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HIT Newser: ACA upheld – Can We Talk Health IT Now?

By MICHELLE RONAN NOTEBOOM

AMGA requests funds and policies to support care for chronically ill

In a letter to members of the Senate Finance Committee Chronic Care Workgroup, the AMGA asks Congress to consider policies and financial and operational technologies that support care for the chronically ill. The AMGA stressed that clinical data from EHRs and details from administrative claims are valuable for analyzing trends on utilization and outcomes.

The AMGA supports the development and use of sophisticated predictive analytic software that have the potential to improve care coordination, cut hospital re-admissions, and reduce the overall cost of patient care. The organization is also encouraging the use of telehealth to care for the chronically ill, as well as financial incentives to encourage provider investment in care management tools.

And now back to us

On the heels of the Supreme Court ruling on the ACA, several health IT organizations express hope that Congress will renew its focus on interoperability, telehealth, Meaningful Use, and other HIT-related issues. Politico reports that Health IT Now Coalition executive Joel White is hoping for a “continued bipartisan focus on interoperability and telemedicine,” while HIMSS believes the decision will create more predictability in the healthcare sector, which may facilitate the advancement of its IT agenda.

It’s great to be optimistic, but I’m sure no one will be shocked if lawmakers find alternative distractions.

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HIMSS 2015: Girish Navani

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By MICHELLE RONAN NOTEBOOM

Our intrepid tech columnist Michelle Noteboom caught up with eClinicalWorks CEO Girish Navani last week to talk with him about his company’s future, his patient engagement strategy and his plans for international expansion.

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Michelle Noteboom: What’s the latest news from eClinicalWorks?

Girish Kumar: There’s a lot Michelle. I like to put it into some buckets so that I can define them. The core is our EHR and practice management space and the focus continues to be on usability and always making it’s more provider-friendly; the whole space around using touch and speech. We seem to be doing some innovative work in that arena to make EHR even more usable than just point and click. In that space we’re seeing continuous growth based on good customer satisfaction and retention.

That’s part one. Obviously the government mandates dictate a lot of other things. Meaningful Use 3 comes on the horizon. Interoperability is a big deal and I think we’ve done some good work with Epic and eCW integrations now for our mutual customers, which is making interoperability even better with faster deployment for our clients.

That’s the core. There are three other things. One is revenue cycle management, which averages 2.9%.  We’ve gotten good momentum in that space, with both new customers and convergent customers.

Population health: we’re competing with stand-alone companies in that space reasonably well in both ACO product lines. We did well with other quality programs, so that’s an area that we’ll continue to invest.

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HIT Newser: Big Win for Epic in San Diego

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 By MICHELLE RONAN NOTEBOOM

 Epic Scores Another Big Win

Scripps Health selects Epic to replace its existing GE Healthcare’s Centricity Enterprise (inpatient) and Allscripts Enterprise (outpatient). The San Diego-based Scripps includes five acute-care campuses, 26 outpatient clinics, and 2,600 affiliated physicians.

No doubt that this is one that Cerner had hoped to win.

Marlin Equity Partners Acquires e-MDs

Marlin Equity Partners acquires ambulatory EMR provider e-MDs. Marlin will merge e-MDs with its existing portfolio company MDeverywhere, a provider of RCM and credentialing services for physicians. e-MD founderContinue reading…

HIT Newser: The Judy Faulkner Foundation or Whatever We’re Calling It

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 By MICHELLE RONAN NOTEBOOM

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Epic’s Faulkner Shares Charitable Foundation Plans

In an interview with Modern Healthcare, Epic founder/CEO Judith Faulkner reveals that she will leave much of her wealth to a specially created charitable foundation that will operate and fund not-for-profit organizations in healthcare and other areas. The 71-year-old Faulkner says that almost all her shares of Epic stock will go to the foundation upon her death, or sooner if she chooses.

The plan is also designed to keep Epic private. “My stock will go to the foundation,” Faulkner said. “The foundation will control the stock. This plan is designed to preserve the company as a private company forever.”

Faulkner, who has an estimated worth of $2.8 billion, says she never wanted the money personally or for her family and wonders, “What would you want with all that money? It doesn’t seem right and I can’t tell you why.”

What’s not to like about Faulkner’s values or her plan?

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HIT Newser: A Meaningful Sigh of Relief

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By MICHELLE RONAN NOTEBOOM

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ONC Issues Draft HIT Interoperability Road Map

The ONC releases a draft of its 10-year nationwide interoperability road map, which includes a focus on helping the majority of providers across the care continuum and consumers achieve basic interoperability of health data over the next three years. The ONC also released a draft of its Interoperability Standards Advisory, which includes an assessment of the best available standards and implementation specifications for clinical health information interoperability.

Public comment for the draft Roadmap closes April 3, 2015; comment period for the Standards Advisory closes May 1, 2015.

Meaningful Use Reporting Relief         

CMS proposes rule changes for the EHR incentive program, including a reduction in the 2015 reporting period from one year to 90 days. An additional change would re-align the reporting period to match the calendar year, giving hospitals more time to incorporate 2014 Edition software into their workflows and better align with other CMS quality objectives. CMS will consider additional program modifications to reduce complexity and lessen providers’ reporting burdens.

CMS noted that the proposed rule changes are separate from the upcoming Stage 3 proposed rule that should be be released in March that is expected to limit the scope of the Stage 3 requirements for MU in 2017 and beyond.

Providers, vendors, and professional organizations are breathing a collective sigh of relief over the CMS announcement.  The proposed changes aren’t too surprising, given low Stage 2 attestation numbers and overwhelming provider dissatisfaction with the MU program.

New Valued-based Payment Goals to Drive HIT Adoption

HHS sets a goal for 30 percent of Medicare payments to be link to value-based performance through alternative payment models, such as ACOs, by 2016 and 50 percent by 2018. In addition, HS wants 85 percent of traditional Medicare payments tied to quality by 2016 and 90 percent 2018.

Achieving those objectives will require technology that supports quality-based payments versus the traditional fee-for-service model, so both vendors and providers will need to make aggressive moves to deploy the appropriate tracking and reporting tools. No doubt this will be one of the hotter topics at the HIMSS conference in April.

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HIT Newser: The Flex-IT Bill, Take 2 + Dr. Google In EHR Bid

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By MICHELLE RONAN NOTEBOOM

Flex-IT Bill, Take 2

flying cadeuciiLawmakers re-introduce the Flexibility in Health IT Reporting Act of 2015, which would shorten the 2015 MU reporting period from one year to 90 days. The bi-partisan-supported bill earned quick support from HIMSS, CHIME, the AMA, MGMA, and other professional organizations. The bill was originally introduced in September but it failed to pass.

Given the growing disenchantment with the MU program, look for this bill to pass – and hopefully give a boost to attestation numbers.

Dr. Google Joins DoD EHR Bid

Google teams up with PwC, General Dynamics, and Medsphere in their bid for the Department of Defense’s $11 billion EHR bid.

Google brings name recognition and a reputation for innovation and data security. While the Epic/IBM team has been looking like the front-runner, Google puts the PwC/Medsphere/GD team back in the hunt. For those keeping score at home, other vendors in the mix include Cerner/Leidos/Accenture Federal and HP/CSC/Allscripts.  A June decision is expected.

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Throwing the EHR Under the Bus …

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By JOHN IRVINE

Given what is now known about how the case of Thomas Eric Duncan at Texas Health Presbyterian was handled, the attempt to blame the hospital’s electronic health record for the missed diagnosis sounds pretty lame.

But people are still doing it:

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Critics of electronic medical records have found a case they will be talking about for years.

Consider this argument from Ross Koppel and Suzanne Gordon:

While it is too early to determine what precisely happened in this case, it is not too early to consider the critical issues it highlights. One is our health care system’s reliance on computerized technology that is too often unfriendly to clinicians, especially those who work in stressful situations like a crowded emergency room. Then there are physicians’ long-standing failure to pay attention to nurses’ notes. Finally, there is the fact that hospitals often discourage nurses from assertively challenging physicians.

Long promised as the panacea for patient safety errors, electronic health records, in fact, have fragmented information, too often making critical data difficult to find. Often, doctors or nurses must log out of the system they are on and log into another system just to access data needed to treat their patients (with, of course, additional passwords required). Worse, data is frequently labeled in odd ways. For example, the results of a potassium test might be found under “potassium,” “serum potassium level,” “blood tests” or “lab reports.” Frequently, nurses and doctors will see different screen presentations of similar data, making it difficult to collaborate.

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What Would You Give Up For a Virtual Doctor Visit?

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By Girish Navani

Screen Shot 2014-09-14 at 1.49.42 PMWith the fast adoption of smart phones, tablets and wearable devices, the way people communicate, travel, eat and entertain have all been simplified. Why not streamline the way we experience healthcare as well? A study released in May 2014 from MDLive discovered that 82% of young adults 18-34 would prefer consulting with their doctor via a mobile device than show up for an appointment. Twenty seven percent of patients confirmed they’d be willing to give up shopping for a month, skip their next vacation, even refrain from showers for a week—if it meant they would be able to access their doctor via a smart phone! These results, along with the multiple surveys and studies conducted in the past year, confirm that a new way to conduct healthcare services is in high demand.

The solution to changing up the healthcare system sits at the center of three key advancements: patient engagement, population health and electronic health records (EHRs). At eClinicalWorks, we consider these components of healthcare to be like a three-legged stool where two cannot stand without the other. We recognized this need as an opportunity within the healthcare IT space and created healow in order to provide our customers and their patients with a platform to schedule doctors’ appointments and get immediate access to medical records via an online interface or mobile app. healow empowers doctors and patients by packaging personal health records (PHRs), healthcare tools and appointment scheduling together, making the data readily accessible to patients and their doctors from the palm of their hand.

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Will eClinicalWorks Win the Race to “Engage” the Patient?

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By Kim Krueger


Patient engagement, for better or worse, is one of those buzzwords that won’t be leaving us anytime soon.

A whole slew of companies use it to describe their products, platforms, and services, but we’re still knee deep in marketing jargon trying to figure out exactly what these tools do and how “effective” they really are.

We got a closer look at one such tool last month at HIMSS from a company that also finds itself knee deep in patient engagement.

eClinicalWorks debuted in 1999 as the Southwest Airlines of electronic health records (EHR). They offered a relatively low cost combined EHR/practice management system, which quickly made them significant players in the small practice market, adding more than 3,000 doctors in just three years.

It wasn’t until 2007 though that eClinicalWorks really broke through when then Assistant New York City Health Commissioner and future National Coordinator for Health Information Technology Dr. Farzad Mostashari selected them for installation with more than 1,300 New York City physicians as part of Mayor Bloomberg’s Primary Care Information Project (PCIP).

Now, eClinicalWorks counts more than 100,000 physician users in over 50,000 facilities in addition to another 14 million users on their patient engagement tool, Healow.

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The Doctor Is In

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By Rob Lamberts, MD

It’s been over a month since I joined the ranks of the unemployed and started building my new practice.  For not having a job I’ve kept very busy.  Here’s what I’ve done.

I presented the idea of my practice to about 150 people.

It was a wonderful experience, and was quite emotional for me seeing a bunch of patients in one place.  The reception was wonderful.  I was hoping to get a video of this up, but the fates were fickle and it was not possible.

I wrote a business plan

My accountant didn’t even laugh when I showed him.  The idea was to look ahead at my months ahead and see when things would become profitable.  There are a bunch of huge questions that my affect this: how many staff I have, how many patients I have, what it costs to upgrade my office space, but I did a worst-case scenario (short of the Zombie Apocalypse) and the fact that my overhead is low makes it easy to be profitable quite quickly.

I got a location for the practice.

Today I went through the building with a designer and am working on getting it ready to use.  I am not doing the whole renovation at the start, as I won’t really know what the practice will need until it’s up and running.  I want it to be very comfortable and welcoming.  Most doctor’s offices are not places that say “welcome” to patients, but that’s what I want to convey.

I set a fee schedule.

· Age 0-2: $40/month
· 3-30: $30/month ($10/month if they are away in college)
· 30-50 $40/month
· 50-65 $50/month
· 65+ $60/month

Family maximum will be $150/month

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