News 8/23/17

Top News

Behavioral health company AbleTo raises $36.6 million in a Series D fundraising round led by Bain Capital Ventures. The company has developed a phone- and video-based behavioral healthcare platform that caters to employees and payer members looking to manage depression, stress, and anxiety. Based on CEO Rob Rebak’s LinkedIn post announcing the funding, it looks like the company will use the investment to expand and offer its services around the clock.

Webinars

September 13 (Wednesday) 1:30 ET. “How Data Democratization Drives Enterprise-wide Clinical Process Improvement.” Sponsored by: LogicStream Health. Presenter: Katy Jones, program director of clinical support, Providence Health & Services. Providence is demonstrating positive measurable results in quality, outcomes, and efficiency by implementing clinical process improvement solutions in arming operational and clinical stakeholders with unlocked EHR data. Providence’s army of process engineers use their self-service access to answer questions immediately instead of waiting for reports to be written and double checked for possibly inaccurate information. The presenter will describe practical applications that include antibiotic stewardship, hospital-acquired infections, and comprehensive knowledge management.

Previous webinars are on our YouTube channel. Contact Lorre for information on webinar services.

Announcements and Implementations

CollaborateMD releases the latest version of its billing and PM software, enhancing security and giving users the ability to create patient payment plans and manage payments.

Innovaccer develops a clinical documentation improvement tool to help providers better identify missed or incorrect diagnosis codes.          

The Illinois Bone & Joint Institute selects the Outcomes Based Electronic Research Database system from Universal Research Solutions to digitally collect and report MIPS-related quality data to CMS. The orthopedic provider, which has 20 practices across metro Chicago, will also leverage OBERD data sets for benchmarking and analysis.

MedicalMine adds instant messaging to its Charm EHR, PM, and RCM platform.

People

The Mental Health Association of Westchester (NY) promotes Stacey Robertson to COO.

Telemedicine

Local behavioral healthcare stakeholders voice their concerns over access and the sluggish acceptance of telemedicine at a roundtable convened by Massachusetts senators. Several bills are circulating in the legislature that would require payers to cover telemedicine services – a move that would likely alleviate the problem faced by behavioral health agencies like Clinical & Support Options, which has six clinics equipped with telepsychiatry services but faces lack of reimbursement for those services from over half of the payers it works with.

The Mental Health Association of Westchester rolls out telemedicine services at three of its seven clinics in New York.

Government and Politics

The local paper highlights the progress the Petaluma Health Center has made in becoming a data-driven organization –  efforts recognized by HHS during National Health Center Week with a $254,000 grant. The center has invested $3.2 million to transform into a value-based care deliverer that relies heavily on real-time data mining to drive population health initiatives. That money has gone towards investing in new IT, building a new call center, and hiring nurse case managers and patient navigators. 

Other

Salina Family Healthcare Center (KS) notifies patients of a June ransomware attack that encrypted several workstations and servers. The FQHC was able to get things up and running thanks to back ups.

The local news spotlights the Volunteers in Medicine clinic on Hilton Head Island, SC. Founded by Jack McConnell, MD after he retired there 20-plus years ago, the clinic is run solely by volunteers like McConnell and his golfing/retired physician buddies. Patients and local community members even provide free landscaping, cleaning services, and building repairs – all in an effort to provide eligible patients with free healthcare. “We’re caring for some of the most medically underserved people in the country,” says Patrick Burns, MD, “and when you go home at night, you really feel good about that.” There are 88 such clinics across the country.

Sponsor Updates

• Attendees at Aprima’s annual user conference make and donate 150 blankets to the Children’s Medical Center in Dallas

Blog Posts

• Medicaid Incentive Program & MACRA Medicare QPP Differences (AdvancedMD)

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Jenn, Mr. H, Lorre

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News 8/22/17

Top News

On his way to China, HHS Secretary Tom Price, MD tours several tribal health facilities in Alaska to better understand the successes and challenges involved in delivering care to Alaska Natives. Price lauded the delivery model of the Southcentral Foundation, which provides integrated primary and mental health care on one campus via a unique model that sees providers moving from patient to patient, rather than the other way around. The region’s remote terrain prompted discussion of the struggles many patients find in accessing care. Telemedicine – and the money necessary to implement it and offer reimbursement for it – must have surely come up. Alaska is no stranger to the promise of virtual visits. It has passed telemedicine-friendly legislation over the last several years, and is home to the National Telehealth Technology Assessment Resource Center. Housed within the Alaska Native Tribal Health Consortium, the center is one of several set up across the country to help local providers understand and implement telemedicine services.

HIStalk Practice Musings

The nearly two-and-a-half minutes of eclipse totality I experienced yesterday were indeed amazing. I traveled a bit further north than originally planned, owing to a friend who extended an invite to hunker down the night before at a cabin in North Georgia. Watching a crescent sun transform into what for me will likely be a once-in-a-lifetime total solar eclipse experience was breathtaking. I enjoyed experiencing it with other people in a public viewing area. That the area was on the shores of Lake Chatuge, on a nearly cloudless day, made it even more memorable. Other than the extra 20 minutes of traffic I faced driving home, my only regret is not snagging a commemorative T-shirt.

Webinars

September 13 (Wednesday) 1:30 ET. “How Data Democratization Drives Enterprise-wide Clinical Process Improvement.” Sponsored by: LogicStream Health. Presenter: Katy Jones, program director of clinical support, Providence Health & Services. Providence is demonstrating positive measurable results in quality, outcomes, and efficiency by implementing clinical process improvement solutions in arming operational and clinical stakeholders with unlocked EHR data. Providence’s army of process engineers use their self-service access to answer questions immediately instead of waiting for reports to be written and double checked for possibly inaccurate information. The presenter will describe practical applications that include antibiotic stewardship, hospital-acquired infections, and comprehensive knowledge management.

Check out Vince and Frank’s brutally honest presentation on “Allscripts’ ‘Repeal and Replace’ of McKesson’s EIS.” It’s been viewed nearly 500 times since we posted it late last week.

Announcements and Implementations

Allscripts launches eParticipate, a service that enables eligible providers to conduct clinical research trials within their own four walls through a partnership with Elligo Health Research. Professional, TouchWorks, and Sunrise EHR customers will have access to trials in the areas of gastroenterology, neurology, pain, urology, pulmonology, and women’s health.

Higi will combine health screening data from its retail health kiosks with clinical, claims, and genomic data synchronized by Interpreta to give providers and payers deeper insight as they move forward with patient care plans.

Acquisitions, Funding, Business, and Stock

SilverVue looks to expand beyond the world of post-acute care search technology with the acquisition of Ergo Sum Health. The Sandy, UT-based company has rebranded ESH’s MACRA software, consulting, and compliance services as Check. Terms of the deal were not disclosed.

People

David Schloss (Caladrius Biosciences) joins Teladoc in the new role of chief human resources officer.

Pivot Point Consulting hires Zack Tisch (Nordic) to take on the role of consulting services executive.

Government and Politics

The Washington Health Benefit Exchange selects San Francisco-based BetterDoctor to collect and verify provider data listed on its Healthplanfinder insurance marketplace, which will launch with a new look and easer to use interface when open enrollment kicks off this November.

Telemedicine

The CDC approves Fruit Street Health to offer its Diabetes Prevention Program to patients via group video calls with registered dieticians. Fruit Street will also issue DPP participants Fitbits, wireless scales, and an accompanying app to help users share and track their progress.

Daniel McDyer, MD offers EpicMD’s telemedicine services to his patients at Florida Woman Care of Jacksonville (FL). As Mr. H mentioned in a recent post, EpicMD – a startup based in Miami – seems to have so far flown under the legal radar of the more well-known Verona, WI-based company.

Other

The Institute for Women’s Health (TX) notifies patients of a keylogger virus that was installed June 5, discovered July 6 and removed July 11. The virus apparently tracks and records every click made within a computer system, potentially giving hackers access to passwords, financial information, health data, and other personal details. IWH is jumping through all of the necessary hoops – reporting the incident to HHS, offering identity theft protection services, etc. All this despite the fact that the practice had installed network filtering and security monitoring, firewalls, antivirus software, and password protection before the virus hit.     

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Jenn, Mr. H, Lorre

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5 Questions With Mark Lewinsohn, Vice President of Clinical Services, LifeWorks NW

Mark Lewinsohn is vice president of clinical services at LifeWorks NW, a behavioral health and addiction treatment nonprofit with 15 locations in and around Portland, OR. The organization recently implemented population health management technology from Enli Health Intelligence to better enable its participation in the federal Certified Community Behavioral Health Clinics demonstration project.

How has LifeWorks NW used healthcare technology in the past to serve its patients? How have you seen health IT improve access to services and treatment outcomes?

LifeWorks NW was an early adopter of the EHR. Implementing electronic records allowed us to build the infrastructure to monitor and track client and service data, and to then support a data decision-making system. Thus, we already had the foundation in place to move forward with the population health solution to address issues that impact a consumer’s outcome (no show, engagement, access to treatment, etc.)

Health IT enables us to use data to determine the root causes of barriers to accessing care, which is critical to improving outcomes. For instance, with such insight we may discover we are not offering enough new patient times or scheduling at times/days that are not desirable. In addition, we can readily identify strategies to engage clients who may be missing appointments or who are disconnected from our services.

What prompted you to begin looking at population health management solutions?

LifeWorks NW has been a pioneer in integrating mental health and primary care. We have had mental health staff embedded in primary care clinics for more than a decade. That integrated care model has proven successful, so now we are focusing on reverse engineering integration: Through a better understanding of an individual’s overall physical health, we will have improved insight into how it may be impacted by their behavioral health condition or vice versa. We know that people with serious mental illness do not access preventative care and have a shorter lifespan than those without. We want to impact
that statistic. Plus, our involvement in the national demonstration project for Certified Community Behavioral Health Clinics has provided additional resources and requirements for increasing our tracking of health metrics and improving coordination of care with primary care providers.

What impact will Enli’s technology have on your participation in the CCBHC demonstration project?

We hope to develop specific protocols that look at the whole health of the individual rather than the siloed approach historically taken in healthcare. Enli will allow LifeWorks NW to efficiently track clients who are receiving CCBHC services and identify those with high health risks due to their chronic medical condition(s). In line with the CCBHC model, we can then more readily identify how their co-morbid condition impacts both physical and mental wellbeing. In addition, through data automation, staff will be able to devote more time to client support because they no longer have to manually track information or look through charts to figure out which clients need outreach/support.

What advice do you have for other behavioral health organizations looking to implement population health management technology?

Population health is new to behavioral health providers. We had a good foundation through our EHR system, and were able to build on that as we moved to implement technology for population health management. To ensure that effort is successful, we believe it is critical to find a partner, like Enli, that has a solid foundation, but is nimble and willing to blaze a new trail and work together to learn what will result for the best outcomes and achieved objectives.

Is LifeWorks NW looking at other types of health IT? What’s on your wish list?

In sum, yes! We believe that there is so much opportunity to make a positive impact on client outcomes and improve community health. We are currently exploring a host of solutions that will improve care coordination between behavioral health and other healthcare and non-healthcare entities. We really see the value of – and great need for – HIEs that will be the pipeline for mobilization of information across our region. That kind of technology will greatly enhance our ability to support the people we serve – and the larger community – with more effective care and treatment.

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Jenn, Mr. H, Lorre

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Readers Write: The Promise (and Pitfalls) of Greater Consumer Expectations

The Promise (and Pitfalls) of Greater Consumer Expectations
By Anne Weiler

Consumer expectations are finally hitting healthcare. We’ve long become accustomed to having anything we want delivered to our homes at any time, in minutes. This level of 24/7 convenience is driving an expectation that all service delivery should be that good. And healthcare is no exception in the eyes of increasingly cost-conscious consumers. After all, rising deductibles, premiums, and copays are causing people to examine where they spend their healthcare dollars, leading them to evaluate care based on outcomes, convenience, and overall experience. We first saw indications of this on highway billboards advertising emergency room wait-times. It’s now spilling over into other areas of healthcare, like concierge medicine and direct primary care, both business models that give patients almost unlimited access to their care team. Healthcare technology is certainly aiding and abetting these expectations, with telemedicine perhaps offering the most promise in meeting expectations around convenience and up-front costs.

Virtual assistants and interactive mobile treatment plans also show huge promise. But for these burgeoning healthcare concepts to take off, their popularity with patients and physicians alike hinges on some basic tenets. First, patients need to feel supported and confident. Once they do, they can start to self-manage outside the clinic. The old way of delivering care instruction – be it verbally or on paper – is seriously lacking in providing this support and confidence. Patients forget between 40 and 80 percent of what is said to them in a face-to-face visit, while paper instructions are often lost. Virtual assistants and apps are always available, and can deliver tailored information when and how patients need it. They can alert both the patient and care team when something requires greater attention. This ability to provide actionable, personalized, and real-time care shows great promise in improving patient experience and outcomes.

However, the challenge in creating this always-connected world of healthcare – whether that’s through consumer health apps, wearables, or even those apps prescribed by healthcare organizations – is that they generate more data than physicians know what to do with. Though this data can provide extremely valuable insights to manage populations, there’s often no place for it in the medical record, which is not designed for patient-generated data.

Data without context is meaningless, which is why physicians initially balked about having device data in the EHR. While understanding how much a healthy person is active is interesting, you don’t need Fitbit data for that when there are other clinical indicators like BMI and resting heart rate. Understanding how much someone recovering from knee surgery is walking is interesting, but only if you understand other things about that person’s situation and care, such as how much they walked before surgery, pain levels, and side effects.

However, if you ignore the patient experience outside the clinic, decisions are being made with only some of the data. In Kleiner-Perkin’s State of the Internet Report, Mary Meeker estimates that the EHR collects a mere 26 data points per year on each patient. That’s not enough to make decisions about a single patient, let alone expect that AI will auto-magically find insights from aggregated information.

How do you marry this patient-generated data with current healthcare IT systems? The value of patient engagement and self-management through virtual assistants and applications is real. Current systems, however, aren’t designed for this data. To the patient, every single one of those Fitbit steps or recorded symptoms is interesting. To the physician, it’s noise. To make sense of these two worlds, we need a few things. First, we need to leverage machine-learning and big data tools to make sense of the terabytes being collected directly from patients. Next, we need to identify indicators of adverse events or negative trends. Then, we need to be able to react to and act on those indicators for patients, either with alerts and instructions delivered by an app, or by direct outreach from a clinician.

Finally, this data needs to make its way back into the patient’s medical record – but not all of it. Scores from patient-reported outcome surveys, important recorded symptoms, and trend data should be attached to the EHR. The rest should be available directly to the patient, and to clinicians and analysts to work with in BI and other tools. To make this new world a reality, patient engagement systems must be interoperable and open, and sit side-by-side with the EHR. There’s a whole world of data and learning out there to improve patient experiences and outcomes, but to capitalize on it, we need openness and interoperability.

Consumer expectations are indeed hitting healthcare – hard. Patients are no longer shy about telling physicians and payers what they want and how much they’re willing to pay for it. While these expectations can seem overwhelming to those insiders who have long become accustomed to healthcare’s glacial pace, we shouldn’t be discouraged. These greater expectations can indeed be met, provided we take the time to develop and offer physicians and patients tools that meet their needs and fit their workflows.

Anne Weiler is co-founder and CEO of Wellpepper in Seattle.

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News 8/17/17

Top News

Phil, a San Francisco-based prescription delivery service, raises $10 million in a Series A round of funding led by Crosslink Capital. Phil has developed technology that automates communication between patients, physicians, pharmacists, and payers to ensure timely deliver of medications and improve adherence. The company, which partnered with telemedicine vendor Lemonaid Health earlier this year, will use the investment to expand its pharmacy network and double its staff by 2018.

HIStalk Practice Musings

Eclipse fever seems to be skyrocketing as everyone prepares for Monday’s event. Case in point: Supply of protective eyeglasses has dwindled, and prices have commensurately skyrocketed. Thankfully, I know a guy who knows a guy. Now, I just need to check and see if the manufacturer of the lenses I bought on the black market are indeed approved by the American Astronomical Society. (You can find their list of approved vendors here.) I’ll be venturing about an hour and a half from home in an attempt to immerse myself in the path of totality. I’ll be interested to see if I do indeed encounter the traffic nightmare many seem to think will occur. Hopefully the atmosphere of wherever I end up will be festive rather than frustrated. How will you view the eclipse in your area? Feel free to share your eclipse party plans in the comments below.

Webinars

None scheduled in the coming weeks. Previous webinars are on our YouTube channel. Contact Lorre for information on webinar services.

Announcements and Implementations

Rio Grande Valley Health Alliance (TX) goes live on care coordination, remote patient monitoring, and telemedicine software from Reliq Health Technologies across its ACO, which includes 15 independent primary care practices and 17 physicians.

Telemedicine

A study of 195 Parkinson’s patients finds virtual consults to be just as effective as in-office visits with regard to quality of care, quality of life, caregiver burden, and patient and neurologist satisfaction. Fifty-five percent of patients preferred the virtual consults over office visits, likely due to the fact that, on average, they saved an average of 169 minutes and 100 miles of driving. The study’s authors note that the biggest barrier to offering telemedicine visits to Parkinson’s patients is a lack of Medicare reimbursement – a situation they hope will change as the telemedicine component of the 21st Century Cures Act evolves.

Des Moines, IA-based Certintell receives the final installment of an $850,000 seed round of funding from Prairie Crest Capital. Founded and led by former Genentech sales and marketing rep Ben Lefever, the telemedicine company is focused on providing its services to FQHCs and other providers that care for Medicaid patients. It plans to next focus on developing a mobile app.

People

The Strategic Health Information Exchange Collaborative hires Kelly Hoover Thompson (Pennsylvania Dept. of Health) as CEO.

Research and Innovation

Aurora, IL, Madison, WI, and Grand Rapids, MI take the top spots in the latest Vitals Access to Pediatric Care report, which looked at pediatrician availability and patient-reported metrics like provider ratings, ease of getting an appointment, and wait times. Practices in the highest-ranking cities reported wait times of under 13 minutes, well below the national average of nearly 19 minutes. Bottom-performing cities (predominantly found in Texas and California) make their patients wait upwards of 30 minutes.

Other

New Jersey Academy of Family Physicians President Peter Carrazzone, MD takes umbrage at the amount of blame being heaped on physicians’ shoulders for the opioid epidemic. In the local paper, he points to physician willingness to check the state’s PDMP, but a lack of follow-up when physicians report suspected “doctor shopping.” “You can download a form,” he says, “you fill it in, you send it to a faceless computer and time passes. You don’t know what’s happening. I really think there should be a more proactive support, maybe some sort of hotline where you could … have a direct person to talk to. Doctors in today’s world have layers and layers of protocols being added to our normal work, and it becomes a little overwhelming. The doctor is not the enemy here. It’s the patients that have addiction problems that are abusing the system.”

The New York Times paints an interesting picture of the progress Aledade is helping independent physicians make in the areas of preventive care and hospital readmissions. Though the Bethesda, MD-based company, formed by former National Coordinator Farzad Mostashari, MD in 2014, prides itself on helping practices transform with technology, its software is “the least interesting thing it does.” It’s the way in which it helps practices implement and use that technology in unobtrusive and workflow-friendly ways that seems to really win the company customers (which as of late has also included payers interested in its ACO services). “We’re very comfortable in our model,” Mostashari says.

Contacts

Jenn, Mr. H, Lorre

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