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E-Patient Update:  Portal Confusion Undermines Patient Relationships

Posted on February 3, 2017 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

I’m not surprised that some medical practice staffers and doctors seem uncomfortable with their EMR system and portal. After all, they’re not IT experts, and smaller practices might not even have any full-time IT staffers to help. That being said, if they hope to engage patients with their healthcare, they need to do better.

I’m here to argue that training staff and doctors to help patients with portal use is not only feasible, it’s important to customer service, care quality and ultimately a practice’s ability to manage populations. If you accept the notion that patients must engage with their health, you can’t leave their data access to chance. Everyone who works with patients must know the basics of portal access, or at least be able to direct the patient immediately to someone that can help.

Start with the front line

If I have problems with accessing a practice portal, the first person I’m likely to discuss it with is someone on the front lines, either via the phone or during a visit. But front office staffers seldom seem to know Thing One about the portal, including how to access it or even where to address a complaint if I have one.  But I think practices should do at least the following:

* Train at least one front-desk staffer on how to access the portal, what to do when common problems occur and how to use the portal’s key functions. Training just one champion is probably enough for smaller practices.

* Create a notebook in which such staffers log patient complaints (and solutions if they have one). This will help the practice respond and address any technical issues that arise, as well making sure they don’t lose track of any progress they’ve made.

* Every front desk staffer (and every doctor) should have a paper handout at hand which educates patients on key portal functions, as well as the name of the champion described above.  Also, the practice should provide the same information on a page of their site, allowing a staffer to simply email the link to patients if the patient is calling in with questions.

* All doctors should know about the champion(s), and be ready to offer their name and number to patients who express concerns about EMR/portal access. They should also keep the handout in their office and share it when needed.

Honestly, I don’t regard any of these steps as a big deal. In fact, I see them as little more than common sense. But I haven’t encountered a single community practice that does any of them, or even pursued their own strategies for educating patients on their portal.

Maximizing your investment

For those reading this who think these steps – or your own version – are too much trouble, think again. There’s plenty of reason to follow through on patient portal support.  After all, if nothing else, you’ve probably spent a ton of money on your EMR and portal, so why not maximize the value it offers?

Also, you don’t want to frustrate patients needlessly when a little bit of preparation and education could make such a difference. Maybe this wasn’t the case even a few years ago, but today, I’d submit, helping patients access their data is nothing more than good customer service. Given the competition every provider faces, why would you ignore a clear opportunity to foster patient loyalty?

Bear in mind that a little information goes a long way with patients like me. You don’t have to write a book to satify me – you just have to help me succeed. Just tell me what to do and I’ll be happy. So don’t miss a chance to win me over!

The Quality Disconnect in Healthcare

Posted on February 2, 2017 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

There’s a big problem with the current healthcare model. There’s no real financial incentive to make sure you’re practicing the highest quality care possible. Doctors don’t get paid for quality. Patients don’t select a doctor based on the clinical quality of the doctor since the patient has no way of measuring a doctor’s clinical quality. The clinical quality a doctor provides doesn’t move the needle on her business.

Certainly, I’m not saying that doctors don’t provide quality care. It is also true that over time a doctor could grow a reputation as a poor quality doctor, but those are usually only the extreme cases that end up in court with big medical class action lawsuits.

What’s amazing is that most doctors can’t event evaluate the quality of another doctor. An orthopedic surgeon has no way to evaluate how well an ENT is doing quality wise. Doctors of the same specialty could evaluate a colleague’s clinical quality, but that doesn’t happen in the current system.

In a perfect world, we could create payments based on the quality of care a doctor provides. That makes a lot of sense and it’s what we do in a lot of other industries. We pay people who provide higher quality more than we pay people who provide lower quality. The problem in healthcare is that we don’t have any good way to measure quality.

While I believe there’s no good way to measure quality, that doesn’t mean that it won’t keep organizations from trying. In fact, that’s the basis of much of MACRA and the PQRS program before it. Same goes for Accountable Care Organizations (ACOs). These are all efforts to evaluate the quality of care that’s being given and reimburse based on those quality indicators. Most doctors will tell you, that’s not a very good system if you want quality.

What’s screwed up about these quality measures is that they do nothing to actually lower the cost of healthcare. Poor quality care only represents a small portion of the massive premium we pay for healthcare in the US. The real costs come from outrageous drug pricing, pallative care, medical liability fears, and chronic conditions. Those are the four areas we should really be focusing our efforts on. The problem is that there’s not a lot of will in healthcare to address these challenging issues.

Practice Management Market To Hit $17.6B Within Seven Years

Posted on February 1, 2017 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

A new research report has concluded that the global practice management systems market should hit $17.6 billion by 2024, fueled in part by the growth of value-adds like integration with other healthcare IT solutions.

The report, by London-based Grand View Research, includes a list of what it regards as key players in this industry. These include Henry Schein MicroMD, Allscripts Healthcare Solutions, AdvantEdge Healthcare Solutions, athenahealth, MediTouch, GE Healthcare, Practice Fusion, Greenway Medical, McKesson Corp, Accumedic Computer Systems and NextGen Healthcare.

The report argues that as PM systems are integrated with external systems EMRs, CPOE and laboratory information systems, practice management tools will increase in popularity. It says that this is happening because the complexity of medical billing and payment has grown over the last several years.

This is particularly the case in North America, where fast economic development, plus the presence of advanced research centers, hospitals, universities and medical device manufacturers keep up the flow of new product development and commercialization, researchers suggest.

In addition, researchers concluded that while PM software has accounted for the larger share of the market a couple of years ago, that’s changing. They predict that the services side of the business should grow substantially as practices demand training, support and system upgrades.

The report also says that cloud-based delivery of PM technology should grow rapidly in coming years. As Grand View reminds us, most PM systems historically have been based on-premise, but the move to cloud-based solutions is the future. This trend took off in 2015, researchers said.

This report, while worthwhile, probably doesn’t tell the whole story. Along with growing demand for PM systems,I’d contend that vendor sales strategies are playing a role here. After all, integration of PM systems with EMRs is part of a successful effort by many vendors to capture this parallel market along with their initial sale.

This may or may not be good for providers. I don’t have any information on how the various integrated practice management systems compare, but my sense is that generally, they’re a bit underpowered compared with their standalone competitors.

Grand View doesn’t take a stand on the comparative benefits of these two models, but it does concede that emerging integrated practice management systems linking EMRs, e-prescribing, patient engagement and other software with billing are actually different than standalone systems, which focus solely on scheduling, billing and administration. That does leave room to consider the possibility that the two models aren’t equal.

Meanwhile, one thing the report doesn’t – and probably can’t – address is how these systems will evolve under value-based care in the US. While appointment scheduling and administration will probably be much the same, it’s not clear to me how billing will evolve in such models. But we’ll need to wait and see on that. The question of how PM systems will work under value-based care probably won’t be critically important for a few years yet.

(Side note:  You may want to check out John’s post from a few years ago on practice management systems trends. It seems that the industry goes back and forth as to whether independent PM systems serve groups better than integrated ones.)

KPMG: Population Health Taking Hold

Posted on January 31, 2017 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

A new KPMG survey has concluded that population health management approaches are becoming popular – and for nearly half of respondents, are already working.

According to the consulting firm, which reached out to 86 respondents working for a payer or healthcare provider, 44% said that they have a population health platform in place which is being used “efficiently and effectively.” Twenty-four percent of respondents said that they were in the process of implementing a pop health program within the next three years, while 10% said they had no plans to use such a platform. (Another 21% said that their organization didn’t need one.)

Thirty percent of respondents said that the biggest individual obstacle to implementing a population health strategy was aggregating and standardizing information from multiple sources. Meanwhile, 10% cited stakeholder adoption as a barrier, and 10% named integrating with clinical work flows as a key issues. Meanwhile, another 34% cited “all of the above” as a significant barrier, along with enabling patient engagement, funding investments and choosing the right vendors.

Along the way, KPMG asked respondents where they stood with value-based payments. Thirty-six percent said “some of our revenue is generated by value-based payments,” and 14% said that the majority of their revenue came from value-based payments.  As for those that weren’t there yet, 26% said they were planning to enter into value-based contracts within one to three years, while just 7% said they were not planning to do so. (The remaining 17% said they don’t require value-based payments.)

All that being said, though, there’s a problem here. And that problem is that while everyone seems to think they mean the same thing when they discuss population health management, I’d submit that in many cases they aren’t on the same page. In fact, I’d argue that until we get that straight, studies like these don’t tell us a lot.

Yes, I think we all have the same broad idea in mind when the topic of PHM comes up, which is to say that we envision a system in which a health system, ACO or health insurer sets broad goals for key health metrics across a population.  And as most readers probably know, the health insurance industry has been managing a population-wide set of standards known as HEDIS (the Healthcare Effectiveness Data and Information Set) for decades. HEDIS is designed to make apples-to-apples comparisons of health plan performance possible by providing very carefully defined criteria.

On the other hand, the number of technologies, approaches and philosophies being implemented by health organizations for population health management do no such thing. While there’s probably many areas of broad consensus on what should be measured – particularly when it comes to chronic, costly conditions like diabetes and heart disease — we don’t have any shared performance standard.

So before we look at pop health stats, it might be a good idea to clarify what that means to those answering surveys like this. Otherwise, it’s GIGO.

Cost and Clinical Practice Improvement Activities (CPIA) Categories – MACRA Monday

Posted on January 30, 2017 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

This post is part of the MACRA Monday series of blog posts where we dive into the details of the MACRA Quality Payment Program.

We’re continuing to move through the various MIPS performance categories as we cover the details of MACRA. Today we’re going to cover the Cost and Clinical Practice Improvement Activities (CPIA) Categories.

MIPS Cost Category
We won’t cover much of the Cost (Formerly known as Resource Use) category since it has basically been relegated to future MACRA requirements. For those that missed it, the cost category has a weighting of 0% in 2017, so it basically won’t impact your MACRA payment adjustment at all. In 2017, they’re looking at feedback for this category, but it won’t affect your 2019 payments.

You’ll probably remember that the Cost category was the replacement to the value-based modifier and didn’t require any reporting on the part of the provider. Instead, the cost category is tracked using the Medicare claims data. This means that CMS will still have the data they need to evaluate this category without any additional work from providers.

MIPS Clinical Practice Improvement Activities (CPIA) Category
You’ll remember that the Clinical Practice Improvement Activities (CPIA) category is a new category that was added as part of MACRA. This category will account for 15% of your MIPS score. This category has some small practice exceptions and also special credit for those participating in a patient-centered medical home or other similar medical home model.

Under CPIA providers must choose from 90+ activities in the following 9 subcategories:

CPIA will be scored on a total of 40 points with “Medium” activities scoring 10 points and “High” activities scoring 20 points. These point totals are doubled for small, rural, and underserved practices. That means that small practices only need to do 1-2 activities to get full credit for this category. Larger practices only need to do 2-4.

The Cost and CPIA MIPS categories only make up 15% of your total MIPS score. So, they’re not going to be a significant impact on your MACRA score either way. However, if you do even just 1 improvement activity (CPIA), then you’ll avoid any negative payment adjustment thanks to MIPS pick your pace.

That’s all for this week’s MACRA Monday. Next week we’ll talk Advancing Care Information (ACI) or what most of you call meaningful use.

Be sure to check out all of our MACRA Monday blog posts where we dive into the details of the MACRA Quality Payment Program.

 E-Patient Update:  The Impact Of Telehealth Confusion

Posted on January 27, 2017 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

I am a huge fan of telemedicine consults. As far as I can tell, all of the chronic conditions I currently cope with can be addressed effectively by a virtual visit unless I’m in a medical crisis.

My reasons are not unusual. Like most people, I hate having to drive to a doctor’s office if I’m already feeling yucky, particularly if it’s not necessary. And since time is money – particularly when you work for yourself like me – there’s some material benefits to telehealth too. Not only that, since I’m a tech fan who lives online, these contacts “feel” as real as face-to-face visits, so I don’t have lingering doubts that I’m not getting much for my money.

Getting a quick visit in regarding an acute medical issue (like, say, a sinus infection) has been pretty easy and relatively affordable as well. But reaching out to a new specialist – or even connecting with my existing providers — is another story. Over the last several months, I’ve encountered a number of barriers which seem to be fairly entrenched in the system.

Garbage contact info

Over the last year, I’ve been with two major health insurers (CIGNA and United Healthcare) whose databases included a list of specialists which were allegedly willing to do telehealth consults. But as it turns out, actually moving ahead with such visits has been impossible.

At one point, I decided to go all out and see if I could actually schedule a telehealth visit with one type of specialist I need. Armed with a list of providers who were supposedly up for it, I called perhaps 15 or 20 offices to see how I could schedule my first virtual visit. But I got nowhere. Most of the physicians simply never returned my calls, and in the rare cases where I got a live person, they had no idea what I was talking about.

I’m assuming that this happened because the doctors had the option to check a “telemedicine” box if they were generally interested in implementing it, and that few if any had actually gone ahead with their plans. But I’m still very annoyed with the whole thing. Sure, insurers don’t have perfect information on hand at any given moment, but isn’t in their interests to steer patients to less-expensive telehealth services if they’re available?

Coverage confusion

Another thing that astonishes me is that while I allegedly have telemedicine coverage via my current insurer (CIGNA) I can’t find anyone who has the slightest idea of how I should use it!  I have called CIGNA’s call center four or five times in an attempt to straighten this out, but none of the reps I spoke with had a clue as to which providers were covered by my policy, if any, and under what circumstances.

At some point, telemedicine coverage will be known as “coverage,” of course. There’s really no reason to segment it out into a separate category if you’re going to pay for it anyway. But at present, if CIGNA is any indication, there’s still some confusion around how and when coverage is even applicable. I can’t understand it, but I can attest to you that such foolishness is a Real Thing.

Launch fears

The other problem I’ve encountered is that while medical practices may have the technical capability to deploy telemedicine, they seem afraid to do so. I’ve asked many of my doctors (and their staff) what it will take for them to begin offering virtual visits, and I’ve gotten a mix of confusion and concern. None, even for example the fairly large and seemingly well-funded PCP office I visit, appears to be anywhere close to rolling out such services.

I can’t prove it, but my sense is that two things are going on here. First, I sense that practice leaders don’t feel ready to take on the technical challenges involved in supporting virtual visits. Though my guess is that security is the only real issue — which can be addressed by using the right vendor — they seem quite timid about even experimenting with this approach. Second, I am pretty sure they’re not sure how to handle billing, or alternatively, what to charge if they don’t bill insurance.

I admit their concerns are reality-based. But I’d argue that the benefits of offering telehealth far outweigh these concerns. Apparently, my doctors don’t agree just yet.

Ultimately, I think we’d all agree that telemedicine uptake will grow by leaps and bounds over the next several years. But it seems we’ll have to deal with a lot of administrivia before that can happen.

What’s It Take to Be a Great Thought Leader – #HITsm Summary

Posted on January 26, 2017 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

At last Friday’s #HITsm Chat, we had a lively discussion hosted by Juliana Ruiz from Bryte Box Consulting (@BryteBox) where we talked about Healthcare IT Influencers and Thought Leaders. If you missed the chat, you can read the whole transcript here.

I thought the first question summarized the chat really well as it talked about the key attributes of a thought leader.

Greg Meyer started the chat off nicely with this observation:


Greg was spot on with his comparison to a minion. We want to listen to someone who says something interesting and thoughtful and not just someone who spits out content like a robot.

His comment about thought leaders not being afraid to make mistakes drew some interesting discussion with some agreeing that mistakes are part of thought leadership, but others saying that social media and other things hold it against many leaders who make mistakes. Although, most agreed that mistakes were ok because it was part of growth.

I did argue that it really depends how the thought leader treats mistakes. Humility matters a lot when you make mistakes:

The concept of humility seemed to be an important concept for thought leaders as was illustrated by these tweets from Greg and @hospitalEHR:

Steve Sisko and @WHAMGlobal also chimed in on the importance of thought leaders to be consistent and have a clear voice and style.

Our host wrapped up the discussion of what makes a great thought leader with this insight:

I love these principles, because they apply to individuals and organizations. They apply online and offline. They apply in your work life and your personal life. There are so many opportunities for us to be thought leaders. By doing so we can impact a lot of people for good and help a lot of people. There’s nothing better in life than doing something that helps someone else.

Be sure to join us at next week’s #HITsm chat hosted by Bill Esslinger (@billesslinger) from @FogoDataCenters on the topic of “Key Components of Health IT Strategy and Disaster Recovery“.

External Incentives Key Factor In HIT Adoption By Small PCPs

Posted on January 25, 2017 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

A new study appearing in The American Journal of Managed Care concludes that one of the key factors influencing health IT adoption by small primary care practices is the availability of external incentives.

To conduct the study, researchers surveyed 566 primary care groups with eight or fewer physicians on board. Their key assumption, based on previous studies, was that PCPs were more likely to adopt HIT if they had both external incentives to change and sufficient internal capabilities to move ahead with such plans.

Researchers did several years’ worth of research, including one survey period between 2007 and 2010 and a second from 2012 to 2013. The proportion of practices reporting that they used only paper records fell by half from one time period to the other, from 66.8% to 32.3%. Meanwhile, the practices adopted higher levels of non-EMR health technology.

The mean health IT summary index – which tracks the number of positive responses to 18 questions on usage of health IT components – grew from 4.7 to 7.3. In other words, practices implemented an average of 2.6 additional health IT functions between the two periods.

Utilization rates for specific health IT technologies grew across 16 of the 18 specific technologies listed. For example, while just 25% of practices reported using e-prescribing tech during the first period of the study, 70% reported doing so during the study’s second wave. Another tech category showing dramatic growth was the proportion of practices letting patients view their medical record, which climbed from one percent to 19% by the second wave of research.

Researchers also took a look at the impact factors like practice size, ownership and external incentives had on the likelihood of health IT use. As expected, practices owned by hospitals instead of doctors had higher mean health IT scores across both waves of the survey. Also, practices with 3 to 8 physicians onboard had higher scores than those were one or two doctors.

In addition, external incentives were another significant factor predicting PCP technology use. Researchers found that greater health IT adoption was associated with pay-for-performance programs, participation in public reporting of clinical quality data and a greater proportion of revenue from Medicare. (Researchers assumed that the latter meant they had greater exposure to CMS’s EHR Incentive Program.)

Along the way, the researchers found areas in which PCPs could improve their use of health IT, such as the use of email of online medical records to connect with patients. Only one-fifth of practices were doing so at the time of the second wave of surveys.

I would have liked to learn more about the “internal capabilies” primary care practices would need, other than having access to hospital dollars, to get the most of health IT tools. I’d assume that elements such as having a decent budget, some internal IT expertise and management support or important, but I’m just speculating. This does give us some interesting lessons on what future adoption on new technology in healthcare will look like and require.

#HIMSS17 Mix Tape

Posted on January 24, 2017 I Written By

Colin Hung is the co-founder of the #hcldr (healthcare leadership) tweetchat one of the most popular and active healthcare social media communities on Twitter. Colin is a true believer in #HealthIT, social media and empowered patients. Colin speaks, tweets and blogs regularly about healthcare, technology, marketing and leadership. He currently leads the marketing efforts for @PatientPrompt, a Stericycle product. Colin’s Twitter handle is: @Colin_Hung


On February 19th 2017, the annual HIMSS conference (#HIMSS17) will be held in Orlando FL. It will once again be the largest gathering of Healthcare IT folks in North America with over 45,000 people expected.

Every year I look forward to HIMSS. It is the best place to see what is happening in the industry, hear the challenges that lay ahead and see what the smart minds in #healthIT are investing in. Although the sessions, keynotes and exhibit hall are all amazing, the best part of the conference is meeting people face to face – especially at the meetups and spontaneous get-togethers. I love catching up with friends that I haven’t seen in a year and meeting new ones for the first time.

For the past couple of years, I have used HIMSS as an opportunity to compile a soundtrack for healthcare – a Mix Tape that can be enjoyed during the conference (see last year’s Mix Tape here). This annual HIMSS Mix Tape is a fun way to reflect on where we have been and where we are going. As with prior years, I asked friends and colleagues on social media for the song they believe best represents healthcare. I also asked them to explain their selection.

Below are the songs chosen for the #HIMSS17 Mix Tape. What would your selection be? Let us know in the comments.

Enjoy.

You’ll be back – Hamilton. Chosen by Regina Holliday @ReginaHolliday.

Because that song could be the words of any doctor who wants his patient compliant and silent and any government that denies care. Hence we must have revolution.

Shine – Camouflage. Chosen by Nick Van Terheyden @drnic1.

After many potential choices ranging from the deep and dark Wadruna by Helvegen through “America” by Young the Giant that celebrates the immigration to the uplifting dance song that captured what seemed to transpire for the year was “Don’t Stop the Madness” by DJ Hush and featuring Fatman Scoop (what an awesome name) I settled on Shine. That captured the spirit of what I need this year: This is the world where we have to live / there’s so much that we have to give / so try to Shine Shine Shine within your mind / Shine from the Inside / if you Shine Shine Shine within your mind.

Can’t you hear me knockin – Rolling Stones. Chosen by Linda Sotsky @EMRAnswers.

In my own life, I started my Mothers  fight for data 17 years ago. As collective patients, caregivers and advocates we are STILL  knockin and screamin “give me my damned data” Can’t you hear us knockin?

Faith – George Michael. Chosen by Rasu Shrestha MD @RasuShrestha.

My HIMSS17 playlist is inspired by some of the best singers we said goodbye to in the last 12 months – an acknowledgement that, even as we continue to push the envelope in healthcare in so many ways, life is fragile, beautiful and melodious in every one of our ups and downs. Other finalists: When Doves Cry (Prince), Rebel Rebel (David Bowie) and The Heat is On (Glenn Frey)

We’re not Gonna Take It – Twisted Sister. Chosen by Mandi Bishop @MandiBPro.

The disenfranchised, the chronically or severely ill, the caregivers, and the underserved communities will rise up and be heard in the face of healthcare weaponization. We will not remain silent. We will not take it.

Sit Still Look Pretty – Daya. Chosen by Geeta Nayer MD @gnayyar

I chose this to represent the HIT chicks movement in health tech. Increasingly women are coming to the table and taking senior leadership roles in health tech which we so very much need as women remain the primary healthcare decision maker in the home with “doctor mom” being the go to for any and every illness first! Spouses rely on their wife to be the care takers when parents get older and when kids are sick and need to run to the pediatrician etc. Also, HIMSS for the first time is giving the women in tech awards which itself is a big statement.

Bring on the Rain – Jo Dee Messina and Tim McGraw. Chosen by John Lynn @techguy

We’ve got challenges all around us in healthcare, but I say “Tomorrow’s Another day, and I’m thirsty anyway, so Bring on the Rain.”  Things will get better in healthcare because so many amazing people work in healthcare and battle through the rain.

Cautionary Tale – Dylan LeBlanc. Chosen by Steve Sisko @ShimCode

A cautionary tale is a story with a moral message warning of the consequences of certain actions, inactions, or character flaws. Healthcare players – CMS, other government agencies, large vendor companies, special interest groups and others – seem to be stuck in a continual cycle of Dictate, Demand, Deviate and Destroy. Half-baked programs, ‘standards,’ reimbursement schemes, “quality measures,” and other mandates are dictated to providers, health plans and others on the receiving end.  Then revisions, waivers and deviations are made over the course of a year or two before they’re eventually destroyed. When will we learn from these cautionary tales? Don’t offer up help that you know that I won’t be needin’ / Cause I do it to myself, like I never get tired of bleedin’

You Can’t Always Get What You Want – Rolling Stones. Chosen by Don Lee @dflee30

Too often in healthcare we only want to look at solutions that solve for 100% of the possibilities, have proven ROI and that are already being used by our peers. That severely limits the possibilities for improvement. There’s no such thing as a sure thing. So, for 2017 I hope we can break this cycle and focus on incremental improvements. Take some shots. Be willing to fail. Think: “what can I do today that won’t require a huge budget and 1000 meetings, but might make something 5, 10 or 20% better?”.5% better today is better than “we might possibly be able to be 100% better 36-48 months from now”. So, “you can’t always get what you want, but if you try, sometime you find, you get what you need”

Livin’ On The Edge – Aerosmith. Chosen by Matt Fisher @Matt_R_Fisher

The whole healthcare industry is balancing on a razor’s edge in many respects. What will happen with the ACA, can EMRs meet their promise and what will value based cared do? All of these unanswered questions mean that these lyrics hold true: Tell me what you think about our situation / Complication, aggravation / Is getting to you

One Step Away – Casting Crowns. Chosen by Jennifer Dennard @JennDennard

While it’s a praise song at its core, its title makes me think of how close the healthcare industry is to interoperability. And yet there are still a few “small” hurdles we need to overcome. (Plus, my daughter is singing this song in her school talent show, so I have developed quite a soft spot for it!)

Record Year – Eric Church. Chosen by Joe Lavelle @Resultant

In hope that all my #HealthIT / #PatientAdvocate / #SoMe / #ThoughtLeader colleagues ignore and overcome the nonsense of the current political climate to keep making HUGE progress on the most important healthcare initiatives like Telemedicine, Interoperability, a National Patient ID,  Care Coordination, alternate payment models like Direct Primary Care, and more.  Let’s all have a Record Year in 2017!

Fight Song – Rachel Platten. Chosen by Max Stroud @MMaxwellStroud

This goes out to all the people in HealthIT that are working diligently for their vision of the future of healthcare.   In a year of major political shifts and possible policy changes, it will be important to maintain focus on our passions and continuing to move toward innovation and improvement of HealthIT.   This goes out to patient advocates from #epatients to the walking gallery, To the folks living the #startupgrind because of thier passion for a better tomorrow, and to the #HealthITChicks working towards gender parity. Like a small boat / On the ocean / Sending big waves / Into motion / Like how a single word / Can make a heart open / I might only have one match / But I can make an explosion”

Crosseyed and Painless – Talking Heads. Chosen by David Harlow @healthblawg.

There was a line/ There was a formula. But we are now in a post-factual environment. Facts all come with points of view/ Facts don’t do what I want them to/ Facts just twist the truth around. We need to focus on achievable goals, on implementing solutions that make sense independent of regulatory engines that have driven so much of health IT over the past eight years.

What Do You Mean – Justin Bieber. Chosen by Lygeia Ricciardi @Lygeia

There’s a lot of talk in health IT that you can’t take it at face value. For example, everyone says they support interoperability, and yet… we’re not there yet. Also, there’s a lot of talk about patient engagement, but is it really about involving patients in their care… or just getting them to better “comply”? Finally, is Trump really going to get rid of Obamacare, or just rebrand it? What *do* you mean?

Addicted to Love – Raymond Penfield. Chosen by Charles Webster MD @wareFLO

Raymond Penfield was 94 when he recorded Addicted to Love and became an Youtube sensation. He made it to 98. Here is his obituary. BTW he was a graduate from the University of Illinois as was I! I hope I have as much energy and spirit and health into my 90s!

Video Killed the Radio Star – Buggles. Chosen by Joe Babaian @JoeBabaian

Why? Because times are changing and status quo is being cast aside.

Truckin’ – Grateful Dead. Chosen by Brian Ahier @ahier

Because this ♫♪♪♪♫♪? ♫♪ What a long strange trip it’s been ♫♪♪♪♫♪?

Under Pressure – David Bowie and Queen. Chosen by Colin Hung @Colin_Hung

Healthcare in the US and around the world has never been under more pressure than it has now. Patients are expecting more (as they should!), governments are trying to regulate everything from drug prices to reimbursements, employers are looking to curb healthcare costs and there is tremendous pressure on the healthIT industry to work together. To me, this song is the perfect collaboration – an example of what happens when two amazing artists come together. We need more of this type of collaboration in healthcare. Plus there is one verse that is very applicable to 2017: And love dares you to care for / The people on the (People on streets) edge of the night / And loves (People on streets) dares you to change our way of / Caring about ourselves

For a full #HIMSS17 Mix Tape Playlist on Spotify, click here or play the embedded player below.

MIPS Quality Performance Category – MACRA Monday

Posted on January 23, 2017 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

This post is part of the MACRA Monday series of blog posts where we dive into the details of the MACRA Quality Payment Program.

It’s time to start diving into more of the details of the MIPS performance categories. For reference, be sure to check out our previous post on the MIPS Performance Category Weightings to see how the Quality performance category fits in with the other MIPS performance categories. The Quality performance category makes up 60% of your MIPS composite score. So, this is a very important category. If you’re looking for a formal course that dives into the nitty gritty details of this category, check out this course taught by Wayne Singer that covers the MIPS Quality Performance Category ($150 off the course if you use this link) in detail.

The Quality performance category is a replacement of the program we now know as PQRS. The program is simplified a little and they have created specialty specific measure sets. This is a valuable resource since the number of measures available in the quality performance category is quite large.

In the Quality performance category you must select 6 measures and at least one measure must be an outcome or high-priority measure. Scoring of these measures will go as follows:

Here’s how you calculate your quality performance category score:

If you’ve been participating in PQRS, this MIPS performance category won’t be a big issue for you. You’ll likely achieve a high score and be well on the road to doing very well with MIPS. If you haven’t been doing PQRS, then you have some work to do. The nice thing is that there are a lot of organizations with experience with PQRS and you can learn from them. Plus, your EHR vendor should be very familiar with PQRS as well and should be able to help.

That’s all for this week’s MACRA Monday. Next week we’ll talk about the Cost Category and new Clinical Practice Improvement Activities (CPIA) Category.

Be sure to check out all of our MACRA Monday blog posts where we dive into the details of the MACRA Quality Payment Program.