Category: Uncategorized

Health IT Newser

Nov 10, 2014• 2

MICHELLE RONAN NOTEBOOM

A No Way for Allscripts and MyWay

A North Carolina arbitration panel rules that Allscripts must pay Etransmedia $9.7 million for a breach of their partner agreement in violation of the state’s Unfair and Deceptive Trade Practices Act. The panel found that Allscripts unfairly profited by inducing Etransmedia to buy MyWay software licenses and assuring Etransmedia that it would make the product Meaningful Use-compliant. Allscripts later announced that rather than update MyWay it would phase out the product, leading the panel to rule that Allscripts “deliberately sabotaged” Etransmedia’s sales efforts.

Post-Election Predictions

The recent Republican sweep of the House and Senate may bode well for health IT, predict several industry pundits. One issue that will likely be discussed: the reduction of Stage 2 MU reporting requirements from 365 days to 90 days. Also look for renewed interest in issues around interoperability, telemedicine, and regulation of medical devices, software, and mobile apps.

Stage 2 Attestations Numbers: Disappointing but Predictable

CMS reports that only 4,656 EPs and 258 hospitals have attested for Stage 2 MU through the end of September. That’s less than 17% of the nation’s hospitals and a mere two percent of EPs (though EPs have until the end of February to report their progress.) Officials from the AMA, CHIME, HIMSS, and MGMA called the results disappointing yet predictable, and renewed calls for a shortened MU reporting period in 2015 and more program flexibility. Continue reading…

Pay for Engagement: A New Framework for Physician Reimbursement

Nov 10, 2014• 26

By Ben Rosner, MD, Kyle Homstead & Jordan Shlain, MD

A thousand channels, and nothing’s on. “Patient engagement” has become an increasingly used buzzword in which healthcare finds itself awash. Yet little around patient engagement has been operationalized into any sort of enduring clinical reality. In part, this is due to the lack of convergence, until recently, of three major and arguably requisite ingredients: 1. A practical, operational definition of patient engagement that allows us to measure it continuously and treat it just as we do a vital sign, 2. A manner by which to connect the two most important parties in the patient engagement equation -‐ the patient and physician – between visits in a way that is clinically compatible and meaningful, and 3. An incentive that helps honor and reward a key missing ingredient – the physician -‐ for the time needed to promote engagement directly with his or her patients. We will discuss these three elements and highlight two current pilot studies that are beginning to break through these barriers.Continue reading…

ONC launches Pilot Program to Catalyze Health IT Innovation

Nov 10, 2014

Investments in digital health have never been higher, with reports indicating that $5 Billion has been invested in health tech startups in 2014. Encouraged by the increasingly favorable changes being made to health policy in the U.S., many entrepreneurs have answered the call to action to solve problems related to health care delivery and access, disease management, and cost reduction. Venture capitalists recognize the value of innovation in health care through technology yet few of these tools have gained widespread adoption. Health care organizations and providers are wary of implementing new technologies that haven’t been tested for fear of disrupting their workflows and causing more problems than before.

Market R&D Pilot Challenge Website

Recognizing these high barriers to entry for digital health startups the Office of the National Coordinator for Health Information Technology (ONC) is hosting the Market R&D Pilot Challenge to bridge the gap between health care providers and innovators. This competition, which is administered by Health 2.0, may award pilot proposals in four different domains: clinical environments (e.g., hospitals, ambulatory care, surgical centers), public health and community environments (e.g., public health departments, community health workers, mobile medical trucks, and school-based clinics), consumer health (e.g., self-insured employers, pharmacies, laboratories) and research and data (e.g, novel ways of collecting data from patients).Continue reading…

Inoculating Your Wellness Program Against EEOC Attack

Nov 7, 2014• 12

By AL LEWIS and VIK KHANNA

Two months ago Al wrote a column titled: Are Obamacare Wellness Programs Soon to be Outlawed? Truthfully that headline was picked for its sky-is-falling value, in an attempt to generalize one Equal Employment Opportunity Commission (EEOC) lawsuit against one wacky wellness program to an EEOC risk for wellness programs everywhere.

As luck would have it, the sky has now fallen — right on the head of Honeywell…and the EEOC is indicating more lawsuits are to come. The scary part here: Unlike the wacky wellness program above, Honeywell was in compliance with the Affordable Care Act (ACA), but compliance with the ACA doesn’t seem to get you a free pass on the EEOC’s own “business necessity” requirement, plucked from the Americans with Disabilities Act (ADA), which they enforce.

Essentially the Honeywell lawsuit means no company doing invasive biometric screenings and mandating doctor visits or measuring health outcomes on individuals, and that has a significant financial forfeiture attached to it, is immune to prosecution, even if they are in compliance with ACA.Continue reading…

Could the ‘Design Thinking’ that Led to the Apple Mouse Transform Health Care?

Nov 6, 2014• 10

By SHANTANU NUNDY

Screen Shot 2014-11-06 at 5.11.35 PM

In 1980, Apple gave a small California design firm (that later became IDEO) a simple yet incredibly complex task: do more with less. The challenge: take a computer mouse that cost $400 and make one that cost $25 while simultaneously improving the quality, functionality and user experience. The result: IDEO not only delivered an exceptional product, but also pioneered a design thinking approach that has allowed it to make innovation a regular occurrence.

This month, as part of the first Evolent Health Clinical Innovation Summit on high-value health care delivery, we visited IDEO at its Palo Alto headquarters. Twenty health care leaders from across the country visited the IDEO toy lab, heard the story of the first Apple mouse and marveled at a 3D-printer. The question on our collective minds: could the design thinking principles that produced the first Apple mouse be used to transform U.S. health care?Continue reading…

No Country for Old Smokers

Nov 6, 2014• 32

By SAURABH JHA, MD

“Traditionally, doctors used to be called in when needed. But this is now changing. Increasingly it is the doctor who calls the person in by issuing an invitation. Healthy people are asked to visit the surgery for a ‘check-up’, or ‘screening’, when their computerized records show they are ‘due’. Non-attendance is known as ‘non-compliance’, indicating an element of recklessness and irresponsibility.”

Petr Skrabanek. The Death of Humane Medicine and Rise of Coercive Healthism.

If CMS endorses MEDCAC’s recommendations regarding low dose screening CT for lung cancer, we may see a coverage scenario that might be mistaken for an episode of Saturday Night Live.

Primary Care Physicians Need To Be More Like Financial Advisors

Nov 5, 2014• 18

By TOM VALENTI

Man looks into the Abyss, and there’s nothin’ staring back at him. At that moment, man finds his character, and that’s what keeps him out of the Abyss. – Lou Mannheim (Hal Holbrook) in the movie “Wall Street”

We hear reform ideas all the time: primary care physicians need to work at the top of license, physicians need to work in teams, healthcare must deliver top-notch customer service, the focus needs to be on creating strong physician/patient relationships, and physicians need to be paid for delivering value.

The question then becomes: how does the healthcare industry implement such ideas?

I believe it would be smart to apply the lessons from other industries.

Specifically, the financial services industry.Continue reading…

ACOs Are Doomed / No They’re Not

Nov 4, 2014• 38

By THCBist

A number of pundits are citing the systemic failure of ACOs, after additional Pioneer ACOs announced withdrawal from the program – Where do you weigh in on the prognosis for Medicare and Commercial ACOs over the next several years?”

Peter R. Kongstvedt

Whoever thought that by themselves, ACOs would successfully address the problem(s) of [cost] [access] [care coordination] [outcomes] [scurvy] [Sonny Crockett’s mullet in Miami Vice Season 4]? The entire history of managed health care is a long parade of innovations that were going to be “the answer” to at least the first four choices above (Vitamin C can cure #5 but sadly there is no cure for #6). Highly praised by pundits who jump in front of the parade and declare themselves to be leaders, each ends up having a place, but only a place, in addressing our problematic health system.

The reasons that each new innovative “fix” end up helping a little but not occupying the center vary, but the one thing they all have in common is that the new thing must still compete with the old thing, and the old thing is there because we want it there, or at least some of us do. The old thing in the case of ACOs is the existing payment system in Medicare and by extension, our healthcare system overall because for all the organizational requirements, ACOs are a payment methodology.

Dear ACO General Hospital

Nov 4, 2014• 11

By ROB LAMBERTS, MD

Dear ACO General Hospital:

Thanks for contacting me about my most recent blog post. I’m sorry to scare your administration about HIPAA information, but I am equally concerned about that and will always do my best to respect the privacy of my patients. At your request I hid even more of that information.

I know it’s kind of embarrassing to have that kind of thing made public, and I am overall grateful that you did not take it personally that I put the “transition of care” documents for all to see. My goal was not to embarrass or ridicule, it was to point out what our healthcare system is driving us all toward: replacing patient care with documentation. You are being encouraged by the system to produce those ridiculous documents, as they are part of the deal you accepted when you became “ACO General” in the first place.

Solving the Primary Care Shortage

Nov 4, 2014• 6

By RICHARD GUNDERMAN, MD

One of the top students at one of the nation’s largest medical schools, Ishan Gohil has made an unusual – and to many of his colleagues – inexplicable decision. Instead of seeking to train in one of medicine’s most highly specialized and competitive fields, he says, “I elected to pursue a career in family medicine.” Many view his choice of primary care as ill-advised, largely because family medicine is one of the least competitive fields and ranks at the bottom for income of all medical specialties.

Until his third year, Gohil had planned to pursue orthopedic surgery, which is considerably more difficult to get into than family medicine. In 2014, the average score on Step 1 of the US Medical Licensing Exam for students entering family medicine was 218, while for orthopedic surgery it was 245 (the overall average is 230). Average annual salary levels diverge even more widely, at $122,000 for family physicians and $488,000 for orthopedic surgeons.Continue reading…