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Primary Docs See Hope For Stronger Financials With EMR

Posted on September 21, 2012 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.

Apparently, some primary care physicians are optimistic about the financial impact EMRs will have on their practice, according to a new survey.

Vendor Hello Health recently completed a survey of 100 practicing physicians without EMRs to discuss their attitudes about key business issues.  Not surprisingly, 37 percent of respondents said EMR adoption was their number one challenge at present; an equal percentage said that financial issues were their biggest worry.

Here’s what, to me, is the most interesting part of the study.  Among doctors for whom practice financial health was a primary concern, 51 percent felt that implementing an EMR would help solve their problems.

Their theory was that EMRs would help by improving coding and documentation to substantiate claims, as well as improving efficiencies and reducing costs.

Of doctors who didn’t think EMRs would help their financial situation, 46 percent felt that the systems would lead higher costs and overhead, and 15 percent felt productivity would decrease.

Now, I’m going to go all cynical on y’all.

I was pretty surprised to read that some doctors feel EMRs will actually improve their financial situation. Sure, improving coding and documentation itself is certainly a worthy financial goal.  The thing is, that’s not exactly what EMRs are designed to deliver.

As for improved efficiencies and reduced costs, well, I don’t find that very credible at all.  Not that some practices don’t achieve this goal,  but if the respondents  had anything near-term in mind they’re likely to be quite disappointed.

Realistically, if I wanted to invest in technology that improved my coding, I’d go with a computer-assisted coding or souped-up billing system. And I’d begin gunning my ICD-10 engines right away. Getting psyched about my pending EMR is nice, but probably setting oneself up for a letdown.

Things EMR Doctors Never Say

Posted on September 20, 2012 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.

Here’s a quick look at Things EMR Doctors Never say (maybe I’ve been watching too many late night shows):

“I’m so glad to be doing meaningful use!”

“I can’t wait until ICD-10 makes my life easier.”

“I wonder when that ACO model is finally going to kick in. I can’t wait.”

“I miss trying to read Dr. Smith’s handwriting.”

“I wish I could go and ask HIM for a chart pull.”

“I miss hiding behind the pile of paper charts on my desk.”

“I love this fax machine.”

“I miss the coffee stains on the paper charts.”

“I love the mix of EHR, EMR, HIE, ACO, ONC-ATCB, ICD-10, 5010, BI, with the RCM cherry on top.”

I’m sure I missed some. Please add more in the comments and I’ll add them to the list.

Meta Health Technology Acquired By Streamline Health; Breakthrough, MyHealthTeams, and PatientCo Ink Receive Fundings

Posted on I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

Aquistions

Streamline Health announced last week that the company will be acquiring Meta Health Technology, a “leading provider of health information management solutions for hospitals, clinics, physician group practices and long-term care facilities across the U.S. and Canada,” according to Red Orbit.

Streamline acquired approximately $15 million capital stock from Meta Health which was $13.4 million in cash and $1.6 million in Streamline Health Stock. Robert E. Watson, President and Chief Executive Officer of Streamline Health Solutions, discussed the acquistion:

The Meta suite of solutions, when bundled with our existing solutions, will help current and prospective clients better prepare for this challenge. In addition, the pending release of a computer-assisted coding solution (CAC) will place Streamline Health at the core of addressing the complexities of the ICD-10 transition.

Fundings

Launched in 2009, Breakthrough addresses that fact that one in four Americans suffer from a mental illness. The company is offering a way for users to contact mental health professionals through email or video. It also allows users to find providers based on various criteria including price, specialty, or disorder.

Breakthrough has raised $900k in seed funding from many different investors. The contributors included the following: Ash Patel and Mike Marquez of Morado Ventures, Charles River Ventures, Square COO Keith Robois, Badoo COO Benjamin Ling, Gus Fuldner, PracticeFusion co-founder Matthew Douglass, PayPal Director and former eHealth exec Avery Kadison, Invite Media co-founders Nat Turner, and Zach Weinberg.

MyHealthTeams is a start up that develops communities, both socially and locally, for those who live with or help those with chronic conditions. The startup announced on Tuesday a $1.75 million round today. The round was led by Adams Street Partners, with participation from 500 Startups.

According to TechCrunch.com, MyHealthTeams’ mission is:

To make it easy for people to quickly find and connect with a network of other people who are in a similar position and can understand the challenges faced via its own condition-specific social networks. In addition, members can also easily find referrals of local providers and businesses best suited to help them — and this, presumably, is part of the business model.

The funding is going toward expanding the company.

and finally, Patientco Ink raised $3.75 million in a Series A financing. The round was led by BlueCross Blue Shield Venture Partners and Sandbox Industries. In addition, as a result to the financing, the Managing Director of Sandbox Industries, Tom Hawkes, will be joining Patientco’s board of directors.

A press release concerning the financing described Patientco:

Patientco simplifies the challenges of understanding healthcare expenses for patients so they pay their healthcare providers faster. Already more than one million patients across 20 states securely receive, pay and track their healthcare expenses via Patientco. Patientco’s proprietary technology integrates with physician and hospital information systems to provide a comprehensive communication, payment and reconciliation solution.

Sandbox Industries invested in the company to help develop and further Patientco’s solution and “to solve the increasing healthcare payments problem.”

Thank you to Rockhealth.com for putting together a list of fundings and acquisitions each week. Be sure to check out their weekly newsletter!

Patient Experience Key to Unlocking Engagement Potential

Posted on September 19, 2012 I Written By

As Social Marketing Director at Billian, Jennifer Dennard is responsible for the continuing development and implementation of the company's social media strategies for Billian's HealthDATA and Porter Research. She is a regular contributor to a number of healthcare blogs and currently manages social marketing channels for the Health IT Leadership Summit and Technology Association of Georgia’s Health Society. You can find her on Twitter @JennDennard.

I enjoy my day job, fortunately (it actually encourages my blogging-on-the-side habit), and I love it even more when our product marketing manager, Jessica Clifton, rolls into town from up North to spend a week or so with our team plotting, planning and catching up. Yesterday found us finalizing a new report, “10 Trends in Hospital Patient Experience,” before the dismissal bell rang at 5 p.m. As I read over it with my editor’s hat on, I realized that if hospitals want to not only increase patient satisfaction, but also more easily meet Stage 2 Meaningful Use requirements pertaining to electronic patient communication, then diving into patient experience/satisfaction surveys are a good place to gain insight into both.

Let me back up a bit. First, let’s review the Stage 2 requirements pertaining to digital patient engagement, as so nicely compiled by Brian Ahier:

  • Use secure messaging to communicate with patients on relevant health information
  • Use Certified EHR Technology to identify patient-specific education resources and provide those resources to the patient
  • Provide patients the ability to view online, download, and transmit their health information within 4 business days of the information being available
  • Use clinically relevant information to identify patients who should receive reminders for preventative/follow-up care
  • Provide clinical summaries for patients for each office visit

Now, let’s take a look at some of the common categories covered in patient experience surveys:

  • How often did doctors communicate well with patients?
  • How often did nurses communicate well with patients?
  • Were patients given information about what to do during recovery at home?

While the national average of patient responses for these particular questions were in the 77 to 83 percent range, other categories of patient experience didn’t fare so well. Our report found that “Patients rated staff explanation of medications (prior to administering) most poorly, with 20 percent of those surveyed indicating it sometimes or never occurred. Seventeen percent of patients surveyed reported not being given instruction on at-home recovery care.”

I’ve obviously cherry-picked those survey sections having to do with patient communication, and I’ve done so to highlight the opportunities providers have to begin meeting their electronic messaging quota in the areas patients seem to need it most.

I’d be interested in hearing from providers as to how they are going to go about increasing their digital engagement with patients. Did the latest batch of patient surveys provide any insight? Please share your experiences below.

HIMSS #NHITWeek e-Book

Posted on September 18, 2012 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 was happy to be invited to participate in the HIMSS #NHITWeek e-Book. They just recently posted the HIMSS ProBook (PDF) which includes mine and 17 other health IT experts responses. It’s nice to see my name alongside wonderful health IT pros like Regina Holliday, John Moore, and Eric J. Topol (to name a few). You can find my responses on page 26-27 in the e-book or I’ve posted my responses below.  I kind of got this last minute, so my responses are a bit off the cuff.  I’d love to hear your thoughts or your responses to these questions.

1. How has the conversation about health IT evolved and / or progressed since last year’s National Health IT Week?

With the announcement of meaningful use stage 2, we’re starting to see a real dividing line between those healthcare organizations that plan to show meaningful use of a certified EHR and those organizations that plan to stay far away from it. All but a few smaller hospitals are getting on board with EHR because the EHR incentive money is so large. In smaller practices, many are still afraid that EHR will slow them down, decrease their productivity, and cause them more headache than the value it will provide.

With EHR incentive money dominating the EHR discussions, ACOs are also drawing a lot of attention and discussion in the world of health IT. Everyone seems to realize that if we’re going to make ACOs a reality, then it’s going to take a heavy dose of well implemented health IT. The increase in discussion happening around health data warehouses has really increased and more and more health organizations are trying to find was to pull value out of all the data that’s now being stored in their health IT systems.

Mobile Health is still the wild wild west. Mobile health apps are popping up in every corner of the mobile world. However, we still don’t have any breakout mobile health app superstars which have captivated the imagination of the world. Considering the number of apps, one of them is bound to reach that point soon.

2. What are the major challenges to hospitals and healthcare providers as we move toward a new century of health technology?

I’ve often said that health IT is the great magnifier. Health IT will take the good and make it better, but it will also point out the bad just as easily. What I think the implementation of health IT has done is caused many healthcare organizations wake up to some of the problems they never realized they had. Overcoming much of the built in healthcare problems is going to be the biggest challenge to the implementation of health technology.

Along similar lines, the biggest built in problem in healthcare IT is the walled gardens which create incredibly difficult to access data silos. Much like a President once famously said, “Healthcare, take down your walls.” Unfortunately, there doesn’t seem to be any authority that can make such a strong statement. Breaking down the walls surrounding healthcare data is going to be an almost insurmountable challenge.

One other major challenge we’ll see and we’re starting to see already is how to handle the literal flood of healthcare data. Floods of data will be pointed at health care providers from HIEs, PHR’s, medical devices, genomics, etc. Creating IT systems which process all the data into a digestible format will be key to the future of healthcare.

3. How can we increase adoption and meaningful use of health IT in hospitals and health systems across the U.S.?

I think we need a fundamental change in how we define meaningful use. The current definition of meaningful use might provide benefits to healthcare in general, but I know very few hospitals and health systems that see value in what HITECH has defined as meaningful use.

The hospitals and health systems I talk to see meaningful use of an EHR as improved patient care, improved revenue integrity, and streamlined processes. This is a much different definition of “meaningful” use of EHR. Once EHR vendors achieve this type of meaningful, healthcare won’t know how to live without it.

4. What advice would you give to the next generation of health IT leaders and their role in improving our healthcare system through advancement of IT?

My advice is that “when you’re a hammer, everything looks like a nail.” To make the comparison, just because you’re an IT leader doesn’t mean that IT is always the solution. Sometimes the solution is to fix the process first. Applying IT to bad processes just makes things worse. Be thoughtful in when and where you implement health IT. IT has tremendous potential, but only when applied the right way to the right problems.

5. What’s one thing the general public should know about health IT that they do not already, and what’s an easy way for them to get involved?

I believe the general public doesn’t realize the power they yield. Patient demand is likely the most powerful force in healthcare. If enough patients requested online patient scheduling, we’d see more doctors providing online patient scheduling. If more patients demanded e-visits, we’d see more e-visits. Patients need to stop accepting the current method of care delivery and start caring more about the healthcare services they receive.

6. What’s one health technology you are most excited about?

I’m absolutely fascinated with non-obtrusive health monitoring devices. It’s amazing how much health data can be collected with a simple cell phone camera. Everything from pulse, blood pressure, and cholesterol can potentially be monitored with a digital camera. Plus, we’re just at the beginning of the health monitoring that will occur using a person’s cell phone.

7. Fill in the blank. Health IT is _________________
Health IT is integral to the future of healthcare.

Those were my responses. You can find the other 17 responses to these questions in the HIMSS ProBook (PDF).

DC to VC Finalists Announced

Posted on 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.

DC to VC has become a place for healthcare startup companies to pitch their company at Health 2.0. Plus, Health 2.0 has wisely partnered with Morgenthaler Ventures and in particular Missy Krasner for the event. I also love that they have Jeff Tangney, CEO of Doximity (Founder of Epocrates as well) as the keynote speaker for the event.

The companies that will be pitching at DC to VC are listed below:

Series A Finalist Companies:
  • GSI Health
  • Beyond Lucid Technologies
  • CarePlanners
  • Starling Health
  • AgeTak
  • HealthLoop
  • Comprisma
  • NudgeRX
Seed Stage Finalist Companies:
  • Nephosity
  • Force Therapeutics
  • United Preference
  • Aidin
  • Capture Proof
  • Genomera
  • Cara Health

It’s a great time to be a healthcare IT startup company. In the DC to VC finalist announcement they offered these stats on the health IT investment landscape:

  • Venture capital funding for Health IT reached $293M for Q2 2012I according to a report by communications and consulting firm Mercom Capital Group. Sixty-one investors participated in 28 deals. The report also identified 39 merger and acquisition deals worth $2.9 billion in Q2 2012.
  • In 2011, capital investments in Health IT generated 86 deals worth $633M. There was a 26% increase in deal activity from the year before and a 22% increase in capital raised.
  • 92 VC firms invested in digital health in 2012 thus far (2012 Mid Year, Digital Health Funding Report, Rock Health)
  • B2B funding is the majority of the deals with B2C funding increasing slightly in 2012. (2012 Mid Year, Digital Health Funding Report, Rock Health)

I’m so busy traveling in October that I’ve sadly had to scratch Health 2.0 from my list of conferences. However, this announcement makes me want to make a day trip to San Fran to attend the event.

EMR Data Often “Inaccurate” Or “Missing”, Study Says

Posted on September 17, 2012 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.

EMR adoption continues to march forward, spurred not only by Meaningful Use requirements but also the need for doctors to access data remotely and the rise of cloud infrastructure to support such initiatives.  According to research firm IDC, 80 percent of healthcare organizations should adopt EMRs by 2016.  Pretty much what you might expect.

Hopefully, this will have a positive impact on clinical care. However, EMRs may be less useful than they should be for population health research, as data is often inaccurate or missing, according to a new report published in the Journal of  The Medical Informatics Association.

Researchers behind the report said that while data from EMRs can be useful, it’s prone to certain types of errors which undermine its value.  For example, EMR data accuracy varies depending on whether the patient was treated during the day or during the night, in part because patients at night are often sicker, according to Dr. George Hripcsak, a professor of biomedical informatics at Columbia, who recently spoke with eWeek magazine.

Another issue of concern is that patient symptoms are often poorly documented in EMRs before death. For example, patients with community-acquired pneumonia who enter the ED and die quickly don’t have symptoms entered into the EMR before they die. Later on, their medical records make it look as though a healthy patient died, the researchers note.

Dr. Hripcsak told the magazine that researchers in informatics, computer science, statistics, physics, mathematics, epidemiology and philosophy will need to work together to get an accurate read on EMR data and avoid biases. (Whew!)

Clearly, the kind of teamwork Dr. Hripcsak has in mind will take a great deal of resources. They’re on their way, it seems. For example, I’m betting that the new Johns Hopkins center for population health IT will serve as a model for the kind of interdisciplinary efforts he’s describing. But that’s just one effort. It will be interesting to see whether other universities follow in Johns Hopkins’ footsteps.

Patient engagement in the digital era

Posted on I Written By

Dr. West is an endocrinologist in private practice in Washington, DC. He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC in 2009. He can be contacted at doctorwestindc@gmail.com.

In the not-so-old days of medicine, patient engagement used to involve things like looking the patient in the eye when speaking to them, facing the patient, asking them how they felt, and asking them if they had any other questions before ending the visit. These so-called rules of engagement have now been augmented by the computer in between the patient and the provider.

No longer are the former etiquette protocols sufficient for interacting in the digital era. Now, patient engagement includes Internet searches using “Dr. Google” for what in my opinion are typically anxiety-fueled questions that are frequently unnecessary and irrelevant and would not have been asked prior to the arrival of Internet searches.

However, the internet isn’t going anywhere anytime soon, and so providers have to be able to deal with this new level of interaction. Fortunately, not all patient engagement is so maladaptive.

Patient engagement is a funny thing though. It seems to be confused by doctors, staff and patients. Some people think patient engagement involves E-medicine, or rather electronic visits over secure messaging systems. I laughed the other day when I viewed a YouTube video showing a woman talking about a third party for-profit software vendor company using their technology to allow patients to pay bills online and therefore be more” engaged”. Right. That’s twistier than Presidential campaign rhetoric.

Another speaker put it well when he said that “reality struggles to keep up with the rhetoric” when he was commenting on the difficulty in defining patient engagement, yet everyone wants to use the jargon liberally.

I prefer to think of patient engagement in the digital era as being positive in several respects. I expect the patients to take an active role in their healthcare, in gaining knowledge about their disease, and in gaining knowledge about health prevention and treating ongoing illness issues. In doing so, the patient becomes empowered to take an active role in the decision-making process during the testing and treatment phases of care. This is not to say the patient should get to consult Dr. Google and then dictate what tests are being done on them regardless of what the ordering provider thinks is appropriate. I think the most ethical and appropriate response to such requests are to, first, consider them seriously; second, discuss with the patient which tests are medically indicated and which tests are medically unnecessary; and finally, to stand one’s ground in either writing or not writing for any medically unnecessary tests to be ordered.

I also completely agree with the definition of patient engagement as defined by the Society for Participatory Medicine. It says that patient engagement is a movement in which networked patients shift from being mere passengers to responsible drivers of their health, and in which providers encourage and value them as full partners.

In order to get patients more engaged in participating in their healthcare, I think we need to make it fun, make it interesting, and communicate using means where the patient actually is, on multiple levels of “is”. In the case of the digitally connected patient, we should be considering communicating using the Internet, smartphones, and mobile devices such as iPads. We need to be able to make this communication valuable to the patient so that they, in turn, want more of it, and so that the movement grows.

Health IT Q&A, Speciality EMRs, and Secure Messaging: Around Health Care Scene.

Posted on September 16, 2012 I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

EMR and HIPAA

Health IT Q&A With Scott Joslyn, CIO and Senior Vice President, MemorialCare Health System

This post features Scott Joslyn from MemorialCare Health System. He talks about a few different Health IT topics, including benefits and disadvantages to EHR and voice recognition. Joslyn is definitely an expert on Health IT, so this is a post you don’t want to miss.

Verizon Hopes To Be Secure Healthcare Network For All

Verizon is more than just switches, routers, and cables. Katherine Rourke discovered what the company has in store in the future with mHealth. She talked with Dr. Tippett from Verizon, who said Verizon’s Connected Health Division is “aiming to set the bar higher.” The company is hard at work, so expect some great things coming from Verizon.

Hospital EMR and EHR

Specialty EMRs: Behind the Curve? 

Are specialty EMRs worth investing in? There is debate on both sides of the issue, and a general consensus doesn’t appear to be developing anytime soon. Anne talks about assertions made in a statement recently about specialty EMRs, and offers her own two cents on the topic.

Study Suggests Most HIEs Aren’t Sustainable

HIEs are very expensive. Unfortunately, according to a recent study, the investment in them don’t seem to have any financial or clinical payback. There’s so much time and effort being put toward HIEs — would money be better spent elsewhere? Likely, but Anne Zieger doesn’t see things changing anytime soon.

Smart Phone Health Care

App Developers Urged to Consider Older Generations

There are apps developed that could make managing diseases like diabetes so much easier. However, these apps may not be designed with all age groups in mind. Researchers from North Carolina State are urging app developers to keep older generations in mind, who aren’t able to use certain apps as they are currently designed.

Happy EMR Doctor

EMRs’ Big Gaping Hole of Secure Messaging

This post is the first in a series from Dr. West, highlighting insights from his recent participating at a breakfast panel in Washington D.C. He talks about issues with secure messaging, including the lack of EMRs that have secure messaging included in their system. In the end, he discusses how secure messaging could impact patients and doctors positively.

Health IT Galore Wrapping Up #NHITWeek — #HITsm Chat Highlights

Posted on September 15, 2012 I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

Every week, HL7 Standards, hosts a #HITsm Tweet Chat and poses four questions “on current topics that are influencing healthcare technology, health IT, and the use of social media in healthcare.” It’s always a great discussion and also a great chance to meet a wide variety of people that are passionate about healthcare IT.

In case you missed it, or are curious about what went on this week, we’ve put together the list of topics with some of the best responses for each topic. There were some interesting topics this week, as well as some great responses. If you have any opinions on any of these topics, feel free to continue the discussion in the comments. This chats take place every Friday at 11AM CST. You’ll find members of Healthcare Scene regularly participating in the chat under some of the following Twitter accounts: @techguy@ehrandhit@hospitalEHR, and @smyrnagirl.

Topic One: Fill in the blank: Health IT is _____. 

 

 

 

 

 

Topic Two: What is the most important message consumers need to know about health IT?

 

 

 

 

Topic Three: Who is the most important driver of educating patients about the use of technology in healthcare?

 

 

 

 

Topic Four: What can be done to improve National Health IT Week for both professionals and the general public?