting News

• A House committee review finds that the VA’s self-developed claims processing system is being used only as a document repository despite a budget that is running double the original estimate of $580 million.
• CMS Administrator Andy Slavitt announces the end of the Meaningful Use program in its current form in favor of “something better” in remarks delivered at the JP Morgan Health Care Conference, where he also warns that “data blocking will not be tolerated.”
• The National Center for Policy Analysis criticizes the Texas Medical Board’s “protectionist” restrictions on telehealth, noting that the state is worst in the country in providing access to care.
• The American Medical Association gets into the for-profit incubator business by spending $15 million to launch Health2047.
• OCR clarifies provider responsibilities in giving patients copies of their medical records, noting that they can’t require patients to physically visit their premises, can’t refer them to an online portal, and must provide electronic copies if patients want their records in that form.

Webinars

None scheduled soon. Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.

Sales

Duke University Health System chooses Phynd’s Unified Provider Management platform.

Announcements and Implementations

TierPoint appoints four former executives of its acquired Windstream Hosted Solutions to key leadership roles. The company offers cloud, co-location, and managed services.

Privacy and Security

In Canada, Alberta Health Services drops disciplinary action against 24 of the 48 employees it had accused of inappropriately accessing patient records in a high-profile case, including rehiring the one employee it had fired and paying any missed wages that resulted for all of them. The nurse and public employee unions successfully argued that hospital’s policies weren’t clear.

Montana health plan New West Health services says a stolen, unencrypted laptop full of PHI covering 25,000 people has inspired it to install “additional security on all company laptops.”

Other

I just noticed that Epic has been running job ads for Epic Hosting as “we enter the realm of multi-tenant hosting and create a data center with a cloud-based approach.” The way it describes the employer as “Epic Hosting” suggests that it’s a separate company.

In England, a doctor shortage is blamed for delays in returning patient calls to the non-emergency 111 service that’s run by a private company, with patients waiting up to 12 hours to hear back. Employees say they were told to falsify records to make the service appear more efficient.

Sponsor Updates

• The Salt Lake City television station features Health Catalyst in a report on the cost of healthcare.
•  T-System, VitalWare, and ZirMed will exhibit at the HFMA Region 11 Healthcare Symposium January 24-26 in San Diego.
• Valence Health will exhibit at the South Dakota HFMA Winter Meeting January 21-22 in Chamberlain.
• Verisk Health’s Sam Stearns and Jon Edwards pen a guest column on on-site clinics for Employee Benefit News.
• Versus real-time location solutions receive Novation’s Innovative Technology designation.
• Huron Consulting Group President and CEO James Roth shares his 2016 predictions with Consulting Magazine.
• The local business paper profiles WeiserMazars Digital Marketing Manager Gabrielle Chwazik-Gee.
• YourCareUniverse releases the latest edition of The Navigator newsletter.

Blog Posts

• A Communication Upgrade Pays Off (Voalte)
• After reading 2016 trends, let’s take some actions (Nordic)
• Healthcare’s Mad Rush to Consumerism (Xerox)

Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Lt. Dan.
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