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Providers: Today’s Telehealth Tech Won’t Work For Future

Posted on July 5, 2016 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 has concluded that while healthcare leaders see major opportunities for growing their use of telehealth technologies, they don’t think existing technologies will meet the demands of the future.

For the study, which was sponsored by Modern Healthcare and Avizia, researchers surveyed more than 280 healthcare executives to see how they saw the future of telehealth programs and delivery models. For the purposes of the study, they defined telehealth as encompassing a broad mix of healthcare approaches, including consumer-focused wireless applications, remote monitoring of vital signs, patient consultations via videoconferencing, transmission of still images, use of patient portals and continuing medical education.

The survey found that 63% of those surveyed used telehealth in some way. Most respondents were with hospitals (72%), followed by physician groups and clinics (52%) and a grab bag of other provider organizations ambulatory centers in nursing homes (36%).

The most common service lines in use by the surveyed providers included stroke (44%), behavioral health (39%), staff education and training (28%) and primary care (22%). Other practice areas mentioned, such as neurology, pediatrics and cardiology, came in at less than 20%. Meanwhile, when it comes to telehealth applications they wish they had, patient education and training was at the top list at 34%, followed by remote patient home monitoring (30%) and primary care (27%). Other areas on providers’ wish lists include cardiology (25%), behavioral health (24%), urgent care (20%) and wound care (also 20%).

Not only did surveyed providers hope to see telemedicine extended into other service lines, they’d like to see the technologies used for telehealth delivery change as well. Currently, much telehealth is delivered via a computer workstation on wheels or ‘tablet on a stick.’  But providers would like to see technology platforms advance.

For example, 38% would like to see video visits with clinicians supported by their EMR, 25% would like to offer telemedical appointments through a secure messaging app used by providers and 23% would like to deliver telemedical services through personal mobile devices such as tablets and smartphones.

But what’s driving providers’ interest in telehealth? For most (almost 75%) consumer demand is a key reason for pursuing such programs. Large numbers of respondents also cited the ability to improve clinical outcomes (66%) and value-based care (62%).

That being said, to roll out telehealth in force, many respondents (50%) said they’d have to make investments in telehealth technology and infrastructure. And nearly the same number (48%) said they’d have to address reimbursement issues as well. (It’s worth mentioning, however, that at the time the study was being written, the number of states requiring reimbursement parity between telehealth and traditional care had already risen to 29.)

This study underscores some important reasons why providers are embracing telehealth strategies. Another one pointed out by my colleague John Lynn is that telehealth can encourage early interventions which might otherwise be delayed because patients don’t want to bother with an in-person visit to the doctor’s office. Over time, I suspect additional benefits will emerge as well. This is such an exciting use of technology!

Cleveland Clinic, Dell Offer Joint Epic EHR Service

Posted on February 27, 2014 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.

Even when you’re a juggernaut the size of Epic, eventually you’re going to reach the point where your customer base is saturated and you need unique new directions to go. This new deal between Dell and the Cleveland Clinic may do just that for Epic.

This week at HIMSS, the two are announcing an agreement in which the two will offer consulting, installation, configuration and hosting services for Cleveland Clinic’s version of Epic. Under the deal struck between the two parties, customers can choose between a hosted version of the Epic instance and a full install on their site.

Cleveland Clinic execs say that their knowledge of using Epic, which they have for more than three years, will give them special expertise in helping providers adjust to Epic.  The Clinic has been selling Epic to providers  through its MyPractice Healthcare Solutions business.  To date, MyPractice has sold EMRs to more than 400 providers, including physicians, nurse practitioners and midwives within a 50 mile radius of Cleveland.

Working with Dell, the two companies plan to offer the new EMR service nationwide. The Cleveland Clinic will handle the EMR installation for new customers, and Dell provides the technology infrastructure. Epic gets a licensing fee for each of these deals, the customers’ relationship will be with Dell and the Cleveland Clinic.

As Dr. C. Martin Harris, CIO of the Cleveland Clinic, told Modern Healthcare, most medical practices and hospitals have EMRs in place, leaving only a much smaller group of first-time EMR buyers. But, Harris said, that minis still a big number. (And there’s always the practices still looking to switch.)

Turning Dell and the Cleveland Clinic into a sales channel for Epic seems like a pretty smart move. With the help of players who know the smaller physician practice market, it might open up a new opportunity for Epic which it hadn’t much of a shot at before.

Should Doctors Say Goodbye To Meaningful Use?

Posted on January 7, 2014 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.

Of late there’s been a lot of concern about doctors exiting the Meaningful Use program, with many saying the financial reward was simply not worth the trouble. This trend, of course, has the medical world abuzz with discussion as to what will happen if doctors drop Meaningful Use like a stone.

Meanwhile, a few months ago, an EMR vendor brought the discussion more heat when it announced that it would no longer be Meaningful Use certified. ComChart Medical Software said, in a letter to the EMR community, “unfortunately, will not be able to meet the Stage 2 (or greater) Meaningful Use certification requirements as its requirements are technically extremely difficult to implement.”

If I were running a medical practice, and my vendor took away from me the choice of complying with Meaningful Use or not, I might be angry, but I might breathe a sigh of relief.  After all, complying with Stage 2 will be a major accomplishment for virtually any practice, and if my vendor takes the choice of complying or not complying with Meaningful Use out of my hands, I won’t have people breathing down my neck saying I’m not a team player.

But even if my vendor continues to support a certified EMR for now and into the future, it’s still worth wondering whether it’s worth the trouble for doctors, half of whom are in smallish practices that don’t have much of an IT budget.  After all, if my practice has completed Stage 1 I’ve already realized most of the financial benefits the program offers, notes Modern Healthcare.

So what do you think readers? Do the next stages of Meaningful Use pay off in other ways that make the struggle for compliance worth the trouble?

Defense Department’s EHR Effort Falters

Posted on October 7, 2010 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.

From reader DKBerry:

You’d think that buying a common EHR platform and deploying it across all of Defense Department’s medical centers (Army, Navy, Air Force) … that they would have done better.  How did VA succeed where DoD is failing?

Unless the Defense Department addresses weaknesses in project planning and management that have hampered its current electronic health-record system’s capabilities, it risks undermining its new EHR initiatives, according to a Government Accountability Office report (PDF) requested by Sen. Judd Gregg (R-N.H.), the ranking minority member of the Senate Budget Committee.

The report notes how the Defense Department has obligated some $2 billion since 1988 to an EHR system for the 9.6 million active-duty service members, their families and other beneficiaries but has come up short and has scaled back its original expectations for AHLTA. (AHLTA was originally an acronym for “Armed Forces Health Longitudinal Technology Application,” but the department later declared it was no longer an acronym, but a brand.)

After finding AHLTA’s early performance “problematic” in terms of speed, usability and availability, the Department of Defense has sought to acquire a new system known as EHR Way Ahead, according to the report.

The new system, according to the GAO report, “is expected to address performance problems; provide unaddressed capabilities such as comprehensive medical documentation; capture and share medical data electronically within DOD; and improve existing information sharing with the Department of Veterans Affairs,” and has initiated efforts to “stabilize” AHLTA so it can act as a bridge until the system is ready.

The Defense Department has allocated $302 million in its 2011 budget request, according to the report, but has not changed its EHR acquisition process to avoid the same shortcomings it experienced with AHLTA.

Source

Sill Unanswered EHR Stimulus and Meaningful Use Questions

Posted on September 16, 2010 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.

NOTE: I had this post sitting ready to be posted back in July and never got around to it. I think it’s still pretty relevant even though we are a few months farther along. Some of the time frames might not be quite right now, but the sentiments are interesting.

DKBerry sent me a passionate email in reference to this Modern Healthcare article about the EHR subsidies unanswered questions and the possibility of EHR Stimulus money flowing in May 2011. While I don’t agree completely with DKBerry, I have to admit that it’s quite disturbing that an 800 page meaningful use final rule later and we still have lots of questions. The following is DKBerry’s reaction/summary of the article:

Trudel makes it sound like a doc could validate his meaningful use on 30 April (end of the first possible 90 day period for reimbursement) … and would get paid by CMS in May.  Wonder how long she has worked for CMS?

I especially like this line …

John Halamka, committee co-chairman, asked whether the reimbursements paid to office-based physicians would be counted by the Internal Revenue Service as taxable income. Trudel said that question was out of her purview.”

Of course its taxable income Dr. Halmaka!  It’s based on Medicare reimbursement payments … and that’s revenue.  Had the bozzos who set up this idiotic incentive program provided tax credits instead of partial reimbursements for meaningful use adoption of a certified EHR … then maybe they would have gotten more than 15 docs to sign up.

You will love the dialog between Judith Faulkner (Epic Systems) and Doug Fridsma (ONCHIT).

Faulkner asked whether he thought “we’re going to make” the Jan. 1, 2011, start date by having both these certification and testing organizations and vendors with tested products in place by then.

Fridsma made no promises.”

He said his hope is that having multiple testing and certifications organizations authorized will “eliminate some of the bottlenecks.” Still, he said, there will be “challenges” to get systems certified if providers “bundle” pieces of EHR systems together to achieve meaningful use, a common scenario at many hospitals.

We are working as hard as we can to meet those timelines and get the capability in place,” Fridsma said.

I appreciate that you are working as hard as you can … but that’s not good enough.  ONC has to get it done now.  Any date after 30 September and its costing hospitals money.  They are going to be still screwing around with this in January … 2 years after they put it out in ARRA.  If I were a doc I would just say screw it … I’m closing my panel to Medicare patients.  This isn’t worth the pain and effort.

Another Meaningful Use Webcast

Posted on January 25, 2010 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.

These webcasts have been popping up all over the place. It’s really quite amazing. You could make it a full time career just attending various webcasts on the EMR stimulus and meaningful use. Well, I’ve seen a ton of them, but this one by Modern Healthcare looked pretty interesting with a variety of people including the Director of CMS Office of E-Health Standards and Services. You can read more about it here and I’ll put some of the details of the meaningful use regulations webcast below:

Wednesday, Jan. 27, 2010
10 a.m. Central Time
FREE REGISTRATION*

About this Webcast

The federal government is offering as much as $34 billion in financial assistance to healthcare providers that buy, implement and use information technology in a manner consistent with the way the government wants it to be used. The government explained what it wants in nearly 700 pages of proposed regulations issued earlier this month.

In this webcast moderated by Modern Healthcare Information Technology Reporter Joseph Conn, four healthcare IT experts will break down those regulations and help attendees:
Identify the key sections of the regulations
Understand the impact of the regulations on hospitals, health systems and physician practices
Teach providers strategies to qualify for federal funding
Featured Speakers

J. Michael Kramer, M.D.
Chief Medical Information Officer
Trinity Health
Novi, Mich.

David Seaman
CEO
Pronger Smith Medical Care
Blue Island, Ill.

Tony Trenkle
Director
CMS Office of E-Health Standards and Services
Washington

Paul Tang, M.D.
Chief Medical Information Officer
Palo Alto Medical Foundation
Palo Alto, CA

P.S. If you’re able to attend this or any other webcast and want to do a guest post on what was said at the webcast, feel free to contact me on the EMR and EHR contact us page.