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News 4/13/17

April 13, 2017 News No Comments

Top News

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Josh Chapman joins Chicago-based healthcare technology incubator Matter as COO. Chapman, who comes to the Chicago-based organization from healthcare crowdfunding website GiveForward, seems positioned to take some of the pressure off CEO Steven Collens, who has made it clear he wants to expand the incubator’s partnerships. Matter has 20 employees and 200-plus member companies.


Webinars

April 26 (Wednesday) 1:00 ET. “SSM Integrated Health Technologies Clinical Data Migration: Functional and Technical Considerations.” Sponsored by Galen Healthcare Solutions. Presenters: Sandy Winklemann, MHA, RHIA, project manager, SSM Integration Health Technologies; Tyler Mawyer, MHA, managing consultant, Galen Healthcare Solutions; Kavon Kaboli, MPH, senior consultant, Galen Healthcare Solutions. GE Centricity and Meditech to Epic EHR transition. Join us for a complimentary webinar as present the decisions that are important to consider when performing a clinical data migration from the point of view of  the healthcare organization program manager, the clinical analyst, and the technical implementation team. Our expert panel will survey data migration considerations, best practices, and lessons learned. The webinar will present a unique client perspective, offering insight into considerations surrounding staffing, clinical mapping, legacy application support, and validation and testing.

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


Telemedicine

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NuggMD begins offering its medical marijuana telemedicine services in New York, one of a handful of states that doesn’t require an in-person physical exam to establish a patient-physician relationship.

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Body & Mind Medical Weight Loss Center (CA) launches Wecounsel telepsychiatry services.

Progressive Care subsidiary PharmCo partners with MDFlow Systems to develop a virtual pharmacy consultation service for large clinics, hospitals, and long-term care facilities.


Announcements and Implementations

Crystal PM will add Solutionreach’s patient relationship management tools to its practice management offering for optometrists.

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Bizmatics will offer PrognoCIS EHR end users patient payment resolution services from Transworld Systems.

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ResCare will implement MediSked’s EHR and portal across its Residential Services operations, which care for people with developmental and intellectual disabilities. The health and human services provider will also leverage MediSked’s BI tools.


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Jenn, Mr. H, Lorre

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HIStalk Practice Interviews ChenMed Chief Quality Officer Jessica Chen, MD and CTO Denise Hatzidakis

April 12, 2017 News 1 Comment

Jessica Chen, MD is chief quality officer and Denise Hatzidakis is CTO at ChenMed.

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Tell me about yourself and the company.

Jessica Chen: I’m chief quality officer for the ChenMed family of companies. I’m an internal medicine physician with a strong background in quality. I cover all of our quality metrics, as well as our onsite medication protocols and systems. I work very closely with our IT team to ensure that our technology always has a physician focus, and we try to make it as efficient and effective as possible for enhancing the clinical encounter.

We call ChenMed a family of companies because we have a few different seats under it. Altogether, we have 39 medical centers across six states. We call it nine different markets because within those states we have different locations or different cities that we cover. Our centers are focused on seniors primarily in under-served areas, and we focus on Medicare Advantage, where we feel we can have the best impact on the full spectrum of care. We’re a totally capitated, at-risk practice, which means you really cover end-to-end care – from inpatient to outpatient, we’re responsible for it all. It allows us, as a clinical organization of physicians, to really take ownership of a patient’s total care. Our goal is to align our patient’s outcome with our outcomes.

Denise Hatzidakis: I’m the CTO for ChenMed. My role is building. I’m responsible for all the technology systems that support our physicians and our care model in other parts of the organization to make the practices work. I have a software development team of 50. I grew up as a "Will Code for Food" computer geek and have grown into really loving, and enjoying maturing and building IT systems. ChenMed gives me the opportunity to do that in a space that really makes a difference.

Jessica, you’ve been with ChenMed since 2009. How have you seen ChenMed’s use of technology evolve alongside the evolution of federal programs like Meaningful Use?

JC: We actually moved to an EHR in the early 2000s. It was non-certified at the time; there wasn’t really such a thing as certification. We had been an early adopter of technology all along. It was a hybrid system that was still somewhat paper-based, somewhat digital. When Meaningful Use came out, we did look at other technology systems. We looked at all the incentives and, obviously, the penalties, but we also had to balance that with our clinical model and what we felt was needed from a patient care standpoint. When we looked at the standards and we looked at the measures … because we’re very focused on seniors, not all of them necessarily applied to our population. There were not any IT systems at the time that were built for value-based care. We had to make a decision: Do we care more about checking the box of Meaningful Use or do we care more about our technology working in a value-based care system?

We made the decision to build something because there was nothing out there that was built for value-based care. We actually did initially look at going for certification, but realized it actually didn’t make sense for us. The majority of the Meaningful Use incentives really targeted fee-for-service medicine. We have very little fee for service. We’re really focused on Medicare Advantage, and so the incentives just didn’t work the same in that population. When we make decisions around what’s prioritized in our development and what we should put in for our own technology, we  do it based on what’s going to improve outcome. What’s going to improve our physician’s efficiency? What’s really needed in our practice?

How did implementation and adoption go with that home-grown technology?

JC: It’s been a little bit piece by piece. What we developed five years ago is very different than what we have today. It’s pretty much been designed by physicians. Denise’s team built it. We take in a lot of feedback from our physicians on the ground, from all the markets. We get a lot of requests and then we kind of conglomerate all of that and ask ourselves, what’s really going to be the highest priority for them and what’s going to impact the business the most? What will improve clinical care, decrease hospitalizations? What’s going to help us do all of this best – that’s what we put in there.

Because we’re typically targeting things that the physicians have asked for, our adoption has been pretty good. We’ve had physicians come out of other systems and it takes them a little bit of time to get used to it, but then the say, "Oh, this is so much easier to write a note than clicking 800 times." The template doesn’t have all the bells and whistles that some of the certified EHRs have, but it really targets our model and so I think that’s really helped adoption.

DH: We use a user-centered design approach to design our software, so it really is technology for physicians designed by physicians. We sit side by side with all of our care providers to understand how they do their job. We have tools that surround our EHR and the data in it that are specifically targeted for those different roles, so the design is specifically for the PCP, or the medical assistant, or someone interacting with our system outside the clinical setting. It’s designed by the users, so to Jessica’s point, it makes the adoption occur much more quickly.

Since adoption has gone so well, have you noticed your end-users becoming more sophisticated in their expectations of what the technology can do? Have you set too high a bar for yourselves?

DH: That’s kind of normal in software development, right? Once you get the "must haves" out of the way – once your end users realize you have the capability to do bigger and better things – then yeah, the requirements keep coming. That said, I defer to Jessica as to hitting the mark with respect to the functionality they have now and the balance between that and what they’d still like. From the IT perspective, we work very, very closely with our end users. We meet with them weekly, and there’s always someone who asks, "Oh, if you could do this, could you do this too?" That’s very normal when you have user-engaged software development.

JC: Our physicians really do feel accountable for their panel, and so they’re constantly saying, "Hey, if you could do this that or the other for me, it would make me more efficient or more effective, or I could prevent hospitalizations if I could have this information." We have non-conventional things in our EHR. For example, our physicians have requested to know how many of their patients are in the hospital at any given time. There’s no system out there that does that, and most systems are not interoperable with hospitals. In most care settings, you have no idea what is happening with your patient outside of your center. And so we’ve had to build our own technology to be able to capture that data. We know when they’re in the hospital. We follow them closely while they’re there. We know when they’re getting discharged. We can go see them in the home. We want to get them back into our center. We know if they’re in assist.

We try to really coordinate that care and the doctors want to see all that. They tell me, "If you want me to be responsible for improving our hospitalization rate, then I need more information." We’ve created a lot of technology around that, but then again, there’s constantly new ideas coming in. Expectations, I think, are always increasing, but we definitely see that as an opportunity to build really neat and innovative tools.

How have you seen this technology affect outcomes?

JC: We’ve definitely seen a clear drop in both ER visits and admits, and hospital sick days because we’re getting the patients in to see us, and we’re trying to do more on the preventive side. A lot of that, I think, is driven by just knowing what’s going on with the patient and being able to identify where they are – to help get them into the right level of care and provide more access to them.

As you’ve been developing this technology over the last several years, have you looked to any other providers or vendors for inspiration or advice?

DH: I think we’re always looking at the state of the art in the industry and trying to understand what makes sense for our care model. What is applicable, and is it something that we should build in because it does provide better outcomes? We spent a good bit of time at HIMSS looking at what people are doing in value-based care. What does is it mean? It means a lot of different things to a lot of different people.

What’s next for ChenMed when it comes to building or buying technology? What’s on your wish list?

JC: We’re always going to be innovating and creating things internally, for sure. That’s never going to stop. I think one of the things we’re trying to tackle, just like everybody else, is interoperability and trying to get more data from more sources. Our experience has been, the more information we have, the better. We’ve been trying to get real-time ER notifications. If our patient hits the ER, we want to know about it and we want to make sure we follow up. That’s actually been one of the hardest to get for a number of reasons. We are already getting more real-time hospital notifications, but it varies somewhat based on the hospital.

I think our biggest ask would be better interoperability and having the full spectrum of care – from hospitals to nursing homes, rehab centers, and outpatient – be better coordinated and more transparent. At this point, that’s actually why we’ve built some of the technology that we have. Better connectivity would improve our efficiency. That’s probably top on our wish list.

DH: If we’re really truly as an industry going to do value-based care, we’ve got to have the ability to exchange that information in a secure and standard way. That capability really just does not exist in this industry vertical. There’s work coming out with the FHIR standard. We’re adopting the standards as they come out in the hopes that the industry will continue to move forward. Unfortunately, the industry moves fairly slowly, and so we’re having to develop a lot of workarounds. Getting data from providers and payers in a consistent  and expected way is quite a challenge. As far as the portfolio maturing itself, we will continue to build purpose-based tools around our EHR to facilitate the care protocols and the care model that we have, because they don’t exist in the industry.


Contacts

Jenn, Mr. H, Lorre

More news: HIStalk, HIStalk Connect.

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News 4/12/17

April 12, 2017 News No Comments

Top News

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Quality Systems subsidiary NextGen Healthcare will acquire mobile physician documentation and communication technology vendor Entrada in a deal worth $34 million. NextGen President and CEO Rusty Frantz says the company will focus on expanding Entrada’s capabilities. The two companies last made headlines together in 2012, when NextGen added Entrada software to its ambulatory EHR and PM systems.


Webinars

April 26 (Wednesday) 1:00 ET. “SSM Integrated Health Technologies Clinical Data Migration: Functional and Technical Considerations.” Sponsored by Galen Healthcare Solutions. Presenters: Sandy Winklemann, MHA, RHIA, project manager, SSM Integration Health Technologies; Tyler Mawyer, MHA, managing consultant, Galen Healthcare Solutions; Kavon Kaboli, MPH, senior consultant, Galen Healthcare Solutions. GE Centricity and Meditech to Epic EHR transition. Join us for a complimentary webinar as present the decisions that are important to consider when performing a clinical data migration from the point of view of  the healthcare organization program manager, the clinical analyst, and the technical implementation team. Our expert panel will survey data migration considerations, best practices, and lessons learned. The webinar will present a unique client perspective, offering insight into considerations surrounding staffing, clinical mapping, legacy application support, and validation and testing.

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


Announcements and Implementations

Care 24/7 will integrate educational video content from The Wellness Network into its care plans for Medicare patients, particularly those with chronic conditions.

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Evoq develops a smartphone app to help physicians collect and share EHR data from multiple sources. The Blynq app can also act as a PHR for patients.


Acquisitions, Funding, Business, and Stock

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Boston-based Redstar Ventures co-founders Jeet Singh and Joe Chung develop Kinto, an app designed to help caregivers, particularly those that care for seniors, check in with their family members, collaborate with care teams, and manage medications. Singh and Chung are serial entrepreneurs, having founded a number of companies including an e-commerce company that was eventually sold to Oracle. Kinto seems to be their first foray into healthcare.

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Spartanburg, SC-based Care.IT (pronounced “carrot”) takes over a former CareWorks clinic in a Weis Markets store in Schnecksville, PA. Care.IT, which seems to have made a small name for itself as a telemedicine company, will offer in-person and virtual care via a team led by former LeHigh Valley Health NP Fran Fasching. 

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Care coordination and PHR software company CareSync goes after Florida-based Orthopedic Injury Management for back payments of $53,000. The practice isn’t the only one that owes money to the Tampa, FL-based company. It filed similar money-collection proceedings against eight other customers in late March – a fact that makes me wonder how often other health IT companies that cater to struggling physician practices deal with this problem.


Government and Politics

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OCR fines Denver-based Metro Community Provider Network $400,000 for potential noncompliance with HIPAA due to a lack of protocol around the safeguarding of electronic PHI. The FQHC will also have to put a corrective action plan into place. The fine stems from an early 2012 data breach reported by MCPN to OCR, after which it failed to conduct a timely risk analysis as required.


Telemedicine

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Rotary Senior Living (IA) offers residents virtual consults through Avera eCare’s long-term care program.

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New York-based startup Virtual Health Partners raises an undisclosed amount of Series A funding, which it will no doubt use to further develop its white-label virtual nutrition and wellness software.


Other

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Samuel Williams, MD makes the local news when he lets it be known that he hopes to offer “$1 a minute” office visits once his Williams Geriatric Medicine and Medical Services practice opens in Albany, GA. He is also weighing his telemedicine options – a wise move given that he hasn’t yet acquired office space. Williams seems genuine in his intent to offer affordable care to an elderly population of patients living in a rural area with limited incomes and access to physicians. “I know how expensive medical bills can be,” he says. “I’m just trying to get started. The one thing that everyone can agree on is that everyone needs healthcare. My goal is to provide the best primary care possible.”


Sponsor Updates

  • AdvancedMD expands its professional services team.
  • The local paper profiles Hartford Healthcare’s (CT) plans to build a predictive analytics “command center” powered by GE Healthcare.

Blog Posts


Contacts

Jenn, Mr. H, Lorre

More news: HIStalk, HIStalk Connect.

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5 Questions with Cara Farooque, Practice Manager, Craft Behavioral Health

April 11, 2017 5 Questions With No Comments

Cara Farooque is practice manager of Craft Behavioral Health in Northeast Florida. The provider of outpatient psychiatric and therapy services employs, in addition to Farooque, one full-time psychiatrist, five part-time psychotherapists and two front-desk staff to care for a highly variable rate of patients. “Our therapists set their own schedule,” Farooque explains, “so some days there are four of them on site in addition to the MD; other times, it is just one. Many of our patients are dependent on public transportation, so weather also has a large impact on our no-show rate. The beginning of the month, when everyone who gets paid on a monthly basis receives their paychecks, is generally quite a bit more busy than the end.”

The practice has spent the last year backing up all of its paper charts and transitioning to Kareo’s EHR and billing platform. “Our clinicians seem pleased so far,” Farooque says, “and the crossover between EHR and billing is seamless. One of our major focuses now is making sure that all patients have follow-up care and remember their follow-up appointments. Culturally, this is sometimes a challenge, as things exist in a ‘here and now’ context rather than in a ‘week from now.’ The automated follow up emails, texts, and calls have made a huge impact on our no-show rate.”

When it comes to federal programs, CBH is in the process of transitioning from Meaningful Use to the Quality Payment Program. Quality measures have already been implemented, as well as some of Advancing Care Information and Improvement activities. A full roll out/transition is expected by April 15.

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How has healthcare technology helped to improve patient access and outcomes since the practice launched in 2010?

I am encouraged just by the QPP measures versus the MU Standards. The QPP measures are actually selected by us, and have meaning to us and our practice. Patients can access selected portions of their charts through the patient portal. The reminders have helped improve our no-show rate and helped patients stay compliant with their medication.

Are you encouraged by the increased focus the industry seems to be placing on using health IT to better integrate primary and mental healthcare?

Currently, the industry is focusing on primary care and preventative medicine. With the new leadership and the proposed changes, I’m afraid we may see some drastic changes and people who finally got coverage as a result of ACA are going to be right back where they were before – underserved and uncovered.

What challenges do mental health providers face when it comes to finding and adopting healthcare technology?

Always vetting the security. What exactly does “HIPAA compliant” mean? I read an article recently that basically said “HIPAA Compliant” wasn’t worth the paper it was printed on. Everyone claims they’re HIPAA compliant yet no one has a standard definition for it yet.

What advice can you offer other mental health practices when it comes to selecting and implementing healthcare technology?

Do your research, check with other providers, get what you need. Don’t think that because it is a standard EHR it can’t be tailored to fit a mental health practice. It is actually the best that way – you can either develop your own templates or work with the vendor to develop templates to suit your practice. Make sure they meet all documentation guidelines, and then the templates are uniquely yours.

What’s next up on your health IT shopping list? How do you hope that this will benefit your patients and staff?

I would love to upgrade all the computers, with all the scanning, eligibility checks, etc. If they don’t empty their cache several times they need to re-start. Upgrading everything from Win8 to 10. I think the facial recognition and fingerprint scanner would really give us another layer of security on both the patient and staff check-ins. Tablets – I would really like to go totally paperless for increased efficiency, as the form would upload straight into the EHR and we wouldn’t have any paper floating around as a potential HIPAA violation. That’s my wish list.


Contacts

Jenn, Mr. H, Lorre

More news: HIStalk, HIStalk Connect.

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News 4/11/17

April 11, 2017 News No Comments

Top News

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Accounting firm Dean Dorton Allen Ford acquires physician billing and credentialing business Metro Medical Solutions for an undisclosed sum. MMS will be rolled into the Dean Dorton Healthcare Solutions consulting practice. Both companies are based in Louisville, KY.


Reader Comments

From Just the Fax: “Re: ‘A study in the Journal of the American Pharmacists Association finds that pharmacists have a better chance of resolving prescription questions when they reach out to physicians by phone rather than fax.’ In discussing a recent study of pharmacy communications, the fact that they are still using faxes was noted as evidence that e-prescribing is still not sufficient in its adoption. There may be multiple explanations. We use e-prescribing routinely – we are in NY. Yet we still get frequent faxes from pharmacies. Even when I’ve called and pleaded with them to stop, they refuse to do so. Sometimes they send them to the primary care physician for renewal even when the original script was from a specialist. This happened with one of my patients a few weeks ago and the primary care physician submitted it for the wrong dose. Then the managed care company refused to fill it for the right dose because it had already been filled for the month. But that kind of error probably wouldn’t be identified as such. Automatic faxes are also a problem because there is a tendency for people to just sign them and fax them back without calling the patient or looking at the chart. Perhaps some MDs like them but I find them risky.”


Webinars

April 26 (Wednesday) 1:00 ET. “SSM Integrated Health Technologies Clinical Data Migration: Functional and Technical Considerations.” Sponsored by Galen Healthcare Solutions. Presenters: Sandy Winklemann, MHA, RHIA, project manager, SSM Integration Health Technologies; Tyler Mawyer, MHA, managing consultant, Galen Healthcare Solutions; Kavon Kaboli, MPH, senior consultant, Galen Healthcare Solutions. GE Centricity and Meditech to Epic EHR transition. Join us for a complimentary webinar as present the decisions that are important to consider when performing a clinical data migration from the point of view of  the healthcare organization program manager, the clinical analyst, and the technical implementation team. Our expert panel will survey data migration considerations, best practices, and lessons learned. The webinar will present a unique client perspective, offering insight into considerations surrounding staffing, clinical mapping, legacy application support, and validation and testing.

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


Announcements and Implementations

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Aprima Medical Software will add ActX’s genomic decision-support technology to its EHR, giving end users drug genomic interaction alerts as part of their prescription workflows. ActX entered into a similar arrangement with CompuGroup Medical earlier this year.

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ZyDoc retools its TrackDoc cloud-based transcription technology to include an EHR-integrated smartphone app and enhanced security.

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Gateway Homes (VA) selects the AlphaFlex EHR from Mediware Information Systems to help improve its mental health skills-building and psychosocial services rehabilitation services at its three facilities.

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The Vascular Experts implements Meridian Medical Management’s VertexDR PM and EHR software, and PrecisionBI analytics tool at its eight outpatient surgical facilities across Connecticut and New York.


Telemedicine

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The State of Colorado’s Medicaid program offers members real-time, text-based mental health consults from Ieso Digital Health through a partnership with behavioral health company Beacon Health Options.

The American Telemedicine Association releases guidelines child and adolescent telemental health, plus stroke assessment.


People

Kellie Rice (Together Health Network) joins primary care services and support company ConcertoHealth as executive director of its Michigan market.


Research and Innovation

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Researchers determine that hospital-based physicians are more likely than their practice-based counterparts to refer patients complaining of back pain, headaches, or upper respiratory tract infections for CT or MRI scans and X-rays, and for further evaluation by a specialist. The authors of the resultant study, which analyzed data from 31,000 appointments, posit that the unnecessary, or low-value, testing and referrals may be due to the fact that hospital-based MDs have such technology at their fingertips. The study also found that physicians – no matter their location – who did not have a steady relationship with the patient beforehand were more likely to order tests.


Other

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Just in time for National Library Week: Researchers develop the Historic Book Odor Wheel, an olfactory identification tool similar to those used to characterize the smells of coffee or wine. The need for such a wheel is part of a greater heritage research project aimed at developing guidelines for characterizing, preserving, and potentially recreating old smells. “When we talk to curators of historic libraries, they point out that smell is the first really important reaction between the visitor and the library itself,” explains researcher Matija Strlič. Colleague Cecilia Bembibre adds that while smell isn’t the whole picture, it “starts a conversation with philosophers, scientists, anthropologists, technologists, and the public itself about what we need to describe a smell.”


Contacts

Jenn, Mr. H, Lorre

More news: HIStalk, HIStalk Connect.

Get HIStalk Practice updates.
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