Month: February 2015

Healthcare’s Reform Pareto Trap

Feb 16, 2015• 28

By SAURABH JHA, MD

It is reassuring that in a country which produced HL Mencken, Homer Simpson and Mark Twain, reports of death of satire have been grossly exaggerated.

Recently, the faculty at Harvard were up in arms because their new health plan involves copayments and deductibles. With ninety cents to the dollar covered, the plan is generous by national standards, and would be rated “platinum” in Obamacare’s exchanges. It’s not as if the professors were placed on Medicaid to show solidarity with the poor.

Increased out-of-pocket contribution is the trend post health care reform. That same reform which many Harvard professors supported and some designed. This is why their revolt, an Orwellian political satire, has spread schadenfreude amongst conservatives who are enjoying Gore Vidal’s favorite words in the English Language: “I told you so.”Continue reading…

Please Choose One

Feb 15, 2015• 88

By PHILIP ALLEN GREEN

Please choose one:

The three words blink in front of me on the computer screen.

Please choose one:
Patient is-
☐Male ☐Female

I click FEMALE.

I watch as the auto-template feature fills in the paragraph for me based on my choices.

Patient #879302045

Patient is: 38-year-old female status post motor vehicle accident. Please acknowledge you have reviewed her allergies, medications, and past medical history.

I click YES.

Have you counseled her about smoking cessation?

I click NO.

A little animated icon of a doctor pops up on the screen. His mouth begins to move as if speaking. A speech bubble from a comic strip appears next to it.

“Tip of the day: smoking cessation is important for both the patient’s health and part of a complete billing record.”

The High Cost of Free Checkups

Feb 13, 2015• 33

By AL LEWIS and VIK KHANNA

A predictable irony of the never-ending Affordable Care Act (ACA) debate is that the one provision that the Republicans should be attacking — free “checkups” for everyone — is one of the few provisions they aren’t attacking. Why should they attack them? Simple — checkups, on balance, are worthless. Why provide a 100 percent subsidy for a worthless good? Where is the GOP when you need it?

How worthless are checkups? Dr. Ezekiel Emanuel — one of the architects of the ACA and its “free” checkup centerpiece — recently recommended not getting them. As if “free” is not cheap enough, the ACA also pushes ubiquitous corporate wellness programs, which often pay employees to get checkups — or fine them if they don’t. This policy establishes a de facto negative price for millions of workers, making checkups the only worthless service on earth that one could get paid to utilize.Continue reading…

Could mHealth Apps Be a Reprise of the EHR? The Need For Clinician Input

Feb 13, 2015• 5

By JAAN SIDOROV, MD

While your humble correspondent continues to delight in the emerging science of “mHealth” as a newly minted start-up Chief Medical Officer, he ran across this interesting article on risk and patient safety.

Authors Thomas Lewis and Jeremy Wyatt worry that “apps” can lead to patient harm.

They posit that the likelihood of harm is mainly a function of 1) the nature of the mistake itself (miscalculating a body mass index is far less problematic than miscalculating a drug dose) and 2) its severity (overdosing on a cupcake versus a narcotic). When you include other “inherent and external variables,” including the display, the user interface, network issues, information storage, informational complexity and the number of patients using it, the risks can grow from a simple case of developer embarrassment to catastrophic patient loss of life.

In response, they propose that app developers think about this “two dimensional app space” that relies on a risk assessment coupled to a staggered regulation model. That regulation can range from simple clinical self assessment to a more complex and formal approval process.

Three Lessons Healthcare Executives Can Learn From the Sony Hack

Feb 12, 2015• 4

By DEAN STEINBECK

As if healthcare executives needed more to worry about, the recent hacker attack on Sony Pictures should send yet another reminder that data security can’t be ignored. On an international stage, Sony management learned the hard way that their e-mails, text messages, and private conversations were vulnerable to attack. Hackers accessed everything from the company’s sensitive financial information to its confidential employee communications. In the immediate aftermath of the attack, Sony is facing government inquiries, class action lawsuits from employees and business partners, and a significantly tarnished reputation.

Many executives in our industry might think that healthcare facilities are better prepared to withstand hacker attacks, with numerous government agencies regulating how we store and transmit protected health information (PHI) and personal identifiable information (PII). In reality, a significant number of healthcare facilities have already suffered damaging hacker attacks over the last few years and expectations are that hacker attacks will be a continued threat for the foreseeable future. The question healthcare executives must ask is: “What are we going to do about it?”

It’s Past Time to End the Employer Mandate

Feb 12, 2015• 50

By DAVID DRANOVE and CRAIG GARTHWAITE

The New Year always brings many changes. In addition to soon to be broken resolutions, this particular year ushered in strict mandates requiring employers with more than 100 full-time employees to either provide health insurance to those employees or pay fines of between $2000 and $3,000. We’ve seen many firms publicly respond to this by cutting benefits to part-time workers. Despite the criticism that often accompanies these decisions, in many, if not all, of these cases this move benefits employees. Without the offer of employer-provided insurance they get access to the ACA exchanges.

Part of the criticism stems from the implicit belief that firms “give” benefits to their employees out of some form of philanthropy. These benefits are just a tax-preferred (though not really for low-income employees) form of compensation, and research shows that increases in benefit costs result in lower wages for employees. The firms that have cut benefits will either increase wages or lose a lot of employees. (If they cut benefits, do not raise wages, and do not lose workers, then they must not have been profit maximizing to begin with; we highly doubt that firms like WalMart would have knowingly forsaken an opportunity to maximize profits.)Continue reading…

HIT Newser: Millions and Millions for More Interoperbility

Feb 11, 2015

By MICHELLE RONAN NOTEBOOM

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.

A Detailed Analysis of the Republican Alternative to Obamacare

Feb 11, 2015• 57

By ROBERT LASZEWSKI

House Energy and Commerce Chairman Fred Upton along with Senate Finance Chairman Orin Hatch and Senator Richard Burr have outlined what is, at least for now, the Republican alternative to Obamacare.

Republicans will now argue they have a better health insurance reform plan and that Obamacare should be repealed and replaced by it––particularly if the Supreme Court plunges the new health law into chaos by throwing the subsidies out in 37 states.

They will have an uphill battle. Not because these Republicans don’t have a lot of good ideas, but because they have put a list of big and complicated changes on the table. Lots of people may not like Obamacare but Republicans have now really muddied the waters with a huge take it or leave it alternative that will have plenty of its own reasons to give voters pause.
Continue reading…

A Shout Out to Our Sponsors

Feb 11, 2015

By THCBist

THCB thanks our corporate supporters

Corepoint Integration Engine is the #1 ranked interface engine by KLAS six years in a row. We have the healthcare IT experience and strength to deliver a dramatically simplified approach to internal and external data integration and health information exchange for hospitals, radiology centers, laboratories, and clinics.

Our next generation software solutions are transformational and will streamline your IT environment, provide a fast track to achieving your interoperability goals, and create operational leverage within your organization.

Learn more: visit CorepointHealth.com

Send a message of support to THCB’s community: Become a corporate underwriter.

Open Enrollment, Take 2: What Matters For The ACA Marketplace?

Feb 11, 2015

By LAURIE T. MARTIN

By the end of 2014, more than 6.5 million people were enrolled in health insurance plans through the Affordable Care Act (ACA) Marketplace, also called the “exchanges.” In some cases, this was relatively easy. But for many, the ACA’s first open-enrollment period was a confusing and frustrating time, compounded by a lack of clear, easy-to-understand information about plan options, coverage, and cost.