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HIStalk Interviews Michael Abramoff, MD, PhD, President, IDx

May 23, 2018 Interviews 1 Comment

Michael Abramoff, MD, PhD is president, founder, and director of IDx of Coralville, IA and professor of ophthalmology, electrical engineering, computer engineering, and biomedical engineering at University of Iowa Hospitals and Clinics.

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Tell me about yourself and the company.

I’m an ophthalmologist specializing in retinal surgery. I also studied computer science, did a master’s, and then did a PhD in image analysis years ago. I worked for years in France in the software industry. I worked on neural networks 30 years ago. I’ve been trying to combine IT and medicine for the last 25 years. People have always said it’s a great combination, but it turns out that it’s pretty hard to do. Right now, I’m excited because we are very successful and it’s going somewhere.

The company was founded in 2010. I had been working on algorithms to diagnose disease before then. As you can hear from my accent, I came from Amsterdam in the Netherlands to Iowa now 15 years ago. I had been doing research on these AI algorithms and was getting good results. By the time I founded IDx, I realized that productivity and loss of productivity in healthcare is key if we want to do something about the cost of healthcare.

If you want to make physicians more productive, AI needs to be autonomous, meaning it makes a clinical decision by itself or a therapeutic decision by itself rather than assisting a clinician, because then you don’t really do something about physician productivity. That’s the key.

Since then, we have been working on a number of products, but primarily on diabetic retinopathy, mostly because it’s the most important cause of blindness. It’s very obvious. We know exactly what to do with these patients if we catch them early. But they are not caught early. The patients are in primary care, but historically they needed to be referred to an ophthalmologist like me, an optometrist, or a retinal specialist to examine the retina for signs of disease. Then you can still prevent vision loss and blindness. But that’s not happening.

It’s the lower-hanging fruit in terms of using a well-defined task in analyzing these images and a well-defined task in terms of what happens to the patients. What the diagnosis should be and where it should happen. You take the diagnostic capability that is in me, as a retinal specialist, into primary care, where I’m clearly not. That’s what we set out to do with the clinical trial of the product.

It took seven years of conversations with the FDA to make sure they’re comfortable about how to validate autonomous AI, which makes a clinical decision without physician oversight. Make sure it’s safe — that’s primary. Make sure it’s efficient. That’s what we did with the clinical trial that led to approval last month.

Who pays for your product and who bills for the testing?

It’s moving a specialist’s high-quality diagnosis into primary care, so primary care is billing for it and we get a part of that.

Many companies are suddenly proclaiming that their product uses AI. How would you evaluate their claims?

Artificial intelligence is the frontier of what we do with computer algorithms. Even databases and SQL were called AI 30 years ago. That term is shifting. Right now, it means analyzing clinical data to help make a decision or to actually make a decision.

Instead of saying AI, I’d rather say “autonomous AI.” You have something called “assistive AI,” which is using computer algorithms to assist the physician or specialist who is making a clinical decision or therapeutic decision, or even helping them do surgery. Autonomous AI makes the decision instead of the physician doing it.

It’s a more interesting distinction to say autonomous versus assistive rather than saying, “This is AI and this not,” because that’s a very much a gray zone right now. Like I said, historically, many things have been called AI that no one in their right mind would call AI as of today. I bet you that things like we’re doing, five years or 10 years from now, people will say, “That’s not AI. That’s not the leading edge.” Whatever we’re doing then, we’re thinking about therapeutic applications. They’ll be the leading edge and that will be called AI then.

But the autonomous versus assistive distinction is very important. You see the same with self-driving cars. It’s assistive, meaning it parks for you and it has lane protection. But it doesn’t drive for you. That’s an autonomous car. Similarly, there’s a difference between autonomous in AI and diagnostics in healthcare.

You have pipeline projects for analyzing blood vessels to predict MI, stroke, and other cardiovascular issues. How could that change healthcare?

First, about that pipeline. We have a number of products right now. We’re most prepared for a glaucoma early detection product that will probably go into clinical trials later this year. Like you said, there’s a number of other products, including some outside of the eye, like for the skin or the ear. We’re working on “the AV product,” as we call it, which relates to analysis of the arteries and the veins in the retina. It essentially tells you how the arteries and veins in the brain look. The retina is part of the brain. It’s just easier to look at it than to get a scan or angiography of the brain. It tells you about the micro-circulation in the brain.

We know from many studies done by many other groups — including my group as a research project — that it tells you about the risk of getting a stroke or other cardiovascular events. It is not a certainty. It is not a diagnosis. It just tells you about the risk. We see this product as a risk analysis, like when the patient comes into primary care and blood pressure is measured. That’s just the risk factor. High blood pressure is a risk factor and so is abnormal retinal arteries and veins. It tells the provider that there’s something really wrong with the vessels in the eye and therefore in the brain, and therefore this patient should be analyzed further.

That is how we see that product developing. But right now, it’s not a product. We’re not ready to put it into the clinical trial, like glaucoma and some other products that we’re very near to, hopefully, getting FDA approval soon.

Google is doing similar work in analyzing the eye to detect broad risk factors. Are many groups using AI in this way?

Google did very good research that other groups, including my group, have been doing for years. Looking at retinal images and seeing what associations with other diseases you can find. They’re able to do it on a large scale.

It’s very exciting, but I want to stress that scientific research involves looking for associations that we didn’t know existed. The big step is going from having an interesting association — between something I can measure and something that is happening to the patient — to actually making a diagnostic or therapeutic decision from that. It’s a very different environment. It needs to be safe. You need to be absolutely sure you can explain how it works and why it works. The FDA has big say in that. So you move there from scientific projects, which is really exciting. I’m a physician-scientist myself with a big research group to make a product out of it and put it through a clinical trial.

What is the potential of using AI in the overall spectrum of image analysis and how might it fit into the workflow of a physician?

I’m an immigrant, so I can say that the US healthcare is in many cases the best in the world. But it’s extremely expensive. The challenge is making it more affordable.

That’s why I think that autonomous AI is so very, very important. With assistive AI, you can make a physician better, a specialist better. That’s not always the case. You need very good studies to figure out whether it’s true. But at least you have the potential to make it better. But it’s at least as important to also make it more affordable. Then you go into autonomous AI. For the near future, at least, definitely in terms of more applications of autonomous AI.

There are many things right now that AI cannot do and should not be doing. That may change in the future. With an IT background, you know that the more well- defined the requirements are, the easier it is to automate. The more ill-defined and vaguely defined it is, the harder to automate. But there’s many things that we have protocols for, very good standards for, and physicians know pretty well why they’re doing what they’re doing. There’s a lot of research at the basis of that. Those are the fields where you’ll first see additional autonomous AI.  Both in the retina and other organ systems, you will see the use of autonomous AI for therapeutic decisions.

For robotic surgery, many groups and companies are doing assistive AI surgery, but autonomous surgery is a little bit farther away. You’ll see this incremental autonomous AI developing. Just like with self driving cars – you’ll see the steps being made now that may lead to, sooner or later, self-driving cars.

It’s so crucial that autonomous AI is happening. There is a role for assistive AI to assist clinicians like me to make better diagnoses, but I see the field going to autonomous AI. I also see also the biggest return on investment going there.

Are you getting lot of interest from investors, potential acquirers, or partners since you’ve had just one funding round from several years ago?

It’s so much we can hardly keep up. From big names to smaller funds, growth equity funds, VCs, investment banks. Big names that you would recognize. I don’t want to disclose here. We’re looking at doing a round this year or we have been thinking and talking about an initial public offering. We are prepared for that. The question is, when is the timing right? We’re still mulling it over and seeing when it would happen exactly. But definitely there’s several opportunities for investment in the near future.

Where do you see the company going in the next several years?

The main thing now is rollout. Getting this into every primary care clinic and every retail clinic in the country is what we focusing on right now. We have this product. We have this FDA approval. Now we need to show that it actually benefits patients. We need to reach the maximum number of patients. That’s why I did this. I want to make it better for people with diabetes. That’s what we’re finally able to do now, because FDA said, this is safe. This is a responsible use of AI. Let’s do it.

Once you are in the primary care clinics, it’s relatively easy — I’m not saying it’s really easy, but relatively easy — to have a different AI product to put on top of there. It’s attractive, once you have that imaging platform, to build additional diagnostics on top of it, without any additional effort for either the clinic or the patient. That’s what you will see coming out of us in the next years. Mostly presence everywhere and additional products. First in the eye, like glaucoma, and then later also in other organ systems.

It’s going to be very exciting time for the next few years. We’re the first. We intend to stay ahead. There’s big, very big names following us. That’s exciting and daunting. But we are very good team and very good company. I think we’ll be successful.

Morning Headlines 5/23/18

May 22, 2018 Headlines 1 Comment

New Cancer Treatments Lie Hidden Under Mountains of Paperwork

A New York Times article says that hospital EHRs are a “medical records mess” that impede research efforts because of incompatible data formats and the reluctance of health systems to share their patient data.

Bruce Greenstein departs HHS CTO role

HHS CTO Bruce Greenstein joins home health provider LHC Group as chief innovation and technology officer.

House Passes Bill to Keep Tabs on VA’s Health Records Modernization

The House passes a bill that would require the VA to provide Congress with regular updates on its Cerner project and to notify lawmakers promptly if it experiences contract or schedule changes, milestone delays, bid protests, or data breaches.

Routine DNA Screening Moves Into Primary Care

Geisinger Health System (PA) will begin offering DNA sequencing to patients, after which results will be sent to their primary care physician for one-on-one counseling and incorporated into their EHR.

News 5/23/18

May 22, 2018 News 8 Comments

Top News

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A New York Times article says that hospital EHRs are a “medical records mess” that impede research efforts because of incompatible data formats and the reluctance of health systems to share their patient data.

The creator of the Metastatic Breast Cancer Project says that genetic tumor analysis is easy compared to manually reviewing hospital charts that are always delivered as paper copies or faxes. He also noted that health systems ignore the patient-approved medical records requests more than 50 percent of the time.

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The article notes that six-year-old oncology EHR and data vendor Flatiron Health – sold to drug maker Roche for $1.9 billion early 2018 by its 31- and 32-year old co-founders — has published the de-identified hospital records of 2.2 million cancer patients, but it took 900 nurses and tumor registrars to extract the 50 percent of required data elements that were stored as unstructured text.


Reader Comments

From Martin Shkreli: “Re: blockchain. This article has a good explanation of blockchain and health IT.” The article offers a balanced and easily read overview of blockchain and its potential uses. The author, who is a Bitcoin developer, concludes that the decentralized nature of blockchain comes with high costs and lack of scalability that make the “slow, expensive database” unsuitable for nearly everything except as currency and for feeding hype to investors:

This naturally means that the software or database must not change things around often, if at all. There should be little upside to upgrading and much downside to screwing up or changing the rules. Most industries are not like this. Most industries require new features or upgrades and the freedom to change and expand as necessary. Given that blockchains are hard to upgrade, hard to change, and hard to scale, most industries don’t have much use for a blockchain. The one exception we’ve found is money.

From Tonsorial Advances: “Re: Epic. Judy once hinted during a staff meeting that it would offer billing services. It was followed by a slide showing Cerner’s much higher services revenue. That is probably where the rumor you were sent came from, since an RCM acquisition might make sense.”


Webinars

May 24 (Thursday) 1:00 ET. “Converting Consumers into Patients: Strategies for Creating Engaging Digital Experiences People Demand.” Sponsor: Healthwise. Presenters: Antonia Chappell, director of consumer solutions, Healthwise; Josh Schlaich, senior product manager, Healthwise. Nearly three-quarters of US adults use a digital channel to manage their health and the internet to track down health information. It’s clear that consumers have come to expect online interactions as an integral part of their overall patient experience. In fact, the Internet may be the first way people come in contact with your organization. They have more choice than ever on where to get healthcare services, and their decisions are increasingly influenced by how well organizations connect with them in the digital space. This webinar will show you how to create engaging digital and web experiences that convert casual consumers into patients and keep them satisfied throughout their entire patient journey.

June 5 (Tuesday) 1:00 ET. “Increase Referrals and Patient Satisfaction with a Smarter ‘Find a Doctor’ Web Search.” Sponsors: Phynd Technologies, Healthwise. Presenters: Joseph H. Schneider, MD, MBA, FAAP, retired SVP/CHIO, Indiana University Health; Keith Belton, VP of marketing, Phynd. A recent survey found that 84 percent of patients check a hospital’s website before booking an appointment. However, ‘Find a Doctor’ search functions often frustrate them because their matching functionality is primitive and the provider’s information is incomplete or outdated. Referring physicians need similarly robust tools to find the right specialist and to send the patient to the right location. Attendees of this webinar will learn how taxonomy-driven Provider Information Management improves patient and referrer satisfaction by intelligently incorporating the provider’s location, insurance coverage, specialty and subspecialty, and services offered that can be searched via patient-friendly terms.

Previous webinars are on our YouTube channel. Contact Lorre for information.


Acquisitions, Funding, Business, and Stock

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Patient communication and appointment management system vendor Luma Health raises $6.3 million in a Series A funding round, increasing its total to $9.7 million.

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Doctor house call provider Heal raises $20 million in funding, increasing its total to $69 million. The service operates from 8 a.m. to 8 p.m. in parts of California and Washington, DC, with house calls covered by some insurance plans or $99 otherwise. Singer Lionel Richie is a company investor and pitchman.

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Athenahealth’s second-largest shareholder — London-based Janus Henderson Investors, which owns 11.9 percent of the company — urges Athenahealth’s board to put the company up for sale. Meanwhile, Deutsche Bank thinks the company is worth $170 per share, but warns that the company’s suitor, activist investor Elliott Management, takes a long time to close deals. ATHN shares rose slightly Tuesday to around $154.

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The US Supreme Court sides with Epic and two other companies in finding that mandatory employee arbitration and non-disclosure agreements are enforceable, meaning employees may not organize together to file workplace-related class action lawsuits.


Sales

  • Columbus Regional Healthcare System (NC) chooses Cerner Millennium via the CommunityWorks hosted model.
  • Australia’s NSW Health names Sectra as its preferred RIS/PACS vendor.

People

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Todd Plesko (Vocera) joins Management Health Solutions as CEO.

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HHS CTO Bruce Greenstein joins home health provider LHC Group as chief innovation and technology officer.


Announcements and Implementations

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InstaMed announces Engage, a patient app that allows patients to check in for visits via Bluetooth beacon alerts or text messaging, view benefit information, pay for services with a digital wallet, and enroll in payment plans. 

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Adventist Health System joins Florida HIE’s Encounter Notification Service to monitor out-of-network admissions, facilitate transfers, and plan discharges, The services is operated in partnership with Audacious Inquiry.

A Black Book survey of 900 physician organization finds that medical practices are moving to value-based care instead of selling out to health systems, with two-thirds of practices with 10 or more doctors planning to hire consultants in the next year to help them transform their operations. Nearly all respondents say they need outside help with implementing value-based care and population health management as well as choosing new software needed for those efforts.

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A new KLAS report finds that most organizations are missing at least some elements of a mature enterprise imaging strategy in the categories of IT support and funding, the ability to electronically ingest images, defining an encounter-based imaging strategy, and applying strong governance. Most of those that have deployed a VNA and universal viewer are not fully meeting the four goals of image access, physician productivity, care collaboration, and data management, with customers of IBM Watson (Merge Healthcare) and Agfa performing best.

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Life Flight Network launches an Uber-like mobile app that allows hospitals and first responders to request its air ambulance transport services.

COPD disease management app vendor HGE Health partners with Change Healthcare to support population health management and improve health plan-provider communication in managing chronic conditions.


Government and Politics

The House passes a bill that would require the VA to provide Congress with regular updates on its Cerner project and to notify lawmakers promptly if it experiences contract or schedule changes, milestone delays, bid protests, or data breaches.

A federal report finds that 40 percent of Americans would have to borrow money or sell something to pay an unexpected $400 expense, which is at least better than 2013’s 50 percent. The report also says that 25 percent of people have zero retirement savings.


Privacy and Security

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A 28-year-old doctor in Nigeria is arrested for hacking into bank accounts and for creating fake payment notices to car dealers to steal cars, including an $80,000 Porsche. He says Nigerian banks are easy to hack and claims to have targeted actors such as John Travolta.

An investigation by Ireland’s data protection commissioner finds that hospitals are giving patient records to researchers without the patient’s consent. It also notes the presence of employee snooping, lack of computer audit trails, insurance companies being given full access to a patient’s medical history, and patient information being discussed in public areas where it could be overheard.


Other

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Sutter Health President and CEO Sarah Krevans addresses last week’s system downtime in a video message to employees, deeming it unacceptable that clinical services were impacted “despite all of our planning, our protocols, our investment in technology, despite our emergency systems.” Meanwhile, two anonymous Sutter Medical Center nurses say the hospital, unlike other Sutter facilities, continued to perform elective surgeries even though the surgical team did not have access to the history and physical information of patients.

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In Australia, an investigation into February’s hospital-wide power outage at Royal Adelaide Hospital finds that its facilities management company ignored erroneous low-fuel warnings from its diesel generators, not realizing that the false alarms prevented the fuel tanks from filling and caused the generators to run out of fuel during system testing.

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In England, University College London Hospitals partners with an artificial intelligence institute to explore automating ED triage, sending appointment reminders, and analyzing images for research projects.

Marketers from addiction treatment centers, which are making fortunes from treating insured opioid addicts, are joining private Facebook addiction support groups to recruit patients, sometimes posing as concerned strangers. Some have been arrested for taking kickbacks for referring patients to rehab companies. The owner of a marketing company that runs a support website sued a treatment center for unpaid patient recruitment fees totaling $700,000 in 18 months from just that single facility.

Mary Washington Healthcare (VA) reprises its outstanding, “Hamilton”-themed EHR video from last year with a sequel that celebrates its Epic go-live next week.

A Georgia plastic surgeon who refers to herself as “doctor to the stars” and who made 20 YouTube videos of herself singing and dancing over unconscious surgery patients is being sued by several patients for malpractice. Windell Davis-Boutte, MD recently settled a case in which a patient claimed to have been left with permanent brain damage after an eight-hour tummy tuck procedure. Her website claims she’s board certified in both surgery and dermatology, but state records indicate that she is certified only in dermatology.


Sponsor Updates

  • The Texas Hospital Association endorses Collective Medical’s care collaboration network for identifying and supporting complex patient populations and for manage ED usage and ED opioid prescribing.
  • Access releases ESignatures 8.0, which includes a patent-pending handoff function.
  • Meditech associate VP Larry O’Toole joins CommonWell’s board.
  • Black Book names Impact Advisors as a leading cybersecurity consulting firm.
  • Bernoulli Health will exhibit at the 108 IHI/NPSF Patient Safety Congress March 23-25 in Boston.
  • CompuGroup Medical will exhibit at COLA – Symposium for Clinical Laboratories May 30-June 2 in Miami.
  • Collective Medical Clinical Advisory Board Member Anne Zink, MD wins several ACEP awards.
  • Conduent is named to the Fortune 500 list of largest US companies.
  • The 2018 EPA National Adoption Scorecard from CoverMyMeds wins a Stevie Award for Best Annual Report.
  • Dimensional Insight will exhibit at the MUSE International Conference May 29-June 1 in Orlando.

Blog Posts


Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates. Send news or rumors.
Contact us.

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Morning Headlines 5/22/18

May 21, 2018 Headlines 3 Comments

Epic Systems gets a win in U.S. Supreme Court decision limiting workers’ ability to sue employers

After reviewing the employee arbitration cases of Epic and two other companies, the US Supreme Court declares that companies do have a right to mandate that employees sign agreements preventing them from taking workplace grievances to courts of law.

Iora Health Raises $100 Million in Series E Financing

Primary care company Iora Health raises $100 million, which it plans to use to further develop its proprietary care coordination technology.

Janus Henderson Reports 11.9 Percent Stake In athenahealth

Janus Henderson Group, Athenahealth’s largest shareholder, urges the company to initiate a formal sale process.

Theresa May: Artificial intelligence will prevent 22,000 cancer deaths a year by 2033

British Prime Minister Theresa May outlines the government’s industrial strategy, which includes significant investments in healthcare-focused AI and analytics to help catch cancer diagnoses earlier.

Curbside Consult with Dr. Jayne 5/21/18

May 21, 2018 Dr. Jayne 1 Comment

It’s the time of year when many people are attending graduations for family and friends. The medical school where I’ve been an adjunct faculty member held their commencement exercises, putting one more checkmark on a long list of accomplishments for its students.

Although some of them will be pursuing additional degrees such as an MBA, MHA, or JD, others will be getting ready to receive their first physician paycheck in a few short weeks. Even though they’re officially receiving a paycheck and are finally called “doctor,” there is still much to learn. Residency is completely immersive learning. Regardless of whether you have work hour restrictions or not, whether you get days off or not, or whether the IRS classifies you as a student or an employee, this is where the real work of “becoming a physician” begins.

Similarly, residents who are already in training programs have been taking in-training exams, licensure exams, and completing the requirements that will allow them to be promoted to the next year of training. Traditionally, everyone moves forward on July 1 unless residents have taken time off or there have been other sidetracks to their educational program.

I’ve had the privilege of working with some great students and residents over the last several years, and enjoy continuing as a mentor as they move on in their careers. Over the last two years, I’ve been working with a young woman who I can only describe as a firecracker. She has an uncanny knack for seeing how processes can be improved and galvanizing people around her to make positive change. When her program sent interns onto the wards without the guidance and direction they needed to be successful, she and her intern peers created a “New Intern Survival Guide” to help the intern class that would follow them. They worked to incorporate opportunities for non-traditional rotations (such as clinical informatics and behavioral analytics) for the hospital’s graduate medical education program. They worked with other residents to lobby their program director and the head of resident education for better family leave arrangements and more flexible ways to maintain their own humanity during grueling years of training.

She’s finishing her second year of residency and getting ready to begin her job hunt in earnest so that she’s ready to roll when her training is done in 13 months. If I was still in traditional practice, I would hire her in a second. She’s a quick learner and loves the data-driven approach to clinical care. She also makes a mean martini.

I was surprised when she called me in tears after receiving a recent evaluation from a member of her residency program’s faculty. Like many other types of high-performing students, to a resident seeking competitive opportunities, grades and evaluations are everything. She’s been a straight-A student her entire career, graduated from medical school at the top of her class, and is being considered for selection as chief resident. After receiving her recent evaluation, however, she was in a state of questioning everything about herself and her performance.

Residents in the program are graded across a variety of disciplines on a scale of 1 to 5, ranging from “remediation required” at the low end to “satisfactory” in the middle and “exemplary” at the top. She’s had nearly all fives during her time in the program, so was completely dumbfounded to receive an evaluation that ranked her “satisfactory” across the board. Even more upsetting to her was the sheer lack of narrative feedback from her evaluator. There were no recommendations for what she could do better, what she should work on to improve her fund of knowledge, any gaps in patient care that could be addressed, or anything else actionable. The entirety of the feedback given to her for a four-week rotation on her own program’s family medicine service was “frequently seems dissatisfied.”

I know the faculty member who evaluated her. He has a reputation for not liking change and for wanting to preserve medical education as it was when he went through residency 30 years ago. I asked the resident if she had perhaps ruffled any of this faculty member’s feathers in her or her classmates’ work to move the program forward. She did recall a discussion about the sports medicine rotations, where the faculty member in question was the department advisor. She and her peers had asked about being able to do rotations with sports medicine physicians other than him and were denied. They escalated it to the graduate medical education committee, as there was an opportunity for several of them to work with a sports medicine group that serves a local professional sports team. They were again denied because they couldn’t get the faculty member to sign off on it.

Having seen this young physician in action, I can’t imagine that her performance had somehow slacked off on this rotation or that she had completely changed her way of doing things. I can’t imagine that she delivered anything less than topnotch patient care to the best of her ability, and with compassion and understanding for patients and their families. But somehow, she had gone from “exemplary” to merely “satisfactory” with no tangible feedback she could use to improve herself.

I advised her to make an appointment with her program director to discuss it, and if nothing else, to request a meeting with the evaluator and the program director together so that she could receive formal feedback other than the three words she was given. I didn’t say it, but it sounded to me like retaliation for too much perceived boat-rocking. I encouraged her to seek feedback from other faculty she worked with on the rotation but who were not her named evaluator, as well as other members of the care team such as nurses, therapists, and consultants. I’m confident that having feedback from those other constituencies will help counter some of the psychological damage that this single evaluation was bringing her.

In reflecting on her call, I couldn’t help but think about similar situations I continue to encounter in healthcare. Healthcare providers are immersed in a culture of safety, yet can be questioned when they ask for a time-out if it negatively impacts the surgery schedule or how quickly patients can be moved through the process. We’re asked to be in cycles of continuous quality improvement for our patients, yet those who question bureaucracy may be labeled as “disruptive” or the nebulous “not a team player.” Those who believe we should have less-toxic educational programs are said to have “gotten soft” or they may be “giving in to the snowflakes.”

There are countless sacred cows out there that are protected at all costs and institutions that seem to be preserved only for the sake of tradition. As healthcare leaders, we should be able to do better. The care of our patients and the future of healthcare depends on it.

What’s the biggest sacred cow in your organization? Leave a comment or email me.

Email Dr. Jayne.

HIStalk Interviews William Bartholomew, Founder, HCTec

May 21, 2018 Interviews Comments Off on HIStalk Interviews William Bartholomew, Founder, HCTec

William Bartholomew is the founder of HCTec of Brentwood, TN.

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Tell me about yourself and the company.

I was born and raised in Nashville, Tennessee. When you grow up here, you get indoctrinated into two things, healthcare and country music. Unfortunately, I do not have any musical talent in my body, so I went the healthcare route.

A group of us founded HCTec in 2010. I’ve been fortunate to be a part of a great group of partners and teammates who have built this business. Today, we’re nearly 1,000 employees spanning the country. We provide healthcare technology workforce solutions. We focus on EMR, ERP, and revenue cycle services, spanning implementation, optimization, and support as well as partial IT outsourcing with our application managed services capabilities.

What is your most requested service?

Without a doubt it has been our application managed services. As we’ve seen clients implement these large EMR systems, their challenge becomes the tension between supporting that system and advancing that system. We have built our service centers and capabilities around assisting clients, supporting their applications so they can focus on the work that’s needed to advance their application so they can drive their business into further digitalization.

The company earned recognition for freeing up the experts at Saint Luke’s Health System in Missouri to do strategic work while HCTec managed the front line support and other day-to-day work. Is that unusual?

It falls under that category of nothing new under the sun. It’s not a new concept, but the investment into these complex EMRs has been forced them to support these systems differently. In healthcare, our approach is unusual in that regard, but it is something that is being used across other industries. That is where we gained some of our lessons learned as we launched.

Debbie Gash, the CIO at Saint Luke’s, is on the cutting edge of a lot of initiatives. Part of the fun and passion I have about our business is getting to work with folks like her. They challenge you, they make you better, and we get to come up with meaningful solutions for her organization.

Does the shortage of Epic-certified consultants still exist?

Overall, yes. With the complexity of the system, the background that you need to have to be an effective consultant in the Epic space — or really any of the others, like Cerner, Meditech, you name it — there’s still a large shortage of that talent pool. Certainly not as limited as it has been in years past, but we still see a marked shortage of those resources.

Your website notes as a differentiator that all of your consultants, whether working onsite or from your offices, are US-based. Do customers find that appealing?

Yes, they do, without a doubt. With the complexities and the skill level you need to have a meaningful impact in these applications, it was to us was never feasible to even consider an offshore component.

Our first partner at HCTec was a company called HCCA International, now called Shearwater Health. These guys have been around since the 1970s. They provide critical staffing and support to hospitals across the US. Their resource base is nurses in the Philippines. They’re very, very good and adept at bringing in that talent pool to the US. It’s certainly a model that we’re very familiar with.

But as we contemplated how to help our clients with application support and be able to reduce their workforce operational expense around supporting a system while increasing their ability to advance the functionality, it just wasn’t viable to do that in an offshore component. There’s still a large resistance among our client base, too. Offshore, you think about the data security issues around that and worst-case scenarios. It made a lot more sense to launch it in the States. We do that work out of Atlanta, Georgia, and out of our office here in Nashville.

Are people still leaving provider jobs after implementing a vendor’s system and then going into consulting? Do they stay in the field, or do they find that it’s not what they thought it would be?

We’re still seeing a lot of it. There’s still a lot of “get through the implementation at my organization and go become a consultant.” There’s a premium paid for those who will travel and can offer their expertise to other clients.

The other trend that we’re seeing – which our application managed services addresses as well — is burnout on the application analyst team within our clients. You think about getting through these huge implementations and the work that they put in — the countless hours, the sleepless nights, all of those descriptors. You go through a go-live, which no matter how well or poorly they go, are always hectic. Then they’re thinking things are slowing down, but then find out that the work has just begun.

We see a lot of turnover within our clients’ analyst teams. That’s something that we incorporated into our model. When we’re working with a client on an application support deal, on average, we’ve seen their internal attrition rate drop significantly for a lot of them, from 15 to 20 percent to the low single digits once we start working with them and start taking on that day-to-day support work for them.

What does it take to keep consultants who travel happy and productive?

We’ve made it easy on them. We’ve invested in the systems, the structure, and the internal processes so that we handle most of the logistical items for them and try to make it easy and less stressful to travel on a weekly basis. All of our employees know that our job is to support them and they have that support system here backing them up.

Culturally, you see some bad stories on the other side, but we’ve tried to put an emphasis at HCTec on our people. At the end of the day, our consultants and our employees are what make this company great. We invest in all of our employees, and consultants in particular, to make sure that they have everything that they need. But they also have a great opportunity for career advancement and continuing education. They understand how much they’re valued, not only by our clients, but also by our team here at the corporate office. We’re always trying to improve what we do for our people. It’s a critical component to building a sustainable business in our industry.

Do you have any final thoughts?

It’s such an exciting time to be in healthcare technology. We’re in a very dynamic place as an industry and that challenge is something that we’ve been excited to embrace.

I’ve got two young kids and one on the way. When I think about what healthcare will look like as they grow up, it’s pretty fun to think about how different things will be five years from now, 10 years from now, as a continued investment in technology improves the way that we deliver care and the way that we receive care as patients.

Overall, we couldn’t be more thrilled to be a part of this journey and to have an impact on the advancement of care.

Comments Off on HIStalk Interviews William Bartholomew, Founder, HCTec

Morning Headlines 5/21/18

May 20, 2018 Headlines 9 Comments

Cerner chief: VA contract taught him about ‘fake news’ that may involve a competitor

Cerner President Zane Burke blames an unnamed competitor (presumably Epic) for publicizing negative reports about the DoD’s MHS Genesis project, labeling the resulting coverage as “fake news” in Friday’s annual shareholder meeting.

TransUnion Expands Healthcare Solutions with Agreement to Acquire Healthcare Payment Specialists

TransUnion will acquire Fort Worth-based Healthcare Payment Specialists, which offers solutions for hospital Medicare reimbursement.

President Trump announces he will nominate Robert Wilkie as next VA secretary

President Trump will nominate acting VA Secretary Robert Wilkie to the permanent position.

Sponsors vie for Cardinal Health’s naviHealth

Cardinal Health hires Allen & Co. to provide financial advice on the potential sale of NaviHealth, a post-acute care services and analytics vendor it acquired in 2015 for $290 million.

Monday Morning Update 5/21/18

May 20, 2018 News 3 Comments

Top News

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Cerner President Zane Burke blames an unnamed competitor (presumably Epic) for publicizing negative reports about the DoD’s MHS Genesis project, labeling the resulting coverage as “fake news” in Friday’s annual shareholder meeting.

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Burke said, “If you had an axe to grind with us and wanted to perhaps keep us from getting to a Veterans contract, and you’re one of our competitors, you might want to use some information negatively. There was some negative information out there.”

He didn’t specify whether the “fake news” involved publication of the DoD’s own internal assessment of the project or some other event.

Burke said that just keeping VistA running would have cost more than $20 billion in the next 10 years vs. the $10 billion the VA will spend on Cerner, so it’s a good deal for taxpayers. Chairman and CEO Brent Shafer, ,asked about what issues keep him up at night, answered, “The VA was keeping me up at night until last night. It was a good night last night,” but added that his big issue is retooling the company to move more quickly.

Cerner has posted the audio recording and presentation from the shareholder meeting.


HIStalk Announcements and Requests

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It’s an even split among the minority of respondents who care either way about someone’s use of fellowship credentials such as FHIMSS and FCHIME.

New poll to your right or here: what should the VA have done about an EHR? Show your work by clicking the comments link on the poll after voting and explaining.

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This week’s “Wish I’d Known” question involves taking the first leap to overseeing the work of others.


Webinars

May 24 (Thursday) 1:00 ET. “Converting Consumers into Patients: Strategies for Creating Engaging Digital Experiences People Demand.” Sponsor: Healthwise. Presenters: Antonia Chappell, director of consumer solutions, Healthwise; Josh Schlaich, senior product manager, Healthwise. Nearly three-quarters of US adults use a digital channel to manage their health and the internet to track down health information. It’s clear that consumers have come to expect online interactions as an integral part of their overall patient experience. In fact, the Internet may be the first way people come in contact with your organization. They have more choice than ever on where to get healthcare services, and their decisions are increasingly influenced by how well organizations connect with them in the digital space. This webinar will show you how to create engaging digital and web experiences that convert casual consumers into patients and keep them satisfied throughout their entire patient journey.

June 5 (Tuesday) 1:00 ET. “Increase Referrals and Patient Satisfaction with a Smarter ‘Find a Doctor’ Web Search.” Sponsors: Phynd Technologies, Healthwise. Presenters: Joseph H. Schneider, MD, MBA, FAAP, retired SVP/CHIO, Indiana University Health; Keith Belton, VP of marketing, Phynd. A recent survey found that 84 percent of patients check a hospital’s website before booking an appointment. However, ‘Find a Doctor’ search functions often frustrate them because their matching functionality is primitive and the provider’s information is incomplete or outdated. Referring physicians need similarly robust tools to find the right specialist and to send the patient to the right location. Attendees of this webinar will learn how taxonomy-driven Provider Information Management improves patient and referrer satisfaction by intelligently incorporating the provider’s location, insurance coverage, specialty and subspecialty, and services offered that can be searched via patient-friendly terms.

Previous webinars are on our YouTube channel. Contact Lorre for information.


Acquisitions, Funding, Business, and Stock

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Cerner shares rose only 1 percent Friday after the announcement Thursday after the market’s close that the VA had signed its $10 billion contract with the company. CERN shares are down 4 percent in the past year vs. the Nasdaq’s 21 percent gain, while over five years CERN us up 28 percent vs. the Nasdaq’s 113 percent gain.

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TransUnion will acquire Fort Worth-based Healthcare Payment Specialists, which offers solutions for hospital Medicare reimbursement that include Medicare bad debt review and disproportionate share analysis. 


Decisions

  • Major Health Partners Medical Center (IN) will switch from NextGen Healthcare to a Meditech ambulatory EHR system by the end of 2018.
  • East Carroll Parish Hospital (LA) plans to go live with JumpStock inventory control software.
  • Brooklyn Hospital Center Downtown (NY) will switch from Allscripts to Epic ambulatory EHR in August 2018.

These provider-reported updates are supplied by Definitive Healthcare, which offers a free trial of its powerful intelligence on hospitals, physicians, and healthcare providers.


People

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RCM vendor Access Healthcare hires Jim Carlough (Cognizant) as SVP of North America operations.

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David Adams (Revenue Platforms) joins consulting firm Crux Strategies as VP of business development and revenue cycle management.


Government and Politics

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President Trump will nominate acting VA Secretary Robert Wilkie to the permanent position, adding in Friday’s announcement at a prison reform event, “He doesn’t know this yet. I’m sorry that I ruined the surprise.” Wilkie is a former lawyer and White House security advisor.


Other

Eastern Maine Health Systems (ME) ends its addiction treatment partnerships with two cities that named individual physicians – some of them present or former EMHS doctors – in their billion-dollar lawsuits brought against drug manufacturers and distributors. The city councils of Bangor and Portland voted to join the lawsuits, causing the health system to say that it will withdraw from any initiatives involving cities or counties that sue it.

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I belatedly learned via a tweet that former UPMC CIO Dan Drawbaugh has since 2015 been CEO of orthopedic group The Steadman Clinic and its research institute in Vail, CO.

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Weird News Andy says there’s “so much wrong” in this story, in which a former hospice executive pleads guilty for her involvement in a $60 million fraud scheme that also involved intentionally killing unprofitable patients as ordered by the hospice’s owners, a CPA and his wife (above). The former operations director says the owners ordered her to falsify EHR entries to admit patients who weren’t eligible for hospice services, fabricated “do not resuscitate” orders to avoid paying for ambulance trips when families called 911, and took patients off medications solely because they weren’t covered by insurance. The FBI’s search warrant says the CPA texted a nurse, “You need to make this patient go bye-bye.”

Medical residents at an hospital in India go on strike to demand better hospital security after the angry family members of a patient who died prior to planned gallbladder surgery beat up two doctors, a nurse, and a visiting relative of another patient who tried to stop the attack. The hospital realized afterward that it had never followed through with installing a security alarm as planned two years ago and says it will get that done.

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Rainbow City, AL police arrest a doctor for breaking into the office of the medical practice from which he had recently resigned to steal six computers, a server containing patient information, and medical equipment. He opened the practice’s safe, apparently in an effort to make the break-in look like a robbery, but police immediately suspected him because the safe’s contents were intact, including cash and narcotics.


Sponsor Updates

  • HBI Solutions posts a case report titled “Client Success: Improved Transitions of Care at DFD Russell Medical Centers.”
  • The SSI Group will host a regional user group meeting May 22-22 in Scottsdale, AZ.
  • Sunquest will exhibit at the Pathology Informatics Summit May 21-24 in Pittsburgh.
  • TriNetX will exhibit at the ISPOR Annual International Meeting May 19-23 in Baltimore.
  • Wolters Kluwer wins eight Stevie Awards during the 2018 American Business awards.
  • ZappRx CEO Zoe Barry will speak at the Greater Boston Chamber of Commerce’s Executive Forum May 22.
  • ZeOmega will host ZeOmega Connections18 May 21-24 in Plano, TX.

Blog Posts


Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates. Send news or rumors.
Contact us.

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Weekender 5/18/18

May 18, 2018 Weekender Comments Off on Weekender 5/18/18

weekender


Weekly News Recap

  • The VA signs a 10-year, $10 billion contract with Cerner for its new EHR.
  • Sutter Health experiences a 27-hour downtime of Epic and other systems at some of its facilities that was caused by activation of a fire suppression system in one of its data centers.
  • A GAO report finds that providers sometimes overcharge patients for copies of their medical records and patients sometimes struggle to get their own information.
  • Elliott Management complains publicly that Athenahealth has ignored its $7 billion takeover offer and says it might offer even more money if given access to the company’s books.
  • A newly declassified April 30 Department of Defense evaluation of the military’s four MHS Genesis pilot sites concludes that the system “is neither operationally effective or operationally suitable” and says it is inadequate for managing and documenting care delivery.

Best Reader Comments

I empathize with providers who negotiate with many many plans, each with their own waivers, to give a price for every procedure/ bundle and therefore price transparency is a non-trivial problem for them. And, I don’t want them to publish their fictitious list price. As a cash-strapped buyer who just wants to know what I will be billed when my PCP orders a dermatology test for a sun spot that I’ve had for 10 years, what am to do? My first inclination is to at least publish the Medicare price. (David)

I absolutely hate when non-clinical people compare healthcare with any other industry. My question – how would this restaurant change its business model if it is mandated that anyone who comes in through a special side door has to be given free burgers? It is not the cost transparency that is causing the problem, it is the cost bloat. The costs are higher than anywhere else. And, let’s not forget the fact that someone’s extra cost/waste is another person’s income, be it pharma industry or doctors. (Restaurant and hospital)

The government actually worsened the opioid crisis by threatening financial penalties to MDs that did not meet patient satisfaction with pain control. The Joint Commission also made similar threats, including their love of the fifth vital sign and recommending the overprescribing of narcotics. So now, they have swung the pendulum fully opposite. Its about time to let MDs be MDs and stop the madness. (meltoots)

With MHS Genesis, I think the majority correctly see the pilot as a test. (Maybe I’m just projecting.) I can’t fathom how any vendor would treat the pilot as anything but their opportunity to put their best foot forward. I think this IS the best foot we’re going to get from these guys. It’s a test and the grade is F. (Vaporware?)

When I was at Epic, this is why I didn’t want Epic to win the DoD bid. There is no way Epic could’ve gotten the level of control they normally have over the project, which is still (unfortunately) necessary to get decent results.(Dodged a Bullet)

We can all bash Cerner as much as we want, and they have earned their fair share of the blame, but the fact is it didn’t matter who won this bid, we still would have had major issues using a commercial product in the Government arena. At its core, the problem isn’t Cerner, Epic, or any of the actual technology vendors. It’s the federal government, an organization that continues to go unchecked. (Associate CIO)

The Big Winner here is Leidos which holds the contracts for the DoD in place systems (CHCS the current EMR, which Leidos/SAIC says it claims proprietary IP rights and won’t let any other company touch) and other third-party applications. Contracts for development, support, and sustainment. So, the Big Whiner is Cerner. Why? Because it’s in Leidos’ best interest to slow play the DoD as long as humanly possible. The MHS Genesis project will run horribly over budget and Cerner will take a black eye and whine about it the whole time. (Big Winner Big Whiner)


Watercooler Talk Tidbits

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Readers funded the DonorsChoose teacher grant request of Mrs. J in Arkansas, who asked for three programmable robots for her third grade class. She reports, “The Ozobots are amazing! My students have gone crazy over them. They are using color coding markers to manipulate and program the robots, coding them to make different moves and change colors. My students are collaborating, thinking critically, and working together while they experiment and learn to code. All of these skills are critical in preparing them for their future.”

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Also checking in was Mrs. M from North Carolina, who asked for 20 Hear Myself Sound Phones for her first graders. She says, “It was a dream of ours that we never thought would be possible. You have made it a reality. They just arrived and the students have already used them. We practiced as a whole group and they could not believe how their voice sounded through the phone. We will use them regularly. It was like they were hearing themselves read for the first time all over again. It was such a joy to watch and we have you to thank for that.”

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I subscribed to Texture even before Apple bought the “Netflix for magazines” company a few weeks back. Its app offers current plus back editions of 200 magazines, allows downloading issues for offline reading, and presents a cool dashboard of new articles that your reading history suggests that you will like, all for $6.95 per month. It replaces subscriptions I had paid for at one time or another, such as Consumer Reports, National Geographic, Wired, Smithsonian, PC World, and Rolling Stone.

A rehab tech at MacNeal Hospital (IL) is sentenced to 10 years in prison for burglarizing the homes of 18 widowed, female patients he was caring for as inpatients after he confirmed with them that they lived alone. Some of the patients are suing the hospital for failing to protect their information.

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The Department of Justice charges a Texas rheumatologist with a $240 million fraud scheme in which he falsely diagnosed patients with rheumatoid arthritis so he could bill for drug administration. The doctor had been reprimanded by the state in 2009 for excessive ordering of lab and radiology tests. The photo above is of his patients’ medical records that were stored in “an unsecured and dilapidated barn” where he tried to hide them from Medicare. The DOJ estimates that the doctor made $50 million from the alleged scam, allowing him to buy extensive commercial and residential real estate in the US and Mexico, two Puerto Vallarta penthouses worth $2 million each, an Aspen condo, a Maserati, and a million-dollar private jet. It’s nice that they caught him, but as usual, puzzling that it took so long under CMS’s pay-and-chase model. His practices are in and near McAllen, Texas, the subject of a 2009 article by Atul Gawande in which Gawande noted that the tiny, poor town had the highest medical costs in the US other than Miami, which Texas locals attributed to everything from malpractice costs to overuse to fraud.

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In another DOJ action, the former CEO, CFO, and executive director of now-bankrupt NJ-based medical billing company Constellation Healthcare are charged with an elaborate $300 million investment fraud scheme. The FBI arrested former CEO Parmjit Parmar — who also runs an investment firm, is an investor in Cancer Treatment Services International, was producer of “Before the Devil Knows You’re Dead,” and is a former fighter pilot with his own fleet of jets and aviation company who claimed to make more than $1 billion per year — near his 39,000 square foot mansion that he apparently was able to keep despite a 2011 foreclosure for the $26 million he still owed on the property. He reported in a 2008 interview that the recession “doesn’t affect me at all,” having just purchased a new Bentley for himself and a BMW for his girlfriend even as he was spending $20 million to build a tiger refuge in Texas.

A former MD Anderson research assistant – now a school nurse – is found by the federal government to have submitted her own falsely labeled blood samples for those of 98 research study participants, requiring the resulting studies to be retracted.


In Case You Missed It


Get Involved


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Comments Off on Weekender 5/18/18

Morning Headlines 5/18/18

May 17, 2018 Headlines Comments Off on Morning Headlines 5/18/18

Statement by Acting Secretary Robert Wilkie – VA signs contract with Cerner for an electronic health record system

Acting VA Secretary Robert Wilkie signs a 10-year, $10 billion contract with Cerner, saying its system will allow patient data to be “seamlessly shared between VA, DoD, and community providers.”

Report: Long waits for health care, outdated technology at Vaughn prison

An assessment of the healthcare services at Delaware-based Vaughn Correctional Center (where inmates last year led a deadly uprising) produces a long list of EHR-related problems, including poor connectivity, inefficient workflows, and numerous workarounds.

FDA reports quality problems for data provided by the firm IQVIA that were used to inform estimates for some controlled substances

FDA says data vendor IQvia has for years provided it with incorrect national opioid dispensing data, as calculation errors “raise serious concerns about systemic issues with IQvia’s data and quality control procedures.”

Comments Off on Morning Headlines 5/18/18

News 5/18/18

May 17, 2018 News 2 Comments

Top News

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Acting VA Secretary Robert Wilkie signs a 10-year, $10 billion contract with Cerner, saying its system will allow patient data to be “seamlessly shared between VA, DoD, and community providers.”

Wilkie adds that VA “will add capabilities as necessary to meet the special needs of veterans, VA clinicians, and our community care partners” and will collaborate with the DoD to share lessons learned.

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Wilkie said in the announcement, “President Trump has made very clear to me that he wants this contract to do right by both veterans and taxpayers, and I can say now without a doubt that it does.”

Cerner President Zane Burke said in an announcement that the company’s technology “has been deployed successfully at Department of Defense (DoD) medical facilities and thousands of provider sites globally … My thanks to the administration for selecting Cerner to collaborate in creating seamless care as service members transition from active duty to VA medical centers and community providers. We expect this program to be a positive catalyst for interoperability across the public and private health care sectors, and we look forward to moving quickly with organizations across the industry to deliver on the promise of this mission.”

The total project cost has been estimated at $16 billion. Cerner will serve as its own prime contractor.


Reader Comments

From Pilsner: “Re: Epic. Heard they have acquired a small revenue cycle form to jump start a outsourced services offering.” Not true, according to a company contact that I was kind of embarrassed to ask given the near-certainty that this didn’t actually happen. Which it didn’t — Epic has never acquired another company and I don’t expect that to change.


HIStalk Announcements and Requests

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I have zero responses to this week’s “Wish I’d Known” question, so it will be a skip week unless folks weigh in over the next day or two.

Here’s the recording of this week’s webinar titled “You Think You Might Want to Be a Consultant?” with Frank Poggio.


Webinars

May 24 (Thursday) 1:00 ET. “Converting Consumers into Patients: Strategies for Creating Engaging Digital Experiences People Demand.” Sponsor: Healthwise. Presenters: Antonia Chappell, director of consumer solutions, Healthwise; Josh Schlaich, senior product manager, Healthwise. Nearly three-quarters of US adults use a digital channel to manage their health and the internet to track down health information. It’s clear that consumers have come to expect online interactions as an integral part of their overall patient experience. In fact, the Internet may be the first way people come in contact with your organization. They have more choice than ever on where to get healthcare services, and their decisions are increasingly influenced by how well organizations connect with them in the digital space. This webinar will show you how to create engaging digital and web experiences that convert casual consumers into patients and keep them satisfied throughout their entire patient journey.

June 5 (Tuesday) 1:00 ET. “Increase Referrals and Patient Satisfaction with a Smarter ‘Find a Doctor’ Web Search.” Sponsors: Phynd Technologies, Healthwise. Presenters: Joseph H. Schneider, MD, MBA, FAAP, retired SVP/CHIO, Indiana University Health; Keith Belton, VP of marketing, Phynd. A recent survey found that 84 percent of patients check a hospital’s website before booking an appointment. However, ‘Find a Doctor’ search functions often frustrate them because their matching functionality is primitive and the provider’s information is incomplete or outdated. Referring physicians need similarly robust tools to find the right specialist and to send the patient to the right location. Attendees of this webinar will learn how taxonomy-driven Provider Information Management improves patient and referrer satisfaction by intelligently incorporating the provider’s location, insurance coverage, specialty and subspecialty, and services offered that can be searched via patient-friendly terms.

Previous webinars are on our YouTube channel. Contact Lorre for information.


Acquisitions, Funding, Business, and Stock

The search for a CEO for the proposed joint healthcare venture of Amazon, Berkshire Hathway, and JPMorgan (or as Gizmodo likes to call it, the incredibly vague healthcare company of rich guys) stalls as the companies change their recruiting tactics to focus on someone with entrepreneurial experience. Payer and policy experts like Todd Park, Andy Slavitt, and Gary Loveman were on the initial wish list, as was entrepreneur and Grand Rounds Health CEO Owen Tripp, who has downplayed any interest in the position.


People

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Dennis Cail (Trintech) joins Nordic as VP of ERP solutions.


Sales

  • Faith Regional Health Services (NE) will implement Epic over the next 18 months through a purchasing arrangement with Nebraska Medicine.
  • Crisp Regional Health (GA) will deploy Cerner Millenium across its ambulatory, acute, and post-acute facilities.
  • Arkansas Surgical Hospital (AR) chooses perioperative software from Picis Clinical Solutions.

Announcements and Implementations

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Holy Cross Hospital (NM) implements Wellsoft’s EDIS.


Government and Politics

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Democrats call for the ouster of acting VA CIO Camilo Sandoval as part of an overall outcry about the lack of effective leadership they believe has led to agency waffling on the proposed Cerner EHR contract. Sandoval’s time as director of data operations for the Trump campaign while it was contracting with Cambridge Analytica and $25 million lawsuit filed against him for discrimination and harassment against campaign staffers have led the lawmakers to declare he “should be put nowhere near veterans’ health and benefits data.”

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An assessment of Delaware-based Vaughn Correctional Center’s healthcare services produces a long list of EHR-related problems, including poor connectivity, inefficient workflows, and numerous workarounds. One healthcare employee, who typically sees between 12 and 15 patients a day, reported spending 80 to 100 hours each week on documentation. Vaughn prisoners, who have complained of inordinately long appointment wait times, led a violent uprising last year that resulted in the death of a correctional officer.

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FDA says data vendor IQvia has for years provided it with incorrect national opioid dispensing data, as calculation errors “raise serious concerns about systemic issues with IQvia’s data and quality control procedures.” The agency is demanding a third-party audit of the company’s procedures. IQvia was known as QuintilesIMS until a November 2017 name change. Shares of the Durham, NC-based research company trade on the NYSE at a market cap of $20 billion.


Privacy and Security

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In Houston, the University of Texas Health Science Center alerts patients that an email sent last week announcing the departure of a physician at its Davis Clinic mistakenly exposed 2,800 patient email addresses.

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LifeBridge Health (MD) notifies patients of a September 2016 malware attack on the server that hosts its registration and billing systems, and the EHR used by its Potomac Professionals group. The health system, which detected the breach on March 18, has since enhanced password protocols and its cybersecurity system. CIO Tressa Springmann says the breach was the work of an external entity and that the organization is on a communications offensive in an effort to be transparent about the incident.

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The EU’s General Data Protecting Regulation goes into effect next Friday, making it a good time to review earlier guidance from Advisory Board that compares it to HIPAA. My interpretation is different from theirs – they say it applies to a US provider delivering care to anyone hailing from a EU country, while I read it as being only for patients who are physically in an EU country at the time services are rendered (telemedicine, website use, and marketing sign-ups are the only use cases I can think of).


Other

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In Australia, SA Health brings in 30 staffers to help clear a data entry pileup brought on by burdensome data entry requirements of the $37 million Cerner enterprise pathology laboratory information system it implemented last year. The backlog has caused delays in getting test results to patients, and in some cases, lost results. SA Health is in the midst of a 10-year, $471 million Allscripts EPAS roll out, which has also been plagued with problems and political hand-wringing.

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A federal jury convicts Suresh Mitta and several co-conspirators for their roles in Cerner impersonation schemes that included selling a fake MRI machine to Dallas Medical Center for $1 million. Mitta even sued an international tech company under the guise of Cerner LLC, ultimately winning $24 million. UPDATE: Suresh Mitta died in the custody of US Marshals hours after his conviction, with law enforcement officials saying it appears he had a seizure in the cell he shared with other prisoners.

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Columbia University Medical Center raises the ire of some ethicists by creating a family tree from inpatient EHR data – including each patient’s emergency contact along with more obvious connections such as mother-child status – to study inherited conditions. “It’s a way of looking at genetics but without having any genetic data,” one author said of the assumption that emergency contacts are often blood relatives. Bioethicists object that those emergency contacts did not give their consent (one compared the study to Cambridge Analytica) and observe the irony in finding “information to help your health, but we’re not going to give you that information.” Columbia is sharing its 2-million de-identified patient record database and its algorithms for detecting family relationships for similar studies. The authors say they can now say as a result that runny noses are inherited, although they admit that they can’t discern shared environmental issues or the possibility that the EHR does not list all conditions.

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Anesthesiologist and Surgeon General Jerome Adams, MD comes to the aid of a Delta passenger who had lost, then regained consciousness before takeoff. Adams, with help from two nurses, saw that the passenger was taken back to the gate and on to a hospital.


Sponsor Updates

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  • The Lightbeam Health Solutions team packs 5,625 meals for distribution by the North Texas Food Bank.
  • Diameter Health becomes a Group Solution Partner of the Strategic Health Information Exchange Collaborative.
  • PokitDok adds its real-time health insurance eligibility app to the Salesforce AppExchange.
  • Learn on Demand Systems becomes the official lab provider or the Veeam Certified Engineer technical certification program.
  • Medicomp Systems will host Medicomp U May 21-24 in Reston, VA.
  • National Decision Support Co. will exhibit at the NPSF Annual Patient Safety Conference May 23-25 in Boston.
  • Netsmart will exhibit at the LeadingAge TX Annual Conference May 22 in San Antonio.
  • Optimum Healthcare IT will sponsor and present sessions at Health IT Expo May 30-June 1 in New Orleans.
  • Hewlett Packard Enterprise names CloudWave and its customer, Upson Regional Medical Center, the Grand Prize Winner of its 2018 Awards for Customer Excellence.
  • Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the E-Health Conference & Tradeshow May 27-30 in Vancouver.
  • Gartner recognizes Healthfinch and Redox as one of its “2018 Cool Vendors in Healthcare Providers.”
  • Platinum System adds Solutionreach’s patient relationship management capabilities to its practice management and EHR software for chiropractors.
  • Healthwise partners with XG Health Solutions to deliver evidence-based assessment and care plan content to payers via Epic’s Healthy Planet software.
  • Phynd publishes a new white paper, “Solving the Health System Network Management Challenge with High Quality Provider Information.”
  • Vecna adds Imprivata’s biometric palm vein scanning technology to its patient check-in platform.
  • In the UAE, Healthpoint implements GetWellNetwork’s interactive patient care system.

Blog Posts

Sponsors Named to Modern Healthcare’s “Best Places to Work in Healthcare 2018”

  • Burwood Group
  • CTG
  • Cumberland Consulting Group
  • Divurgent
  • Experian Health
  • Health Catalyst
  • Huron
  • Impact Advisors
  • Pivot Point Consulting, A Vaco Company
  • PMD
  • ROI Healthcare Solutions
  • Santa Rosa Consulting
  • The Chartis Group

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates. Send news or rumors.
Contact us.

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EPtalk by Dr. Jayne 5/17/18

May 17, 2018 Dr. Jayne Comments Off on EPtalk by Dr. Jayne 5/17/18

An opinion piece in the Annals of Internal Medicine provides data on what many refer to as “note bloat” in clinical documentation. Documentation in the US often contains information needed for billing or to meet regulatory requirements that doesn’t materially contribute to the care of the patient. The authors note different attitudes towards EHRs in the US compared to other countries, where physicians may be excited about using them to enhance patient care rather than viewing them as burdensome, and recommend strategies that many of us have been recommending since the dawn of EHRs, such as shifting administrative tasks away from physicians. My favorite quote from the authors: “Although EHRs have great potential to improve care, they may also have perverse effects.”

Alex Azar, Secretary of the US Department of Health & Human Services, spoke this week on drug pricing. He starts out by noting that pharmaceutical manufacturers are “one of the most aggressive industries when it comes to lobbying.” The proposals he highlighted include:

  • Improved competition – positioning the FDA to “stop drug manufacturers from gaming our patent system to block generic competitors.” This includes allowing generic manufacturers to have access to samples of the branded drug so they can perform the testing needed to receive approval for generics. Manufacturers who abuse the system are to be publicly identified.
  • Lower out-of-pocket costs – preventing pharmacy benefit manufacturers from enacting gag clauses with pharmacies, which would allow pharmacists to tell patients when they could get a drug cheaper by paying cash than using insurance.
  • Enhanced negotiation – giving Medicare the ability to negotiate drug prices, starting with certain classes of drugs that are relatively protected under Medicare Part D and also for drugs covered under Medicare Part B which are administered in physician offices. There is also a plan to merge Part B into Part D.
  • Incentives for lower list prices – changing how indicators like the Average Manufacturer Price are used in creating drug pricing. The AMP is inflated compared to what private payers are actually paying, since there are often rebates involved.

He also mentions addressing how drug companies reach out to the public, working to require pricing information when there is direct-to-consumer advertising. He calls on pharmaceutical manufacturers to do this now, including the list price in advertising, before it’s mandatory. I’d go a little farther: let’s stop direct-to-consumer (DTC) advertising altogether. Since DTC advertising started, I can count the beneficial patient-driven conversations I’ve had as a result of advertising on one hand. Conversely, I can’t begin the estimate the number of conversations I’ve had about DTC-marketed drugs not being right for a patient or having significant risks or cost issues.

While we’re at it, let’s create systems to prevent the US Food and Drug Administration from being gamed during the drug approval process. When we have drugs that have been effective for years and cost pennies, such as colchicine, don’t let drug companies play games where they send those drugs through the system again and are allowed to sell them at a tremendous markup (Colcrys), making patients wait years for a generic to return only to see it more expensive than the original generic. Most of the physicians I talked to about the proposals are in the “I’ll believe it when I see it” camp, noting that Azar’s past roles included being a pharma executive and serving on the board of directors of a pharmaceutical / biotechnology industry lobbying organization.

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I don’t know who Ron Carucci is, but I think he’s planted listening devices at some of my clients. His excellent piece on how leaders create toxic cultures highlights some phenomena I see more often than I’d like. He calls out “scattered priorities” as a major issue. I see this in nearly every client I engage. Rather than doing a few key initiatives well, leaders overcommit. This tends to result in either under-delivering as they try to move dozens of initiatives an inch at a time or a frantic scramble to try to meet deadlines that were unrealistic to begin with.

Whenever I hear about leaders being double-booked or having to constantly shuffle meetings due to conflicts, there is usually a prioritization problem. This is often manifested through lack of regular leadership meetings and lack of agreement on team priorities. Those teams that do meet may have ineffective meeting dynamics and don’t accomplish much during their time together.

Another issue Carucci identifies is “unhealthy rivalries” and I see this as well, usually when teams have similar goals but may be competing for scarce resources or precious time with end-user champions. I also see it in organizations where one team ends up being rewarded for work that is performed by others. For example, a sales team member who receives a hefty commission for closing a deal with the support of analysts, programmers, and other staff who don’t get to share in the monetary rewards.

Oversharing and the blurring of work/personal lives on social media platforms such as Facebook may exacerbate this. A couple of years ago, I was working with a vendor sales rep who constantly talked on social media about his extensive car collection. It was a hot topic in the office as staffers Googled the value of the cars he owned (well over $1M) and talked about how unappreciative he was towards the workers who helped enable the sales that paid for his hobby. The culture around this rep was positively toxic, yet one of his peers who generated more sales but acted with humility never had his motives questioned.

He also talks about unproductive conflict, which to me extends to mismanagement of conflict. Companies that sweep HR issues or workplace complaints under the rug aren’t doing themselves or their employees any favors. He mentions workers who talk behind one another’s backs, along with holding back on opinions or vetoing decisions after they are made. I’d add the “meeting after the meeting” crowd to this bunch, when people who don’t show up are given the ability to change the course of decisions made by those who made the time to be part of the process. I urge people to think about whether they exhibit some of these traits or whether they’re present in company culture. Many of our organizations have an opportunity to make a change for the better.

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I enjoy reading stories about people who selflessly give to help others, and this one definitely merits a mention. An Australian man has been donating blood for over sixty years, with a total of 1,173 donations. His blood contains a rare antibody used to treat hemolytic disease of the newborn and it’s estimated that over 2.4 million babies have received treatments derived from his donations. At 81, he exceeds the maximum donor age and has been officially retired off the Red Cross rolls, but his legacy will live on in the babies treated, including two of his own grandchildren.

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Morning Headlines 5/17/18

May 16, 2018 Headlines Comments Off on Morning Headlines 5/17/18

Jury Convicts Texas Man of $19 Million Fraud Scheme

A federal jury convicts Suresh Mitta and several co-conspirators for their roles in Cerner impersonation schemes that included selling a fake MRI machine to Dallas Medical Center for $1 million.

The Bezos-Buffett-Dimon joint venture to save health care is struggling to find a CEO

The search for a CEO to lead the proposed joint healthcare venture of Amazon, Berkshire Hathway, and JPMorgan stalls as the companies change their recruiting tactics to focus on someone with entrepreneurial experience.

LifeBridge Health and LifeBridge Potomac Professionals Notify Patients of a Recent Security Incident

LifeBridge Health (MD) notifies patients of a September 2016 malware attack on its registration and billing systems, and the EHR used by its Potomac Professionals group.

Democrats call for firing of VA’s top technology official

A group of Democrats call for the ouster of acting VA CIO Camilo Sandoval as part of an overall outcry about the lack of effective leadership (and staff) that they believe has led to agency waffling on whether or not to move forward with the Cerner EHR contract.

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Readers Write: Creating Clarity from Confusion: The Importance of Healthcare Price Transparency

May 16, 2018 Readers Write 5 Comments

Creating Clarity from Confusion: The Importance of Healthcare Price Transparency
By Rajesh Voddiraju

Rajesh Voddiraju is founder and CEO of Health IPass of Oak Brook, IL.

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Picture this. It’s Saturday night and you’ve decided to try a new restaurant. You pick up the menu, only to discover that there are no prices listed for any of the items. When you flag down a member of the wait staff to inquire about the cost of an item to order , their response is to shrug and say, “I’m sorry, but we aren’t authorized to tell you the prices of our menu items. You will have to have to contact the company that prints the menu to to find out about that.”

You have no idea who to call or what to expect. However, you are hungry, so you order a hamburger, which seems like a safe, economical choice, only to be billed $50 for it weeks later. Of course, had you known the hamburger would cost $50, you might have ordered something else or even found a different restaurant, but now you are stuck paying an unexpected bill. How long would a restaurant with these businesses practices stay open? Not very long, that’s for sure.

Yet this is exactly the situation patients face when they enter most healthcare provider offices. There is no menu of medical procedures with prices clearly labeled. Patients are essentially presented with a choice—face the unknown of paying for healthcare or forgo it altogether.

This lack of price transparency is one of the reasons that people avoid regular preventative care, which in turn leads to a higher incidence of preventable disease. The chain reaction goes on from there. The ultimate effects of uncertain healthcare costs are more far-reaching and devastating than most Americans realize, to the detriment of patients, providers, and the healthcare industry as a whole.

The clear loser in land of opaque healthcare pricing is the patient. Just as the aforementioned diner is left feeling frustrated and helpless by a menu without prices, so too is the uninformed healthcare consumer. The main difference between the restaurant scenario mentioned above and the plight of the healthcare consumer is while a restaurant with such questionable practices would undoubtedly go out of business, the lack of price transparency in healthcare has been considered the status quo.

For years, Americans have grown to accept that medical billing and payment was a mysterious and complex process where prices were kept secret and the ability to review and evaluate the cost of care prior to treatment was non-existent. Fortunately, state policymakers have begun to recognize the urgent need for greater price transparency in healthcare and are beginning to enact legislation that mandates medical providers publish their prices for some of the most common procedures and treatments offered.

For example, at the state level, Colorado Senate Bill 65 went into effect January 1, 2018, requiring hospitals to post self-pay prices for their most common procedures and treatments. Health and Human Services (HHS) Secretary Alex Azar is leading the federal charge toward greater healthcare price transparency as evidenced by his comments at the May 2018 World Health Care Congress, which stressed the importance of lowering drug costs, the consideration of new healthcare models, and free-market forces as a determinant for value-based care. If this trend towards price transparency in healthcare continues to gain momentum, American healthcare consumers will be more informed to make smarter decisions about their care and extract the highest amount of value from out-of-pocket expenditures.

With greater healthcare price transparency, patients go from confused and frustrated to supported and empowered. Informed healthcare consumers are better able to plan and budget for major medical expenses. In addition, when patients are aware of costs, they are more likely to meet their healthcare financial responsibilities, meaning less crippling patient medical debt that burdens the entire system and increased revenue for providers, allowing them to keep their doors open.

As the healthcare industry becomes increasingly consumer-driven, increased price transparency has yet another important function for medical providers – it has become a major piece of the patient retention puzzle. Providers build trust when they are upfront about the cost of care, leading to better, more sustainable positive relationships between patients and provider.

Due to factors such as the 24-hour news cycle and the escalating use of social media, Americans have become more aware of healthcare system deficiencies and weaknesses that inhibit the effective and affordable administration of care. As healthcare costs skyrocket, patients and legislators alike are searching for ways to increase the quality of care. The push for greater price transparency into the cost of care is partly grounded in the move towards value-based care that rewards quality rather than the traditional model of fee-for-service that incentivizes providers to call for tests and procedures that may not be necessary. Price transparency plays a key role in the transition to value-based care because the transition relies on patient access to all care-related data, including medical records and costs.

Price transparency has more than just an educational value for the patient. It has the power to actually lower the cost of healthcare. According to the Robert Woods Johnson Foundation, “Health economists and other experts are convinced that significant cost containment cannot occur without widespread and sustained transparency in provider prices.”

The bottom line is that the modern healthcare consumer refuses to remain captive in an enigmatic healthcare system with a seemingly arbitrary cost structure. Just as the restaurant at the beginning of this article is likely doomed to go out of business due to its suspicious business practices, providers who fail to adapt to changing consumer expectations will suffer negative consequences. Changes are on the horizon for all healthcare providers as healthcare policy begins to catch up to public demand. Savvy healthcare providers will see the writing on the wall and implement healthcare price transparency now, before it becomes a mandate.

HIStalk Interviews Raul Villar, CEO, AdvancedMD

May 16, 2018 Interviews Comments Off on HIStalk Interviews Raul Villar, CEO, AdvancedMD

Raul Villar is CEO of AdvancedMD of South Jordan, UT.

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Tell me about yourself and the company.

I’m the CEO of AdvancedMD. I’ve been with the company for the past seven years. AdvancedMD provides integrated, end-to-end solutions to the ambulatory market.

How would you describe the ambulatory EHR/PM market?

From a market perspective, we focus on independent physicians. We think the market is strong and growing. Some of the things that we’ve seen over the past four or five years are an explosion in mental health and physical therapy providers. Also, we continue to see about 20-25,000 new entrants in traditional primary care physicians.

The market itself is growing. We size the market at about 1.6 million doctors that we think are eligible to be on the AdvancedMD system.

Where does the opportunity come from?

We see the opportunity coming from all segments. When we break it down, there are definitely still new entrants into the market. New entrants are excited about cloud opportunities. They tend to be more open to new technology. There’s a whole bunch of folks who are on existing cloud solutions and we see those as great opportunities.

In the ambulatory space, the largest component of ambulatory is still running on-premise solutions, legacy solutions that they bought decades ago. Ultimately over time, as they look for new solutions, they tend to be great opportunities for companies like us.

How much penetration do cloud-based systems have in independent practices?

I would say cloud today is about 25 percent of the market. Like anything else in our day-to-day lives, we’re all becoming more attuned to leveraging the cloud. whether it be for personal enjoyment, music, TV, movies, banking, and those type of things. As people become more comfortable and familiar with the cloud and cloud technology, it is becoming more acceptable.

As the demographics of physicians change, the newer physicians want new technology. They grew up with it. We’re seeing that. It’s not 100 percent there, obviously. A big bulk of the physicians are in their 50s and 60s. Over time, that transition to technology will continue to evolve. In healthcare, it’s probably slower than anywhere else. I think we would all admit that in healthcare, with the sensitivity of the information and the data, people need to feel comfortable that they’re going to be able to provide service.

We’re seeing fewer and fewer objections to the cloud. It’s more about, how does your work flow help our practice? That has become the question. When I came here seven years ago, it was more about, is the cloud safe? Is my data going to get stolen? Am I going to have service? Am I ever going to be down? Now, it’s more about, tell me about the workflow of your solutions. Tell me how you can help us collect more for our claims and how can you help us with all of the government regulations that continue to pour down on the heads of the independent physicians.

How has usability affected physician EHR acceptance?

I’m kind of in the middle on the topic. The first-generation clinical solutions that we all developed, including AdvancedMD, were built to government regulation, not to physician workflow. It was frustrating to the physician to have to enter a lot of information that didn’t necessarily help patient care or help them with a diagnosis. The second generation of clinical solutions that companies like ours are developing are much more user friendly, easier to use, and enable physicians to create the workflow that works best for them.

No workflow is the same for any physician. Every physician has their nuances. For them to continue to embrace clinical solutions, we have to reduce the number of clicks. We have to clean up the user interface and make it easy for them to document the information and also learn from the information. That’s where the power is. How can they become more effective, because all the data is in one place and they can see it like they used to see with a chart?

Ultimately, we have to make the online clinical solutions as easy as a chart was for them to look at, understand the patient situation, and make the correct diagnosis based on the information provided. Most of the progressive vendors are making those changes in their new-generation clinical solutions. We’ll continue to see better adoption. It will also help with chronic care management and care management in general. That’s the critical component in healthcare. If we can all do a better job of making it easier for the physician to understand the information in an easy and simple format, it will be much more effective.

Is outsourced revenue cycle management growing?

Yes. Everyone is under pressure. We’re asking physicians to do more for less. It’s not a great place to be, from a profession perspective. The new dynamics of doing more for less and more regulatory overhang and more requirements to be reimbursed for what they did is putting a lot more pressure and creating demand for revenue cycle management.

Revenue cycle management though comes in two flavors. There’s software technology like ours that enables people to do it themselves with simple, intuitive tools. Then there’s also that same software wrapped with services. It really depends on the physician and their staff as to which they prefer. Some prefer to do it themselves and manage the ecosystem. Others want you to follow up and make sure that all the denials are resubmitted and they’re maximizing their reimbursements.

There’s interest in general in maximizing reimbursements. It’s done through software and it’s done through services. That’s really a behavioral decision by a physician of what they like. Some people like to do everything in house, some people like to outsource, and some people like to co-source. Our job is to be flexible enough to enable physicians to use any of the models that they feel most comfortable with.

It changes as their staff changes. Sometimes they may have an experienced biller and they want to do it in-house because they know how it works, they know their procedure codes, and they know their insurance companies. They have that dynamic tied down. But then there may be turnover and they’re replaced by someone who’s new and not as sophisticated. At that point, they may want to leverage services to help them follow up on denials. It’s about providing flexibility to the provider and letting them choose what solution they prefer.

How much information exchange do you see happening between your users and health systems?

We see a lot of that, and we’re seeing more and more of it. Our philosophy has been that we have to provide all the information to users so they can export it to whatever health systems or health organization that they want. We haven’t felt like we know what the outcome of healthcare’s going to be, whether it’s ACOs, HIEs, large health systems, or independent providers. There’s a lot of different care settings. Our mantra has been that we have to be able to enable patients and providers to take all their information and be able to port that information to whatever systems they want.

Being in the cloud makes that much easier than if you’re in on an on-premise solution or pen and paper. Ultimately, that’s one of the advantages, that over time, as healthcare becomes more open and data is exchanged more efficiently, it’s only going to help push more people to the cloud because the data’s already in that format. It’s easy for us to share data across systems.

You offer a physician reputation management system. Is that important to medical practices?

Today, it’s an emerging concept. If we think about what’s really going on in the macro environment, as high-deductible health plans continue to increase and the consumer is forced to pay more, then the consumer is going to care more about who they’re meeting with, how much it costs, and then how much they’re going to be reimbursed.

Independent physicians historically have been able to plant the flag where they’re located. They generate their clients within a 10-15 mile radius, depending on the density of the city they live in. That’s changing. People now are willing to go online. We’ve seen it in other industries, such as restaurants with Yelp. People want to go online, get a review, see where they’re located, see what it costs, and see the menu. We’re going to see the same transformation in healthcare. The demand is coming from the patient. As the patient has to pay more, the patient is going to have more questions.

None of us five years ago were that focused on how much an encounter would cost us. It was going to be paid for by someone else. As that share gets pushed to the consumer, they’re going to care more. Our physicians have come to us and said, we would love to be able to have our patients tell us how we’re doing after every encounter. If we’re doing really well, great. If we’re not doing well, we need to know. Sometimes in a practice, the breakdown can happen in the waiting room. It can happen at the front desk. It can happen with the nurse practitioner or medical assistant or it could be with the physician.

There’s a lot of different pain points. There’s a lot of people involved in delivering healthcare. The more information that physicians have, they can help to modify what’s going on in their practice and use it as a tool to attract more patients. We believe that physicians are going to need to compete for patients in the future. Today, it’s more on the come, but we’ve seen that people are extremely interested in it. They’re using it in their personal lives for a lot of different services. This is a very easy transition for independent physicians.

Where do you see the company going in the next five years?

AdvancedMD will continue to expand its product set. We’ll continue to deliver an integrated, end-to-end solution that includes practice management, revenue cycle, clinical solutions, reputation management, and patient engagement tools. We’ll continue to deliver that to independent physicians.

From our perspective, healthcare doesn’t need to be complicated. If we all work together, we can find a way to treat more patients more effectively and more efficiently. We’re just happy to be a very small part of that equation.

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Readers Write: Can Appropriate Prescribing Practices Curb the Opioid Crisis?

May 16, 2018 Readers Write 4 Comments

Can Appropriate Prescribing Practices Curb the Opioid Crisis?
By Victor Lee, MD

Victor Lee, MD is VP of clinical informatics at Clinical Architecture of Carmel, IN.

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According to a 2014 report from the National Institute on Drug Abuse, the misuse and abuse of opioids is associated with a staggering number of emergency department visits, hospitalizations, overdose deaths, and many other adverse outcomes. Altarum estimates the economic impact from 2001 to 2017 to be more than $1 trillion, with a projected $500 billion of additional cost through 2020 at current rates. The White House Council of Economic Advisers estimates a burden of $504 billion in 2015, stating that prior estimates of the economic costs of the opioid crisis undervalue overdose fatalities. On October 26, 2017, The United States Department of Health and Human Services declared the opioid crisis to be a nationwide public health emergency.

There are efforts to combat the opioid crisis at many levels, including government (federal, state, and local), professional societies, health systems, health plans, academic institutions, and health IT vendors. Let’s look at a few selected recent events. The President’s Commission on Combating Drug Addiction and the Opioid Crisis provides a multifaceted set of 56 recommendations across categories that address federal funding, prevention, and treatment of opioid addiction. The Centers for Medicare & Medicaid Services issued a final rule which implements the Comprehensive Addiction and Recovery Act of 2016 and states, “a sponsor can limit at-risk beneficiaries’ access to coverage for frequently abused drugs beginning with the 2019 plan year. CMS will designate opioids and benzodiazepines as frequently abused drugs.” The Institute for Healthcare Improvement summarizes four main drivers to reduce opioid use, one of which is to limit the supply of opioids.

The Role of Opioid Prescribing as a Contributor

Why is it necessary to limit the supply of opioids? There is clear evidence that the prescription of opioids for pain management is a major driving force of the opioid crisis in the United States. A case-cohort study by Bohnert et al (2011) links higher opioid doses with opioid overdose death among US veterans. A retrospective cohort study by Brat et al (2018) shows that compared with opioid dosage, opioid prescription duration is even more strongly associated with misuse and overdose in a general surgery population. Findings from a series of structured interviews by Cicero et al (2017) reveal no qualitative differences in the onset and progression of opioid substance use disorder between medically treated patients and recreational opioid users. A review article by Compton et al (2016) provides further discussion of opioid prescriptions resulting in non-medical opioid and heroin use and cites numerous references.

Perhaps the most comprehensive review of risk factors for prescription drug misuse is provided in a 2017 publication by the Substance Abuse and Mental Health Services Administration. In summary, the body of research on prescription opioids shows a consistent link with resultant substance use disorder. This suggests that the demand side of the opioid crisis is critically important to address.

A Potential Solution

Prescribers of opioid medications are in an excellent position to fight the opioid crisis. While there are numerous evidence-based guidelines, a reasonable starting point would be to follow the “CDC Guideline for Prescribing Opioids for Chronic Pain” for appropriately selected patients. Recognizing that other opioid prescribing guidelines exist, the CDC guidelines are most commonly referred to by numerous organizations as part of a multifaceted approach to mitigating the opioid crisis.

While guidelines, clinical trials, reviews, and other literature may be widely available, they are not always translated into practice when applicable. This is where clinical decision support (CDS) may help. Kawamoto et al (2005) systematically reviewed the literature and found that the automatic provision of CDS as part of clinician workflow is 112.1 times more likely to improve clinical practice as compared with control groups (P< 0.00001).

CDS can lower the barrier to adhering to certain CDC recommendations such as:

  • Calculating morphine milligram equivalents (MME) dosages and justifying decisions to use ≥ 50 MME/day or ≥ 90 MME/day
  • Identifying risk factors for opioid overdose and considering of naloxone as part of an opioid management plan
  • Applying other prescribing best practices from the CDC’s 12 recommendations

We’re In This Together

While there are other ways to address the opioid crisis — such as national legislative / regulatory action, statewide technology implementation of prescription drug monitoring programs, and treatment of substance use disorder — there is also an opportunity to prevent opioid overutilization in the first place. If a bathtub is overflowing, the question is not whether to turn off the water, unplug the drain, or to mop up the water—the question is how to do all of these things in the most expedient way to address the problem.

Similarly, lawmakers, administrators, technologists, clinicians, and patients can work together to contribute their efforts in concert with one another to optimize pain management, minimize opioid overutilization, and to effectively treat substance use disorders.

Readers Write: Five Best Practices for Care Programs for Members

May 16, 2018 Readers Write Comments Off on Readers Write: Five Best Practices for Care Programs for Members

Five Best Practices for Care Programs for Members
By Jessica Schiller, RN, BSN

Jessica Schiller, RN, BSN is director of clinical programs at Wellframe of Boston, MA.

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What if your members had all of the information they need and wanted? Medication regimen, social / lifestyle support, education for their conditions, access to a care manager — all the critical pieces related to their health and care in one place, right at their fingertips?

In many ways, this vision is becoming a reality as digital member engagement has become a high priority focus for care management. A crucial part of sustained engagement is the information that members receive about their health and that care managers utilize to structure interventions. Embracing a modern approach to engagement demands a new paradigm for care programs altogether — designed for members, delivered digitally, and personalized to meet each individual’s needs through digital and human support.

The application of personalized, interactive, member-facing care programs can amplify the medical risk reduction of care management by putting the right information in members’ hands at the right time, in the right format. With this in mind, let’s examine five best practices for care programs for health plan members.

One of the primary frameworks of care management is the care plan. In parallel to the medical record, the care plan is a collection of each member’s health history, diagnoses, problems, goals, and interventions, which evolves over time. Care plans function as decision support tools designed to help care managers structure interventions and methods for member support, typically delivered over the phone.

While they have been effective to date, the transition to member engagement through mobile and digital channels highlights where care plans are deficient: they are only available to the care team. In the booming digital age, members should be allowed to engage with this information directly.

Multi-channel engagement methods present an opportunity to extend part of the care plan directly and digitally to members in a new format adapted for the audience and the channel. We call this new concept a “care program.”

There are five best practices for effective member-facing care programs. These strategies ensure members receive the information they need to stay on track with their health in a way that aligns with their needs. In addition, well-designed member-facing care programs have proven to dramatically increase care team efficiency by saving clinicians valuable time in relaying information to members.

1. Optimize for mobile

  • Create short, interactive content
  • Stick to 400 words or less for engaging clinical articles
  • Hold attention with under-two-minute video stories from peers or tips from their doctor

2. Meet health literacy standards

  • Deliver content at the lowest reading level possible for broad accessibility
  • Write in short sentences with basic structure and simple words
  • Provide definitions for medical terminology
  • Break complex concepts into digestible pieces

3. Be holistic

  • Support the whole person, not just the chronic condition
  • Give members the support they want for lifestyle factors like weight loss, nutrition and Exercise
  • Provide information on key areas of health maintenance like emotional health, safe alcoholuse, and pneumococcal vaccinations, which also relate to HEDIS metrics

4. Deliver content over time

  • Start with foundational topics and build on them over time
  • Begin with must-know information, like what to do in an emergency, the importance of routine follow-ups, and red flags for the member’s condition
  • Progress to education on complications associated with their condition, what their medications do, and psychosocial / lifestyle factors that can impact their day-to-day

5. Enable personalization

  • Adjust care programs to meet the unique needs of each member
  • Ensure educational components are modular and easy to customize
  • Empower care teams to determine what information to send to members

The Outcome of Application

Adhering to these principles for member-facing care programs will generate a positive feedback loop for member engagement that is particularly feasible, cost-effective, and scalable via mobile, particularly when compared to care managers repeating information many times on the phone.

With health education that is personalized, relevant, and accessible, members will engage more often, feel better supported (satisfied), and learn how to self-manage chronic conditions more effectively.

Further, in the context of a therapeutic relationship with their care team, members’ interaction with the care program provides the kernel of insight around which the relationship is able to thrive: everything the member does with the care plan matters and informs better care. In turn, member-facing care programs advance the goals of care management and quality improvement overall, through effective health education to reduce complications, avoid readmissions, and improve outcomes.

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