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The Positive Impacts of EHRs and MACRA on Patient Care – #KareoChat

Posted on July 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.

If you were to look at the Twittersphere or read a lot of the healthcare IT publications out there, you might think that nothing good has come from EHRs or MACRA. While there are plenty of points of criticism that are worthy of discussion about both of these things, I think the negative discussion overwhelms many of the positive things that have come out of EHRs and MACRA (and it’s predecessor meaningful use).

With this in mind, I recently did a blog post for Kareo which looked at some of the ways EHRs and MACRA can improve patient care. The intro to the post summarizes what’s happening well:

When healthcare pundits talk about MACRA they often offer a basic analysis of how the move to value-based reimbursement will be a good thing for healthcare, since then we are only spending money on care that provides value. Many doctors disagree and suggest that value-based reimbursement won’t create the value it purports to create. Either of these analyses overlooks many of the benefits that MACRA and the move to EHR software offer healthcare. The reality is that many of the most exciting initiatives in healthcare would not be happening today and would not even be possible if it weren’t for programs like MACRA and the implementation of EHR software. Let’s take a look at some of these improvements.

Be sure to check out the full blog post to read about a number of ways we’re benefiting from EHRs and MACRA.

This idea became a theme for me this month and so when Kareo asked me to host their weekly #KareoChat I thought it would be a great topic of conversation for the larger healthcare IT Community as well. I’m sure many of you can offer a lot of great perspectives on how patient care has been improved sthanks to these programs and technology. If you’d like to join the discussion, I’ll be hosting the #KareoChat on Thursday, July 27th at 9 AM PT. Just hop on Twitter and join in!

During the #KareoChat we’ll be discussing the topic of “The Positive Impacts of EHRs and MACRA on Patient Care.” Here are the 5 questions that will serve as the framework for the discussion:

1. Are you planning to participate in MACRA? At what pace? And why or why not?

2. Where do you see MACRA having a positive impact on patient care?

3. What are the short term benefits to patient care from having an EHR?

4. What are the long term benefits to patient care from having an EHR?

5. What other things beyond MACRA and EHR can we do to improve patient care?

I have a feeling that this chat is going to be a challenge for many. It’s so easy for us to see the negative. It takes much more work to see the positives. I think that’s largely because we start to take the positives for granted. Hopefully, during this chat we’ll take a step back and realize all the positives of EHRs and MACRA.

Full Disclosure: Kareo is a sponsor of Healthcare Scene.

Various Medical Practice Model Types

Posted on May 3, 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.

The EHR vendor (and many other services), Kareo, has put out a practice model guide which they call “Practice Models: The ABCs from ACOs to Concierge and Everything in Between.” With this guide they shared this picture that includes various practice models:

When I see an image like this I’m torn on if this is an extremely exciting time for physicians or if it’s a miserable time to be a physician. One thing is clear, times are a changing. The medical practice models of the past are going to be blown up by new models.

Take for example Telemedicine. Can you imagine any healthcare future where telemedicine is not part of that future? I can’t.

I’m still personally torn on concierge practices. I can see why they’re appealing to so many. I love the idea of unlimited primary care and getting insurance out of primary care. However, it’s not clear to me that this idea can scale across the entire healthcare system. Certainly the rich can do it no problem. Can the concierge model work for the middle and lower class? Many fans of concierge tell me it can. I’m still not so sure.

I know a lot of doctors that are part of ACOs. I don’t know very many that are excited by the work ACOs are doing. Most of them just feel like they need to be part of it to understand the future of medicine. They’re not joining ACOs because they think it’s something that shows a lot of promise for their patients.

I’m probably coming off a little more cynical than I am about these shifts. A number of these changes are really exciting to see happening. However, I’m also not blind to the challenges that many of these medical practice models face.

Needless to say, it’s an exciting and challenging time to be in medicine. The structure of how we pay for healthcare is being questioned and new models are being explored. This can be really exciting if you find yourself tracking the right wave. However, if you miss the wave, then you can be stuck out in the middle of the ocean wondering how you missed out.

What’s Been the Impact of ICD-10 and the End of the Grace Period – Join This Week’s #KareoChat

Posted on October 12, 2016 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.

kareochat-icd-10

I’m excited to be hosting this week’s #KareoChat. I decided that it would be a great time to discuss the impact of ICD-10 on your organization and take a look at what impact the end of the ICD-10 grace period will have on your practice. This is an important topic that I don’t think has gotten enough discussion.

The chat is happening Thursday, October 13th at 9 AM PT. All you need to do to join is to search for the #KareoChat hashtag on Twitter and then add #KareoChat to any tweets you send during that time. I expect this will be a lively discussion, so please join in so you can learn and share.

Here are the 6 questions we’ll be discussing for the hour long #KareoChat:

  1. How has ICD-10 impacted your organization and healthcare for good?
  2. How has ICD-10 impacted your organization and healthcare for bad?
  3. The ICD-10 grace period ended on 9/30, what does this mean for your organization?
  4. Does the added specificity in ICD-10 post grace period help with care? Why or why not?
  5. What things still need to be improved in ICD-10 and how we’ve implemented it?
  6. Was the move to ICD-10 much ado about nothing?  Should we move to ICD-11 more quickly than we did 10?

There was a lot of hype around ICD-10 when it was implemented and certainly cost organizations a lot of money to be prepared for the change. However, things seem to have gone generally pretty smooth because of that preparation. I haven’t seen the same discussion happening with the end of the ICD-10 grace period. I’ll be interested to learn from people if this is a big deal or if practices will just take it in stride.

Join us to discuss the impact of ICD-10 on healthcare and the end of the ICD-10 grace period.

Full Disclosure: Kareo is an advertiser on this site.

What’s the Impact of MACRA on Small Practices?

Posted on July 22, 2016 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.

I recently had a chance to sit down and chat with Tom Giannulli, MD, Chief Medical Officer of Kareo and Michael Sherling, MD, MBA, Chief Medical Officer and Co-founder of Modernizing Medicine, to talk about the impact of the MACRA legislation on small practices. Both of these CMOs at EHR vendors rode the meaningful use wave and now they’re preparing to ride the new MACRA wave as well. So, they were the perfect people to talk about the impact of MACRA on small practices and how a small practice should prepare themselves for the new MACRA legislation. If you’re a small practice that’s wondering about MACRA (or doesn’t even know what it is), then take the time to watch the video below to see what it means for small practices.

After our formal interviews, we always like to hold what we call the “after party.” We never know how it’s going to go. Sometimes people join in and offer their insights and ask questions and sometimes they don’t. In this case, we continued our conversation about the MACRA and small practices, but we also talked about the impact that legislation like MACRA has on an EHR vendors development lifecycle. You can learn more about MACRA in the video below:

This post was a great way to wrap up the week and also for us to announce a new blog post series we’re starting on Monday called MACRA Monday. Long time readers may remember the Meaningful Use Monday series of blog posts we did every Monday for a few years. This will be similar as we dive into the MACRA legislation and help small medical practices understand the details of what’s coming in MACRA. Watch for that on Monday!

The Virtual ACO

Posted on April 26, 2016 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.

“Virtual ACOs may be the next big thing for small practices,” says our host Dr. Tom. “I want to talk about how independent practices can lead and not just follow the shift to value-based care.”

Who here has looked at or talked to someone about virtual ACOs?

My guess is that most small practices haven’t really heard about it. Maybe it has to do with most doctors being too busy to consider other innovation. I’ll admit that the idea of a virtual ACO is a new one to me and so I was interested in the discussion that Dr. Tom from Kareo led on virtual ACOs.

The concept of a virtual ACO makes sense. Basically use technology to provide coordinated care across the care system. In fact, that’s what most patients think is already happening with their care, but we know it’s generally not happening. We all know it should and most doctors would embrace the ability to have the right information in the right place so that their patients get the right care. I don’t know anyone who’s against that principle.

However, as was pointed out in the chat linked above, the financial model for a virtual ACO is up in the air. There’s no clear financial model that makes sense. The care model makes sense, but the financial model is a mess.

Dr. Tom did make this assertion in the virtual ACO discussion:

Although S. Turner Dean responded with something we’ve talked about quite a few times before:

I love Dr. Tom’s optimism that this new world of value based reimbursement simplifying things, but I’m not sure it will be any simpler than fee for service. That’s not even taking into account the fact that we have the whole infrastructure set up to handle fee for service and that we know how it works. Set that aside and I’m still not sure that a virtual ACO would be any less complicated than our current fee for service world.

What do you think of the concept of a virtual ACO? Will it simplify medicine? Will it help doctors love their work again? Will it help the independent physician practice survive?

Full Disclosure: Kareo is an advertiser on this blog.

Healthcare IT Vendor Blogs

Posted on December 24, 2015 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.

After 10 years and 9404 blog posts later, I’ve come to know a little something about blogs. You might also say that I’m totally bias about the power of a well written blog. The reality is that blogging is just a simple way for anyone to publish content online. Blogging has really opened up the opportunity to publish great content to everyone.

With that said, it’s not easy sustaining a blog with great content. The tyranny of time is real and however far ahead you get on your blog, time will eat that away before you can blink your eye. It takes a real commitment to keep a blog up to date with regular content.

To honor some of these efforts, I thought it would be fun to share some of my favorite healthcare IT vendor blogs. It’s great to acknowledge the effort these vendors put into creating great content. Sure, they likely want to get more exposure for their companies. That’s a given, but that doesn’t diminish that many healthcare IT vendors are creating amazing free content on a regular basis on their blogs. Here’s a quick look at a few that I enjoy.

Information Advantage Blog by Iron Mountain – This blog focuses deeply on the challenge of health information management and topics such as: health information governance, medical records scanning, health data storage, etc. Those in the AHIMA and HIM community will really enjoy the blog, but there’s a little something for anyone interested in healthcare IT.

HL7 Standards by Corepoint Health – Most of you are likely familiar with this blog since it’s the home of the #HITsm Twitter chat. They post the host and topics for each week’s #HITsm chat, but they do much more. The HL7 Standards blog has a wide variety of amazing healthcare IT content from a diverse group of guest bloggers. They rarely put up a post that’s not worth a read.

Kareo Blog by Kareo – The Kareo blog is home to Kareo product updates and the #KareoChat, but they also regularly post some great content. Kareo has long been the advocate for the independent small practice physician. Therefore, you can imagine that their content is all focused around that audience.

CloudView Blog by athenahealth – This blog is a reflection of the athenahealth CEO, Jonathan Bush. You never know what to expect. No doubt Jonathan Bush has created a culture at athenahealth that’s trying to push boundaries and we often see that reflected on the athenahealth blog. In fact, the best posts on the athenahealth blog come from Jonathan Bush himself. I also love that the CEO of the company is present on the blog. Some might argue that it’s not really Jonathan writing the post, but when you read his posts it’s all Jonathan coming through in the message.

There are many more great healthcare vendor blogs out there. If you have some favorites or ones I should check out, please share them in the comments. If we get enough recommendations we’ll do a follow up post featuring other healthcare IT vendor blogs.

Enjoy the light reading this holiday weekend!

Full Disclosure: I’ve written a few posts over the years for the Kareo and Iron Mountain blogs.

Ways to Grow and Market Your Medical Practice – Healthcare Scene “Minute”

Posted on October 8, 2015 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.

If you also read EMR and HIPAA (which you should), then you probably read that I hosted today’s #KareoChat where we discussed how to grow and market your medical practice. It was a lively discussion full of great insights.

After the chat, I decided it would be useful to hop on Periscope and share a Healthcare Scene “Minute” covering 4 insights into growing and marketing your practice that I gleaned from the chat. In case you missed it live, here’s the video recording below:

If you’d like to dive deeper into the topic, you can read the full transcript from today’s chat or check out the Storify that Kareo put together.

Let us know what you think about the 4 medical practice marketing insights I talk about in the video in the comments below.

Full Disclosure: Kareo is a Healthcare Scene advertiser.

The Impact of Patients Recording Their Doctors Visits

Posted on September 14, 2015 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.

Martine Ehrenclou has a great article titled Patients Secretly Record Visits with Their Doctors that is worthy of further discussion. Here’s an excerpt from the article to get the discussion started:

Since I suspected this office visit might contain some complicated and possibly stressful information, I considered recording what the surgeon said by using an app on my iPhone. I envisioned asking the doctor’s permission to record the conversation and decided against it because he might not have responded well to that idea. Some physicians and other providers react with suspicion and a defensive medicine posture when asked by patients to record what they’ve said.

My husband’s surgeon had a reputation for highly successful surgeries but not the greatest bedside manner. He’d always been pleasant with us, but since my husband’s recovery had been compromised with episodes of pain, I decided that an audio device could have instigated alarm. That would have interfered with the doctor’s focus on Jamie. With only 7-10 minutes, we had to make the most of this office visit. I wanted my husband out of pain.

In place of an audio recording, I took notes instead.

I’m sure that many patients have gone through the same situation. They want to have the valuable information that the doctor has shared, but they’re afraid of the impression they’ll give the doctor if they tell them they’re going to record the visit. Unfortunately, that’s the culture of fear that we’ve created in our healthcare system. Doctors are rightly afraid of the medical malpractice implications of anything they do.

The article goes on to talk about some patients who secretly record their visit with their doctor. A commenter and the author both described this trend of patients secretly recording doctors visits as alarming. However, that feels like a bit of a contradiction to me. The article talks about how asking your doctor to record the visit could compromise the patient-doctor relationship. In order to avoid compromising it, recording the conversation privately seems like the natural alternative.

What’s worth noting is that these private recordings might not be admissible in court depending on your state. I’m not a lawyer, so I’m not sure of the exact laws, but I know that in many states both patients have to be aware that a recording is being made. This should actually provide much comfort to doctors. If a secret recording isn’t admissible in a medical malpractice case, then the doctor should be glad that the patient is secretly recording the visit. It would illustrate that the patient really just wants to review what the doctor said as opposed to trying to ensnare the doctor in some legal lawsuit. Sounds like deep patient engagement to me.

Since pretty much all of us now have an audio recording device in our pocket (better known as a cell phone), this topic is going to become more and more popular. More and more patients are going to want to record their office visit. No doubt some will do this in full disclosure to the doctor and others will do it privately.

I wonder when we’ll see the first doctors flip the script on the patient and suggest that the patient record the office visit. We probably won’t see this happen for the full visit anytime soon, but you could easily see the doctor recording the plan and instructions part of the visit and sending it to the patient or the doctor encouraging the patient to record it themselves. In fact, I recall Kareo doing something like this for doctors using Google Glass. It’s a happy medium where the doctor is likely more comfortable having what they say recorded. A great part of a patient portal would be a list of all the things a doctor’s instructed the patient as part of a visit.

Of course, all of this leads to my concept of a video EHR that captures the audio and video of every visit. I’ve been talking about it more and more lately. I’ll have to do a full post on my vision for a video EHR in a future post. If the idea of a video EHR makes you uncomfortable, that’s no surprise. However, it’s not as far fetched as you might think.

Outsourced Medical Billing #KareoChat on Twitter

Posted on August 26, 2015 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.

On Thursday, August 27th at 9 AM PT (Noon ET), I’ll be hosting the #KareoChat where we’ll be discussing the good and bad of outsourced medical billing. You can follow along tomorrow on Twitter by watching the #KareoChat hashtag or by checking out my tweets on @ehrandhit.
Outsourced Medical Billing Twitter Chat
Here are the questions we’ll be discussing in tomorrow’s Twitter chat:

  1. Why are many practices choosing outsourced billing over in house?
  2. What are the disadvantages of outsourced billing?
  3. How will ACOs and value based reimbursement work with an outsourced billing company?
  4. How do you select a high quality outside billing company? What differentiates these companies?
  5. Does your outsourced billing company need to have tight integration with your EHR? Why or why not?
  6. What are the pros and cons of outsourcing your billing to your EHR vendor?

I’m particularly interested in people’s responses to question number 3. I think many in healthcare understand the good and bad of doing the billing in house or outsourcing it. Although, I’m pretty sure I’ll learn even more on the Twitter chat tomorrow. However, how things like ACOs and value based reimbursement will impact an outsourced billing company is still a really important topic of discussion. Will it drive more people towards outsourcing their billing or will it mean more practices bring their billing in house? I’ll be interested to hear people’s thoughts on tomorrow’s Twitter chat or feel free to start the discussion in the comments below.

We’re Hosting the #KareoChat and Discussing Value Based Care and ACOs – Join Us!

Posted on June 23, 2015 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.

ACO and Value Based Reimbursement Twitter Chat
We’re excited to be hosting this week’s #KareoChat on Thursday, 6/25 at 9 AM PT (Noon ET) where we’ll be diving into the details around Value Based Care and ACOs. We’ll be hosting the chat from @ehrandhit and chiming in on occasion from @techguy and @healthcarescene as well.

The topic of value based care and ACOs is extremely important to small practice physicians since understanding and participating in it will be key to their survival. At least that’s my take. I look forward to hearing other people’s thoughts on these changes on Thursday’s Twitter chat. Here are the questions we’ll be discussing over the hour:

  1. What’s the latest trends in value based reimbursement that we should know or watch? #KareoChat
  2. Why or why aren’t you participating in an ACO? #KareoChat
  3. Describe the pros and cons you see with the change to value based reimbursement. #KareoChat
  4. What are you doing to prepare your practice for value based reimbursement and ACOs? #KareoChat
  5. Which technologies and applications will we need in a value based reimbursement and ACO world? #KareoChat
  6. What’s the role of small practices in a value based reimbursement world? Can they survive? #KareoChat

For those of you not familiar with a Twitter chat, you can follow the discussion on Twitter by watching the hashtag #KareoChat. You can also take part in the Twitter chat by including the #KareoChat hashtag in any tweets you send.

I look forward to “seeing” and learning from many of you on Twitter on Thursday. Feel free to start the conversation in the comments below as well.

Full Disclosure: Kareo is a sponsor of EMR and EHR.