EPtalk by Dr. Jayne 5/30/24

I was talking to a colleague this week. We had a stroll down memory lane about the changes that have happened in the healthcare technology sphere during our tenures in the industry. I had made a comment about “doing electronic healthcare records since before Meaningful Use was a thing” and the conversation just spiraled from there.

We’ve seen practices opt out and take the penalties for non-participation, and we’ve seen practices overhaul themselves trying to get the most out of the bonuses. We’ve also seen a lot of organizations in the middle of that spectrum that just seem perpetually lost because they struggle to keep up with everything that’s going on in the regulatory world.

For those organizations in the swirl, the Merit-based Incentive Payment System (MIPS) Value Pathways (MVPs) registration is open for the 2024 practice year. Organizations that plan to report an MVP can register through December 2, 2024 at 8 p.m. ET. That seems a bit of an arbitrary choice on the time and date to close out registrations, but I’m far from being the clock or calendar police. Organizations that plan to register should identify the MVP they plan to report, whether they’re going to use the Consumer Assessment of Healthcare providers and Systems (CAHPS) for MIPS Survey, and the population health measure they would like to be evaluated on. There are several other decision points, such as participating as an individual versus group versus subgroup, so if you’re not familiar with all of that, it might be time to do some reading.

I haven’t heard much about data being used in this way, but Vanderbilt University Medical Center is using data to identify outlier clinicians who are receiving a high number of patient complaints. Once the physicians are identified, trained physician peers review the data and provide feedback that is targeted towards behavioral modification. The program has lowered malpractice claim costs for the identified physicians by 83%. Although the work at Vanderbilt was only done in orthopedic surgery, it would be interesting to see how similar initiatives might pan out in other specialties. I’m curious how other organizations might be using patient complaint data – it’s not something I hear much about in the informatics community.

Speaking of data, I can’t wait to see some actual research on this new solution. Crescent Regional Hospital in Lancaster, TX has deployed a solution that creates life-size holograms of physicians in patient care areas, “creating an immersive, engaging, interactive experience.” It sounds exciting and all, especially when the hospital CEO uses the word “teleport” to describe what is going on, but other than being in 3D and requiring specialized equipment, it’s a very fancy video visit. It is being described as a “non-touch” visit rather than a virtual visit or video visit. I’d love to see a head to head study comparing this type of solution with in-person care and non-hologram virtual visits. I suspect it will score similarly to the latter, although there’s a potential for it to score worse if there are technical issues. I wholeheartedly support the use of video / virtual care, especially in areas where it’s challenging to recruit clinicians, but I can’t help but remember something else that creates an “immersive, engaging, interactive” environment – live physicians.

Depending on the specialty, some departments have been slow to integrate virtual care into everyday practice. A recent submission in JAMA Pediatrics looks at the incorporation of clinician-to-clinician e-consults within pediatric care organizations. Ideally, it would allow primary care physicians to collaborate with subspecialists about the care of a particular patient. However, researchers found rates for the under-18 population that were significantly lower than other patient groups. The authors note key areas that need to be addressed in order to expand the use of the modality: specific payment mechanisms, EHR interoperability, operational processes, consent, privacy, and patient engagement. It will be interesting to look back at this topic in a few years and see if advances have been made.

As I was wrapping up my recent trip, the idea of innovation labs was a hot topic. Apparently Atrium Health is building a 20-acre “innovation district” in Charlotte, NC that includes research buildings, a residential tower, retail shops, and a hotel. It will surround the medical school that is planned for the area.

Plenty of large health systems have innovation centers or programs. I’ve heard of them ranging from high-performing units that can create and commercialize solutions to buzzword-friendly boondoggles. One of my drinking buddies shared a feature from The Hustle that suggests that the innovation lab concept has lost its sparkle. Examples of non-healthcare innovation labs that were cited in the piece include Estee Lauder and Microsoft “to infuse AI into your beauty routine (whatever that means)” along with Major League Soccer, Mars (home of M&Ms and Snickers), Sephora, and Visa.

That particular edition of The Hustle also included a blurb about a startup (BrainBridge) that wants to transplant a human head onto a donor body within eight years. They plan to use high-speed robotic surgeons and AI algorithms to make it all work (of course there is AI!) The blurb links out to an article in the New York Post, so that’s something right there. I’d love to hear what actual neuroscientists think about the potential for this.

My buddy also shared that the edition mentioned that Firefox recently resolved a software defect that was opened in March 2000 for the Netscape Navigator product. I had a 15-year relationship with a software company once, but generally gave up on defect fixes once the requests hit the five-year mark. Kudos to the team for closing the loop on this one.

I’m back in the cicada zone this week, and I’d be lying if said I wasn’t eager for them to finish their life cycle and have the next generation burrow back into the ground. They are projected to decrease in my area in mid-June, but work travel will take me to places where they might continue well into July. I try to dodge them when I’m out for a walk or a run, but it’s amazing how loud it can be when one of them hits your windshield at high speed. Good luck, little critters, we’ll see you again in 13 years.

What is your cicada-palooza experience? Are you fascinated by it or ready to be done with it? Or tired of hearing the Eastern half of the US talk about it? Leave a comment or email me.

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