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5 Questions with Dennis Eberhardt, Clinic Director, Cow Creek Health & Wellness Center

August 10, 2017 5 Questions With No Comments

Dennis Eberhardt is clinic director of Cow Creek Health & Wellness Center, which provides healthcare services to the Cow Creek Band of Umpqua Tribe of Indians at two locations in Oregon. Part of the US Indian Health Service, the center recently decided to replace its government-issued Resource and Patient Management System with Intergy software from Greenway Health.

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Why did Cow Creek decide the time was right to move from its government-provided patient management software to a commercial product?

The need to move from RPMS has been present for a long time. RPMS, never developed as a true EHR but rather as an Indian Health Service-centric public health data collection device, has been obsolete for a couple of technological generations at least. From an operational vantage point, the decision was simple. Implementing a change of this magnitude, however, is difficult and can be more injurious to an operation than staying with a poor solution if not done correctly. Once the expertise to select and implement a new EHR was brought into the operation, along with the time resource to perform the selection and data conversion, the time was right to proceed. The pressure to bring the EHR technology into the current century is mounting as healthcare is rapidly evolving to a data-driven venture.

What adoption and implementation challenges are unique to organizations that are part of the Indian Health Service?

For a compacted facility there really are not that many. Of utmost importance are the Purchased and Referred Care functions, and accurate data collection and reporting for the National Data Warehouse – both of which are easily handled by Greenway Intergy.

Is Cow Creek participating in any federal value-based programs? If so, which ones, and how important is healthcare technology to your participation?

Unfortunately, RPMS makes participation in value-based programs difficult. Technologically, the reporting of the necessary data is resource intensive and, depending on how the report is formatted, the data can appear to be different for two queries. Greenway’s recording and reporting functions are made with value-based programs in mind, so it will be a natural progression for us once the EHR is fully implemented.

What other types of health IT is Cow Creek using at the moment? How have you seen these technologies improve patient access and care outcomes?

Part of the Intergy package is a patient portal, which will allow patients to communicate with the clinic electronically; and request appointments, refills, and information. The clinic can push out surveys and relevant information regarding current events or patient-specific education.

An optional program within Intergy is the Community Health module, which constantly scrubs the records and reports for actionable items for each patient, called “care gaps.” These can be reported according to established selection criterion, be that all patients or even the next day’s scheduled patients. This will increase our compliance with value-based initiatives, as well as help us deliver a more comprehensive primary care service to our patients.

We are investigating an add-on to Intergy that improves the patient experience. Allowing full electronic patient check-in and then delivery of (age/gender) relevant and branded interactive education for consumption during the waiting time.

Patient outcomes and safety are partially dependent on a well-trained staff. We just recently implemented a fully functional Learning Management System that houses all training and training records online, and is accessible 24-7.

Due to our two-clinic footprint and the fact that our PCP teams travel between locations, patients sometimes need to be seen by the resident team and not by their own PCP team. Although quality is good, it is less than optimal. We are instituting an in-house telemedicine program that will allow the PCP to be virtually present at the other clinic if one of their patients desires to be seen on a day when they are at the other location. This increases access as well as continuity of care.

After-hours care is always problematic. Placing providers on-call has been the go-to option in the past. This is suboptimal for a provider, and has not been shown to deliver better outcomes nor increase patient satisfaction when a provider who is not their PCP is answering the call. We have instituted a 24-7-365 After-Hours Nurse Triage line. RNs address the issues of the patient according to nationally accepted protocols. Patient satisfaction has been higher than on-call since the patient expectation is different. Emergency department visits for routine care are decreased as a result.

The next step is to institute a year-round after-hours, physician-staffed telemedicine service option for patients. Again, patient expectation is that this is equivalent to an urgent care visit. But this increases access to 24-7-365, and patient satisfaction with these services is high. Due to the high degree of communication between the telemedicine vendor and the clinic, as well as our practice of follow up for each after-hours call, outcomes are likely to improve.

What’s next for the clinic in terms of health IT adoption?

Telepsychiatry and tele-behavioral health augmented by in-person support personnel. We are investigating a vendor relationship to bring in service that we would not be able to staff due to rural location and patient loads. These would address true capacity gaps in the community.

Next year will see us fully embrace the outsourcing of claims management, payment posting, and patient statements functions. While this may not directly translate to better outcomes, it does release resources that can be used to deliver more services.

The other next big thing is health information exchange. We will be engaging with partners to share aggregated and specific PHI among various providers and entities to facilitate prior authorizations, insurance eligibility confirmation, referrals, and care coordination.

Finally, interactive online education. There is a large body of knowledge now about how brains function while learning – what sticks and what doesn’t work. Interactivity that is contextual, gamified, and meaningful is under development by our own content producers to be deployed via the patient portal as well as our revamped Web presence.


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Jenn, Mr. H, Lorre

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News 8/9/17

August 9, 2017 News No Comments

Top News

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President Trump declines to issue a state of emergency related to the opioid crisis, despite the recommendations of an interim report authored by a special commission on the crisis chaired by New Jersey Governor Chris Christie. Instead, the administration will tackle the problem through a developing strategy that will involve a number of federal departments and local resources including healthcare providers, law enforcement, community organizations, patients and their families. HHS Secretary Tom Price, MD shared the news during a Q&A after his briefing on the epidemic with President Trump and the First Lady. He reiterated that the president will give it all the attention it deserves: “The President certainly believes that we will treat it as an emergency – and it is an emergency. When you have the capacity of Yankee Stadium or Dodger Stadium dying every single year in this nation, that’s a crisis that has to be given incredible attention, and the President is giving it that attention.”


Webinars

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


Announcements and Implementations

Gettysburg Diagnostic Imaging (PA) selects RCM and PM software and credentialing services from Healthcare Administrative Partners.

Integra Connects will offer Community Oncology Medical Home program triage pathways for first responders and nurses from Innovative Oncology Business Solutions as part of its Oncology Care Model and population health solutions for oncology practices.

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The Rhode Island Primary Care Physicians Corp. – an IPA comprised of over 350 PCPs and specialists – will pilot Seniorlink’s Vela care coordination and communication technology for providers, caregivers, patients, and family members over a six-month period. The success of the pilot, which will enroll 500 patients, will be based on patient satisfaction, the ability of providers to communicate with patients, medication reconciliation, ED utilization, and ease of access to advance directives.

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Evolution Physical Therapy (CA) adds EWellness Healthcare’s tele-physical therapy services (including live and on-demand PT regimens) at its four clinics in Los Angeles.


Government and Politics

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Physicians in Colorado cry foul thanks to a new Medicaid reimbursement system that, since undergoing an upgrade in March, has routinely rejected claims it previously accepted. State officials have pointed to user enrollment error as the cause of delayed payments. Providers like Charles Hanson, MD – who is still waiting on $100,000 in reimbursement – aren’t taking the situation lying down. The large LED sign on his office building now reads, “Newsflash! Medicaid is NOT paying its claims.”

The Illinois Blockchain Initiative will work with Hashed Health on a pilot that will test the ways in which blockchain can streamline and securely automate the process of approving and obtaining multistate and interstate licensures.


Telemedicine

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Population health management company ApolloMed takes a minority equity stake in Boynton Beach, FL-based telemedicine hardware and software startup LifeMD. ApolloMed CEO Warren Hosseinion, MD will join LifeMD’s Board of Directors. ApolloMed will likely extend LifeMD’s virtual consult capabilities to its customers, which include ACOs, IPOs, and home health providers.

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Nearly 100 percent of employers will make telemedicine services available to their employees in 2018, according to a National Business Group on Health survey of 148 large employers that offer health benefits to a combined 15 million employees and their families. Just over half will offer telemedicine for behavioral health. The ubiquitous interest in the technology comes at a time when these same employers expect to see a 5-percent increase in benefit costs for the fifth year in a row, according to NBGH.


Other

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Because this is important: This article highlights the science behind the discovery of optimal dunking time for an Oreo cookie. (Spoiler alert: It’s about three seconds.) Utah State University’s Splash Lab conducted the determining tests. The team has also assessed the insulating properties of bears, the physics of the perfect skipping stone, and the fluid dynamics of urinal splashback (because that, too, is important).


Sponsor Updates

  • Aprima will host its annual user conference August 18-20 in Dallas, TX.
  • Nordic publishes a podcast titled “Why change management is critical to a successful EHR transition.”
  • EClinicalWorks announces that users of its EHR have exchanged two million documents in the past 12 months through the Carequality Interoperability Framework.

Blog Posts


Contacts

Jenn, Mr. H, Lorre

More news: HIStalk, HIStalk Connect.

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JennHIStalk

News 8/8/17

August 8, 2017 News No Comments

Top News

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CMS Deputy Administrator and CMO Patrick Conway, MD will leave the agency after six years to head up Blue Cross and Blue Shield of North Carolina. Conway, who is also head of the Center for Medicare and Medicaid Innovation, will take over from retiring Brad Wilson on October 1. Conway’s decision follows the similar path of former National Coordinator Vindell Washington, MD who joined Blue Cross and Blue Shield of Louisiana in June as CMO.


Webinars

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


Announcements and Implementations

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EClinicalWorks announces that over 2 million documents have been exchanged by its EHR via the Carequality Interoperability Framework over the last year. The company was one of the 13 founding adopters of the framework, which became available in late 2015.

Elsevier and the AMA will develop e-learning course content for the CPT code set.

OneTouch EMR adds Kno2’s Direct messaging capabilities to help its ambulatory end users more easily share data with other providers.

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Center for Life Management, a New Hampshire-based behavioral health services provider, replaces its 10 year-old document management system with OpenText’s document capture and retention management solution.


People

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DoctorsManagement promotes Gene Good to CEO. Former CEO Paul King will remain president and chairman of the board.

InstaMed adds Karen Atwood, Bill Frist, MD (Cressey & Co.), Cynthia Nustad (HMS), Larry Stone, and Lew Trowbridge to its Board of Directors and Advisory Board.


Telemedicine

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Mobile dermatology clinic and telemedicine company WellAve expands in Maryland with the opening of a new practice in Annapolis. The company brings its mobile clinics to local employers, senior living facilities, and other providers.


Research and Innovation

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A study in Health Affairs highlights the increasing levels of job dissatisfaction experienced by FQHC employees. Researchers surveyed 564 physicians, nurses, and staff at 296 centers – all of which were pursuing medical home designations – over a two-year period. Respondents noted declining satisfaction with job satisfaction, work environment, and practice culture, which analysts attribute to rapid adoption of technology and the intense workloads that come with participating in federal programs. “Things appear to have gotten worse over a short period of time at clinics that serve many of the nation’s poorest and sickest patients, and we’re not sure why,” says the Mark Friedberg, MD the study’s lead author. “This merits more attention.”


Other

The Medical Society of Delaware will work with Clearwater, FL-based healthcare blockchain startup Medscient to develop distributed ledger technology for prior authorizations. The organizations will work with technology developed by Symbiont, Delaware’s Blockchain Initiative partner, which will incorporate rules agreed on by caregivers and payers that hopefully speed up the prior authorization process.


Contacts

Jenn, Mr. H, Lorre

More news: HIStalk, HIStalk Connect.

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

JennHIStalk

News 8/7/17

August 7, 2017 News No Comments

Top News

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American Telemedicine Association CEO Jon Linkous will step down after 24 years with the organization. COO Sabrina Smith, MD will take on the role until a replacement is found. Linkous helped found the Washington, DC-based nonprofit in 1993. His departure comes at an interesting time for the association, which outsourced its certification capabilities earlier this year; and telemedicine in general, which seems to be increasing in popularity thanks to relaxed state regulations, better/existing reimbursement policies, technology that is more ubiquitous and easier to use; not to mention its attractiveness as a customer service differentiator.


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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Exeter, NH-based CBS Medical Billing & Consulting opens a second office in nearby Portsmouth. Founded in 2010 by Erin Cammarata, the company has grown to 30 employees, nine of which will work at the new location.


Government and Politics

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Congress confirms anesthesiologist and Indiana state health commissioner Jerome Adams, MD as the 20th Surgeon General of the United States. Adams has said he will focus on bringing more attention to the opioid epidemic and its roots in mental health, as well as employer and community engagement around wellness.

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Lawmakers also confirms Elinore McCance-Katz, MD to be the first Assistant Secretary for Mental Health and Substance Use within HHS. She comes from Rhode Island, where she served in the state’s Department of Behavioral Healthcare, Development Disabilities and Hospitals as CMO. She also served as SAMHSA’s first CMO, from 2013-2015. I imagine she and the new Surgeon General will interact often given the administration’s focus on opioid abuse.

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New Jersey’s Division of Consumer Affairs adds a Suspicious Activity Report portal to its PDMP, giving pharmacists, physicians, and citizens the ability to report suspected overprescribing, doctor shopping, and forged or stolen prescriptions. The portal’s addition comes a month after the DCA expanded the PDMP’s archived prescribing records from one year to two.


Telemedicine

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A Chance to Change, a behavioral health, alcoholism, and drug addiction treatment center in Oklahoma City, OK, will use grant funding from the Oklahoma City Community Foundation to develop telemedicine services for its patients. The nonprofit seems to be developing software in-house, and is also scouting locations on which to build or install private areas for virtual consults.


Research and Innovation

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A study published by the National Bureau of Economic Research finds that physicians from top-tier medical schools wrote far fewer opioid prescriptions between 2006 and 2014 than did those that attended lower-ranked institutions. Harvard grads, for example, wrote less than 100 prescriptions annually, while their less prestigious peers averaged 300. The discrepancy, according to the study’s authors, highlights a need for more rigorous curricula around the prescribing of controlled substances.


Other

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HITRUST enlists the expertise of cybersecurity firm Trend Micro to set up its Cyber Threat Management and Response Center. Building on its Cyber Threat XChange information-sharing capabilities, the new center aims to come to the defense of organizations with “varying cybersecurity maturity levels” by bringing new research and educational resources to market more quickly. It will launch on October 1.

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In San Francisco and Australia, LinkedIn launches a mentoring service that aims to connect users interested in sharing their expertise with those interested in learning from it. “We have done research and found that among the senior ranks of our user base, nine out of 10 people have said they want to give back,” says Hari Srinivasan, head of identity products. “Paying it forward is a powerful force. All of them received help on the way up and now want to find a way to give that help back to others.” The service will eventually be open to all users.


Contacts

Jenn, Mr. H, Lorre

More news: HIStalk, HIStalk Connect.

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

JennHIStalk

News 8/3/17

August 3, 2017 News No Comments

Top News

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The Government Accountability Office announces the 15 members of its new Health Information Technology Advisory Committee. Created by the 21st Century Cures Act, the committee will offer ONC recommendations on health IT policies, standards, certification criteria, and implementation specifications. Nine work for health systems, one works for a payer, three work for vendors, and two work for nonprofits. None seem to represent independent providers.


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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Acuitas Health, a physician services organization serving practices in New York, will offer its customers data warehousing, analytics, and care management software from Health Catalyst.

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Cancer Care Specialists of Illinois selects care management technologies and consulting services from New Century Health as part of a multi-year agreement focused on its participation in the CMS Oncology Care Model.

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State of Franklin Healthcare Associates (TN) implements business intelligence and analytics tools from EQHealth Solutions at its 12 practices.


Acquisitions, Funding, Business, and Stock

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Colorado-based Encompass Medical Partners rebrands to Encompass Healthcare Data Solutions. Initially a billing company for physician specialty practices, the company now also offers data science services.


People

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Medication education company Knowledge to Practice appoints Joseph Lemheney (Lehigh Valley Health Network) chief learning officer.

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Former Healthcare.gov CEO Kevin Counihan joins Centene, where he’ll lead the health insurer’s Midwestern business. Centene has bucked the “imploding” ACA marketplace trend by announcing entry into several new state markets and expansion into six existing ones.

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Meade Atkinson (Genesis Healthcare Solutions) joins RCM and consulting company TDM RCM Services as partner and chief growth officer.


Telemedicine

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Teladoc announces Q2 results: revenue up 68 percent, with membership increasing 33 percent to 20.5 million, and visits increasing 55 percent to 309,000. The company wrapped up its $440 million acquisition of Best Doctors, a global company that provides virtual medical consult services to employers and payers, last month.

Global Office Software will make EWellness Healthcare’s PHZIO virtual physical therapy solution available through its EHR and PM software.


Government and Politics

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CMS opens up applications for providers interested in exempting from the Quality Payment Program in 2017. Hardship exception applications will be accepted on a rolling basis.


Other

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Twitter seems awfully quiet now that Andy Slavitt’s tweet storms have abated.


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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