The Health Care Blog – Page 453 – Everything you always wanted to know about the Health Care system. But were afraid to ask.

Above the Fold

HIT Newser: The CommonWell Alliance Gets More Common

Nov 24, 2014• 1

MICHELLE RONAN-NOTEBOOM

The CommonWell Alliance Gets More Common

Aprima and CareCloud join Allscripts, Cerner, McKesson, athenahealth, Greenway, and RelayHealth in the CommonWell Alliance, a nonprofit consortium of HIT vendors focused on fostering interoperability.

Coalition Says Stick to ICD-10 Schedule

CHIME, AHIMA, HFMA, and a dozen more industry organizations send a letter to Congressional leaders urging no further delays to the implementation of ICD-10.

CVS Health Ramps Up Digital Health Efforts

CVS Health will expand its efforts in digital healthcare with the opening of a 15,000 square foot innovation lab in Boston that will house up to 100 employees.

KLAS: NextGen Tops for RCM Services

KLAS names NextGen Healthcare the top provider of ambulatory 2014 RCM services in a report that ranks the best-performing HIT vendors for outsourced billing and RCM.

Is Deborah Peel up to her old tricks?

Nov 23, 2014• 38

By Matthew Holt

Long time (well very long time) readers of THCB will remember my extreme frustration with Patients Privacy Rights founder Deborah Peel who as far as I can tell spent the entire 2000s opposing electronic health data in general and commercial EMR vendors in particular. I even wrote a very critical piece about her and the people from the World Privacy Forum who I felt were fellow travelers back in 2008. And perhaps nothing annoyed me more than her consistently claiming that data exchange was illegal and that vendors were selling personally identified health data for marketing and related purposes to non-covered entities (which is illegal under HIPAA).

However, in recent years Deborah has teamed up with Adrian Gropper, whom I respect and seemed to change her tune from “all electronic data violates privacy and is therefore bad”, to “we can do health data in a way that safeguards privacy but achieves the efficiencies of care improvement via electronic data exchange”. But she never really came clean on all those claims about vendors selling personally identified health data, and in a semi-related thread on THCB last week, it all came back. Including some outrageous statements on the extent of, value of, and implications of selling personally identified health data. So I’ve decided to move all the relevant comments to this blog post and let the disagreement continue.

What started the conversation was a throwaway paragraph at the end of a comment I left in which I basically told Adrian to rewrite what he was saying in such a way that normal people could understand it. Here’s my last paragraph

As it is, this is not a helpful open letter, and it makes a bunch of aggressive claims against mostly teeny vendors who have historically been on the patients’ side in terms of accessing data. So Adrian, Deborah & PPR need to do a lot better. Or else they risk being excluded back to the fringes like they were in the days when Deborah & her allies at the World Privacy Forum were making ridiculous statements about the concept of data exchange.

Here’s Deborah’s first commentContinue reading…

Unlucky In Coverage

Nov 21, 2014• 7

By ACA DATABASE

Unlucky in Coverage writes from the Southwest:

I am self-insured. I was quite pleased last year when I had a chance to purchase health insurance through the Federal Marketplace because my new plan was significantly less expensive and more comprehensive than the coverage I had previously. However, I just learned that my (Gold Plan) insurance is jumping from $399 to $508 a month – that’s 29%! I’ve been reading reports that the average rate increases are only a few percentage points but all of those studies are based on the lowest-priced Silver Plans.

Preparing for Updates to the Medicare Shared Savings Program

Nov 20, 2014• 3

By FARZAD MOSTASHARI, MD and TRAVIS BROOME

Later this month – perhaps as early as this week – the Center for Medicare and Medicaid Services (CMS) is poised to release a proposed rule to update to the Medicare Shared Savings Program (MSSP). MSSP is the national program which allows providers to create ACOs, and it is the program under which Aledade ACOs operate. This will be the first update to the program in three years, and we expect there will be a great deal to unwrap once the rule is public (we also acknowledge that we are among the few who await publications of CMS rules with the anticipation of children on Christmas morning). I’m sure we’ll spend the day of the release tweeting our initial reactions — be sure to follow @Farzad_MD, @Travis_Broome, and @Aledade_ACO for those updates.

The new rule will contain a lot to unpack; but we believe that the decisions that CMS makes in 4 key areas will play a large role in whether participation in the program continues to be robust and whether the program succeeds in being the flag-bearer for new payment models.

Why You Should Ditch Your IT System

Nov 20, 2014• 38

By JOE FLOWER

So you spent millions to billions of dollars on information systems over the past few years, right?

How’s that working out for you?

For a large percentage of you, whether or not you admit it, not so well. What you bought needs some serious tweaks, re-engineering, re-thinking, re-vamping.

For an even larger percentage, maybe most of you, the best advice is: Junk it. Throw it out and start over.

Poorly designed and poorly implemented information systems are worse than useless, worse than a waste of those millions and billions of dollars. As we go through rapid, serious changes in health care, poor information systems will strangle your every strategy, hobble your clinicians, kill patients and actually threaten the viability of your organization.

A lot of health care executives dismiss the complaints about the new systems as the carping of stubborn technophobic doctors and nurses who should just get with the program. If you are tempted to do that, you need to take a step back. You need to get real. The complaints and concerns are too widespread, too deep and indeed too frightening for that kind of blithe denial. And they are not just coming from disgruntled docs.

Dr. Clem McDonald of the National Institutes of Health, a true pioneer in pushing for electronic medical records (EMRs) over the last 35 years, has called the current implementations a “disappointment,” even a “tragedy.” He is far from alone in this assessment.

Is Becoming a Doctor Worth $2.6 Million?

Nov 20, 2014• 12

By RICHARD GUNDERMAN, MD

Each year, over 20,000 US students begin medical school. They routinely pay $50,000 or more per year for the privilege, and the average medical student graduates with a debt of over $170,000. That’s a lot of money. But for some who pursue careers in medicine, the financial cost has been considerably greater. Melissa Chen, 35, a final-year radiology resident at the University of Texas San Antonio, calculates that her choice of a medical career has cost her over $2.6 million in lost wages, benefits, and added educational costs. And yet in her mind, the sacrifice has definitely been worth it.

Help With Covered California

Nov 19, 2014• 3

By ACA DATABASE

JOE wrote THCB with an interesting question that could be an outlier or could be significant:

Do you know of a consulting firm or advisory firm that can assist me in applying for insurance through Covered California? When I applied for insurance through the Covered California website, they gave me a list of places where I can get assistance. The phone numbers go to dead voice mail boxes or don’t work at all. I am willing to pay for assistance from somebody that understands the system.

Grubernomics

Nov 18, 2014• 100

By SAURABH JHA, MD

In the giddy days after the passage of ACA, I was chatting to a PhD student in health economics. He was in love with the ACA. He kept repeating that it would reduce costs, increase quality and increase access. Nothing original. You know the sort of stuff you heard at keynotes of medical meetings; ‘Healthcare post Obamacare’ or ‘Radiology in the new era.’ Talks warning us that we were exiting the Cretaceous period.

He spoke about variation in healthcare, six sigma, fee-for-value and ‘paying doctors to do the right thing.’

‘How?’ I asked.

‘I just told you, we need to pay doctors for value and outcomes.’ He smugly replied.

‘How?’ I asked again.

He did not answer. Instead he gave me the look that one gives an utter imbecile who doesn’t know the difference between a polygon and a triangle.Continue reading…

HIT Newser

Nov 18, 2014• 6

By MICHELLE RONAN-NOTEBOOM

HIMSS and CHIME to HHS: ONC Needs Full-time National Coordinator

In a letter to HHS Secretary Sylvia Burwell, CHIME and ONC stress the need to hire a full-time National Coordinator for the ONC, should Karen DeSalvo continue to serve as both the ONC head and the assistant secretary of health:

“If Dr. DeSalvo is going to remain as the Acting Assistant Secretary for Health with part-time duties in health IT, we emphasize the need to appoint new ONC leadership immediately that can lead the agency on the host of critical issues that must be addressed.”

AMA Calls for Removal of MU Penalties

The AMA calls for all MU penalties to be halted and for the program to be more flexible with a shorter reporting period. In addition, the AMA urges policymakers to refocus the MU program on interoperability and seek ways to improve product usability.

Cerner Breaks Ground at New Campus

Cerner breaks ground at a new $4.45 billion campus in Kansas City, which is expected to house 16,000 new Cerner employees within the next 10 years. The project includes about $1.75 billion in public tax subsidies.

The Nurse Practitioner … Er, We Mean Doctor Is In

Nov 17, 2014• 7

By HANS DUVEFELT, MD

A rash could be leukemia or idiopathic thrombocytopenic purpura. A sore throat could be glossopharyngeal neuralgia or a retropharyngeal abscess. A blocked ear could be Ramsay-Hunt syndrome, a self-limited serous otitis or sudden sensorineural hearing loss with an abysmal prognosis if not treated immediately with high doses of steroids. A headache or sinus pain could be cancer, and a cough could be a pulmonary embolus or heart failure.

Treating the Well:

In my early career in Sweden, well child visits were done in nurse-led clinics, some of them only open on certain days, with a local doctor in attendance. Parents carried the children’s records with them, containing growth charts, immunization records and so on.

These nurses had great expertise in differentiating normal from abnormal appearance of children, and would direct the attending physician’s attention to children with abnormal metrics, appearance or behavior.

With this arrangement, the physician time requirement was reduced, and limited to evaluating children attending the clinics who needed special attention. Physicians also performed specific examinations at certain ages, such as checking for hip clicks. These clinics freed up the local pediatricians to evaluate more sick children.

Well-baby visits are now the bread and butter of American pediatricians and family practitioners, and with the ever expanding mandates of politically determined items that must be covered in order for doctors to get paid for their services, we sometimes have trouble accommodating illness care demands.