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News 2/11/16

February 11, 2016 News 1 Comment

Top News

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EClinicalWorks, LifeImage, HIMSS, ImageTrend, Mana Health, MediPortal, and Modernizing Medicine join CommonWell at various levels of membership. The nonprofit alliance’s 40 members represent 34 percent of the ambulatory care EHR market.


Webinars

February 17 (Wednesday) noon ET. “Take Me To Your Leader: Catholic Health Initiatives on Executive Buy-In for Enterprise Analytics.” Sponsored by Premier. Presenters: Jim Reichert, MD, PhD, VP of analytics, Catholic Health Initiatives; Rush Shah, product manager analytics factory, Premier. Catholic Health Initiatives, the nation’s second-largest non-profit health system, knew that in order to build an enterprise analytics strategy, they needed a vision, prioritization, and most importantly buy-in from their executives. Dr. Jim Reichert will walk through their approach.

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February 23 (Tuesday) 1:00 ET. “Completing your EMR with a Medical Image Sharing Strategy.” Sponsored by LifeImage. Presenters: Don K. Dennison, consultant; Jim Forrester, director of imaging informatics, UR Medicine. Care coordination can suffer without an effective, cost-efficient way to share images across provider networks. Consolidating image management systems into a single platform such as VNA or PACS doesn’t address the need to exchange images with external organizations. This webinar will address incorporating the right image sharing methods into your health IT strategy.


Acquisitions, Funding, Business, and Stock

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Chattanooga, TN-based GigTank expands its accelerator program, adding a healthcare track and additional cycles for year-round appeal. Local physician network One to One is GigTank’s official partner for the new track. “Pairing technology-minded startups with experienced physicians can be a launch point for exciting changes in medicine that will increase access to care and deliver a better healthcare experience,” said One to One CEO Keith Helton. GigTank 365 will officially launch in May. Applications are now being accepted. Perks include free housing, courtesy of the University of Tennessee at Chattanooga (one of my all-time favorite cities).


Telemedicine

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ATA finds fault with a proposed rule on clinical practice from the Texas State Board of Examiners of Professional Counselors, particularly as it pertains to the rule’s requirement of a face-to-face visit for initial visits, and in-state residency for “distance counseling.” In a letter to the board, ATA explains that “the regulations will require licensed Texas professional counselors to follow a separate standard of practice when using telehealth, resulting in two different standards of care for clients in the same state. With regard to clinical practice rules and ethical guidelines, we believe that, as much as possible, the practice of telehealth should not be regulated differently or held to a different standard than in-person care.”

Dictum Health adds ECG algorithm processing and interpretation technology from Monebo Technologies to its new telemedicine platform.


People

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The Joint Commission promotes Ronald Wyatt, MD to the new position of patient safety officer.


Announcements and Implementations

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ProHealth Care Associates (NY) selects patient educational resources, including an online resource library and digital exam room poster, from Health Monitor Network.


Government and Politics

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AHRQ updates its Consumer Assessment of Healthcare Providers and Systems Ambulatory Care Improvement Guide to reflect changes in the CAHPS survey.


Other

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File this under “Phew!”: Centene finds the six hard drives containing the data of a million patients that went missing last month. An employee apparently fessed up to placing the payer’s hard drives “in a locked receptacle for secure destruction.” The St. Louis-based company is confident that no information was leaked.


Contacts

JenniferMr. H, Lorre, Dr. Jayne, Dr. Gregg, Lt. Dan

More news: HIStalk, HIStalk Connect.

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HIStalk Practice Interviews Jennifer Hanscom, Executive Director and CEO, Washington State Medical Association

February 11, 2016 News No Comments

Jennifer Hanscom is executive director and CEO of the Washington State Medical Association.

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Tell me about yourself and the association.
I’m the CEO of the Washington State Medical Association. I became CEO in February of 2013. Prior to that, I was the director of communications and membership. WSMA represents about 10,000 physicians, physician assistants, medical students, and residents throughout Washington State. They are of all specialties and all practice sizes. I have told people recently that about 60 percent of our membership is in practices or hospital health systems of 100-plus physicians. The landscape has certainly changed in terms of who we represent. I started at the association in 1996. At that point in time, we had about 38 percent of our membership in solo, small practices. Today, that represents 8 percent. Again, 57 percent and 100-plus practices, so there’s been a huge shift in terms of the practice landscape. Our vision is to make Washington the best place to practice medicine and to receive care.

What state and federal healthcare policies are Washington physicians keeping an eye on? Any specifically related to healthcare technology?
Payment reform is at the top of their list. How can we best transition from a fee-for-service world to one that rewards quality without placing a burden on or physicians? The future of value-based reimbursement really depends on leveraging health information technology. You may have heard that, in our state, we are moving forward with an initiative called "Healthier Washington" to transform Washington State’s delivery system by 2020. We’re really focusing on the resources that need to be dedicated to help physicians in their practices transition to the new system of care delivery in a way that is financially viable, doesn’t create additional administrative burden, and doesn’t impede their ability to deliver care in a safe and timely manner. We’re really focusing on how to help practices transform in the future to be set up to be successful.

With the launch of the Affordable Care Act, CMS had new numerous programs and models to help providers achieve that large-scale transformation. That certainly helps on the resource side. Then, for us as an organization, we’re really looking at anything we can do to eliminate unneeded expenses so that independent practices can redirect their limited resources. Looking at the ease of use with tools for quality reporting and methods that allow physicians and patients to find and use relevant information is critical. I think that stems into why we held the town hall with AMA – we need to really look at the time spent on navigating EHRs that can severely impact the physician’s ability to see patients and/or spend enough time with them to address all their concerns. This affects physicians in large systems as well as physicians in small practices.

Is Washington beginning to embrace telemedicine?
After several years of advancing the concept of telemedicine before our state legislature, as of last year, I’m happy to say, telemedicine is now covered in our state. It had some limitations as it originally passed; for instance, in-home telemedicine visits weren’t covered, but there have been some conversations in our state legislature this session to start having those services covered. We are starting to already see improvements to the original legislation.

How have Washington physicians reacted to the latest ups and downs of Meaningful Use?
I think there was certainly some confusion, but my sense is that our physicians have a lot of optimism that the pause button has been pushed. The Stage 3 requirements of Meaningful Use made it unreasonable to expect positive change in the next generation of EHRs unless significant program changes were made. Pushing that pause button may result in improved systems and tools, which is certainly something that will be embraced by the physician community. They see the advantages to EHRs. At our town hall event with AMA, one physician in particular shared that it’s revolutionized the way she provides care.

The majority of folks who attended the event said they absolutely do not want to go back to paper. They’re really committed right now to making EHRs and health IT work to improve patient care. They’re frustrated with the continuous interferences in workflow, the constant mouse clicks, and data entry. That’s something I hear over and over again: "Jennifer, just make the constant clicking stop." Interoperability, usability, the complex regulations that require a lot of time from our physicians really get in the way of patient care. When systems can’t exchange data, they demand too much of a user – that’s frustrating and hard for folks to embrace. Several physicians commented at the event that we really need to focus on separating the billing portion – again, the endless box checking – away from the clinical reasoning and the clinician portion.

How involved were you with the decision to bring that event to Seattle?
The AMA reached out to us. They had events in Atlanta and Boston, so we were quite pleased that they looked to us to have their third event. I think in part because the WSMA has advanced an initiative called "Healthy Doctors Healthier Patients" that really focuses on tackling the challenges and regulations that are getting in the way of a physician’s ability to practice good quality of medicine. It’s very similar to the AMA’s "Break the Red Tape" campaign. Although with us, we’re focusing on the Quadruple Aim in medicine and the notion that if we don’t have physicians who are professionally satisfied, it’s really hard to achieve the Triple Aim in medicine. Certainly, having a well-functioning EHR and IT tools is key to improving that professional satisfaction in the physician community, and I will say with their staff as well. Medicine is practiced as a team. Staff is critically important. If staff are feeling burned out and stressed, physicians are feeling burned out and stressed … it certainly doesn’t help them deliver good quality patient care.

What patient wants to go in to see a stressed individual? When you peel back that onion and look at the cause of this stress and burnout, we see it’s those administrative challenges. It’s working an EHR that they don’t feel is conducive to the patient care that they’re trying to deliver, not understanding why it takes 12 clicks to give somebody a flu shot. It’s, "Why do I have to sit on the phone for half an hour with an insurance plan to get pre-authorization when I went through all the clicks on my EHR and all the information is there?" The interoperability, the usability, it all contributes to that satisfaction. If we can spend some time there, I think we can really turn those physician satisfaction scores and practice satisfaction scores around.

What other takeaways did you get from the town hall event?
I was really pleased to hear that the physicians in the audience had some optimism that folks were willing to listen, and that they’re committed to making the change. It was very insightful to me that they did not come just to complain, but rather to offer ideas and solutions about how best to move forward to really improve efficiencies and provide patient care. I will say that won’t be good just for the physician in practice; it will also be good for patients. I think we all want better experiences in terms of capturing the information that we want to have access to as patients in a timely and efficient manner, much like we do when we’re on other websites, getting information or filling out forms. I think there can be some win-wins for both if we get focused on interoperability and usability rather than government regulations.

How is WSMA going to work with AMA to move forward and address these talking points?
At the national level, we’re already been engaged with the AMA and the other state and specialty societies offering detailed recommendations for moving forward to both ONC, CMS, and members of Congress. We’ll continue to collaborate on a grassroots campaign to advocate solutions to policy members or policy-makers, members of Congress, as well as industry vendors at that national level. Then, here in Washington State, whatever improvements we can make locally as our state moves forward with that "Healthier Washington" initiative will be key, so that we’re making improvements at the federal level and the local level.

Aside from EHRs, what other healthcare technology related concerns or even successes are your members experiencing?
I’m going to focus on the successes. I have to say that our members are really embracing strategies that provide them with relevant and useful information at the point of care. One thing we hear over and over again is, "How can I have this information at the point of care?" For instance, we’ve embraced technology such as the prescription monitoring program that allows physicians to access information before they prescribe or dispense drugs. That’s really critical, especially with access to opioids via emergency rooms. Being able to get in there and see if someone’s overprescribing narcotics is extremely important in reducing accidental death and overdose.

We’re looking right now at creating a central repository for advanced care plans including advanced directives in the POLST form. Again, so that at the click of a button, a physician in the ER, a physician who doesn’t typically see this patient, has that information on hand so that that patient’s information or wishes are being honored. We’re finding ways to incorporate Choosing Wisely tools into EHRs in order to guide and reduce overuse of unnecessary tests, treatments, and procedures as well as measure and track efforts to improve care. We’ve had several grants going on in our state where we’re working with some systems like Swedish and Group Health to see how to do that successfully, and then we’ll share those best practices with other practices.

One comment that was made at that EHR town hall the other day was from a physician who mentioned that she loves her EHR, but is struggling with how to incorporate population health referrals so that if she has a patient who needs some kind of service, that information pops up in her EHR so that she can get the patient to the right social services after the visit. Lots of good insight. I do want to be clear that we don’t want to layer on; rather, we want to just reorient the data and the measures away from a process-based task to focus on the goals that are useful to patients and physicians. Having physicians at the table voicing that and sharing that information will really be critical to success going forward.

Do you have any final thoughts?
Our healthcare system is in the throws of an unprecedented degree of change and disruptive innovation. As that transformation occurs, physicians and their practices must receive the support necessary to ensure sustainability so that they can provide the care needed by their patients. That’s the primary role of the Washington State Medical Association in helping our state physicians be successful going forward.


Contacts

JenniferMr. H, Lorre, Dr. Jayne, Dr. Gregg, Lt. Dan

More news: HIStalk, HIStalk Connect.

Get HIStalk Practice  updates.
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News 2/10/16

February 10, 2016 News No Comments

Top News

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CMS clarifies Meaningful Use hardship exemption eligibility for secure messaging and patient electronic access based on lack of broadband access. Both measures allow for exemptions if the attesting EP “conducts 50 percent or more of his or her patient encounters in a county where 50 percent or more of its housing units do not have 4Mbps broadband availability on the first day of the EHR reporting period.” CMS bases its broadband information on the latest coverage data from FCC, which has come under fire for being woefully underreported.


Webinars

February 17 (Wednesday) noon ET. “Take Me To Your Leader: Catholic Health Initiatives on Executive Buy-In for Enterprise Analytics.” Sponsored by Premier. Presenters: Jim Reichert, MD, PhD, VP of analytics, Catholic Health Initiatives; Rush Shah, product manager analytics factory, Premier. Catholic Health Initiatives, the nation’s second-largest non-profit health system, knew that in order to build an enterprise analytics strategy, they needed a vision, prioritization, and most importantly buy-in from their executives. Dr. Jim Reichert will walk through their approach.

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February 23 (Tuesday) 1:00 ET. “Completing your EMR with a Medical Image Sharing Strategy.” Sponsored by LifeImage. Presenters: Don K. Dennison, consultant; Jim Forrester, director of imaging informatics, UR Medicine. Care coordination can suffer without an effective, cost-efficient way to share images across provider networks. Consolidating image management systems into a single platform such as VNA or PACS doesn’t address the need to exchange images with external organizations. This webinar will address incorporating the right image sharing methods into your health IT strategy.


Announcements and Implementations

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The American Academy of Emergency Medicine selects PM and analytics services from Intermedix to support its new independent physician group.


People

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Doug Cusick (Next Wave Connect) joins Atigeo as chief growth officer for healthcare.

Rennova Health – parent company of Medical Billing Choices and Medical Mime -  names Thomas Mendolia, DO chairman of its new, eight-member scientific advisory committee. Mendolia, a retired gastroenterologist, co-founded Medytox Solutions, which merged with CollabRx to become Rennova Health last year.


Telemedicine

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A tiny study finds that pediatricians who remotely evaluate children with fever or respiratory distress using FaceTime on an iPad perform just as well as those who conduct their examination in person.

ATA endorses President Obama’s FY2017 budget proposal, which includes HHS funds to expand the ability of Medicare Advantage organizations to deliver services via telemedicine. It’s the first time that any administration has included specific telemedicine improvements in its proposed budget.


Research and Innovation

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The California Health Care Foundation publishes an insightful paper on the use of digital technologies in caring for underserved populations. Authored by Jane Sarasohn-Kahn, the 14-page report outlines the solutions that have taken hold, including texting, telemedicine, and platforms that incorporate personal coaching.


Other

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Washington State’s Apple Health Medicaid program notifies 91,000 members that their medical records may have been handled improperly, thanks to a two year-long email exchange between brother and sister state employees that contained member PHI. The incident is being treated as a breach because state officials can’t confirm the information remained within state systems. The data was not used improperly by the pair or forwarded to unauthorized users.

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Vance Lassey, MD cites a desire to escape from the “mountains of medical paperwork that are taking up too much of his time” as one of the reasons he’ll open one of the first direct primary care practices in rural Kansas next month. Lassey, who worked for nine years at a nearby family practice, has also made the privacy of patient medical records (perhaps playing on consumer fear of data mining) a selling point: “The government has access to all of your medical records now, but it will be private with me.”

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One for the baby book: Married Fitbit users take to a Reddit Fitbit forum to understand the implications of the wife’s unnaturally high resting heart rate, thinking it was perhaps due to a faulty device. Imagine their surprise when a commenter’s suggestion of pregnancy as the culprit turned out to be true.

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Looks like The Walking Gallery will convene during HIMSS. I had the opportunity to meet many of its members last year at HIStalk’s HIMSS booth. I highly encourage you to tap a member on the shoulder should you see them roaming the exhibit hall. They all have amazing patient advocacy stories to tell.


Contacts

JenniferMr. H, Lorre, Dr. Jayne, Dr. Gregg, Lt. Dan

More news: HIStalk, HIStalk Connect.

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Contact us online.
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JennHIStalk

Readers Write: ICD-10’s Momentum Can Help Physicians Meet New Revenue Cycle Goals

February 9, 2016 News No Comments

ICD-10’s Momentum can Help Physicians Meet New Revenue Cycle Goals
By Jim Denny

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For the past several years, the industry was inundated with warnings about the impending ICD-10 transition that finally occurred October 1, 2015. There were warnings that productivity would be impaired, and that the financial health of physicians could suffer with the anticipated increase in denials and rejections. As the implementation deadline came and went, however, the industry pulled off a relatively smooth and successful transition.

According to Navicure’s ICD-10 post-implementation survey of healthcare leadership, 60 percent of respondents didn’t see any impact on monthly revenue following the transition date. Another 34 percent only saw their revenue decrease by less than 20 percent. In addition, respondents only saw a 13-percent decrease in administrative staff productivity and a 15-percent decrease in clinical staff productivity.

In light of the predictions for a rocky ICD-10 transition, how did physicians achieve success? The right strategy, technology, and preparation plan certainly contributed, but another essential factor was drive: Everyone in healthcare knew ICD-10 would require substantial changes, and everyone knew the consequences for unpreparedness would be severe. Physicians, along with other key players such as payers and technology vendors, worked together and worked hard. In the end, this drive enabled physicians to beat industry predictions about lost productivity and revenue.

Ninety-nine percent of participants in the survey indicated they were ready for the transition on October 1, which was 14 percent higher than the sentiment in August 2015. These metrics show how physicians stayed on task and gained the momentum necessary to achieve their ICD-10 goals, and are consistent from even earlier studies to measure readiness confidence.

As physicians turn their focus toward new priorities, 2016 presents a great opportunity to leverage the same drive that made them successful with ICD-10. Consider these results and corresponding best practices:

  • Two-thirds of survey respondents indicated they plan to work on improving overall RCM processes. Claims management was a key part of ICD-10 transition planning, and physicians can continue this momentum by using business intelligence to pinpoint problem areas and set improvement goals. Monitoring key performance indicators such as charge lag, days in A/R and denial and rejection rates can show providers exactly where they need to focus, enabling them to improve processes and staff performance.
  • Another top priority included working toward a value-based care model (15 percent). The switch from volume to value is well underway, and physicians can benefit from putting all processes under a microscope to ensure they’re achieving both efficiency and effectiveness. In addition to leveraging BI, physicians should ensure ongoing analysis is a priority — and part of the organizational culture.
  • Physicians also identified revamping patient collections strategies (nine percent) as a key goal following ICD-10 implementation. As patients adjust to paying a larger portion of their healthcare costs, two components of a patient collections strategy are particularly important – providing price transparency via pre-service or time-of-service estimates and making arrangements at time of service to collect balances in full, ideally both utilizing automated solutions to streamline efforts.

While none of these initiatives have a hard deadline like that of ICD-10, they’re essential to the financial health of physicians. They’ll require ongoing drive and strategic focus; fortunately, with ICD-10’s success, physicians have already proven they’re up for the challenge.

Jim Denny is president and CEO of Navicure in Atlanta.


Contacts

JenniferMr. H, Lorre, Dr. Jayne, Dr. Gregg, Lt. Dan

More news: HIStalk, HIStalk Connect.

Get HIStalk Practice  updates.
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JennHIStalk

News 2/9/16

February 9, 2016 News No Comments

Top News

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President Obama’s FY 2017 budget allocates $82.8 billion in discretionary funding for HHS. Technology spending highlights include over $700 million for the Cancer Moonshot Task Force; $309 million to help ONC, FDA, and NIH advance the Precision Medicine Initiative; $24 million for AHRQ research; and an unspecified amount that will support “efforts to reform the healthcare delivery system by finding better ways to deliver care, pay providers, and increase access to information so that individuals can receive the right care, at the right time, at the right price.” 


Webinars

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February 23 (Tuesday) 1:00 ET. “Completing your EMR with a Medical Image Sharing Strategy.” Sponsored by LifeImage. Presenters: Don K. Dennison, consultant; Jim Forrester, director of imaging informatics, UR Medicine. Care coordination can suffer without an effective, cost-efficient way to share images across provider networks. Consolidating image management systems into a single platform such as VNA or PACS doesn’t address the need to exchange images with external organizations. This webinar will address incorporating the right image sharing methods into your health IT strategy.


Acquisitions, Funding, Business, and Stock

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McKesson Business Performance Services will lease a 50,000 square-foot call center in Port St. Lucie, FL to support its Patient Access Solutions business. The company, which already employs 300 in the area, has  hired 31 employees to staff the new operation, and anticipates bringing on an additional 80 to 100 over the next six to eight months. The center will open on May 23. A job fair will be held in Port St. Lucie on February 11.

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Patient payment technology vendor SwervePay closes $10 million in funding as part of a Series B round. Led by Garland Capital Group, the new funds will enable the Chicago-based company to expand its partner network and hire additional staff. The company has raised $11.6 million since it was founded in 2010.


Announcements and Implementations

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San Diego Health Connect selects the Verato patient-matching platform to enhance its patient record location and exchange services across 25 health clinics and hospitals.

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In other patient-matching news, Rochester RHIO implements NextGate’s MatchMetrix software as its Enterprise Master Patient Index solution. The RHIO connects 70 healthcare organizations in the 13-county region of Rochester, NY.

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MGMA and AMA partner to host the Collaborate in Practice Conference, set to take place March 20-22 in Colorado Springs, CO. The speaker lineup includes Sen. Bill Bradley (D-NJ) and practicing physician and Healthfinch co-founder Lyle Berkowitz, MD. Registration fees start at $1,500; hopefully the “2 for Tuesday” offer will make it easier for already cash-strapped physicians to attend.

The National Billing Center adds evaluation and management tools to its coding automation software.

Everseat joins the Allscripts Developers Program, offering Allscripts end users and their patients access to Everseat’s appointment-booking app.


People

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Arcadia Healthcare Solutions appoints Richard Bohmer, MD (Harvard Business School) chair of its new nine-member advisory network.


Telemedicine

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First Stop Health, a Chicago-based startup that caters to employers, secures a seed round of $2.1 million, bringing its total funding to $5.6 million.


Other

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A family physician in British Columbia fires a patient of 13 years via letter after his office receives documents pertaining to her walk-in clinic visits. “One of the conditions of my taking over your care as your family doctor was that you try if at all possible to avoid using other clinics and keep your medical care at our office,” he wrote. “I would ask that you have my name removed as your family physician as I will not follow up on any further medical correspondence.” The patient, who promptly posted a picture of the letter to social media, says her clinic visits were necessary due to a lack of availability on the part of the physician’s practice.

Finally! App developer Allen Wong develops a hack for the Tesla Model S that enables owners to use the car’s Summon feature from their Apple Watches. The feature enables the car to open the garage door, enter or exit the garage, park itself, shut down, and close the garage door. The company predicts that, “Eventually, your Tesla will be able to drive anywhere across the country to meet you, charging itself along the way. It will sync with your calendar to know exactly when to arrive.”


Contacts

JenniferMr. H, Lorre, Dr. Jayne, Dr. Gregg, Lt. Dan

More news: HIStalk, HIStalk Connect.

Get HIStalk Practice  updates.
Contact us online.
Become a sponsor.

JennHIStalk

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Reader Comments

  • Shocked: CommonWell is still around? If so, what does it do? Has it done anything? They launched three years ago, or was it four?...
  • huskydoc: Re: the EMR bi+ch session... we here in the PNW know how to implement clinical IT :-)...
  • Elizabeth Coons: Though it is early in 2016, these observations are very prescient. One trend that they convey is the arrival of cost-ben...
  • Karen Coste: I hope Dr. Khan predictions for the Year of the Patient come true. The group that is being left behind is our senior cit...
  • Dr. Rick: Dr. Gregg, It's on my To Do list. By the way, I was in a rock band in college too. I played electric bass....