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Population Health Management Weekly Wrap Up 12/18/16

December 18, 2016 News No Comments

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Dawn Weathersby (Mediquire) joins I2I Population Health as SVP of product strategy and solutions.

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Scott Cullen, MD (Valence Health) signs on with Erdman as EVP and CMO.

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Medecision appoints Cory Courtney (Alere) to lead its new population health consulting team, which also includes Jackie Luchsinger, RN (Dearborn Advisors) and Carolann Engler, RN (Engler & Associates) (not pictured).

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Chicago-based Cook County Health & Hospitals System expands its use of Medical Home Network’s care coordination portal and alert system to its entire Medicaid managed care population including those served by its mental health and substance abuse providers, immediate and urgent care centers, and Cermak Health Services, which cares for inmates within the county’s prison system.

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Community Health Network/Indiana ProHealth Network selects ZeOmega’s Jiva population health management software.

MedTek21 incorporates genetics-based clinical decision support technology from Translational Software into its pharmacogenomics-based monitoring for its population health and medication risk management platform. The integration will enable providers to take into account a patient’s genetic profile and corresponding medication risks when prescribing treatment.

Indiana-based payer MDwise extends its contract with ZeOmega and upgrades to the latest version of Jiva.


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News 12/15/16

December 15, 2016 News No Comments

Top News

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CVS Health further creeps into the primary care space with the launch of the Transform Diabetes Care program, the first in a line of such programs that will focus on helping pharmacy benefit management customers better manage the chronic conditions of their patients. The program hopes to improve outcomes and lower medical and pharmacy costs through custom support that will include digital tools like connected glucometers, apps, and backend analytics. No overt mention is made of looping in PCPs, though the company does note that its managed pharmacy network will help simplify medication refills and improve care coordination with its members’ providers.


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HIStalk Practice Musings

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This weekend marks the last full one before Christmas – a fact that leaves me with little time to shop for and complete any holiday cooking/baking I had hoped to do. Close to 20 empty cookie tins are waiting to be filled for neighbors, friends, teachers, and service providers so I’ll have to shelve my excuses, put on my snowmen apron and get to the kitchen. I’ll attempt to tackle sausage balls, peppermint bark, and sugar cookies in festive shapes with copious amounts of frosting and edible décor. Thankfully, the new family favorite – pimento cheese topped with pepper jelly baked in phyllo cups – is also the easiest. If you’re looking for more classic takes on holiday cooking, check out Quartz’s compilation of what constituted a holiday meal 100 years ago. Green Sea Turtle Soup, anyone?


Announcements and Implementations

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The Los Angeles County Dept. of Health Services expands its use of Safety Net Connect’s physician-to-specialist consulting software to include its 21 mental health facilities.

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Lexington Clinic (KY) rolls out Athenahealth’s AthenaOne services including EHR, RCM, and quality management tools across its 30 locations.

The Indiana Health Information Exchange, Michiana Health Information Network, and East Tennessee Health Information Network agree to share data between their respective HIEs.


Telemedicine

Konica Minolta taps private-label telemedicine vendor SnapMD to power its new cloud-based Virtual Care Management technology aimed at physicians looking to launch branded virtual consults.

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Concentra signs on with American Well for telemedicine services. The chain of occupational medicine and urgent care clinics, which serves employees at over 400 facilities, will launch the virtual consults in select states early next year. 

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A Health Affairs editorial points out that offering telemedicine services in underserved areas may do more harm than good if no in-person follow-up care is available. An evaluation of Direct Dermatology and the Maven Project – both of which offer virtual consult capabilities to PCPs working in underserved areas (presumably with large Medicaid and uninsured populations) – found access to telemedicine to be more of a band-aid on the local dysfunctional health system, rather than an end-all, be-all cure for a patient’s ailment. “Telehealth has great promise but it is important that in introducing it, we do not digitize the same flawed and overcrowded health care system that struggles to meet the needs of patients today,” the authors conclude. “The solution is not to bring in episodic, disconnected telehealth and assume it will fix our problems. Rather, we must experiment with more comprehensive strategies that combine telehealth and the necessary in-person care so that we are digitizing a better, more efficient, and more equitable healthcare system.”

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Statistics continue to roll in concerning the enthusiasm patients have for telemedicine. A Rock Health survey of 4,017 people shows that the number of telemedicine utilizers increased from 7 to 22 percent between 2015 and 2016. That’s quite an increase, but it still doesn’t jive with the amount of news I’ve covered this year relating to new telemedicine companies and partnerships. It seems like availability far outstrips demand, and likely will for some time.

On a related note, a Federation of State Medical Boards study finds telemedicine to be the most important regulatory topic to 57 of the 70 state medical and osteopathic boards surveyed. Resources related to opioid prescribing and the telemedicine-friendly Interstate Medical Licensure Compact rounded out the top three topics.


Government and Politics

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ONC invites developers to submit methods by which vendors can create a user-friendly “snapshot” of a product’s Model Privacy Notice. One lucky winner will receive $35,000. Submissions are due April 10.

Venice, CA-based startup Pwrdby wins the FDA Naloxone App Competition with its OD Help app, which connects potential opioid overdose victims with a crowd-sourced network of nearby naloxone carriers. The app, which earned its development team a $45,000 prize, is capable of interfacing with a breathing monitor to detect and alert carriers when a victim’s breathing rate drops to levels concurrent with an overdose.

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Bon mots from Acting CMS Administrator Andy Slavitt, who appeared at the CMS Quality Conference alongside former administrators Don Berwick, MD and Mark McLellan, MD.


Other

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The National Academy of Medicine will launch a collaborative effort of between 20 educational and professional organizations to combat physician burnout. Dubbed the “Action Collaborative on Clinician Well-being and Resilience,” the effort will initially consist of public workshops and meetings held throughout the year.

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If only I had known about this while I was at the post office yesterday: The USPS offers a free augmented reality smartphone app that lets priority mail senders choose between two holiday-themed messages, and receivers create similarly animated thank-you messages. FYI: USPS Christmas mail-by dates include December 20 for first-class mail and December 21 for priority mail.


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5 Questions with Dennis Dunmyer, VP, Behavioral Health & Community Programs, Kansas City Care Clinic

December 15, 2016 News No Comments

Dennis Dunmyer is vice president of behavioral health and community programs at Kansas City Care Clinic in Kansas City, MO. The clinic, previously known as the Kansas City Free Health Clinic, was awarded FQHC status last year. It employs 140 to care for an average of 120 patients each day for primary care, behavioral health, and oral health visits. The clinic sees a similar number of patients for HIV or hepatitis C tests. It also caters to patients seeking a case manager, peer counselor, or community health worker. KCCC uses a variety of health IT, including Greenway’s Success EHS and patient portal, and NextGen’s Scout care coordination software for HIV patients enrolled in its Ryan White HIV/Aids care coordination program. It recently incorporated BluePrint Healthcare IT’s Care Navigator platform in its Community Health Worker program. It plans to attest for Meaningful Use for 2016.

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Why did KCCC decide the time was right to implement Care Navigator technology? What are the organization’s goals for the tool and its impact on patient care? 
We run a community health worker (CHW) model care coordination program that serves patients from a regional network of providers, hospitals, and community-based settings, including our own primary care practice. These CHWs are performing intensive, community-based patient navigation with these largely uninsured patients. KCCC decided to adopt Care Navigator primarily to be used with this program to allow for a centralized system to manage the day-to-day workflows of the CHWs, the assessments and care plans for these patients, and to allow cross-provider communication. This platform will allow us to more efficiently create care plans, track referrals, and provide automated prompts to the CHW to ensure that patients are connected to the resources and providers they need to improve their health. After this initial use case, we envision further adoption with our patient-centered medical home team within our FQHC practice.

The final MACRA rule is still making news. What are the clinic’s participation plans?
Since FQHCs have different payment methodology systems for Medicare and Medicaid, we are not planning to do anything with MACRA. We understand that we are not expected to participate in either track.

What has the PCMH journey been like for the clinic? How do you believe this experience will help the clinic transition to value-based programs?
The PCMH journey is a challenge and we continue to travel that road as this practice model is a shift in culture from how most clinicians are trained. The team-based concept requires putting the patient first and thinking about aspects of patient care that do not fall within traditional healthcare interventions. As an FQHC, our patient population often has more social barriers to their health than they do healthcare barriers to health. We certainly believe this framework helps set us up for improved patient outcomes, and value-based reimbursement models make more sense to encourage these additional activities. For us, the challenge has been finding ways to support the additional staff infrastructure required while a large number of our patients remain uninsured, and to make this investment prior to the proliferation of value-based reimbursement that will reward us for improved health of the population we are managing.

Are any other coordinated care initiatives underway?
As I alluded to above, we are an NCQA Level 3 PCMH, Missouri Medicaid Primary Care Health Home and have care coordination processes embedded throughout. Our practice is working to fully integrate our primary care, behavioral health, and oral health services through technology and staff-driven care coordination models. We are also a large Ryan White provider and have a lot of medical case management for those clients, and we run a regional CHW model care coordination program that serves patients from four area hospital systems and several other safety net healthcare providers.

How is the clinic using technology to better integrate behavioral health and primary care? What impact is this having on patient access and outcomes?
The clinic uses the same EHR platform for primary care and behavioral health, and our EHR allows integration of our dental module as well. We made a choice to not blind anyone on the care team from any aspect of patient care in the EHR so that the team can use the information gathered in other disciplines to drive care decisions. A shared medication list, labs reports, and access to care plans and progress notes across the system allow for better coordination of care in an integrated environment. We have not yet found an ideal platform for this type of practice, and have had to sacrifice some functionality on the behavioral health side to allow this shared model. We are hopeful that over time we will make up for some of the limitations in our EHR in this regard as we fully implement the Care Navigator functionality across our system.


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News 12/14/16

December 14, 2016 News No Comments

Top News

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CareSync expands with its relocation to 51,000 square feet of office space in Tampa, FL. The company, which employs 150 at its new headquarters, plans to hire at least 200 more in the areas of clinical care coordination, product development, HR, IT, and administration by the end of 2017. The technology-fueled care coordination company has raised $22.5 million since launching in 2011.


Webinars

Here’s the recording of the recent webinar titled “Charting a Course to Digital Transformation – Start Your Journey with a Map and Compass.”

Email Lorre for details about webinar services.


Announcements and Implementations

Workplace healthcare provider Marathon Health implements Quippe documentation technology from Medicomp Systems as part of an upgrade to its homegrown EHR.


Acquisitions, Funding, Business, and Stock

Re-Habit will license and resell Telehealthcare’s CarePanda secure messaging app to detox and residential treatment facilities.


People

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Staffing firm Medicus Healthcare Solutions promotes O’Neil Pyke, MD to CMO.


Telemedicine

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Motion PT implements EWellness Healthcare’s Phzio physical therapy telemedicine technology at its clinic in Brooklyn, NY.

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Community Health Center of Cape Cod (MA), which seems to be an Epic shop, offers telepsychiatry visits at its three locations. It will roll out teleoptometry and teledermatology services sometime next year.

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Academic Alliance in Dermatology (FL) selects DermatologistOnCall services from Iagnosis.


Research and Innovation

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A new Surescripts survey reveals that patients spend about eight minutes explaining their medical history to their physician, and eight minutes filling out paperwork. Not surprisingly, 80 percent feel they should only have to fill out said paperwork the first time they visit a new physician. Most interesting to me is the fact that 52 percent expect their physicians to start offering virtual consults and 36 percent believe most visits will be remote within 10 years. I have trouble reconciling the fact that over half want virtual visits and yet statistics have shown low consumer utilization. Conceptualizing the business models and legislative landscape that would have to evolve to make most visits virtual is also a hard sell.


Other

Humana consolidates 1,116 quality metrics used across its programs into 208 – an 80-percent reduction made in an effort to better support physicians who are transitioning to value-based care programs. Physicians will no doubt welcome the less burdensome quality reporting, which has surely played a role in physician burnout.

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While it’s never a good time to get laid off, being let go during the holidays must be one of the hardest. Those health IT professionals looking for a career about-face may be interested in the role of “emoji translator.” London-based Today Translations has created the role to explain cross-cultural misunderstandings in the use of the mini pictures, and compile a monthly trends report. Though the job is the first of its kind (candidates must demonstrate a “passion” for emojis), I wouldn’t be surprised if similar job openings were to pop up across the pond, especially given the fact that a UK linguist has dubbed emoji the country’s fastest growing language.

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If you’re looking for a more seasonal gig, consider joining the ranks of Santas who are on LinkedIn. To stand out, however, you’ll need to list membership in the International Brotherhood of Real Bearded Santas and credentials from one of the exclusive Santa schools here in the US. LinkedIn lists 100 Santa openings, so get that beard growing!


Sponsor Updates

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  • EClinicalWorks employees help out families through Project New Hope, Project Just Because, and the United Way.
  • The Indo-UK Institute of Health names GE Healthcare a preferred technology partner in its IUIH Medicities program in India.

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Jenn, Mr. H, Lorre

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5 Questions with Chris Romandetti, CEO, First Choice Healthcare Solutions

December 13, 2016 News No Comments

Chris Romandetti is CEO of First Choice Healthcare Solutions based in Melbourne, FL, which focuses on outpatient orthopedic and spinal care. It employs 128 people across its five facilities, including a dozen physicians and seven PAs, to care for between 425 and 450 patients daily. The organization successfully weathered the effects of Hurricane Matthew in early October.

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How did Hurricane Matthew impact FCHS operations? How did your staff prepare, especially with regard to the potential downtime of IT systems?
Thankfully, all of our facilities’ main utilities, including power, air conditioning, and Internet connectivity, remained fully operational throughout and following the storm. Moreover, our buildings sustained no notable damage that would otherwise disrupt the company’s medical or business operations. Consequently, we were back to business as usual on Monday morning immediately following the storm.

Is your IT infrastructure onsite, in the cloud, or a mix of both?
We utilize a mix of both the cloud and redundant servers – our EHR system operates in the cloud, but our day to day business operations are maintained on the server. However, we are considering moving all of our data to the cloud – including any potential new accounting system solution that we may choose to implement in the future. The cloud offers us numerous benefits associated with enhanced care collaboration among our providers, cost considerations, scalability, data security, document control, and disaster recovery, among others.

Does the annual hurricane season prompt your IT team to review its downtime procedures?
Absolutely. Hurricane season is six months long, so we review our unplanned downtown procedures prior to the beginning of the season; and then we reevaluate shortly after the end of the season to determine what things we learned from an unplanned downtown and/or what contingency procedures or communications protocols may need to be refined or modified to further improve our plan.

What advice can you offer other providers who may be thinking it’s time to take a fresh look at their natural disaster preparedness?
It is vital to have a plan in place, because disruption of power, Internet failure, physical property damage, et al could cause you to rely on your downtime procedures to effectively administer patients. The time to review is not when a potential natural disaster is looming, but on a regular basis. This is particularly important when there are changes in staff. Everyone needs to know what to do in the case downtime procedures are activated.

On a side note, how is FCHS and its practices preparing for MACRA. Any other coordinated care initiatives underway?
We are currently evaluating our options for participating in MACRA. When it comes to other programs, we are currently performing outpatient total hip and total knee replacements, as well as minimally invasive spine surgical procedures at our ambulatory surgery center, Crane Creek Surgery Center. In addition, we are planning to submit bids for bundled payment programs on total hip and total knee replacements to CMS, several large insurance payers, and a number of large self-insured employers in our local market (Brevard County, Florida).


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Jenn, Mr. H, Lorre

More news: HIStalk, HIStalk Connect.

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