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HIStalk Practice Interviews Daphne Bascom, MD SVP, Community Integrated Health, YMCA of Greater Kansas City

May 10, 2017 Interviews 1 Comment

Daphne Bascom, MD is SVP of community integrated health at YMCA of Greater Kansas City in Missouri.

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Tell me about yourself and the organization.

I am a physician by training, board certified in otolaryngology, and head and neck surgery. I trained out of the University of Pittsburgh and Oregon Health Sciences University, and have been in Kansas City now for about five years. I completed my fellowship in microvascular reconstruction at Case Western University, then left there and joined Cerner for the first time. I then worked for Ascension Health for a short time and then Cleveland Clinic. I spent six years rolling out Epic at Cleveland Clinic. During that time I was able to work as part of their wellness institute. I went back to Cerner about five years ago and was most recently CMO.

I joined the Y in January of 2017. It’s probably easier to call me the medical director for health and wellness; that is my role today. I am the first physician employed at the association level – the first local doc. The YMCA of Greater Kansas City is actually an association of 14 different YMCA centers that are both in Kansas and Missouri. We have about a million visits to our Y annually, and are the largest provider of childcare in Missouri and Kansas.

I’ve read that you’re also a competitive body builder. How did you become involved with that?

Around the time I turned 40 I treated myself to some personal training, and my trainer was a professional figure competitor. She was preparing some competitors for competition and I thought it looked fun, so I decided to start competing. I earned my professional card six or seven years after I started competing. While I’ve always been a gym junkie, it wasn’t until I turned 40 that I really started to understand how important nutrition was, and how to really wed health and wellness together.

What prompted you to make the switch fro the vendor world to the Y?

I was already a member, and had been on their board for two years. I’d watched this Y as they started to make the transition from what we call “swim and gym” to really starting to engage with the community. I introduced the Y to Cerner because I saw a huge opportunity, given what they were doing, to integrate population health strategies into what the Y was doing. This was while I was still at Cerner. I also started facilitating conversations between the Y and Truman Medical Center, which is our safety net hospital, and then I pulled in the university. It was one of the most fascinating set of conversations I’d heard in years because they were throwing to the wind what we had done conventionally, asking, "How do we do this differently? How do we better leverage our community partnerships?" I got excited about doing the work when I was on the Cerner side. When the Y posted for a clinical leader, I threw my hat into the ring and was fortunate to get the position.

How has your health IT experience already started to help inform your role at the Y?

On top of my Cerner and Epic experience, the YMCA started an Athenahealth deployment in January. Any YMCA that delivers our diabetes prevention program is using Athenahealth, which is going to be our standardized EHR across all of the Ys nationwide. I’m getting a little bit of exposure to Athena now and it’s really exciting.

The technology connection is probably at multiple levels. I think there’s a community connection where we can improve how we are using e-referral processes, and improve decision support so that providers can perhaps be prompted to refer patients to community services in the context of their workflow. I’d also like to get rid of the paper trail by having more electronic processes to refer patients into the Y, or for me to refer patients to a provider. And – this is my dream, especially living in Kansas City and seeing what Cerner is doing with Healthy Intent – having the potential for a true community health record.

If all of this data were above our individual organizations in the cloud, you could tie in clinical needs with community needs and then add in social determinants of health, which isn’t done that well today in the EHR. That could help create a better picture and help people understand what it is they really need from the health side, the care side, and the community side.

We’re also in the process of rolling out a mobile platform for delivering evidence-based programs. We partner with a company called Noom. We just started our first diabetes prevention program on smartphones.

Given that the Y isn’t a conventional healthcare provider, how does it plan on using the EHR?

The diabetes prevention program is delivered by trained lifestyle coaches, who we are training to use the EHR to almost as if they were an ancillary care provider. Every one of their classes becomes a schedule for them, the provider. All of the participants in their classes will be on their schedule as if they were seeing people in clinics. They are required to enter the participant’s weight, their activity, if they are completing their food log. We also have them doing "billing" just to document their participation – if it’s their first session, their 10th session – so that we can also report on their progress. It’s the same Athena that everyone uses. It’s a little nuanced.

The funny thing is I hear the exact same complaints from the coaches that I hear from the physicians with regard to the technology: “It’s too many clicks. It takes me too long.” The great thing is that it’s standard, so regardless of whether you’re in Atlanta or Kansas City, you will have the same experience and the same data will be collected. At the national level, the Y is beginning to aggregate the data across all of our facilities so that we can begin to look at our outcomes. One of the primary motivators is that we want to be able to participate in Medicare reimbursement starting in 2018. We needed a certified EHR in order to be able to submit those claims.

All of the Ys have their NPI and we’re in the process of working on NPIs for our coaches. From an organizational change perspective it’s huge, because YMCAs historically have not really had to be HIPAA-compliant. Now, one of my responsibilities is as our privacy officer, and getting everyone HIPAA-trained and HIPAA-certified, and putting in place the policies and procedures to make sure that we are compliant. It’s been a massive organizational change effort, and I have to applaud the national office for taking this on.

We’re also working on e-referrals. The three primary EHRs that we’re working with in Kansas City are Cerner, Epic, and Athena. I can’t directly receive a referral from any of them or send a note back to them. We’re hoping to turn on Athena Communicator, which will give us some capability to do Athena to Athena communication. We’re exploring Direct messaging, although we know some of the challenge with Direct nationally in terms of adoption and usage. And then we’re also part of an initiative out of the Million Hearts program that is interested in exploring the same things. There are a few different organizations trying to figure this out.

Are you thinking about adding telemedicine?

That’s a great question. The answer is yes. I just don’t have the answer for who the provider will be. We just built a new Y in one of our underserved communities called Linwood. In partnership with Truman Medical Center, we’re going to build a clinic that’s physically attached to the Y. It’s not a new model; there are multiple Ys that already have integrated rehab and physical therapy or other clinical services. But as part of that, we are going to have an e-visit room, and so we’re looking at what that may be and who may provide that. I’m advocating that it should not be seen as just a clinical visit, but that it could be a care team visit. If I needed to have a provider on a line along with a coach, along with the patient … we want to make sure that the technology can scale and have a care team concept – not just a patient-to-provider concept.

Are you already thinking about connecting to a local or regional HIE?

Yes. We met with the Kansas Department of Health several weeks ago to see if we can help them with some of their rural communities. They wanted to know, “Can we send this health data to the Kansas HIE?” I’ve also talked with the Missouri Primary Care Association. We have three HIEs in Missouri. I think the challenge from the YMCA’s perspective will be point-to-point in every state. It’s going to be very expensive. And will it be sustainable?

I would love to have all of this go up into some big, massive cloud, but again I’m probably just dreaming. In Missouri I have to decide, “Do I send the data to all three HIEs or do I bet on one being sustainable? Will I make people mad if I choose one and not the other?” There are some politics involved. Nationally, I don’t know if funding and maintaining all of those connections is going to be the Y’s long-term strategy.

You mentioned working with a public health agency. What social determinants of health are you incorporating into your community-integrated health program?

As many as possible. And I know that’s not an answer. One of the things I’ve been doing for the past four months is making introductions around the community, both to share what the Y is doing and then also to better understand what other resources are available. I’ve also been visiting all of our Ys to understand what are the important non-swim-and-gym elements of healthcare that we can address with appropriate services from the Y or our partners. We’re already working with Truman, KU, and food trucks. There are significant areas of Kansas City that are food deserts.

With our Million Hearts Program, the Dept. of Health in Missouri has agreed to help us organize transportation for patients that may want to participate in our blood pressure self-monitoring program. If they are recommended by their provider to be part of a BPSM program and transportation is an obstacle, can we work with the health department to schedule a van or Uber to get them to meet with our Healthy Heart ambassadors. From a language and literacy perspective, our Y is piloting an English as a second language program. We’re helping address literacy within members of our community. These programs are actually taught by community volunteers, not even employees at the Y.

What are your goals for these programs? What are your aspirations when it comes to continuing to build them out?

I think the first goal is for both the community and the healthcare community to know that these programs are available. Communication and program availability is key, and more importantly, as well as making our programs part of the clinical care workflow. I’d love to enable providers to either refer patients and/or to see data from participation in these programs. Another goal is to scale the programs across more of Kansas City and Missouri and Kansas. Kansas and Missouri are not the healthiest states. I need to be able to scale the programs and deliver them to more members of the community. Those aren’t just YMCA members. We deliver programs in churches, schools, and to employers. To do that, part of it has to be having the resources to fund our coaches.

I think a lot of what I’m going to be leveraging technology for is to meet people where they are. You may not be able to come into a Y physically, but if you can meet with a YMCA coach on your smartphone or iPad, then we can help you maximize your health potential with whatever resources are available. The last part would be for the Y to become a trusted and respected member of the community care team. It takes a village to be healthy. In a 15- or 20-minute clinic visit, there’s no provider that’s going to be able to address all of the key factors that make people well or help keep them healthy. It may be that they don’t have electricity, or that they don’t have great access to food. They may not have an ID that allows them to get their health insurance on the exchange.

We want to continue to extend what we consider to be health and care to be inclusive of our community resources, and to make those resources available to people as they need them. We want to make sure that the provider community has immediate access to us when it’s appropriate so that we can help extend what they’re doing to keep people healthy.


Contacts

Jenn, Mr. H, Lorre

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News 5/10/17

May 10, 2017 News No Comments

Top News

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Boca Raton, FL-based Modernizing Medicine announces a $231 million investment from private equity firm Warburg Pincus. The specialty-specific EHR vendor has raised $322 million and acquired two companies – GMed and Aesyntix- since opening its doors in 2010. It anticipates using the latest round of funding to ramp up efforts around prior authorization automation, eCommerce platform development, data exchange and reconciliation, and telemedicine. Fred Hassan and Amr Kronfol, both of Warburg Pincus, will join the company’s board.


Webinars

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


Announcements and Implementations

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DocsInk adds CCM-friendly features to its charge capture services.

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Integra Connect offers cloud-based RCM services for large urology and oncology practices looking to transition from fee-for-service to APMs.

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TCI develops the SuperCoder Smart Assistant browser extension, giving coders the ability to look up codes without exiting whatever program they’re working in.

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California Highlands and Recovery Centers of America (PA) select medication management and communications technology from Compliance Meds Technologies.


People

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Michael Lovett (NextGen Healthcare) joins Formativ Health as chief commercial officer. It is the practice management services company’s third executive hire in the last two months.


Government and Politics

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The Senate confirms Scott Gottlieb, MD as FDA commissioner. The cancer survivor was quick to respond to congratulations from NIH Director Francis Collins, tweeting that he’s looking forward to working with the NIH to “advance science in pursuit of medical progress and public health promotion.”


Research and Innovation

Findings from MGMA’s annual physician compensation and productivity survey highlight that pesky wage gap we’ve all heard so much about: Male PCPs earn 17-percent more than their female counterparts, while male specialists earn 37 percent more than women working in the same areas.


Other

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The local paper covers OptumHealth’s impending acquisition of Reliant Medical Group, a Massachusetts-based group that has been independent since it opened for business in 1929. RMG CEO Tarek Elsawy attributes the decision – supported by the group’s 230 physicians – as a step in the right direction when it comes to remaining competitive. He explained that, “Reliant expects to bolster its ability to grow and expand, modernize many of its clinical facilities, have access to advanced data analytics capabilities, and attract top medical talent to its practices.”

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Authorities arrest Public New Service reporter Dan Heyman for “willful disruption of governmental processes” after repeatedly asking HHS Secretary Tom Price, MD about pre-existing conditions under the AHCA, and purportedly doing so in breach of Secret Service proximity protocols. The incident occurred during Price’s visit to the West Virginia State Capitol to learn more about the state’s opioid crisis.


Sponsor Updates

  • NVoq will exhibit at the MGMA NE conference May 10-12 in North Falmouth, MA.

Blog Posts


Contacts

Jenn, Mr. H, Lorre

More news: HIStalk, HIStalk Connect.

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

JennHIStalk

News 5/9/17

May 9, 2017 News No Comments

Top News

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Healthcare CRM/care coordination company Updox raises $12.7 million in a Series B round led by TT Capital Partners. The company has raised $15.2 million since launching in 2008. CEO Michael Morgan joined Updox in 2012 after stints with Netsmart and ProductManage.


Webinars

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


Announcements and Implementations

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Compulink develops an EHR for OB/GYNs that includes PM, RCM, and telemedicine capabilities.

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CORHIO will add FHIR-based API access o its HIE services next month. The move is part of a broader interoperability and data aggregation effort that will soon see the Colorado-based organization gather the housing, transportation, and financial data of patients.

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Drchrono adds new OB/GYN-specific flow sheets and medical forms to its EHR.

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Great Falls Clinic (MT) selects RCM software and services from MTBC. The clinic already uses MTBC subsidiary MediGain Practice Management’s RCM support services.


Acquisitions, Funding, Business, and Stock

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Boston-based Polaris Partners launches a $435 million fund that it will use to invest in healthcare, technology, and biotech companies. Current health IT investments include managed primary care services company Iora Health, patient intake vendor Phreesia, and telemedicine startup First Opinion.


People

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The American Association of Clinical Endocrinologists elects Jonathan Leffert, MD (North Texas Endocrine Center) president.

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Brent Asplin, MD (Mercy Health) joins VillageMD as COO.


Telemedicine

The ClearHealth Quality Institute takes over management of the American Telemedicine Association’s accreditation program. ATA will help CHQI draft and update standards associated with the program, which will be rebranded as the Telemedicine Accreditation Program. American Well, Avera, Care Simple, Doctor on Demand, HealthLinkNow, MDLive, United Concierge Medicine are the only vendors thus far to take advantage of the program.


Research and Innovation

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Scientists at the University of Illinois and the Carle Foundation Hospital’s Research Institute design a digital doctor capable of explaining lab tests to patients via a provider’s portal. Developed for adults with low levels of health literacy in mind, the “computer agent” has been tested on seniors in two pilot studies; both of which found no preference for the agent’s “natural-sounding” or computer-generated voice. Next steps will include applying for grant money and developing a more robust pilot study.


Other

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I’m labeling this a hipster data breach: Thieves use fishing lure, poles, and lines to steal mail from a box outside of a post office in Palm Beach County, FL. Postal officials are now encouraging patrons to drop off mail inside the building. One post office employee has already been arrested for stealing checks and gift cards from a similar mailbox.


Contacts

Jenn, Mr. H, Lorre

More news: HIStalk, HIStalk Connect.

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

JennHIStalk

News 5/8/17

May 8, 2017 News No Comments

Top News

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A Black Book survey of nearly 9,000 practices identifies the top challenges physicians are dealing with when it comes to MACRA participation. Seventy-seven percent are on the hunt for software that will support their MIPS endeavors, making me wonder if vendors will conveniently contract buzzword-itis and rebrand some of their offerings to suit physician Google searchers (as we saw, and still see, with “population health management”). Other health tech-related nuggets include:

  • Over 80 percent of users are optimizing their EHRs for MIPS.
  • A similar percentage believe an audit of their current technology will help position them for MIPS success, yet 75 percent of practices with three or fewer physicians can’t afford to hire outside help.
  • Over 20 percent of those surveyed had planned on delayed implementation of the program; as such, 80 percent have no MACRA plan in place and hope to play catch up with a turnkey solution bought at the last possible minute.
  • Seventy-five percent of independents are considering selling their practices to reduce increasingly oppressive administrative burdens.

HIStalk Practice Announcements and Requests

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Thanks to PerfectServe for supporting HIStalk Practice. Click the logo above for more information. Learn about the benefits of sponsoring HIStalk Practice here.


Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre for information on webinar services.


Acquisitions, Funding, Business, and Stock

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Intelligent Medical Objects receives a patent for its system of terminology management that responds quickly to regulatory changes and simplifies coding.


People

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Reed Liggin joins EazyScripts as CEO. Liggins comes to the e-prescribing tech company from Athenahealth by way of its 2015 RazorInsights acquisition.

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The Texas Medical Association elects gastroenterologist Carlos Cardenas, MD (Doctors Hospital) president. In his spare time, Cardenas and several physician colleagues play charity gigs in their band, The Renaissance Rockers.


Announcements and Implementations

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MedPhoto Manager creates a secure medical image capture and sharing app.

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Integrity Urgent Care (TX) selects billing, EHR, contracting, and credentialing services from Practice Velocity.


Telemedicine

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Teladoc announces Q1 results: revenue up 60 percent, membership up 34 percent to 20.1 million, and a visit increase of 60 percent to nearly 385,000. Revenue from subscription access fees trumped visit fees at $34.3 million versus $8.6 million.


Government and Politics

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CMS develops an interactive lookup tool providers can use to determine their MIPS participation status.


Research and Innovation

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Reaction Data publishes its “Big Mega HIT Purchasing Report,” which finds that independent practices place telehealth at the top of their 2017 shopping list, with equal interest in four vendors. EClinicalWorks takes the top spot for greatest outpatient EHR mindshare; VMware and Cisco evenly split the information security category.


Other

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The local paper previews efforts in Central Oregon to finally get an HIE underway. The Reliance eHealth Collaborative will formally launch this summer with support from St. Charles Health System, Mosaic Medical, High Lakes Health Care, Central Oregon Pediatric Associates, Advantage Dental, and Deschutes County Health Services. The Central Oregon Health Council, which oversees care for the region’s Medicaid population, is contributing $2 million to the project.

Here’s the final installment of Vince and Elise’s series on physician practice vendors, this time looking at the “other” 622 vendors with under 5,000 implementations.


Contacts

Jenn, Mr. H, Lorre

More news: HIStalk, HIStalk Connect.

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Population Health Management Weekly Wrap Up 5/7/17

May 7, 2017 News No Comments

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Gary Smithson, MD (Smithson Healthcare Consulting) joins RedBrick Health as CMO.

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Patient communication and care coordination software vendor Conversa hires Chris Edwards (Validic) as chief marketing and experience officer, and Becky James (WebMD) as VP of operations.

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Maury Regional Health (TN) implements population health management tools, including data warehouse and analytics, from Lightbeam Health Solutions to support its new ACO efforts.

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St. Louis-based care management company Lumeris acquires analytics business Forecast Health for an undisclosed sum. Forecast Health co-founder and chief analytics officer Michael Cousens will join Lumeris in a similar role.

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The Michigan Dept. of Health and Human Services develops the Michigan Environmental Public Health Tracking Program, a Web-based dashboard that offers up data by county; highlights environmental public health issues; and enables users to create graphs, maps, and tables.

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Relias Learning acquires population health analytics vendor Care Management Technologies for an undisclosed sum. The acquisition is the sixth for Relias in the last 14 months, and part of its five-year plan to add 450 employees at its Cary, NC headquarters by 2021.

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Innovaccer offers a complimentary social determinants of health portal, aggregating six years’ worth of SDOH data for over 3,000 counties.

Analytics vendor Koan Health buys ZirMed’s value-based care analytics business.

Hearst Health and Thomas Jefferson University’s Jefferson College of Population Health open up submissions for their annual $100,000 Hearst Health Prize.


Contacts

Jenn, Mr. H, Lorre

More news: HIStalk, HIStalk Connect.

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

JennHIStalk

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