I realize it's been quite a while since I taught - or was in school myself - but I'm distressed…
Morning Headlines 7/27/16
ONC announces availability of a $250,000 grant for cyber threat information sharing services, authorized under the recently enacted Cyber Information Sharing Act. Karen DeSalvo, MD and national coordinator for health IT, explains that “Establishing robust threat information sharing infrastructure and capability within the Healthcare and Public Health Sector is crucial to the privacy and security of health information, which is foundational to the digital health system,”
Athenahealth Announces Industry’s First MIPS Guarantee
Athenahealth guarantees that its clients will meet MIPS national performance thresholds and avoid payment penalties, and promises to reimburse any MIPS penalties incurred.
ONC publishes new MU hospital attestation numbers by vendor, showing that Cerner has the most attestations, followed by Meditech and Epic.
AMA, Omada Health, Intermountain Healthcare Partner to Reduce Incidence of Type 2 Diabetes
Omada Health partners with Intermountain Healthcare and AMA to begin
offering digital diabetes prevention programs designed to support the population health management efforts of large health systems across the country.
Covenant Health Selects Cerner’s Enterprise-Wide Clinical, Financial and Population Health IT System
Covenant Health (TN) will implement Cerner across its 9 acute-care hospitals and 100 ambulatory centers.
Covenant picks Cerner…That’s a significant thing in Tennessee… maybe folks there heard too much about what’s happening at Erlanger. Do you think that is part of what’s happening in that market?
Bad idea Athenahealth.
The last thing physicians want to hear is that you NEED to do this for MIPS, so these 10000 clicks are necessary or we wont guarantee your penalty.
Plus it enables CMS to continue to pile on these needless burdens on physicians.
Its a marketing ploy that is for all the wrong reasons, and wont work.
RE: Monday Morning Update 7/18/16 – “I’m tiring of the Pokemon Go phenomenon as quickly as I did other pointless, imitative fads like the Ice Bucket Challenge…”
Hi HIStalk, you recently struck a nerve with your opinion of the Ice Bucket Challenge as a “pointless, imitative fad”. Per this weeks headline, turns out it has actually been instrumental in fundraising and research advancement (article link attached below).
$115M+ raised to date for ALS research is not pointless… Assisting in identifying a new gene that may lead to alternative therapy treatment is not pointless. Your comment was in poor taste and in hindsight, wrong. Was the “challenge” silly? Yes. Did people participate without donating? More likely than not. Yet, at the end of the day it was productive – It: a.) raised awareness and money, and b.) gave those with ALS, like Peter Frates a welcomed distraction from the disease.
The ALS ice bucket challenge was and always will be much more than a pointless, imitative fad.
https://www.washingtonpost.com/news/the-intersect/wp/2016/07/27/the-als-ice-bucket-challenge-is-working/
[From Mr H] Only if people actually donated money instead of just creating crappy, self-promoting videos, which I suspect few of those in healthcare IT did. The awareness aspect is positive and beneficial, although that only goes so far (see: wearing pink in October and still racing for the cure). I also had an unusual perspective in having PR people flooding me (no pun intended) with their client CEOs being ice bucketed, demanding to be recognized, some of them well after the fad ran its course, which makes me think committees had to find time to create a “campaign” around 60 seconds of unconvincingly impromptu video. I wonder if they even knew anything about the cause they were supposedly supporting.
@meltoots I am confused…can you explain to me how this “marketing ploy” is bad? Aren’t they just saying if you use the athena system they will ensure you hit your quality metrics (measures handed down by CMS/government not athena) or else they pay the penalties? Seems to me like they are just putting their money where their mouth is and adapting to industry change.
Covenant picks Cerner? Not that significant. UT Hospital just down the street is also a Cerner shop, so it makes a lot of sense. The closest Epic sites are Erlanger and Wellstar, neither of which probably has significant overlap in patient population, unlike UT.
@obfuscator The Covenant pick is significant if you think epic is winning large systems. And I wouldn’t dismiss Erlanger, it’s only a 100 miles and a recent win. And listen, heads have rolled there let me tell you! This is market momentum not necessarily because one vendor is doing well. It could be because epic costs hospitals even more than expected.
I certainly didn’t mean to say that it has no significance. I just think you’re blowing it a bit out of proportion. There are tangible gains from going with the system most of the physicians in the Knoxville area are already familiar with and with whom you share significant patient population. If I were Covenant and looking at a new EHR, certainly I’d look at Erlanger’s case, but not because it’s 100 miles away. I’d look at Erlanger if it’s relevantly similar to my Health System in size, management, etc. I’d be a fool if I didn’t, just as I’d look at relevant cases that were 1000 miles away from both Epic and Cerner. I never said that Epic is winning all the large systems. They are winning enough of them though that I think you’re making a mountain out of what is little more than a locally-famous hill.
Every Cerner win is significant at the rate their losing existing clients. Replacements of millennium actually higher than replacements of soarian last data i saw.
@MissingThePoint We hear this EVERY day, we must do this crazy workflow, clicking, nonsensical unsafe method to do something in our EHR. We ask for ANY improvements, and we are told that “because of Meaningful Use” you have to do it this way. So for Athena to guarantee penalty coverage, they have some heavy conditions to meet. Which also means Athena will tell the providers that you PURPOSEFULLY did not comply (you avoided all the clicking and data entry) and therefore we will not cover it (its in the fine print). Its a terrible idea because, MACRA must balance neg and pos and potentially the quality indicators and costs will push a practice over the edge to the negative. The middle is a moving target (again a stupid idea from CMS to pit providers against each other, thats poisonous). We just HAVE to get away from EHR process, clicking, counting, attestation, penalties, and the MACHINE running medicine.
For the uninitiated…
Medicare Access & CHIP Reauthorization Act of 2015 (MACRA)
Ends Sustainable Growth Rate (SGR) formula. Makes a framework for rewarding providers giving better care, not just more. Combines existing quality reporting programs into one system.
Merit-Based Incentive Payment System (MIPS)
Combines parts of the Physician Quality Reporting System (PQRS), the Value Modifier (VM or Value-based Payment Modifier), and the Medicare Electronic Health Record (EHR) incentive program into one program where Eligible Professionals (EPs) will be measured.
Alternative Payment Models (APMs)
New ways to pay health care providers for the care they give Medicare beneficiaries. Accountable Care Organizations (ACOs), Patient Centered Medical Homes, and bundled payment models are some examples of APMs.
This is interesting, I thought Covenant health was also running NextGen and that was a fairly recent implementation (within the last 5-10 years) – has NextGen really gone downhill that much that people are jumping ship and taking the financial hit? A quick google search reveals a job posting within the last 15 days for an Applications Analyst to support the NextGen application at Covenant. I’d be interesting in knowing if they are planning to run dual systems or compress everything to Cerner.
@meltoots ok I see your point to some degree, but saying we “have to get away from the EHR process” is absolute nonsense, you sound like you belong in that luddite category. What do you want to revert back to paper? I do agree government regulations have created poor software by in large….but at the same time most consumers of EHR software are poor users (yes that is a sweeping generalization, but not wrong) which just compounds the issue. Even with garbage software that is available now students graduating from med school now can move through a note exponentially faster than handwritten ones. Furthermore, the data aggregated from computer systems is going to literally change the world in how we can look at medicine in a way never before seen. Look at how powerful big data is now for things like advertising or social interaction (not saying that it provides a societal benefit, just that it is hugely powerful). Imagine harnessing accurate data like that in healthcare, and using it in a proper manner. It will take a generation for it to work, what we need is regulators and clinicians that understand programming/coding…which in a generation or two will literally (not figuratively) be everyone. You will NEVER remove computers from healthcare, and to do so would be asinine. It is only going to get more invasive, just as it has become in every other industry. What we need to focus on is making that software so ingrained into medicine that you don’t even notice it exists.