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EPtalk by Dr. Jayne 4/13/17

April 13, 2017 Dr. Jayne Comments Off on EPtalk by Dr. Jayne 4/13/17

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I unfortunately had to spend some non-quality time this week at the Microsoft Store. The pen for my Surface Pro tablet has been acting up over the last month and all troubleshooting maneuvers have failed. Since I’ve been on the road a lot, I’ve spent more time than I care to admit perusing various support articles, blogs, and commentaries on how to get it back up and running. Although the button was working, the business-end was not, and then the tip started to actually disintegrate. I had to wait until I was in a city that actually has a Microsoft store, and until I had free time during normal store hours to address it.

The staff at the store was eager to greet me, but then when they found out I was (gasp!) an individual consumer and not a corporate or enterprise customer, it started going downhill. The fact that I bought my device at Costco rather than directly from Microsoft was clearly an issue for them, and they made a big deal about not being able to locate the purchase in their system and having to use another system to find me (which they did, in about 20 seconds, so I’m not sure why we needed the drama). They then informed me that I was out of warranty on the pen. Apparently it’s not hard to be out of warranty when the warranty is only 90 days, which is pretty short in my opinion.

The rep did all the troubleshooting I had already done, then replaced the tip, which didn’t make a difference. He then proceeded to tell me he’d have to make me a tech appointment, but didn’t explain what that meant or what the timeframe might be. I was treated like a child when I asked, as if I should know intrinsically what a “Microsoft store tech appointment” expectation might be. As a consultant, I’m sensitive to my hourly rate and how much time and money I’m burning with exercises like this. Knowing the pen was about $50 and that I had been down for weeks and getting to the store when it was open was an ordeal, I asked if I could just buy a new pen and be done with it. He acted like that was the strangest thing he ever heard, then disappeared “to see if there is anything else we can do.”

I appreciate the fact that he was trying to save me money and resolve my issue, but it felt like an odd piece of “service recovery” after the initial stumbles over being an individual consumer and having purchased from a reseller. Ultimately they agreed to warranty the pen and swap it out, which took an additional 15 minutes of paperwork and back and forth. Counting the drive, the trek through the mall, and the troubleshooting, then getting home and back to work, I spent an hour and a half getting a new pen. Adding in the hours of troubleshooting that I did before even going to the store, you can bet that if this one malfunctions in the least I’m going straight to an online order for a new one.

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I mentioned a couple of weeks ago that I was working with a clinical informaticist that was learning the ropes of actually managing a team – dealing with expense reports, vacation approvals, and the other managerial functions that we don’t learn much about in medical school. This week we waded into the minefield that is the annual performance evaluation. I’m a firm believer in the concept that the annual performance review should never be a surprise. It’s important for managers to incorporate the concepts they’ve been discussing with the employee for the last year, and to make overall comments on progress (or lack thereof) but nothing should be a revelation. When there is a transition in managers or a change in job role, this is particularly tricky because one needs to incorporate any available feedback from the previous manager or role.

The good thing is that the time frame for the review process is usually clear, and shouldn’t be a last-minute exercise. Of course there are exceptions to that, such as when my previous employer decided to move everyone from “review on your anniversary date” to “review the entire company all at the same time, STAT,” which was a horrendous exercise I never want to repeat. But in this case, my managerial trainee had well over a month to track down information from previous managers, peruse previous reviews, assess completion of employee goals, etc. We had been talking about the process for a couple of weeks, and he seemed like he was with the program, so I was surprised when I met with him in person and he looked like a cornered animal. He said he had no idea what to do with some of the feedback he received from employees.

The company asks employees to write a one-page summary of their growth and accomplishments over the last year, highlighting successes and what they have learned from challenges. It’s the employee’s opportunity to offer specific details that can bolster a high-scoring review or give a new manager more flavor for what the employee has been working on and how they see themselves. However, it has the potential to be a mine field, because “one page free text” can apparently mean different things to different people. He has more than 20 people on his team, and let’s just say the variability of the personal narratives was striking. The most effective employees provided bulleted lists or well-organized statements, often with supporting quotes from other employees or customers. Those were easy to get through. The ones he wasn’t sure on handling were frankly ones that I wasn’t sure on handling either.

I’ve done a lot of performance reviews, going back to my time as Chief Resident. I can definitely say I’ve never encountered an employee or supervisee who decided to use the annual review as an opportunity to roast the company or provide openly hostile comments about management in writing. Until now, that is. The employees were clearly informed that their statements would be part of their records as part of the annual review process and would be seen by second-level approvers, yet still elected go down this path. Needless to say, after seeing their statements, their objective rankings on “insight” and “professionalism” just went down the tubes. Additionally, if there was a score for Tasseography, they’d score low on that as well. When you openly throw your manager under the bus, and fail to appreciate that your manager has a significant amount of executive support, you’re not doing yourself any favors.

These are the things that as a consultant make you say “hmmmm,” and also ensure the ability to propose ongoing engagements and assistance for your clients. We definitely need some coaching/education for these two employees, as well as creation of performance improvement plans. It’s also the opportunity to assist with the hiring process should they not be able to right themselves. In the short term, I’m going to continue supporting my new manager, and help him build the skills to get through this, manage these folks objectively, and not give in to his emotions. It’s also an opportunity to reflect on giving direction for future reviews. The idea that a review should not be a surprise goes both ways when employee comments are involved.

What’s your wildest performance review story? Email me.

Email Dr. Jayne.

Comments Off on EPtalk by Dr. Jayne 4/13/17

Morning Headlines 4/13/17

April 12, 2017 Headlines 1 Comment

Trump Threatens to Withhold Payments to Insurers to Press Democrats on Health Bill

In an effort to draw Democrats to the healthcare policy negotiation table, President Trump threatens to withhold payments to insurers meant to cover discounts for low-income consumers, explaining “I don’t want people to get hurt. What I think should happen—and will happen—is the Democrats will start calling me and negotiating.”

The Leapfrog Group Releases Groundbreaking Tool to Estimate Lives and Dollars Lost to Medical Errors

The Leapfrog Group launches a calculator designed to illuminate the impact medical errors have on an employer’s covered population. The calculator estimates the number of avoidable deaths among covered lives, how much employers spend annually due to medical errors within general acute care hospitals, and how much of their total health care spend goes to these medical mistakes.

2017 Venrock Healthcare Prognosis

Venrock publishes results from a survey of “a few hundred of the smartest people we know across healthcare” on the future of healthcare under the new administration and the impact legislative changes will have on various healthcare IT subsectors.

ECMC officials remain mute on cause of computer shutdown

Erie County Medical Center (NY) returns to paper after a virus brings down its network. A hospital spokesman refused to comment on speculation that the virus was actually a ransomware attack, and differed questions about whether it had been contacted by hackers or asked for payments to restore access.

Morning Headlines 4/12/17

April 11, 2017 Headlines 1 Comment

How Washington’s favorite cancer fighter helps himself

A Politico investigative report on Patrick Soon-Shiong finds that the majority of funds distributed by the healthcare billionaire’s non-profit, NantHealth Foundation, ultimately flow back into his own businesses. Shares fell 14.4 percent after the report was published Monday, and dropped another 4.7 percent Tuesday. This follows a STAT investigative piece published in March that uncovered similar practices and drove shares down 35 percent following publication.

Association Between Hospitals’ Engagement in Value-Based Reforms and Readmission Reduction in the Hospital Readmission Reduction Program

A longitudinal study published in JAMA finds that participation in one or more of Medicare’s value-based reimbursement programs is associated with reductions in 30-day risk-standardized readmission rates.

SA Health CIO defends EPAS following coroner’s criticism

South Australia Health CIO Bill Le Blanc defends the health system’s EPAS after the state coroner publically complained that the readability and formatting of printed reports are preventing clinicians from effectively doing their jobs.

News 4/12/17

April 11, 2017 News 13 Comments

Top News

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A Kentucky-based physician with a troubled past is hospitalized after being dragged off a United Airlines flight. David Dao, MD was one of four passengers told to get off the overbooked flight to make room for United stand-by employees. Dao refused on the grounds that he needed to get back to Kentucky to see his patients, and was subsequently (and literally) dragged off the airplane by police. While United has faced extreme backlash over its handling of the situation, Dao’s criminal history hasn’t done him any favors when it comes to casting him as an innocent victim. United employees described him as disruptive and belligerent when told he needed to give up his seat. The incident brings up the issue of overbooking policies, which, as one Twitter observer noted, won’t be a problem for United if all their planes are empty.


Reader Comments

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From NantWatcher: “Re: Layoffs at NantHealth. Another round last week – spread across multiple sites, departments, and seniority from entry-level to VP. Roughly 50 impacted.” Unverified, though Politico reports that shares of the company fell 15 percent earlier this week – a circumstance it seems to directly attribute to its exposé of Soon-Shiong and his self-serving philanthropic efforts.

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From NewCrop VP Randy Barnes: “Re: NewCrop losing customers. This is nothing short of FAKE NEWS. NewCrop continues to grow at a steady pace. EHR losses to competitors are extremely rare. What have we been doing? Patient support programs, real-time benefits across a multitude of insurance companies, intelligent prior auths, pharmacogenomics, lab integrations, patient portals, secure communications, immunization registry reporting to support all 50 states, new UI and more.”


Webinars

April 26 (Wednesday) 1:00 ET. “SSM Integrated Health Technologies Clinical Data Migration: Functional and Technical Considerations.” Sponsored by Galen Healthcare Solutions. Presenters: Sandy Winklemann, MHA, RHIA, project manager, SSM Integration Health Technologies; Tyler Mawyer, MHA, managing consultant, Galen Healthcare Solutions; Kavon Kaboli, MPH, senior consultant, Galen Healthcare Solutions. GE Centricity and Meditech to Epic EHR transition. Join us for a complimentary webinar as present the decisions that are important to consider when performing a clinical data migration from the point of view of  the healthcare organization program manager, the clinical analyst, and the technical implementation team. Our expert panel will survey data migration considerations, best practices, and lessons learned. The webinar will present a unique client perspective, offering insight into considerations surrounding staffing, clinical mapping, legacy application support, and validation and testing.

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


Acquisitions, Funding, Business, and Stock

Azalea Health acquires San Diego-based EHR and PM company LeonardoMD for an undisclosed sum.

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A new CB Insights report shows that, while the large majority of digital health funding has gone to US-based startups, young companies globally are also addressing the challenge of improving healthcare. On a quarterly basis, equity funding to private US-based digital health companies saw a 128-percent increase from $768 million in Q4 2016 to $1.75 billion in Q1 2017. Meanwhile, funding to digital health companies outside the US saw a 146-percent increase from $252 million in Q4 2016 to $621 million in Q1 2017. Deals to US-based companies, which picked up at the end of 2016 after taking a dive in Q3 2016, again fell in Q1 2017, down to 147. This marks the second lowest quarter of the last three years. Deals outside the US, however, have surged recently from 55 in Q3 2016 to 102 in Q4 2016 and 104 in Q1 2017.


People

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Impact Advisors promotes Rob Faix and Mike Garzone to vice president.

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Health Catalyst hires Stanley Pestotnik (Pascal Metrics) as VP of patient safety products, and Carolyn Simpkins, MD (BMJ) as CMIO.

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Teri Thomas (UNC Health Care) will join Orion Health in May as EVP for global sales, marketing, and strategy.

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Doug Abel (Encore) has joined North Kansas City Hospital (MO) as CIO.

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Recondo Technology names Dan Grote (ReadyTalk) CFO and Tom Cooke (Advisory Board) (not pictured) VP of channel sales.


Sales

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Lancashire Care NHS Foundation Trust selects UK-based Servelec’s Rio EHR.

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St. Joseph’s Healthcare System (NJ) will move from Cerner’s Soarian EHR to its Millenium EHR and HealtheIntent population health management system. It has also opted for the company’s RCM software and services.

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Arizona-based Banner Health will roll out patient access and provider management technology from Kyruus at its facilities in six states.


Announcements and Implementations

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Lake Regional Health System (MO) prepares to roll out a single patient portal for its clinic and hospital patients. The portal, presumably part of the system’s conversion to Meditech 6.1, will go live in May. CIO Scott Poest has advised patients to print out any medical records related to care provided prior to May, since data from the previous portals will apparently not carry over.

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Trinity Health (ND) implements Acute, Population, and Practice Performance software from WhiteCloud Analytics.

Mercy (LA) wraps up a six month implementation of an imaging management system from Medicalis across its 50 imaging facilities. It plans to connect the system to its virtual care center in the near future.


Research and Innovation

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A Pennsylvania Patient Safety Authority report released several weeks ago reveals that, in the first half of 2016, hospitals in the state reported 889 medication errors that were attributed in some way to EHRs and other healthcare IT. Nearly 70 percent of those errors – the majority of which involved missed or incorrect dosages – impacted patients, eight of whom were actually harmed. Co-author and pharmacist Matthew Grissinger counter intuitively stresses that while these results are the “classic tip of the iceberg” when it comes to uncovering medication errors, many of which go unreported, patients should feel no less safe.

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A University of Michigan study finds that participation in one or more value-based care programs resulted in fewer hospital readmissions and greater cost savings. Researchers looked at patient care from 2,877 hospitals over a seven-year period and found that participation in Meaningful Use, ACOs, and/or bundled care payment programs helped the organizations save a combined $32 million.


Technology

CPSI will add TruCode’s Encoder coding software to its Evident and Healthland EHRs.

AthenaHealth adds electronic prior authorization technology from CoverMyMeds to AthenaClinicals.

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Allscripts puts its DbMotion software – part of its CareInMotion population health management platform -  on the cloud via Microsoft Azure.

Aprima Medical Software will add ActX’s genomic decision-support technology to its EHR.


Privacy and Security

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From DataBreaches.net:

  • News Corp Australia discovers that privacy settings on the nationwide My Health Record are set to “universal access,” giving the government’s 650,000 registered providers access to the information.
  • Tullamore Hospital in Ireland mistakenly sends a fax containing PHI to the office of the Data Protection Commissioner.

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Brooklyn-based artist Ace Volkov depicts computer viruses as comic book-like aliens as part of his “Brief History of Computer Viruses” series. Brain.A earns a special place in hacker history for its role as the first detected virus. Characterized by Volkov as a menacing mass of magenta-hued lines, the MS-DOS-based virus was created in 1986 to infect floppy disks.


Government and Politics

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President Trump nominates University of Minnesota healthcare economics professor Stephen Parente for assistant secretary for planning and evaluation at HHS, a role that would position him as the main advisor on policy development to HHS Secretary Tom Price, MD. Parente has had a taste of government work, having served as a health policy advisor for Sen. John McCain (R-AZ) during his 2008 presidential run.


Other

In Australia, SA Health CIO Bill Le Blanc defends the system’s beleaguered enterprise patient administration system after a coroner complains he can’t properly investigate a patient’s death because the EPAS won’t print out readable paper copies. “It was never designed to be used as a printed medical record,” Le Blanc says. “While we have already made significant improvements, the readability of printed records is an emerging issue across almost all jurisdictions using different electronic medical record systems and is not specific to the electronic medical record system used by SA Health.”


Sponsor Updates

  • Besler Consulting will present and exhibit at the 2017 HFMA Northern California Annual Spring Conference April 13 in Sacramento.
  • ECG Management Consultants ranks as a top consulting firm in the KLAS report, “Vendor Selection 2017: Crucial Factors to Consider When Choosing a Consulting Firm.”
  • AdvancedMD expands its professional services team.
  • ZeOmega releases 2017 updates to integrated patient assessments for its Jiva population health management software.
  • The local paper profiles Hartford Healthcare’s (CT) plans to build a predictive analytics “command center” powered by GE Healthcare.

Blog Posts


Contacts

Mr. H, Lorre, Jenn, Dr. Jayne, Lt. Dan.
More news: HIStalk Practice, HIStalk Connect.
Get HIStalk updates. Send news or rumors.
Contact us.

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Morning Headlines 4/11/17

April 10, 2017 Headlines Comments Off on Morning Headlines 4/11/17

New Compact Helps Physicians Obtain Multiple State Licenses

The Interstate Medical Licensure Compact Commission begins accepting applications from providers seeking cross-state licensure from one of 18 participating states. The new licensing agreement is expected to ease legislative burdens on providers offering telemedicine services.

Medication errors in hospitals don’t disappear with new technology

The Pittsburg Post-Gazette reports on medication errors at Pennsylvania hospitals that were, at least in part, attributed to EHRs.

The US ACA Individual Market Showed Progress In 2016, But Still Needs Time To Mature

Standard and Poor issues a forward-looking report on insurer performance in individual markets, noting “we expect insurers, on average, to get close to break-even margins in this segment in 2017,” but cautions that 2018 and beyond are uncertain given potential legislative changes and pending legal battles.

Case giving entrepreneurs a hand, with help from MIT

Mark Chance, vice dean for research at Case Western Reserve University School of Medicine, launches a program to mentor hopeful healthcare-focused entrepreneurs through the process of starting a company. The program is based on an MIT program that has mentored more than 2,500 participants since its 2000 launch.

Comments Off on Morning Headlines 4/11/17

Curbside Consult with Dr. Jayne 4/10/17

April 10, 2017 Dr. Jayne Comments Off on Curbside Consult with Dr. Jayne 4/10/17

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Physician burnout is always a hot topic within informatics circles, especially since clinicians frequently cite the rise of EHRs as a key reason for stress and burnout. In reality, though, it’s difficult to prove causality, especially since increasing requirements for EHR use have generally been timed with governmental regulations, demanding payer programs, and the overall shift from fee-for-service to value-based care. I’m always looking for ideas to help physicians at the breaking point, and a friend recently shared this article about using military training concepts to help physicians build resiliency.

According to the American Psychological Association, resilience is “the process of adapting well in the face of adversity, trauma, tragedy, threats or significant sources of stress – such as family and relationship problems, serious health problems, or workplace and financial stressors.” As physicians, we’re assaulted by these kinds of stressors all the time, and they often cross work/home boundaries as working hours become longer or as physicians bring work home with them, now that they can access charts from anywhere. During residency training, many physicians develop the skills to adapt to the intermittent stress that being a trainee brings – long call nights, resuscitations, emergency surgeries, high-risk procedures, and more. For the most part, residency training doesn’t prepare young physicians for the daily grind of being in an office setting or dealing with the stressors of owning a practice or being an employed physician.

The article discusses statistics for physicians – that depression hits nearly a third of residents, and that physicians have higher suicide rates compared to the rest of the population. It goes on to look at how some Canadian hospitals and medical schools are using training based on US Navy SEAL programs to help build psychological skills. Both populations are under ongoing stress with overlaying episodic stress, sometimes involving life and death situations. I think the latter element is important – the life and death situations. Although many think of those as being in-hospital, emergent-type situations, I see more and more of my primary care colleagues experiencing that “life and death” level of stress even within the boundaries of office-based medicine. When patients can’t afford their medicines and physicians have to cobble together plans to try to ensure compliance, we are in effect fighting for that person’s life.

The diabetic patient who came into my urgent care last night with a blood sugar of 434 wasn’t sick enough to be admitted to the hospital, since his sugars had been high for months and his body had been trying to compensate for it. Yet, he needs intensive therapeutic interventions to get his disease under control. I can send him back to his primary care physician, but then she has to battle to get him to see the diabetic educator, get him a new blood glucose meter to replace his broken one, and try to help him figure out how to get to appointments and take care of his disease when he’s working long shifts as a municipal bus driver. Those situations, which sometimes border on hopeless depending on the patient’s insurance coverage (or lack thereof), job situation, and social supports add to the ongoing level of stress faced by physicians. This is worse now that the primary care physician is going to be penalized for this patient’s lack of blood sugar control.

This problem isn’t unique to our US system. According to the article, studies show that as many as 75 percent of Canadian resident physicians experience burnout. One can anticipate that those burned-out residents are going to carry that baggage into practice. The resiliency training created for the Canadian trainees is delivered as a four-hour course. It encourages trainees to identify how they’re faring on a mental health or stress scale. They grade themselves as green, yellow, orange, or red depending on their current level of stress and dysfunction. Similar to the kind of asthma action plan we provide patients, it also details recommended steps the trainee can take to reduce stress. Another component of the training includes skills to help the body process physical responses to stressors, such as the fight-or-flight response. It seeks to move decision making away from the emotional response and to instead harness the rational thought process.

The article also mentions that “discussions around physician mental health still remain very taboo.” Unfortunately, this is also true in the US. I know of quite a few physicians who have untreated mental health conditions who are afraid to seek help and have it on their records. Our state still asks a question during the license renewal process about treatment for mental health conditions, and people don’t want to risk whatever process might arise from checking “yes” on the affidavit. A friend of mine who is a psychologist specializes in physician care, and doesn’t bill insurance for those patients so that there isn’t a record of treatment.

Although the article doesn’t specifically mention it, we also need to work on skills for physicians to understand that doing their best really is good enough. We can’t really give it more than our best, can we? Although the quality metrics might not support this approach, the idea that we can save everyone or ensure all our patients are compliant is ludicrous. As quality increases, it’s more and more difficult to be “better” when everyone is already earning an A. I’ve lost two colleagues to suicide in my career, and both were brilliant, caring individuals who unfortunately felt their best wasn’t good enough, that they should have been doing more. No one in their lives, including spouse or fiancée, realized how bad things were or that they were at high risk for suicide.

Additionally, this discussion doesn’t just apply to physicians. It applies to all of us working in the patient care arena regardless of your title. Most of my support staff at my patient care sites are paramedics, and many have migrated to urgent care as a solution to the stressors in the field. For those readers not in the patient care space, ask your organizations what they’re doing to address caregiver burnout. Ask your friends and colleagues how they’re doing and offer support when you can. Their lives might just depend on it.

How does your organization address burnout? Email me.

Email Dr. Jayne.

Comments Off on Curbside Consult with Dr. Jayne 4/10/17

Readers Write: Top Health IT Marketing Trends From #HITMC

April 10, 2017 Readers Write Comments Off on Readers Write: Top Health IT Marketing Trends From #HITMC

Top Health IT Marketing Trends from #HITMC
By John Trader

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John Trader is VP of communications at RightPatient in Atlanta.

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I had the opportunity to attend the Health IT Marketing & PR Conference in Las Vegas last week, and thought I’d share some of my top health IT marketing takeaways.

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Content, Content, Content

Content was certainly king in terms of session topics. What works. What doesn’t work. How to establish a sound content-marketing strategy (even if you’re a small company with a shoestring budget). My biggest takeaway on content is that marketers need to start with the end in mind. Understand what content resonates with the demographic you target by listening first, and then developing a strategy that addresses customer needs and is strategically presented to them as they make their way down the sales funnel.

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I enjoyed Sarah Davelaar’s (from the The Signal Center for Health Innovation) session where she outlined the key elements in content strategy. I also enjoyed a panel discussion featuring four physicians who shared their content consumption habits – where they go to find information, what content resonates with them, and what they like versus what they ignore. The million-dollar question for any health IT marketer is: What influences their decision to buy? Most docs said that conferences are a great place for them to discover new products. Those docs on social platforms like Twitter do pay attention to who shares their posts and who interacts with them. Catchy headlines are important, and most of them look for unique perspectives on issues as opposed to extolling the virtues of a product.

Innovation Versus Value

Conference organizer and Netspective founder Shahid Shah’s opening presentation on day two was excellent (although the amount of information on his slides was a tad overwhelming). There was a lot of discussion at the conference about whether marketers should position themselves as innovators, since nothing we do is truthfully going to "disrupt" healthcare. The truth is, customers care a lot more about value than innovation. One of the best quotes from his presentation was, “Do customers care about what you think is innovation or will they care more about you when you care about what their innovation needs are?” 

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Social

Although I didn’t attend any sessions dedicated to social media use or strategy, there were a few that addressed how to navigate the online universe, and how to develop and execute effective social media strategies. “Go where your customers are” seemed to be the general takeaway from attendees of those sessions. Don’t chase the latest shiny social platform just for the sake of having a presence. Again, start with an end goal in mind (create leads and eventually sales), and make sure you are measuring your results (how will you be able to tell if your efforts are successful?) There was also some discussion on how to effectively measure social to gain a better understanding of what works versus what doesn’t work. There was also a lot of chatter moving beyond brand awareness and more into how social efforts are creating leads and sales.

Leveraging the Customer

A recurring theme was how to leverage existing customers to create new business. Kathy Sucich of Dimensional Insight delivered an excellent presentation, where she provided a case study on how she increased her own company’s “share of voice” (a term that was new to me), and gave sound advice on how to successfully leverage customers to create new content and increase brand visibility and messaging. The key takeaway for me here was that capturing and then bringing the customer’s voice to your messaging requires personal relationships with customers. You simply must spend the time to cultivate these relationships by establishing a set of expectations at the outset of the relationship that outlines your plan to work with your customers and get their story in front of others.

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Video

There was lot of buzz about creating more video as part of an effective marketing strategy. It continues to be a hot topic of interest because it’s clear that people want to consume more of it. The key is making it resonate. The key seems to be keeping it simple, short, and focused on addressing a problem instead of extolling the virtues of a product. Christine Slocumb’s (of Clarity Quest Marketing) session was excellent in reiterating the point that in this day and age, videos have to be personalized to be effective.

SEO Isn’t Dead

Kristine Schachinger of The Vetters Agency presented an excellent session covering modern SEO practices, soup to nuts. We talked about ways to analyze SEO performance, online SEO resources, ranking factors, inbound link tactics, do’s and don’ts for SEO, how to add Google Search Console to your site, how content affects SEO, and keyword research – just to name a few topics. There was a great deal of interaction between the presenter and the audience, and directly between audience members, which, in my opinion, is what makes this conference excellent. Questions were asked and topics brought up that were a great supplement to Kristine’s curriculum. This is perhaps what I like best about HITMC. It has a more intimate setting than most conferences I attend.

About That Other Conference

The buzz around the conference seemed to be the forthcoming HIMSS marketing conference (which, by the way, I don’t anticipate being able to offer the intimate setting I mentioned above). Many have said they heard through the rumor mill that it may be frowned upon by the marketing community to attend in lieu of supporting HITMC’s more grassroots efforts. I talked to several people who have already signed up for the HIMSS event but seem to be keeping that information to themselves. Other buzz has been the quality of HITMC – most people agree that it’s an excellent conference and gets better each year by addressing the most relevant topics to marketers.

The only drawbacks I found, aside from freezing temps in the conference rooms, was that the few tough questions I asked during Q&As weren’t answered as thoroughly as I would have liked, and there was a lack of substantial, real-world case studies to back up presenter assertions. Overall, I think the conference was a great investment. It’s always helpful for me to be around likeminded professionals eager to gain insight and tips on how we can do our jobs more effectively.

Comments Off on Readers Write: Top Health IT Marketing Trends From #HITMC

Morning Headlines 4/10/17

April 9, 2017 Headlines Comments Off on Morning Headlines 4/10/17

Practo Technologies cuts 10% of workforce, explores new revenue engines

India-based provider appointment scheduling vendor Practo lays off 10 percent of its workforce, citing “natural redundancies that emerge as we integrate our 5 acquisitions.”

DHA launches unified electronic medical record system

In Dubai, the Dubai Health Authority’s Rashid Hospital, Al Barsha Medical Center, and several offsite clinics go live on Epic.

Before you send your spit to 23andMe, what you need to know

STAT provides more insight into the genetics-based personal health risk reports 23anMe recently won FDA approval to resume marketing to consumers.

Comments Off on Morning Headlines 4/10/17

Monday Morning Update 4/10/17

April 9, 2017 News 4 Comments

Top News

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India-based provider search and appointment-booking tech company Practo lays off 150 – a 10-percent workforce reduction the company attributes to “a combination of natural redundancies that emerge as we integrate our five acquisitions and evolve our businesses, as well as the performance required for the next phase of Practo’s growth.” The company operates in four other countries, and has raised $180 million since launching nine years ago. It acquired Fitho, Genii Technologies, Qikwell Technologies, Instahealth, and Enlightiks – all India-based businesses – between April 2015 and December 2016.


Reader Comments

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From North West: “Re: Larry Krassner’s passing. He passed away after a long battle with cancer in late December. I was shocked that it isn’t more widely known and thought that you might want to include something in HISTalk. He was well known in the 70s through early 2000s in the HIT industry. He was part of SMS in the early days, TDS, McKesson, and IDX (before it was bought by GE). He was the consummate salesman and probably responsible for many of the big enterprise deals that SMS and TDS did in the 70s-90s.” 

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From Harvest Gal: “Re: Word on the street is that NewCrop has been losing EHR customers – and end-user doctors – over the past couple months. We’ve also heard that those EHR vendors are moving to e-prescribing company DrFirst. Is greater industry consolidation on the horizon?” Unverified. I wouldn’t be surprised given the general state of health IT affairs. NewCrop’s e-prescribing tool has been on the market since 2003, and has been flying fairly under the radar (at least from a media perspective) for the last several years. I last mentioned them in September 2016, when the company added specialty medication prescribing software from AssistRx.

From Lab Tester: “Re: Theranos vs. 23andMe. Seems like Elizabeth Holmes could learn a thing or two from Anne Wojcicki. Both companies faced governmental scrutiny; one continues to go down in flames, while the other seems to be trying to play by the rules.” The Theranos saga does indeed continue: Media reports suggest that founder Elizabeth Holmes owes her own company $25 million -  a fact made semi-public after reports surfaced that some investors were considering suing the company. 23andMe, meanwhile, has seemed very intentional about recovering from the reprimand it received from the FDA in 2013. It seems to have eschewed the media-blitz machine Holmes favored to instead hunker down and legitimize its business model.

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From Ambulance Chaser: “Re: Ambulance rides via Uber. It boggles my mind that people are opting for rides to the ER from ride-sharing services like Uber and Lyft. Have any of your readers noticed an increase at their facilities in drop-offs from these services?” AC is no doubt referring to this article focusing on the use of ride-sharing companies to get emergency patients to the hospital. While I doubt ER staff have time to pay attention to patient transport, I’ll invite readers to weigh in. It’s just another nail in healthcare’s already deteriorating coffin, if you ask me. The industry has yet to (and probably never will) become the nimble, Amazon-like company that caters to consumer whims – much less one based on a gig-economy model. The regulatory tape is wrapped too tightly at this point, and administration in-fighting would suggest it’s not loosening up anytime soon.


HIStalk Announcements and Requests

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Nearly a third of poll respondents expect blockchain to have a significant impact on healthcare in five to 10 years. Perhaps the more compelling result is the 25 percent of respondents who “don’t know, don’t care.” Realist explains that, “Blockchain will never have a significant impact on HIT; in the short-run, it will be a boost to conferences, consultants, and marketing. In the long-run, it will be utilized but won’t have any material impact.” HITgeek takes a less pessimistic view: “We do not need yet another niche, domain security control. Instead, what we desperately need is a ubiquitous one. Blockchain is a contender for that. We need to determine who will pay for it. Nominally, the beneficiaries will pay through some proxy rather than taxpayer funding. The boundary between what is health data and what isn’t is shifting and porous. Any security technology that draws a bright line border will soon become obsolete. On the other hand, security technology that straddles or ignores the boundary has a greater and continuing return on investment.”

New poll to your right or here: How likely would you be to use a company like 23andMe to better understand your hereditary health risks? Feel free to explain your level of likeliness by leaving a comment.


This Week in Health IT History

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One year ago:

  • Massachusetts General Hospital, Massachusetts Eye and Ear, and Newton-Wellesley Hospital all go live on Epic over the weekend as part of Partners Healthcare’s $1.2 billion Epic implementation.
  • A CMS inspection report confirms that Theranos’ proprietary blood testing analyzer, Edison, failed internal quality control tests 29 percent of the time, while its California lab was also cited for doing tests with unqualified personnel and storing samples at the wrong temperatures.
  • e-MDs completes its acquisition of McKesson ambulatory products Practice Choice, Medisoft, Medisoft Clinical, Lytec, Lytec MD, and Practice Partner.
  • The DoD brands its Cerner implementation project MHS Genesis.
  • Pfizer backs out of its plan to acquire Allegran and move its headquarters to Ireland for tax reasons after the Treasury Department puts new rules in places to make tax inversions less lucrative.

4-5-2012 9-06-11 PM

Five years ago:

  • The Gingrich Group LLC, doing business as the Center for Health Transformation, files for Chapter 7 bankruptcy in a Georgia court.
  • The Coast Guard prepares to go live on its Epic-based EHR.
  • A new KLAS report says that Cerner, Meditech, and Siemens are the only HIT vendors that provide their solutions to all world regions.
  • A National eHealth Collaborative paper says that HIEs have great potential to improve care and reduce cost, but despite ONC emphasis and incentives, not a lot of value has been realized so far.

Weekly Anonymous Reader Question

Last week I asked readers to share their favorite moment from any past HIMSS conferences:

  • Leaving.
  • Getting my leadership to explain why a bunch of gray beards in suits with no health IT market experience were getting paid trips to HIMSS, while our actual industry experts (like me) weren’t.
  • HIStalkapalooza in Chicago ’15!
  • The stillness in the office as the bosses are all gone!
  • Going home.
  • (From Dr. Jayne) My favorite moment was at HIStalkapalooza in New Orleans at the Rock’n’Bowl. I managed to have pictures taken with both Judy Faulkner and Jonathan Bush. I keep them in a hinged frame on my desk so they constantly have to look at each other. It makes me smile when I am writing for HIStalk.

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This week’s question: What passion would you pursue given adequate free time and money?


Last Week’s Most Interesting News

  • The FDA authorizes 23andMe to market direct-to-consumer genetic health risk tests and reports.
  • VA CIO Rob Thomas confirms the agency is on track to make a decision by July 1 on whether to replace Vista with a commercial EHR vendor.
  • Cleveland Clinic launches an investment business, Cleveland Clinic Ventures, that will work with its innovation department to turn new medical breakthroughs into funded spin-off companies.
  • Former CMO of Siemens Healthcare, Donald Rucker, MD joins ONC as National Coordinator.
  • A media company that Patrick Soon-Shiong, MD rescued from a hostile takeover attempt with a $70 million investment claims that its CEO was forced to personally invest $10 million in NantHealth’s initial round in exchange for the help.

Webinars

April 26 (Wednesday) 1:00 ET. “SSM Integrated Health Technologies Clinical Data Migration: Functional and Technical Considerations.” Sponsored by Galen Healthcare Solutions. Presenters: Sandy Winklemann, MHA, RHIA, project manager, SSM Integration Health Technologies; Tyler Mawyer, MHA, managing consultant, Galen Healthcare Solutions; Kavon Kaboli, MPH, senior consultant, Galen Healthcare Solutions. GE Centricity and Meditech to Epic EHR transition. Join us for a complimentary webinar as present the decisions that are important to consider when performing a clinical data migration from the point of view of  the healthcare organization program manager, the clinical analyst, and the technical implementation team. Our expert panel will survey data migration considerations, best practices, and lessons learned. The webinar will present a unique client perspective, offering insight into considerations surrounding staffing, clinical mapping, legacy application support, and validation and testing.

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


Acquisitions, Funding, Business, and Stock

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Meditology Services opens offices in Denver, Nashville, and San Diego. The company, which seems to have repositioned itself as a privacy and security consulting firm since I first mentioned it in 2013, already has offices in Atlanta and Philadelphia.


Announcements and Implementations

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Northern Arizona Healthcare’s Verde Valley Medical Clinic – Camp Verde implements Versus Advantages Clinic patient flow technology from Versus Technology Solutions.

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Several facilities within the Dubai Health Authority (UAE) go live on Epic.


Decisions

  • Johnson Memorial Hospital (IN) will go live with Optimum HRIS in May.
  • Madison Memorial Hospital’s (ID) HR department will go live with Paychex MyStaffingPro this year.
  • Womankind Obstetrics and Gynecology (OH) will switch from Athenahealth to Epic ambulatory next month.

These provider-reported updates are provided by Definitive Healthcare, which offers powerful intelligence on hospitals, physicians, and healthcare providers.


Other

 
Here’s Part 3 of the top 10 HIS vendors report from Vince and Elise.

Sponsor Updates

  • The Chicago CIO Leadership Association honors TransUnion CIO & CTO Mohit Kapoor with its 2017 CIO of the Year Orbie Award.
  • ZirMed updates its Coverage Detection patient payment product.
  • CRM Magazine recognizes West Corp. with a 2017 CRM Service Leader Award for Contact Center Infrastructure.
  • ZeOmega publishes a new case study demonstrating how Community Health Network/Indiana ProHealth implemented its Jiva case management solution.
  • ZirMed releases a new eBook, “The Reality of Patient Payments.”
  • Clinical Computer Systems, Inc., developer of the Obix Perinatal Data System, announces that Jake Chacko, Philip Strang, and Chris Zoellner have completed field service manager certification training.

Blog Posts


Contacts

Mr. H, Lorre, Jenn, Dr. Jayne, Lt. Dan.
More news: HIStalk Practice, HIStalk Connect.
Get HIStalk updates. Send news or rumors.
Contact us.

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Morning Headlines 4/7/17

April 6, 2017 Headlines Comments Off on Morning Headlines 4/7/17

23andMe, Inc. Granted First FDA Authorization to Market Direct-to-Consumer Genetic Health Risk Reports

More than three years after being shut down by the FDA for selling genetic health risk reports to consumers without clearance, 23andMe finally receives the FDA’s approval to resume sales. The approval covers reports on personal risk for ten conditions, including late-onset Alzheimer’s disease, Parkinson’s disease, and celiac disease.

Highly confidential psychotherapy records from Maine center listed on the dark web

A mental health center in Maine reports that 4,500 patient records have been stolen by hackers and offered for sale on the dark web. The records include highly-sensitive information, including names, addresses, social security numbers, medial histories, and full session notes.

SAFER Guides

ONC updates its SAFER Guides, a series of guides designed to help healthcare organizations address EHR safety issues.

Comments Off on Morning Headlines 4/7/17

EPtalk by Dr. Jayne 4/6/17

April 6, 2017 Dr. Jayne 2 Comments

For people breathing easy after completing their 2016 Medicare-related attestations, it’s time to start gearing up for next year. Organizations need to register or update their information via the CMS Web Interface  prior to June 30 if they plan to participate as a group. Organizations that plan to use the Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS survey also need to register. There are many other details on who does or does not need to register, so consulting the website and making sure you know whether an ACO or registry will be reporting on your behalf is recommended. For those not breathing easy because they’re still completing 2016 Medicaid-related attestations, good luck! Some states have extended their attestation windows into May.

CMS has also been busy promoting the value of Chronic Care Management, launching a new Connected Care program to raise awareness through the Office of Minority Health and the Federal Office of Rural Health Policy. Connected Care will focus on racial and ethnic minorities along with rural populations who statistically have higher rates of chronic diseases. The new website includes toolkits with detailed information about CCM, resources for implementation, and patient education resources. CCM requires a patient copay, and that has posed a barrier to adoption in my area. Patients already think physicians should be providing these services for free and don’t always understand the value of why CMS is making a push to specifically address the need for services. Although the copay is small, patients living from Social Security check to check and who may be choosing between medication and food are often reluctant to consent to enrollment. Sadly, those can be the patients who most need the services.

CMS has also been busy with its Social Security Number removal initiative. I’m working with my first consulting client on a project to look at how it uses the SSN within the organization and to assess vendor plans to remove the SSN from software systems. There is a new provider webpage, in addition to the main page, for the initiative. Although this program impacts Medicare beneficiaries and the use of the SSN as the de-facto Medicare ID, organizations use the SSN in a variety of different ways. Not everyone is excited about the removal program, as the SSN has also become a proxy for an individual identifier to a large degree. Kind of makes you think about our lack of a national healthcare identifier, doesn’t it?

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ONC has updated the SAFER Guides, which are designed to help organizations assess EHR safety and best practices. Topics include organizational responsibilities, contingency (downtime) planning, interfaces, patient identification, clinician communication, and test results reporting/follow-up. I really wanted to review the latter topic, but received an error. There are plenty of practices that need this information. I can’t believe the number of groups I run across that either don’t track their laboratory and diagnostic orders from ordering through completion and patient notification, or track but don’t notify. The era of “no news is good news” should be long gone by now. Patients should never be expected to assume results are normal unless they hear otherwise.

Medicomp Systems announces its Medicomp University event, to be held starting April 24 in Reston, VA. Attendees will gain in-depth knowledge of the Quippe products and how to integrate them into EHRs. I’ve enjoyed watching the Quippe offerings evolve since I first saw it at HIMSS11. If you haven’t seen them, they’re definitely worth a look.

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I’m way behind on email again, but it’s been fun to go back and weed through all the premature commentary about the repeal of the ACA. What had us hanging on tenterhooks now seems like a long time ago. For those of you who have never seen them, this is what tenterhooks look like. I’m also catching up on some educational webinars. My new pet peeve is people who use PowerPoint for presentations, but fail to put it in presentation mode, forcing the audience to review shrunken versions of the slides while being distracted by the thumbnail navigation.

I came across this article about what hospitals waste and it’s startling to think about. When patients are discharged, many supplies are thrown out due to concerns about infection control or potential contamination after they’ve been left accessible to patients or visitors. Policies vary dramatically from facility to facility across the country. I’ve worked at places that toss everything and at those where supplies are restocked, and seen all kinds of variations. There’s also the issue of hospitals getting new equipment and needing to get rid of old devices. I once assisted with an effort to send a “gently used” MRI machine to South America – now that was a project.

Scholarly research has been done looking at the problem, with findings that when hospital staff are appropriately incented, waste can be reduced. Many surgeons in one study were unaware of their operating room costs; when they were asked to reduce costs, they met goals where the control group’s costs actually increased. Getting people to be conscious of the true costs of the care provided is central to the concept of value-based care, especially when those costs are obscured, such as costs that are included in a hospital room charge.

During my recent hospitalization, most supplies were kept in a secured cabinet inaccessible to patients and family members, which not only controls costs but reduces contamination and the risk that something would have to be tossed for fear that someone had opened it or otherwise ruined it. Other items that are placed out for every patient (shower products, toothpaste, etc.) are discarded after each patient whether they were used or not, since it’s too difficult to determine if they’ve been opened or used. I specifically asked the staff about this prior to discharge – I hadn’t used anything, since I brought my travel kit with me. But they were going to toss everything, so I grabbed it for a community drive that gathers non-food items to be distributed to food pantries for their clients. You’d think hospital leadership would have considered that when crafting their policies and reached out to a local organization. Maybe they did, maybe they didn’t, but I’m trying to connect the two for some potential community benefit.

What does your hospital do with discarded or excess supplies? Email me.

Email Dr. Jayne.

News 4/7/17

April 6, 2017 News 1 Comment

Top News

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23andMe receives approval from the FDA to market its genetic health risk tests for 10 diseases, including celiac, Parkinson’s, and late-onset Alzheimer’s. The approval – the first for a home DNA test – is no doubt being celebrated by the Google-backed startup, which stopped giving consumers health analysis information in 2013 after an FDA slap on the wrist. The company received approval two years later to disclose a person’s carrier status, and has since been largely providing results to consumers seeking answers about their ancestry.


HIStalk Announcements and Requests

This week on HIStalk Practice: The AAFP creates the Center for Diversity and Health Equity to study social determinants of health. The National Governors Association selects seven states to participate in rural health collaborative. MTBC debuts analytics for ACOs. Arizona Connected Care selects referral management tech from Fibroblast. CVS Health awards $1 million to 33 health centers. New report sheds light on physician compensation. American Society of Sleep Medicine studies patient receptiveness to virtual consults. Nancy Gagliano, MD helps readers strategize for MACRA.


Webinars

April 26 (Wednesday) 1:00 ET. “SSM Integrated Health Technologies Clinical Data Migration: Functional and Technical Considerations.” Sponsored by Galen Healthcare Solutions. Presenters: Sandy Winklemann, MHA, RHIA, project manager, SSM Integration Health Technologies; Tyler Mawyer, MHA, managing consultant, Galen Healthcare Solutions; Kavon Kaboli, MPH, senior consultant, Galen Healthcare Solutions. GE Centricity and Meditech to Epic EHR transition. Join us for a complimentary webinar as present the decisions that are important to consider when performing a clinical data migration from the point of view of  the healthcare organization program manager, the clinical analyst, and the technical implementation team. Our expert panel will survey data migration considerations, best practices, and lessons learned. The webinar will present a unique client perspective, offering insight into considerations surrounding staffing, clinical mapping, legacy application support, and validation and testing.

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


Acquisitions, Funding, Business, and Stock

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PHI protector CloudVault Health closes a $2.6 million Series A funding round led by investors that include Rudish Health Solutions. President Richard Nelli came to CloudVault in 2015 after a two-year stint at Streamline Health.

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Data analytics company Intermedix acquires Nashville, TN-based WPC Healthcare, bolstering the predictive analytics division it created in 2015. WPC CEO Ray Guzman will join Intermedix, also based on Nashville, as SVP of strategy.

Predictive analytics investments continue … Boston-based OM1 secures $15 million in a Series A round led by venture capital firm General Catalyst.

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TeleTech Holdings – a global company that specializes in the vague (but presumably profitable) business of customer experience and growth – acquires Connextions from OptumHealth for $80 million. Connextions, which offers tech-enabled member acquisition and retention services, will be folded into TeleTech’s Customer Management Services division.

Drchrono raises $12 million in a Series A funding round led by Runa Capital.

Efforts to eschew becoming a healthcare company don’t stop Alphabet from hiring healthcare tech talent. Job listings for subsidiaries including Sidewalk Labs, Calico, and Verily indicate strong interest (and compensation packages) in computational biologists, robotics experts, and researchers. The Google parent company has already pulled Tom Insel, MD away from heading up the National Institutes of Mental Health, and Jessica Mega, MD from Harvard Medical School.

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Redox receives an additional $1 million from the Healthbox-managed Intermountain Healthcare Innovation Fund, bringing its total Series B round to $10 million. The healthcare API vendor took part in the Healthbox Studio Program several years ago, and will now help Intermountain integrate digital health apps with its Cerner system. (Thanks to the reader who reminded me they were on Cerner, not Epic.)


Sales

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Sinai Hospital (MD) will roll out predictive analytics from PeraHealth this summer.

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Appalachian Regional Healthcare (KY) will begin implementing Meditech’s Web EHR later this year.


People

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Stuart Long (Monarch Medical Technologies) joins InfoBionic as CEO.

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I2I Population Health names Dawn Berg (Assist Consulting Group), Scot McCray (CamCare) (not pictured), and Jay Wilkes (RyMir Consulting) to its sales team. Adam Ackerman (Relatient) joins the company as director of client development.

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Medecision hires Donald Casey, Jr. MD (Alvarez & Marsal) as chief clinical affairs officer, and Ian Chuang, MD (Netsmart) as SVP and chief analytics officer.

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Erik Phelps (Epic) joins genetic testing and data analysis startup Tempus as EVP and general counsel.


Announcements and Implementations

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Sylvester Comprehensive Cancer Center (FL) selects oncology data-sharing technology from Syapse as part of a new precision medicine initiative.

The NJSHINE HIE connects to the Camden Coalition HIE, launched in 2010 by the New Jersey-based Camden Coalition of Healthcare Providers.

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Adirondack Health (NY) will equip local public health agencies and their patients with remote monitoring and videoconferencing services with help from Health Recovery Solutions and the Hixny HIE.

Iowa-based Mercy ACO selects Innovaccer’s Datashop data warehouse to aggregate health data from 65 participating facilities including ambulatory sites, hospitals, and payers.


Government and Politics

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FDA Commissioner nominee Scott Gottlieb, MD pledges to uphold the agency’s “gold standard of safety and efficacy” during his confirmation hearing before the Senate HELP Committee. He also stressed that there are ways of modernizing and expediting clinical trials without compromising safety, adding that addressing the opioid crisis and speeding generic drugs to market will be two of his top priorities if confirmed.

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Efforts in Missouri to implement an opioid prescription drug monitoring database take one step forward then two steps back when vocal PDMP senatorial holdout Rob Schaaf announces he will finally support a bill authored by proponent Rep. Holly Rehder on the condition that physicians must register on it. The Missouri State Medical Association, however, was quick to tweet its opposition.


Privacy and Security

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From DataBreaches.net:

  • Behavioral Health Center (ME) discovers that 4,500 records from between 3,000 and 3,500 patients have been stolen and sold on the dark Web.

Research and Innovation

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The Washington Post sensationalizes a Mayo Clinic study published in the Journal of Evaluation in Clinical Practice that found 20 percent of patients who asked for a second opinion had been misdiagnosed by PCPs – a result the WaPo author admits is “generally similar to other research on diagnostic error.” The retrospective study of 286 patients found the second diagnosis to be “distinctly different” from the first in 62 cases, the same in 36 cases, and partly correct in the remaining 188.


Technology

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Medable develops Cerebrum, machine-learning technology that aggregates health data from a variety of sources to better power smartphone apps like Apple’s HealthKit and CareKit with disease predictions and treatment.


Other

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After a recent hospital stay filled with slamming doors and beeping medical equipment, ambient electronic musician Yoko Sen proposes using sound design to reduce alarm fatigue and make hospitals calmer places for patients. She has created a “tranquility area” at Sibley Memorial Hospital (Washington, DC) that offers staff green tea, reclining chairs, soothing music, lavender scents, and projected images. A similar area for patients is under consideration.

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@HuffPostComedy urges tweeters to share #AHCASequelTagLines. Legislators seem unlikely to reach any sort of compromise on the rumored resurrection of repeal and replace efforts before they adjourn for a two-week recess.


Sponsor Updates

  • Intelligent Medical Objects will exhibit at the Allscripts Northeast Pro ARUG April 7 in Hartford, CT.
  • MedData introduces an app to help providers keep better tabs on patients suffering from binge-watching illness.
  • The American College of Radiology features National Decision Support Co.’s latest case study, “Homing in on Quality.”
  • The Atlanta Journal-Constitution recognizes Navicure with its Atlanta Metro Area 2017 Top WorkPlaces Award.
  • Netsmart is the first and only behavioral health EHR vendor to achieve ONC 2015 Edition Health IT Module Certification.
  • Nordic Consulting presents what employees love most about the company.
  • CloudWave will exhibit at the HIMSS New England Conference April 11 in West Lebanon, NH.
  • Experian Health will exhibit at the HFMA NorCal Spring event April 12-14 in Sacramento, CA.
  • Sutherland Healthcare Solutions publishes “Digital Reinvention in Healthcare: How Lawrence General Re-Engineers Their Patient Experience.”
  • GE Healthcare adds the CareFinity business continuity and archiving solution from EMedApps to its Centricity Partner Program.

Blog Posts


Contacts

Mr. H, Lorre, Jenn, Dr. Jayne, Lt. Dan.
More news: HIStalk Practice, HIStalk Connect.
Get HIStalk updates. Send news or rumors.
Contact us.

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Morning Headlines 4/6/17

April 5, 2017 Headlines Comments Off on Morning Headlines 4/6/17

FDA Nominee Scott Gottlieb Commits to ‘Gold Standard’

Scott Gottlieb, President Trump’s nominee to run the FDA, had his confirmation hearing before the Senate HELP Committee today, during which he committed to upholding the “gold standard of safety and efficacy,” but noted that he believed there were ways of modernizing and expediting clinical trials without compromising safety.

Missouri senator says he’ll end years of opposition to prescription drug database

In Missouri, efforts to implement an opioid prescription drug monitoring database faces renewed opposition from the Missouri Medical Association, which opposes any legislation requiring doctors to check the database before writing opioid prescriptions.

Thousands of brokers exit HealthCare.gov as plan commissions go unpaid

Insurance resellers are exiting the exchange markets as payers stop paying commissions on a variety of plans. Utah-based insurance broker Craig Paulson explains, “they’re not paying commissions on platinum plans, and they are not paying them for special enrollment plans which cover some of the sickest patients.”

How Redesigning The Abrasive Alarms Of Hospital Soundscapes Can Save Lives

After a recent hospital stay filled with slamming doors and beeping medical equipment, ambient electronic musician Yoko K. Sen proposes using sound design to reduce alarm fatigue and make hospitals calmer places for patients.

Comments Off on Morning Headlines 4/6/17

Morning Headlines 4/5/17

April 4, 2017 Headlines Comments Off on Morning Headlines 4/5/17

VA’s most important 2017 decision

Speaking at a conference Monday, VA CIO Rob Thomas confirms the agency is on track to make a decision by July 1 on whether to replace Vista with a commercial EHR vendor.

Q1 2017: Business as usual for digital health

Rock Health publishes its Q1 report on VC investments in the digital health startup space, noting that 2017 investment activity is keeping pace with 2015 and 2016 levels despite the uncertainty around ACA repeal.

Electronic Health Record Logs Indicate That Physicians Split Time Evenly Between Seeing Patients And Desktop Medicine

A Health Affairs study that analyzed the EHR activity logs of physicians found that they appear to split their day between computer work and patient care.

Why the Orion Health Group Ltd share price was slammed today

New Zealand-based Orion Health Group fall seven percent after announcing stalled growth and a full-year net loss between $22 million and $26 million.

Comments Off on Morning Headlines 4/5/17

News 4/5/17

April 4, 2017 News 9 Comments

Top News

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The VA confirms that it remains on track to make a decision about the future of VistA by July 1. It also raises the possibility of continuing to use VistA, but as a vendor-hosted service.

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VA Secretary David Shulkin committed to the July 1 date last month. He has also said that the VA made a mistake in not working with the Department of Defense — which chose Cerner for its MHS Genesis project – to buy a single, integrated system.

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Acting VA CIO Rob Thomas says a commercial solution remains an option, specifically mentioning Cerner.

The VA has hired consulting firm Grant Thornton to create a business case for four possible actions, one of which is to turn VistA over to a vendor that would then provide it as a service.


Reader Comments

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From CIO Uptime Monitor: “Re: BIDMC/Harvard Medical School job posting. Says the CIO is retiring this spring. Is that John Halamka?” No. That job posting is for the Harvard Medical School CIO position held by Rainer Fuchs, PhD, who has been at HMS since 2012 and who is indeed retiring.


HIStalk Announcements and Requests

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Welcome to new HIStalk Platinum Sponsor Docent Health. The Boston-based company provides health systems with the people, technology, and insights they need to improve and personalize the patient experience, giving each person a set of customized touch points to cover their journey. Its consumer-centric approach drives higher satisfaction scores by satisfying the human need of patients to understand and to be understood. The company provides on- and off-site liaisons – or docents – who coordinate with patients before, during, and after their clinical experience and who participate in nursing huddles and rounds to make sure the non-clinical needs and preferences of patients are met and to empower clinical staff to deliver empathetic care. Health systems get operational patient data dashboards and executive reporting to spot service gaps and identify community health needs. Doing the right thing also drives measurable return on investment via more loyal customers, better satisfaction compensation, and long-term savings. I interviewed CEO and industry long-timer Paul Roscoe a few days ago, obviously catching him off guard with my spur-of-the-moment question wondering whether “data-driven empathy” is an oxymoron. Thanks to Docent Health for supporting HIStalk.

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We funded the DonorsChoose grant request of Mrs. S in Missouri, who says her high school pre-calculus students are learning from the Breakout EDU problem-solving kit we provided. She says, “This donation to my classroom has completely engaged students. They are thinking critically and creatively while also practicing the content. I am so proud of my students during these challenges and their willingness to persevere and solve the problem. It is truly a learning environment any teacher would be thrilled to witness and it is all thanks to your generosity!”


Webinars

April 26 (Wednesday) 1:00 ET. “SSM Integrated Health Technologies Clinical Data Migration: Functional and Technical Considerations.” Sponsored by Galen Healthcare Solutions. Presenters: Sandy Winklemann, MHA, RHIA, project manager, SSM Integration Health Technologies; Tyler Mawyer, MHA, managing consultant, Galen Healthcare Solutions; Kavon Kaboli, MPH, senior consultant, Galen Healthcare Solutions. GE Centricity and Meditech to Epic EHR transition. Join us for a complimentary webinar as present the decisions that are important to consider when performing a clinical data migration from the point of view of  the healthcare organization program manager, the clinical analyst, and the technical implementation team. Our expert panel will survey data migration considerations, best practices, and lessons learned. The webinar will present a unique client perspective, offering insight into considerations surrounding staffing, clinical mapping, legacy application support, and validation and testing.

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


Acquisitions, Funding, Business, and Stock

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Healthcare payments system vendor Ability Network acquires ShiftHound, which offers staff scheduling and credentialing systems.

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Attorneys for Chicago-based Tronc (the former Tribune Publishing) file a letter with the SEC in response to a complaint by NantHealth’s Patrick Soon-Shiong, who made a $70 million investment in the company last year to help thwart a hostile takeover attempt by Gannett. The company says that before investing in Tronc, Soon-Shiong first suggested that Tronc invest in NantHealth’s IPO, and after being rebuffed, then insisted that Tronc Chairman Michael Ferro make a personal investment in NantHealth is an “implicit threat” to pulling out of the deal. Tronc says Ferro took a $10 million stake in NantHealth to pacify Soon-Shiong. Tronc has removed Soon-Shiong for board member re-election and has capped his ownership stake, leading to accuse the company of intentionally squeezing him out. Tronc also claims that Soon-Shiong is demanding payments for Nant-provided technology he made available to Tronc to monetize its online content even though the technology turned out to be unsuitable.

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Doctor search website Amino raises $25 million in a Series C funding round, increasing its total to $45 million. The company makes money selling customized versions of its search function to employers and health plans and by offering access to its insurance claims database.

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Orion Health Group shares drop sharply after the New Zealand company’s trading update predicts lower revenue. They’re down 61 percent in the past year with a market cap of $226 million. The company says it still hopes to swing to profitability in 2018.

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McKesson completes its $1.1 billion acquisition of CoverMyMeds.


Sales

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Pomona Valley Hospital Medical Center (CA) chooses Cerner Millenium to replace Cerner Soarian Clinicals and NextGen ambulatory. It will continue to use Cerner Soarian Financials.

Bon Secours Virginia Health System will implement Tonic Health to automate its intake and payments processes.

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Skagit Regional Health (WA) and San Joaquin General Hospital (CA) choose MPI clean-up services from Harris Healthcare’s QuadraMed Patient Identity Solutions as they move to Epic and Cerner, respectively.  


People

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Nadine Hays (Verscend) joins OmniClaim as chief growth officer.

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Texas Health Resources promotes Debbie Jowers to VP of ambulatory ITS services.


Announcements and Implementations

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Baystate Health’s Techspring innovation center launches a software development and testing environment for its partners, built on the InterSystems HealthShare interoperability platform.

Rock Health releases its Q1 2017 digital health report, indicating that providers and health plans are delaying expenditures based on regulatory uncertainty but key players remain cautiously optimistic and feel well positioned to navigate any regulatory changes. In Q1, they counted 71 digital health deals totaling over $1 billion. The top six categories by deal volume were Analytics/Big Data, Care Coordination, Telemedicine, Hospital Administration tools, Consumer Engagement, and Wearables/Biosensing.

A small Spok survey finds that health systems rarely apply strategic hospital initiatives to their mobile strategy and don’t often include clinicians in their planning teams.

Change Healthcare releases InterQual 2017.  


Government and Politics

The revised ACA replacement apparently being pushed for quick approval would allow individual states to permit insurers to offer less than the current “essential health benefits” and to charge higher premiums for people with pre-existing conditions. Both were the pre-ACA norm, when less-expensive insurance bought directly from insurers (rather than via an employer) often didn’t cover pregnancy or drug addiction treatment and denied policies to those with relatively minor medical conditions.


Privacy and Security

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A review of significant hospital data breaches finds that major teaching hospitals were more commonly involved than smaller or non-teaching hospitals from 2009 to 2016, possibly because they allow more employees to view patient data.

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Hackers breach the systems of the International Association of Athletics Federations, exposing the information of athletes who have applied for exemptions that would allow them to use drugs contained on anti-doping lists. The Fancy Bears hacker group, which claims responsibility, previously published the medical records of mostly American and British Olympic athletes after the IAAF accused Russia of state-sponsored doping and banned their teams from competition. 

ABCD Pediatrics (TX) is hit with ransomware, and though it was able to restore from backups without paying the hacker, it found evidence that its systems had been compromised for some time.

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HHS OCR warns healthcare organizations that use HTTPS security that malware-detecting HTTPS interception products may not pass along any warnings or errors, allowing the organization to validate only the connection between themselves and the interception product’s certificate rather than all the way to the server.


Other

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Ambulatory practice physicians in a community-based health system spend about as much time practicing “desktop medicine” as they do in face-to-face office visits, an analysis of time-stamped EHR records finds. Physicians are spending an increasing amount of time communicating with patients via the  patient portal, managing prescription refills, ordering tests, communicating electronically with staff, and reviewing test results, none of which are billable activities. Work that isn’t logged in the EHR made up the remaining 20 percent of the average doctor’s day. The authors suggest using scribes to manage progress notes, which they estimate would free up one-third of the physician’s time.

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World Wide Web creator Sir Tim Berners-Lee wins the Turing Award (computing’s Nobel Prize) for that 1989 accomplishment, but his concern for net neutrality and an overly centralized, commercialized Web storage model that threatens individual privacy has led him to create Solid. Users would be able to decide where their data is stored and how it is shared. He’s also concerned that the web has been turned into a “purveyor of untruth” by an ad revenue model that rewards click-baiting rather than accuracy.

A study finds that ABIM’s Choosing Wisely campaign that encourages both clinicians and patients to skip low-value services had a small but statistically significant reduction in back pain imaging, for which patients often must pay out of pocket. It concludes that the 4-5 percent reduction indicates that consumer incentives may be ineffective for reducing low-value medical care.

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A study finds that chargemaster prices not only vary widely among hospitals, they correlate to the price actually paid by insurers and patients. Not surprisingly, list price was not correlated with hospital quality. The authors conclude that hospital list prices are neither irrelevant nor indicative of price gouging, but are rather a subtle method hospital use to get favorable deals from insurers, leaving uninsured patients stuck with paying the made-up high prices in cash while everybody else gets negotiated discounts.

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Doctors at Lancaster General Health publish a medical staff newsletter retrospective on its 10 years of using Epic. It refreshingly includes negatives as well as the expected positives – its larger-than-expected $100 million cost, the extra time some doctors spend documenting after hours, and its contribution to physician burnout. One surgeon says Epic is struggling to fulfill its potential because he has to look in other systems to review images, operative reports, and pathology reports, while also noting that EHRs are designed to optimize billing and therefore relevant clinical information is “buried in giant pile of clinically unimportant information.”

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Cambridge Mobile Telematics, which offers brilliant smartphone driving apps to educate drivers and allow auto insurance companies to set rates based on driving habits, analyzes its user records to determine that drivers were distracted by their phones in 52 percent of trips that ended in crash, with an alarming one driver in four using their phone within 60 seconds of their crash. The company also found that distraction was just as bad in states with laws against using phones while driving. Users of the company’s DriveWell program reduce their phone distraction by 40 percent within two months.

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In England, a newspaper’s undercover investigation of the NHS 111 non-emergency hotline call center finds that workers sleep at their desks, send text messages while pretending to listen to callers, and put suicidal callers on hold until they hang up because “after a while you can’t talk to them no more – it just gets awkward.”

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In England, an Iran-born doctor referred to by co-workers as “Little Hitler” loses his medical license after being found guilty of several bizarre outbursts in which he used vulgar terms to describe patients who didn’t bring him gifts, called his receptionist a “fat blob,” referred to a colleague as a cockroach that he hoped would die, and described to female co-workers his vacation adventure in which he “inserted his private parts into a hole in the wall at a nightclub.”


Sponsor Updates

  • Crossings Healthcare Solutions posts its most recent newsletter.
  • Daw Systems will integrate CoverMyMeds electronic prior authorization into its ScriptSure e-prescribing system.
  • Bernoulli’s John Zaleski and Jeanne Venella, RN co-author an article in the Spring 2017 issue of AAMI Horizons.
  • Besler Consulting releases a new podcast, “How much revenue is your chargemaster costing you?”
  • Black Book honors top cybersecurity firms at InfoSecWorld Conference and Expo.
  • Dimensional Insight will exhibit at the Cannabis Business Expo April 12-14 in Phoenix.
  • Healthgrades announces Outstanding Patient Experience and Patient Safety Excellence Award recipients.

Blog Posts


Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Lt. Dan.
More news: HIStalk Practice, HIStalk Connect.
Get HIStalk updates. Send news or rumors.
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Morning Headlines 4/4/17

April 3, 2017 Headlines Comments Off on Morning Headlines 4/4/17

CMS readies insurance market stabilization rule as insurers wait nervously

CMS sends rules designed to stabilize the individual insurance markets to the Office of Management and Budget for final review as insurers wait decide whether to offer plans on the exchanges in 2018.

Soon-Shiong made ‘implicit threat’ to spur investment in NantHealth, media company says

A media company that Patrick Soon-Shiong recently rescued from a hostile takeover attempt with a $70 million investment is claiming that its CEO was forced to personally invest $10 million in NantHealth’s initial round in exchange for the help.

Clinic venture arm hopes to assist innovation work

Cleveland Clinic is launching an investment business, called Cleveland Clinic Ventures, that will work with its innovation department to turn new medical breakthroughs into funded spin off companies.

Wellness Apps Evade the FDA, Only to Land In Court

Wired Magazine covers the legal accountability of health apps that make misleading claims and the effect those court decisions might have on a market that has largely escaped FDA oversight.

Political battles are a ‘distraction’ for health-care business, CEO says

Athenahealth CEO Jonathan Bush discusses the ACA and AHCA, and comments on how healthcare-related political battles affect providers.

Comments Off on Morning Headlines 4/4/17

Curbside Consult with Dr. Jayne 4/3/17

April 3, 2017 Dr. Jayne 1 Comment

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I’ve been doing a lot of thinking about my work lately. I’ve been doing consulting for a while now, starting with side work even when I was a CMIO. I left that ersatz glamour to do consulting full time and it’s been an adventure.

My clients are generally good to work with, and that is a side effect of being your own boss and having the ability to terminate clients who are difficult or want to play mind games. Still, they get stressed out like anyone does, and often the consultant is expected to try to fix issues whether they’re in scope or not. That creates some tension around whether I should allow them to change the scope of work or whether I need to send them in another direction, especially when they try to game the system to get their new problem included for free.

Everyone is under significant economic pressures and I understand where they are coming from. Just because you’re in healthcare, though, doesn’t mean that we can give you services for free. Especially as a small consulting firm, even small discounts can make a big dent in our bottom line. We’re in the purest of “eat what you kill” models and even though we have low overhead, we still have bills to pay like everyone else. Fortunately, my partner and I are both fairly frugal and we’re not in this business for the money (although it is nice at times). But with increasing financial pressures due to the shift from volume to value, many more of our client-facing conversations are about money rather than vision, mission, or strategy.

Our clients feel increasingly like they’re in the crosshairs with payer audits, federal and state regulations, anti-kickback worries, medico-legal issues, and legislative uncertainty. Not to mention there are also decreasing contract rates, more bundled payment initiatives, and the ever-present worry about the inefficiencies of EHR. For the most part, we can help clients tackle many of their stressors, but the fact that healthcare delivery continues to be in a state of rapid change is something that we can’t do a lot about. Of course, we can help the clients with strategic planning and trying to future-proof their businesses, but that’s a big change for clients who thought they would be independent practitioners forever.

I work for myself, which has a lot of perks. I can generally control my travel schedule and have no problem saying no, although clients have been less flexible the more they are stressed. We have a solid plan to divide and conquer when our clients have needs for specific expertise, although we can cross cover each other enough that we don’t ever feel we are working without a net. Still, I thought we’d be at a different place by now in the evolution of healthcare. Unfortunately, we’re still grappling with some of the same concepts that we grappled with decades ago. They were challenging then, but throw the technology piece at them as well and they can be even more messy.

I’ve been in the healthcare technology leadership space for more than a decade and I’m still fighting the fact that my clients (and their patients) don’t have full access to their medical records. In a lot of ways, they can’t even cobble together a medical record because of the barriers to sharing that are all around them. I’m personally enrolled in four patient portals. One has two of my physicians on it, but they don’t share any data. It might be better that we’re not sharing data, though — my new primary care physician sent me a summary of care record, but unfortunately it has multiple family history errors and even gave me some new diagnoses that I never knew I had, including a pulmonary embolus and clear cell carcinoma.

Because of the crazy way our payment system works, many providers game the system to gain the maximum reimbursement possible. Anyone who has experienced provider-based billing knows what I’m talking about, as do those who have pushed the boundaries on time-based services to achieve higher codes. This creates a lot of stress in the ambulatory space as everyone struggles to figure out how they’re going to add headcount for care management and preventive services while fee-for-service payments are decreasing. Although there are some programs seeking to provide those payments up front, such as the Comprehensive Primary Care Plus program, providers are constantly under the threat of missing some kind of documentation, reporting deadline, or other hurdle that might mean they have to pay back those monies even though they were trying to do the right thing by their patients and communities.

We’ve thrown a lot of precious time and billions of dollars at a healthcare system that isn’t generating the return on investment that we need it to. Divorced from the payment scheme by insurance and other third parties, the majority of patients have no idea whether their providers are gaming the system or not. Is the price they’re charging fair? Is the patient receiving value? It’s hard to tell. In many parts of the country, the only entity that has even close to a full picture of the patient is the payer, and that’s a shame. I’m watching my friends who are only 20-25 years into their careers plan for early retirement when they realize selling out to a big health system wasn’t the answer to their struggles with independent practice.

When physicians are together, we talk about the predicaments we’re in and whether the primary care physicians can hold on long enough for the balance to tip in their favor, helping them come off the hamster wheel and be able to truly connect with their patients again. I know of many physicians who have gone into politics – talk about going from the frying pan into the fire. Although most of them are altruistic, one in my state makes spectacularly poor decisions about a variety of issues. For those in the trenches, especially after the last election cycle, there is plenty uncertainty around tomorrow even if they make it through today.

Some days it’s harder than others to grind through the muck. Whether you’re seeing patients or whether you’re trying to help practices and organizations survive an obstacle course that would make an American Ninja Warrior take cover, it’s tough. I miss the days when we were adding technology to our lives because it solved problems, not because we were forced to and certainly not if it added hardship. Although I see the bigger picture and try to translate it to our clients, it’s getting harder to convince people to hang in there and keep moving forward.

I relish my office days, when I put on my hourly employee hat and just see patients to the best of my ability. For the most part, I make patients’ bad days better and they’re grateful. It reminds me of why I wanted to be a doctor in the first place. But I know that behind the scenes there is still a seedy underbelly of coding, billing, modifiers, and more. I’m spoiled by how well my partners run our practice and spend a lot of time thinking about how much I’d like to bottle their leadership skills and atomize their fortitude around my clients.

Although it feels like healthcare is behind where it should be, it also feels like we’re on the verge of something big. We do things every day that no one had heard of when I was in medical school, and that’s a good feeling. It makes me want to stay in this game another month, another year, another five just to see what happens.

If you could bottle one thing and spread it all around healthcare, what would it be? Email me.

Email Dr. Jayne.

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