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Does Healthcare IT Need Some Celebrity Endorsement?

Posted on March 17, 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.

Yesterday, I was part of the Dell Healthcare Think Tank event at SXSW. It was a great event that covered a broad range of topics over 3 hours of discussion with some really amazing people like Dr. Eric Topol and Mandi Bishop to name just two of the many. If you missed it, they’ve posted the 3 part recorded live stream.

At one point in the Think Tank discussion, someone suggested that maybe we needed Kim Kardashian to endorse a national patient identifier in order to get it the attention it deserves. The example of Dennis Quad was cited as the model. Basically, a celebrity who is impacted by some ineffective part of the healthcare system. Although, I don’t think anyone would have an issue identifying Kim K, so the national patient identifier and Kim K might not be a match.

There’s no doubt, celebrity has power that can be leveraged to get healthcare messages out. We all know what damage Jenny McCarthy has done with her comments about vaccinations. Something to remember about the double edge sword of celebrity power.

With this on the top of my mind, I was intrigued by this image that came floating across my Facebook page:
Colts Cheerleader Promoting Health

This seems like a mix of celebrity (I think NFL cheerleaders qualify) and sex mixed together to try and improve health. There’s no doubt this ad will catch the eye. I’m not sure this is the best executed campaign. I’m sure some people will try watermelon and tomato from this ad, but does it really promote healthy eating?

One thing is for sure, the right celebrity focused on the right topic can bring a lot of exposure to a topic. We saw that with the ALS Ice Bucket Challenge as well. Could we push some healthcare IT issues forward using celebrities? Which topics and which celebrities?

St. Patrick’s Day ICD-10 Codes

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.

Wendy Aiken, Product Manager at ADP AdvancedMD, sent me a few ICD-10 codes that might come in handy during your St. Patrick’s Day shenanigans.

I25.810 Coronary Artery Bypass
Graft Corned beef and cabbage are staples at any St. Patrick’s Day celebration. But if eating too much red meat requires a different kind of CABG, use this code.

L25.2 Unspecified Contact Dermatitis
Due to Dyes Green beer, green clothes, green…well, everything. If someone’s skin is sensitive to the color of the holiday, this code could end up in his or her electronic health records.

H53.50 Unspecified Color Vision Deficiencies
Legend has it that leprechauns hide their gold at the end of the colorful rainbow. Color blindness may make finding the treasure difficult.

D50.8 Hypochromic Anemia
No doubt you may get sick of seeing all the green this St. Patrick’s Day. However, if a patient exhibits a greenish discoloration of skin, he or she may have the real “green sickness”—Hypochromic Anemia.

R44.1 Visual Hallucinations
Leprechauns are a fanciful legend for children. But if you see little green men running around, your doc may use this ICD-10 code.

F40.11 Social Phobia, Generalized
The Irish celebrate St. Paddy’s Day by gathering for large parties and parades. Not everyone loves the chaos of large groups, however. This ICD-10 code is perfect for anyone missing out on festivities due to their fear of crowds.

B27 Infectious mononucleosis
With so many shirts and pins reading “Kiss Me, I’m Irish”, there is bound to be some smooching going on. Irish or not, not all St. Patrick Day partiers will be lucky enough to avoid the “kissing disease.”

I42.6 Alcoholic cardiomyopathy
Drinking green beers year after year may put a hamper on the St. Paddy’s Days in the future. This code is used for what’s been called “beer-drinker’s heart.”

Y92.22 Religious Institution as Place of Occurrence
Some celebrants may observe the religious day of Saint Patrick in a more traditional way. This code may get some use if a trip to the cathedral results in injury.

Healthcare Interoperability in Action

Posted on March 16, 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.


100+ live clinical information systems sharing health data at HIMSS makes for a good headline. What’s not clear to me is how this is really any different than the past 2-3 interoperability showcases at HIMSS. Don’t get me wrong. I love that these systems can interoperate, but they’ve been able to interoperate for a long time. At least that’s what you believe from the headlines coming out of every interoperability showcase at HIMSS.

I’m hoping to learn at HIMSS why there’s such a wide gap between interoperability between systems at HIMSS and the real world. Is it a lack of desire on the part of healthcare organizations? Is it that the sandbox environment is much simpler than trying to share data between EHR systems which have had a series of customizations as part of every EHR implementation?

I also think there’s a major gap between hospital interoperability and ambulatory care. Most doctors I know aren’t working on interoperability at all. They wouldn’t even know where to start. They just assume that their EHR vendor is going to eventually solve that problem for them. Sure, they wish that it would happen, but I don’t think doctors feel like they have any power in making it a reality. I’d love to hear if you think that’s a good or bad assumption on the part of doctors.

Talking HIMSS interoperability showcase headlines, how much more powerful would it be to have the headline say “100s of live clinical information systems sharing data throughout the country.” 100s still feels weak, but at least we’d be talking about interoperability in a real life situation and not just the perfectly designed test systems.

I guess I’m still interested in “A little less healthcare interoperability talk…a lot more action.

Are Pilot Implementations the New “Evidence”?

Posted on March 13, 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.

I’ve talked with hundreds of healthcare IT companies. Many of them are new healthcare IT startup companies. It’s a feature of being a blogger and also of me organizing the Healthcare IT Marketing and PR conference. One challenge that every healthcare IT startup company faces is proving that whatever they’ve built will actually achieve the results they describe.

In many ways, this is a chicken and an egg problem. You need some customers that are using the product and show that it works before you can get people to use your software. However, no one wants to be the first one to try the software. They’re all sitting on the fence waiting for someone else to try it out.

In the IT world, some example pilot studies are the “evidence” a healthcare IT company needs to prove their solution works. Theories don’t work. They can send it off to a lab that tests it and certifies that it works (although, that’s kind of what EHR certification did and we know how that turned out). The only effective way I’ve seen a company prove that their product will work is to have some customers that are using the product.

Although, one user using it is not enough. If you’re in the hospital world you need a trifecta of users: large medical system (often academic), medium medical system, and small medical system (usually rural or community). In the ambulatory world you usually need a user from each specialty. While we’d love to think that what works for one specialty will work just as well for another one (and sometimes it does), it’s really hard to get someone to buy something when someone else in their category isn’t using it.

The best way I’ve seen to solve this problem is to beg, borrow, and steal your way to an effective group of pilot users. I’m not sure this is such a bad thing. We all know that a product being used is very different from a product that’s only been developed. However, we need more leaders that are willing to be the pilot implementations.

I think many organizations would want to do this, but they’re just so overwhelmed by meaningful use and other regulations that they haven’t had the time. Hopefully now that MU is more mature, they’ll make the time. It turns out that there are some real advantages to being the first. It’s like having your own development team at your fingertips. We need more of this engagement in healthcare.

Why Meaningful Use Should Balance Interoperability With More Immediate Concerns

Posted on March 12, 2015 I Written By

Andy Oram is an editor at O'Reilly Media, a highly respected book publisher and technology information provider. An employee of the company since 1992, Andy currently specializes in open source, software engineering, and health IT, but his editorial output has ranged from a legal guide covering intellectual property to a graphic novel about teenage hackers. His articles have appeared often on EMR & EHR and other blogs in the health IT space. Andy also writes often for O'Reilly's Radar site (http://oreilly.com/) and other publications on policy issues related to the Internet and on trends affecting technical innovation and its effects on society. Print publications where his work has appeared include The Economist, Communications of the ACM, Copyright World, the Journal of Information Technology & Politics, Vanguardia Dossier, and Internet Law and Business. Conferences where he has presented talks include O'Reilly's Open Source Convention, FISL (Brazil), FOSDEM, and DebConf.

Frustration over the stubborn blockage of patient data sharing is spreading throughout the health care field; I hear it all the time. Many reformers have told me independently that the Office of the National Coordinator should refocus their Meaningful Use incentives totally on interoperability and give up on all the other nice stuff in the current requirements. Complaints have risen so high up that the ONC is now concentrating on interoperability, while a new Congressional bill proposes taking the job out of their hands.
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Meaningful Use Stage 3 to Come Out Before HIMSS15?

Posted on March 11, 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.

Madelyn Kearns from Medical Practice Insider is reporting that we might see meaningful use stage 3 regulations before HIMSS. Here’s the exact quote from Robert Anthony, deputy director of CMS’ quality measurement and health assessment group:

“We will have two regulations that will come out in time to discuss meaningful use”

It’s hard to imagine that one of these 2 regulations will not be meaningful use stage 3. No doubt CMS and ONC will want to get some feedback from the HIMSS community on meaningful use stage 3. What better place than at the conference?

Madelyn aptly points out that Robert Anthony already has one session scheduled at HIMSS to discuss the meaningful use stage 3 requirements. I have a feeling that is going to be one of the really well attended sessions. Especially if the MU stage 3 rule does come out before HIMSS.

I realize that CMS is bound by laws on when they can announce the various rules and regulations, but I hope they’ve planned out the timeline better than they’ve done in the past. My colleague Neil Versel at Meaningful Health IT News has regularly pointed out how the rules always seem to go public on a Friday. He’s hypothesized that it was the case that they were trying to hide something. I think that’s true for many Washington news stories, but I think it was coincidence in meaningful use’s case.

Even worse than a Friday is the Friday before HIMSS. Talk about ruining the weekend before HIMSS. Although, if I remember right one time they announced the rule in the middle of HIMSS. I remember meeting with a number of EHR vendor’s government relations people who were grumbling about the late night reading of the meaningful use rule that they’d be consuming all night in the middle of the craziness of HIMSS.

Hopefully CMS has learned from past experience and has planned properly to be able to announce the meaningful use stage 3 rule well before HIMSS. Doing so will give people time to look over the rule so they can have a meaningful discussion of the rule at HIMSS as opposed to some frenetic review of what’s been proposed.

Either way, I’m very interested to see what meaningful use stage 3 will look like. My prediction is that it won’t be dramatically different from stage 2. It will be more of the same with maybe 1-2 additions. It’s too bad, because I’d still love to see them blow up meaningful use. Every doctor I know would love to see that as well. Instead I think we’ll be saying “more of the same.”

Next Generation Accountable Care Organization (ACO) Model Fact Sheet

Posted on March 10, 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.

Overview

Medicare Accountable Care Organizations (ACOs) provide coordinated, high-quality care and better value to Medicare beneficiaries.  Building on experience from the Pioneer ACO Model and the Medicare Shared Savings Program (MSSP), the Next Generation ACO Model offers a new opportunity in accountable care—one that sets predictable financial targets, enables greater levels of financial risk so that providers have more opportunities to coordinate beneficiaries’ care, and maintains the highest of quality standards consistent with other Medicare programs and models.  This is in accordance with the Department of Health and Human Services’ “Better, Smarter, Healthier” approach to improving our nation’s health care and setting clear, measurable goals and a timeline to move the Medicare program — and the health care system at large — toward paying providers based on the quality rather than the quantity of care they provide to patients.  CMS is adding the Next Generation ACO Model to its existing portfolio of ACO models:

  • Medicare Shared Savings Program (Shared Savings Program)
  • Pioneer ACO Model
  • Advance Payment ACO Model
  • ACO Investment Model
  • Comprehensive End Stage Renal Disease (ESRD) Care Initiative

This document includes background information on ACOs, a summary of the Next Generation ACO Model, information on eligibility and the application process for the model, and general information on the CMS Innovation Center.

Medicare ACO Background

Medicare ACOs are comprised of groups of doctors, hospitals, and other health care providers and suppliers who come together voluntarily to provide coordinated, high-quality care at lower costs to their Original Medicare patients. ACOs are patient-centered organizations where the patient and providers are true partners in care decisions.  Participating patients will see no change in their Original Medicare benefits and will keep their freedom to see any Medicare provider.  Provider participation in ACOs is also voluntary.  When an ACO succeeds in both delivering high-quality care and spending health care dollars more wisely, it will share in the savings it achieves for the Medicare program.

The goal of care coordination is to ensure that patients, especially those with chronic conditions, get the right care at the right time while avoiding medical errors and unnecessary duplication of services.  Any patient who has multiple doctors has experienced the frustration of fragmented and disconnected care: lost or unavailable medical charts; duplicated medical procedures and tests; difficulty scheduling appointments; or having to share the same information repeatedly with different doctors.  ACOs are designed to lift this burden from patients, while improving the partnership between patients and doctors in making health care decisions.  Medicare beneficiaries will have better control over their health care, and providers will have better information about their patients’ medical history and better relationships with patients’ other providers.  For providers, ACOs hold the promise of realigning the practice of medicine with the ideals of the profession—keeping the focus on patient health and the most appropriate care.

Medicare beneficiaries whose doctors participate in an ACO will still have freedom of choice among providers and can still choose to see providers outside of the ACO.  Patients choosing to receive care from providers participating in ACOs also will, as in Original Medicare, have access to information about how well their doctors, hospitals, or other caregivers are meeting quality standards.

Summary of the Next Generation ACO Model

The Next Generation ACO Model is an initiative developed by the Center for Medicare & Medicaid Innovation Center (CMS Innovation Center) for ACOs that are experienced in coordinating care for populations of patients.  It will allow these provider groups to assume higher levels of financial risk and reward than are available under the current Pioneer Model and Shared Savings Program (MSSP).  The goal of the Model is to test whether strong financial incentives for ACOs can improve health outcomes and lower expenditures for Original Medicare fee-for-service (FFS) beneficiaries. Core principles of the Model are:

  • Protecting Medicare FFS beneficiaries’ freedom to seek the services and providers of their choice;
  • Engaging beneficiaries in their care through benefit enhancements that directly improve the patient experience and reward seeking care from ACOs;
  • Creating a financial model with long-term sustainability;
  • Utilizing a prospectively-set benchmark that: (1) rewards quality; (2) rewards both improvement and attainment of efficiency; and (3) ultimately transitions away from an ACO’s recent expenditures when setting  and updating the benchmark;
  • Mitigating fluctuations in aligned beneficiary populations and respecting beneficiary preferences by supplementing a prospective claims-based alignment process with a voluntary process;
  • Smoothing ACO cash flow and supporting investment in care improvement capabilities through alternative payment mechanisms.

The Next Generation ACO Model includes strong patient protections to ensure that patients have access to and receive high-quality care.  Like other Medicare ACO initiatives, this Model will be evaluated on its ability to deliver better care for individuals, better health for populations, and lower growth in expenditures.  In addition, CMS will publicly report the performance of the Next Generation ACOs on quality metrics, including patient experience ratings, on its website.

The CMS Innovation Center

The CMS Innovation Center was created by the Affordable Care Act to test innovative payment and service delivery models to reduce program expenditures while preserving or enhancing the quality of care for CMS beneficiaries.

Working in concert with the Shared Savings Program, the CMS Innovation Center is testing a number of ACO models and has sponsored learning activities that help providers form ACOs and improve their results.  More information on all of these initiatives is available on the CMS Innovation Center website at http://innovation.cms.gov.

Eligibility/Selection

CMS expects approximately 15 to 20 ACOs to participate in the Next Generation ACO Model with representation from a variety of provider organization types and geographic regions.  The Model will consist of three initial performance years and two optional one-year extensions.  Specific eligibility criteria are outlined in the Request for Applications found at the Next Generation ACO Model web page.

Application Process

For round one consideration, interested organizations must submit a Letter of Intent (LOI) no later than 11:59 p.m. EDT May 1, 2015.  Round one applications will be made available in March, 2015 and must be submitted electronically no later than 11:59 p.m. EDT June 1, 2015.  Round two Letters of Intent and applications will be made available in March, 2016.  The round two Letter of Intent must be submitted electronically no later than 11:59 p.m. EDT May 1, 2016, and the application no later than 11:59 EDT p.m. June 1, 2016.

To file an LOI and complete the online application, interested organizations may access the instructions at the Next Generation ACO Model web page.

CMS staff will review applications for the applicant organization’s ability to meet criteria identified in the solicitation.

Additional Resources

More information about the Next Generation ACO Model, including the Request for Applications, is available on the CMS Innovation Center website at the Next Generation ACO Model web page.  Any questions about the Model can be directed toNextGenerationACOModel@cms.hhs.gov.

Should the Interoperability of Health Care Records Be the Law of the Land?

Posted on I Written By

Andy Oram is an editor at O'Reilly Media, a highly respected book publisher and technology information provider. An employee of the company since 1992, Andy currently specializes in open source, software engineering, and health IT, but his editorial output has ranged from a legal guide covering intellectual property to a graphic novel about teenage hackers. His articles have appeared often on EMR & EHR and other blogs in the health IT space. Andy also writes often for O'Reilly's Radar site (http://oreilly.com/) and other publications on policy issues related to the Internet and on trends affecting technical innovation and its effects on society. Print publications where his work has appeared include The Economist, Communications of the ACM, Copyright World, the Journal of Information Technology & Politics, Vanguardia Dossier, and Internet Law and Business. Conferences where he has presented talks include O'Reilly's Open Source Convention, FISL (Brazil), FOSDEM, and DebConf.

The upcoming three days may be critical to health care in the US. Representative Michael C. Burgess (R-Texas) has introduced a bill to promote the interoperability of health care records, and is accepting comments to his office only through March 13. This bill states valuable goals, but also embodies implications we should be wary of–and some real dangers.
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Healthcare IT and EHR Jobs

Posted on March 9, 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.

It’s been a while since I features some of the healthcare IT jobs we have available on Healthcare IT Central. For those not familiar with Healthcare IT Central, it’s the leading healthcare IT Job board with well over 23,600 registered job seekers and approximately 12,000 active healthcare IT resumes in our job database. It’s a fantastic resource for human resource organizations across healthcare that are trying to fill their healthcare IT jobs. Many HR organizations in healthcare haven’t created a great ability to fill skilled EHR and healthcare IT jobs, so we’re happy to provide them a highly focused resource.

For those seeking out healthcare IT or EHR jobs, all of our services are free. You can signup up for free, upload your resume so it’s searchable by potential employers and you can search our healthcare IT jobs. We also do a weekly healthcare IT jobs newsletter.

Here’s a look at a few of the companies who have recently posted jobs along with the list of healthcare IT jobs they’ve posted:

Those are some of the really great healthcare IT companies that are hiring right now. You can search of other companies and positions. We hope this helps those employers who are searching to fill healthcare IT jobs and those professionals who are searching for the right healthcare IT position as well.

Can An EMR Focus on Patient Care in the Current Reimbursement Environment?

Posted on March 6, 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.

In response to a discussion I was part of on LinkedIn, Hirdey Bhathal, CEO of Zibdy Health, offered these interesting comments:

In your comment above you say “Doctor’s are eager to improve revenue”, “clinically based reimbursement” and “emphasizing the clinical documentation that needs to be the base line for billing”….Given that how can a EMR even try to focus on patient care? Two workflows are very different and probably mutually exclusive or very difficult to bring together with any degree of success. In a situation like that a new vendor like practice fusion or any other will be forced to comply with revenue needs otherwise no provider will adopt them. This is the first feature any EMR company sells.

Are quality patient care and quality reimbursement mutually exclusive in an EHR?

I think it’s a bit much to say that they are mutually exclusive. I think you can have both. However, I think that very few EHR vendors have both right now. Hirdey is absolutely right that no doctor would buy an EHR if they didn’t take care of the revenue needs of a practice. That is the first feature that most doctors look for when looking at EHR software.

As in most parts of life, you get what you pay for. Doctors are willing to pay for something that will increase their revenue. That’s why the EHR incentives worked so good (even if it’s fuzzy math). They saw some government money and so they adopted EHR to go after the money. I can’t remember someone ever asking if the EHR would make them more effective clinicians. I can’t remember them asking if the EHR would help them provide better patient care.

It’s kind of sad thing that are reimbursement system is so disconnected from the quality of care a doctor provides. The good news is that now that reimbursement is tackled and meaningful use is tackled, I have hope that EHR vendors will start to differentiate themselves from other EHR vendors based on their clinical abilities.

What do you think? Are we heading for a new era of EHR that’s more focused on clinical and patient outcomes and less on maximizing reimbursement? Or at least that we’ll see both?