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Tom GuillaniWhen providers and their staff don’t have the time or tools to effectively communicate with patients, a slew of issues can result: from physicians missing important cues and misdiagnosing patients to preventable hospital readmissions and poor outcomes because patients didn’t understand or follow care guidelines.

The problem has become endemic. According to one study, 80% of what doctors tell patients is forgotten as soon as they leave the office. Beyond that, 50% of what the patient did recall is incorrect. In addition to impact communication and follow up have on care and outcomes, patients are expecting a different experience than they once had. Nearly two thirds of patients now say they would consider switching to a physician who offers access to medical information through a secure Internet connection. Continue reading “Go Beyond Using Your EHR; Practice Heads Up Medicine”

flying cadeucii

  •  Decide who you are and don’t kid yourself
  •  Don’t bluff; the triple (quadruple) threat is an illusion
  • Know your subject; teaching is not a trick; you must have something real to transmit
  • Don’t replace substance with gimmicks (e.g. fancy powerpoint)
  • Simulated patients produce simulated doctors and de-professionalize students
  • Respect your teachers but don’t believe in the Days of the Giants; they have feet of clay
  • Don’t become “one of them.”
  • Develop a reputation beyond the local environment
  • Train people, but remember that some will not respect you (remember Bouchard)
  • Stand proudly for clinical excellence
  • Write briefly, simply and parsimoniously (remember Babinski)
  • Be a professional
  • Don’t be an asshole
  • Don’t bullshit

Abstracted from the “Academic Medicine Survival Guide” Martin Samuels, MD. The Health Care Blog. March 2015.

AMA: What’s the ICD-10 Contingency Plan?

The AMA and about 100 other physician groups urge CMS to develop an ICD-10 contingency plan in the event of a “catastrophic” backlog following the October 1 transition. The organizations want CMS to make public its plans to make advanced payments or reimbursements for services already rendered, work with ONC to ensure EHR systems are ICD-10 ready, and confirm contractors won’t audit for the correct code.

The silver lining here is that these organizations are (finally) not asking for a delay in implementing ICD-10. CMS apparently has drafted a contingency plan in the event of claims process disruptions but does not plan to make it public. In this age of more transparency, CMS needs to make the plan public – even though provider groups will surely find fault with the plan. But, isn’t it better to continue moving the conversation forward, just in case of there is a catastrophe?

Continue reading “HIT Newser: What’s the ICD-10 Contingency Plan?”

flying cadeuciiThis Year’s Meaningful Use “Sticks”: Not that Big

CMS reports that the majority of physicians who will be penalized this year for not having met MU requirements will lose less than $1,000 of their Medicare reimbursement; 34% of the penalties will be $250 or less, while 31% will exceed $2,000.

The adjustments will impact approximately 257,000 eligible providers. While no one likes losing money, the CMS penalty “stick” is pretty small compared to the overall cost of implementing an EHR.

Mayo Provides Dr. Google with 2nd Opinion

Google consults with the Mayo Clinic to expand its healthcare information for 400 medical conditions.

Given that 20% of all Google searches are related to health conditions, the change will no doubt shake up what Americans find when searching for medical information. The update includes the addition of illustrations for each condition, plus a full list of search results from sites such as WebMD and Wikipedia.

Continue reading “HIT Newser: The Not-So-Big Meaningful Use Stick”

 


athenahealth logo new


Athenahealth Pushes Further Into the Inpatient World

Beth Israel Deaconess Medical Center partners with athenahealth to enhance its homegrown in-patient EHR. Athenahealth is buying Beth Israel’s clinical applications, which it will enhance and rebrand as athenaNet. The purchase comes just a few weeks after athenahealth’s purchase of RazorInsights, an EHR platform for rural and community-based hospital.

Never underestimate Jonathan Bush’s ability to disrupt the HIT world. Athenahealth may be a little late to the in-patient EHR party, but they wouldn’t be the first company to successfully transition from an ambulatory-only vendor to an enterprise vendor: Epic, of course, got its start as a provider of ambulatory solutions.

ONC Offers $28 Million to Advance HIE

The ONC will award $28 million in grants to advance the adoption and use of interoperable HIT tools and services to support HIE.

The announcement coincided with the ONC’s annual meeting – which reportedly focused heavily on interoperability issues – and on the heels of the agency’s release of its draft HIT interoperability roadmap. Though it’s still early, “interoperability” seems to be taking an early lead as this year’s top HIT buzz word.

MGMA Asks CMS to Reduce Portal Duplication

The MGMA asks the federal government to consolidate its reporting programs and eliminate its use of multiple Web portals for physician reporting.

MGMA says its best: “it makes not practical sense to have multiple systems which create unnecessary work by requiring duplicative registration with separate usernames and passwords for physicians and practices to access reports or report information pertaining to Medicare Part B programs.”

FDA Recommends Minimal Oversight for Medical Devices

The FDA finalizes guidance on data transmissions from medical devices, saying it doesn’t intend to regulate software that receives, transmits, stores, or displays data due to the low risk to patients.

That’s good news for mHealth developers and enthusiasts, who had been concerned that too much regulation might spur continued innovation in the space.

Wheeling and Dealing

  • CareTech Solutions wins an eight-year agreement with Maryland’s Adventist HealthCare to provide outsourced IT services.
  • Boulder Community Health selects Voalte’s smartphone mobile communication technology for its acute-care hospital and regional trauma center facilities.
  • Lehigh Valley Health Network’s 200 outpatient offices go live this month on Epic as the first phase of the health system’s $200 million implementation. LVHN’s regional competitor St. Luke’s University Health Network will also be switching to Epic at a later date.
  • Gulf South Quality Network in Louisiana selects Medecision to build a data warehouse based on Medecision’s Aerial platform.

Show Me the Money

  • Athenahealth reports Q4 adjusted EPS of $0.58 versus the previous year’s $0.57 and beating analysts’ estimates of $0.39. Revenue was up 24%. Despite the strong performance, analysts note that revenue from Epocrates services fell 32% from the previous year, and, general and admin costs grew more than 50% as a result of increased headcount.
  • McKesson posts Q3 EPS of $2.89, up from last year’s $1.48 and beating estimates of $2.62. Revenues grew 36.9% to $47 billion, beating estimates of $44.6 billion. Despite strong overall results, revenues from McKesson’s Technology Solutions segment fell 7.3% as the company continued its planned elimination of its Horizon hospital software product line.
  • Vital Medicals, a developer of a smart glasses application for surgeons, raises $925 million from angel investors and the Stanford StartX Fund.
  • Telehealth solution provider Kura MD secures $1.5 million from Moneta Ventures.
  • PB Capital Holdings invests an undisclosed amount in EHR provider ITelagen.
  • Under Armour acquires Enomondo for $85 million and MyFitnessPal for $475 million, establishing the company as the “largest digital fitness community” reaching more than 120 million users.
  • Workflow automation software provider Aventura closes a $14 million Series C financing round co-led by Safeguard Scientifics and Merck Global Health Innovation Fund.

New Blood

  • Kaiser Permanente names Richard (Dick) Daniels EVP/CIO. Daniels has served as interim CIO since September 2014; previously he was SVP of enterprise shared services for Kaiser.
  • Former Epic executive Dave Cassel joins Healtheway, a nonprofit collaborative focused on advancing interoperable HIE, to lead the company’s Carequality initiative.
  • RemitData appoints Laura Hescock (Public Consulting Group) director of strategy and operations and Stacie Bon (Rodgers Townsend) senior director of marketing, and, promotes Jason Whiteaker from director of sales to VP of partner strategy.
  • Specialty surgical hospital network Coordinated Health names Greg Flanagan, former COO for Advanced Health, CIO.

Etcetera

  • A spokesperson for New York City Health and Hospitals Corporation attributes its use of EHR for protecting the health system from record loss after a fire destroyed a warehouse that housed duplicate copies of archived patient records.

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Farzad MostashariWe launched Aledade on June 18th, and by the end of July we had recruited 80 primary care physicians in 4 states to join us in creating the very first Aledade ACOs. We have been work together ever since- but haven’t been able to talk about our wonderful practices until the official notification from CMS that came today.

We are thrilled to announce that beginning January 1, our two newAledade ACOs will be taking accountability for the care of over 20,000 attributed Medicare patients, and stewardship of nearly a quarter of a billion dollars of health care expenditures each year. We’re building a new delivery system on the foundation of trust between patients and the physicians who have been caring for them in their communities for decades, and enabled and accelerated with cutting-edge technology and analytics.

One ACO will operate in the state of Delaware, in close collaboration with our physician partners and our field team, Quality Insights of Delaware. Our second ACO, the Primary Care ACO, will take the same model spanning three states — New York, Maryland, and Arkansas, where we are also working with local partners like the Arkansas Foundation for Medical Care. Our hand-picked ACOs physician partners are some of the most capable and inspiring primary care physicians in the country. They are leaders in their local, state and national physician associations; they are pioneers of Meaningful Use and Patient Centered Medical Homes; they are much-decorated top doctors in quality; but most of all, they are the pillars of their communities. Continue reading “It’s Official: Aledade ACOs Up and Running”

flying cadeuciiJacques Johndreau did not look like his usual self when I saw him in the office a few weeks ago. He looked part retired bank manager and part Disney cartoon chipmunk.

He spoke with hardly any facial movements:

“Holy Boys, my wife said to me this morning, you look like you’ve got the mumps again!”

I was aware that Jacques had an atrophic testicle from catching the mumps as a teenager. This time, it was not likely the mumps, but a bacterial parotitis. He was afebrile, and could open his mouth when asked to. I could not palpate a stone in Stensen’s duct and he didn’t experience any worsening of pain when eating acidic foods, so I wasn’t so sure he had a stone.

This was an early, mild case of parotitis and I thought he had a good chance of beating the infection with oral antibiotics. The majority of these infections are caused by staphylococci, but sometimes gram-negative bacteria are the culprit. Whatever I chose, I needed to consider that Jacques takes a blood thinner, warfarin, which interacts with many antibiotics, particularly ones with gram negative coverage.

I e-prescribed a high dose of Ceftin, or cefuroxime, a second generation cephalosporin with good coverage for both staph and gram-negatives and no effect on warfarin.

Continue reading “Zen and the Art of Antibiotics”

flying cadeucii Omnibus Bill Impacts HIT

The 2015 federal budget includes about $60.4 million for the ONC, which is less than the $75 million requested and on par with the 2014 budget. Congress allocated an additional $38.8 million to the HHS Office for Civil Rights, the agency that enforces HIPAA. Also in the bill: a controversial requirement for the ONC to decertify products that block health information sharing.

Appalling Meaningful Use Penalties

CMS reports that more than 257,000 eligible professionals will face penalties in 2015 for failing to meet Meaningful Use requirements. The AMA quickly announced it was “appalled by the news.”

Another Call to Cut Reporting Period

A group of 30 Republican House members call on HHS to shorten the 2015 Meaningful Use reporting period from 365 days to 90 days. A number of professional groups, including the AAFP and CHIME, support the extension.

From Foes to Financiers

Former Allscripts executives Glen Tullman and Lee Shapiro invest in Lightbeam Health Solutions, a population health management solution provider. Pat Cline, the founder and former president of NextGen, is currently Lightbeam’s CEO.

ATA Offers Accreditation

The American Telemedicine Association launches an accreditation program for providers offering online, real-time consults to patients. 

Continue reading “HIT Newser: Appalling Meaningful Use Penalties”

flying cadeucii The Board of Governors of the Patient-Centered Outcomes Research Institute (PCORI) will consider a plan for funding comparative clinical effectiveness research on hepatitis C virus infection at its day-long meeting on Monday, Dec. 8. In addition, the Board will vote on a plan to fund the second phase of development of PCORnet, PCORI’s initiative to improve the efficiency of health research by harnessing data from electronic health records (EHRs) and other resources.
The meeting will run from 10:15 a.m. to 5:45 p.m. EST Monday, Dec. 8, at the Renaissance Dupont Circle Hotel, 1143 New Hampshire Ave., NW, Washington, DC. The public may attend in person or via teleconference/webinar. Visit the meeting page on PCORI’s website to view the agenda and register to join the teleconference.
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