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Allscripts to Pay $100 Million Cash to Acquire Practice Fusion

Posted on January 8, 2018 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.

Today, Allscripts announced that it would pay $100 million cash to acquire EHR vendor, Practice Fusion. I wouldn’t quite say this is a fire sale, but in Silicon Valley it’s pretty close when you consider that according to CrunchBase Practice Fusion had raised over $157 million. These seem to be the kind of transactions that Allscripts likes to do. I’ve heard it said that Allscripts is the place where EHR software goes to die. That’s a corrupt way of describing what I think has been their strategy.

The press release said that Practice Fusion supports 30,000 ambulatory practices and 5 million patients. I wouldn’t be surprised if the practices number is inflated since it’s a free EHR and a lot of ambulatory practices signed up to check it out, but don’t actually use the software. I’m at least 2-3 of those practices and haven’t touched my accounts in years. The July 2017 meaningful use attestation data listed 8,440 providers using Practice Fusion software. So, Practice Fusion still has a good size user base, but it’s probably closer to 12-15k practices in my opinion.

As I’ve looked at the ambulatory EHR market, I’ve often been describing EHR vendors as distribution channels as opposed to EHR software vendors. If you go around any exhibit hall, EHR vendors aren’t really selling EHR software much anymore. In most cases, EHR vendors are catering to their existing user base and then using them as a distribution channel for other products and services. With this in mind, Allscripts acquisition of Practice Fusion expands their distribution channel. That’s a valuable thing.

One other piece of this transaction which I believe many won’t understand is Practice Fusion’s relationships with life science organizations. Those relationships are how Practice Fusion was funding their free EHR. I’ve heard mixed reviews on those relationships, but no doubt Allscripts is hoping those relationships can generate more revenue for their company when they add Allscript’s large userbase.

Fierce Healthcare also found in the SEC filing for this acquisition an interesting note about Practice Fusion receiving a request from the US Attorney’s office:

The SEC filing also noted that Practice Fusion received a request from the U.S. Attorney’s Office for the District of Vermont in March 2017 requesting information and documents as part of a civil investigation into the company’s EHR certification. Allscripts stated that although Practice Fusion has complied in “a cooperative, thorough and timely manner,” any legal proceedings, damages or settlements could “adversely impact” future operating results.

No doubt these requests are an extension of the $155 million eCW Whistleblower lawsuit. I expect most major EHR vendors have had some sort of inquiry after the eCW lawsuit. Hopefully, the team at Allscripts vetted the inquiries well especially given Practice Fusion’s past history of pushing the envelope. Considering Practice Fusion’s FTC Charges and Settlement, I’d think that they’d have been careful about their EHR certification, but it’s hard to take the Silicon Valley mentality out of your culture.

The other obvious tie into this story is Allscript’s previous acquisition of McKesson’s HIT software business. I’ll admit that it’s hard for me to keep up with all the EHR software that exists under Allscripts umbrella, but with the addition of Practice Fusion, Allscripts certainly has an EHR software for healthcare organizations of every shape and size. Plus, I expect they run their EHR businesses at break even while they make most of their money off of other lines of business they can sell to their EHR customers. It’s not just Allscripts that’s seen how much money can be made doing revenue cycle management and providing other services to their EHR users.

I will be interested to see what Allscripts chooses to do with Practice Fusion long term. Will they eventually sunset the Practice Fusion EHR and encourage users to migrate to one of their other EHR? Will they start charging Practice Fusion EHR users for the EHR? You can imagine the outrage that would come if they did start charging, but EHR switching isn’t a simple process. So, I’d imagine that many practices would just start paying and it would take months and years for them to finally switch EHR vendors and many would probably just decide to stay with “the devil they know.” That would be a big gamble on the part of Allscripts, so it will be interesting to see if they make it. Then again, maybe they have enough revenue from being a distribution channel to Practice Fusion users that they’ll be able to continue the free EHR model. Time will tell.

Those are some initial thoughts on the acquisition of Practice Fusion by Allscripts. I should also note that the acquisition isn’t complete. It still has to go through the standard ant-trust evaluation process, but I don’t expect that to be an issue. What do you think of this acquisition? Is this a good move by Allscripts? What does this mean for Practice Fusion users?

An EHR Designed for Doctors at the Anti-Aging World Congress

Posted on December 19, 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.

I recently attended the Med Tech Impact Expo and Conference in Las Vegas. The event was colocated with the A4M (American Academy of Anti-Aging Medicine) World Congress. I was a judge at the Quadruple Impact startup competition that was organized by Medstro where I enjoyed hearing a number of promising startup companies pitch their ideas. They were all pretty early stage, but I couldn’t help but appreciate their passion and creativity.

While not my normal area of expertise, I had to take a trip around the Anti-Aging medicine exhibit hall. There were a large number of pharmaceuticals, neutraceuticals, body toners, etc etc. However, I was of course attracted to the booths that talked about technology.

The first category of company I saw was the practice marketing companies. Most of them were offering the full service soup to nuts offering to these medical practices. It makes a lot of sense for them to target this market since many of the doctors attending the anti-aging conference offer a lot of products and services direct to consumer. So, all of the direct to consumer marketing, SEO, social media, etc can be really effective for these practices. Of course, at this show they mostly send their salespeople, so they didn’t really want to talk with me much since I wasn’t representing a medical practice.

The second category of technology companies I found was the EHR vendors. I think I found 3 of them placed throughout the floor and I stopped and talked with 2 of the companies. Both of them focused solely on this market and so their approach was quite different. They designed the EHR to cater to the doctor and the practice instead of EHR certification and meaningful use regulations.

One of them talked about how they approached the sale of supplies much differently than a traditional EHR might do. In fact, it was an integral part of their system. This made a lot of sense since many of these medical practices have a huge retail sales component.

I did find that each of these EHR was still straddling the billing line. Many of them had practices that still needed to bill insurance companies rather than billing the patient directly for everything. At least one of them admitted that their insurance billing engine wasn’t that great and you could tell that they were a little bit torn on whether they should go all in on the insurance billing side of things or not.

In fact, one of them I talked to was pondering whether to go after EHR certification. I advised them to not do it since it will likely alienate their existing users. Although, I’m sure they’ll look at their addressable market and the potential medical market and be really tempted to not listen to my advice. It’s a powerful thing to say that you have an EHR that’s focused on the doctor and the practice as opposed to regulations. Why would they want to give that up?

I asked to get a full demo of their EHR after the conference. There wasn’t enough time at the event. Once I do, I’ll give you a full report on these hidden EHR. I’ll be interested to see what an EHR that was designed for the doctor and the practice looks like. I’ll let you know what I find.

MIPS Twitter Roundup – MACRA Monday

Posted on December 11, 2017 I Written By

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

This post is part of the MACRA Monday series of blog posts where we dive into the details of the MACRA Quality Payment Program (QPP) and related topics.

As we near the end of 2017, I found a number of tweets from CMS and other people that I thought would be useful to those that are interested in MACRA and MIPS.

First up is this tweet from CMS that it’s not too late to still participate in MIPS and collect some performance data before the end of 2017. This is them promoting the Test Option which would allow you to avoid the 4% penalty:

Next up is a fact sheet from CMS which outlines the different between 2017 and 2018 when it comes to MACRA/MIPS. I particularly like page 6 of the document. As you go through it, you’ll realize why 2018 is going to be much harder than 2017.

Next up is a stat from MGMA. I’d be interested in learning about the 14% of practices that think that their value-based reimbursement is going to decrease. Are these people going to direct primary care? I don’t see it going down for almost anyone. What do you think?

Finally, Matt Fisher asks a question about whether MIPS should be voluntary. I don’t think they can make it any more voluntary given the current legislation and do any of us think that congress is going to take up this topic? I don’t. So, it’s kind of a moot point. However, there is a lot of doctor angst about MIPS/MACRA. I just don’t see enough of it to really move the needle on things. I think we’re stuck with MACRA/MIPS for the forseeable future.

MIPS Penalties Include Medicare Part B Drugs – MACRA Monday

Posted on November 13, 2017 I Written By

This post is part of the MACRA Monday series of blog posts where we dive into the details of the MACRA Quality Payment Program (QPP) and related topics.

I’m sure most regular readers can tell that we’re pretty worn out and tired of MACRA, MIPS, and related government regulation. No doubt you’ll see us posting fewer MACRA Mondays going forward, but we’ll still try to cover major MACRA events as they occur. We just won’t be publishing MACRA Monday every Monday like we’ve been doing.

Jim Tate recently posted about the Real MIPS Timeline which included:

  • Phase 1 – Denial
  • Phase 2 – Shock/Anger
  • Phase 3 – Acceptance

You should read his full writeup, but he’s right. There’s a lot of denial that’s going to lead to shock and anger until the majority of healthcare have to finally accept that MIPS and MACA aren’t going anywhere.

Jim Tate also wrote another important piece related to the MIPS penalties and Medicare Part B drugs. You can read the full details of the change, but for those too lazy to click over, here’s the summary:

  • Many organizations argued that Medicare Part B Drug Costs Shouldn’t be Included in the MIPS Penalties (I mean…payment adjustments)
  • The MACRA Final rule still includes Medicare Part B drug costs (for the majority of people) in the MIPS reimbursement and eligibility calculations

If you’re a practice with a high volume of part B drugs, you better start figuring out your MIPS strategy now! Otherwise, that payment adjustment is going to hit pretty hard.

Thanks Jim for the great insights into MACRA and MIPS. If you need help with MIPS, be sure to check out Jim’s company MIPS Consulting.

MACRA Twitter Roundup – MACRA Monday

Posted on October 30, 2017 I Written By

This post is part of the MACRA Monday series of blog posts where we dive into the details of the MACRA Quality Payment Program (QPP) and related topics.

We took last week off from our MACRA Monday series of blog posts. It seems like we’re in a kind of lull period for the program. Either you’ve started collecting the data you’ve needed or you haven’t. Plus, we’re kind of waiting for the next MACRA Final rule to drop for more details.

With that in mind, I did want to see what some of the latest things that were being shared on Twitter when it comes to MACRA. I found a lot of strong opinions about the program, some good resources, and some forward-looking thoughts on what could be coming in the next MACRA final rule.


It’s hard to argue with John. Not just because he’s a smart guy, but because he’s right that it’s hard to imagine a path forward that’s fee for service and doesn’t include a shift to value based care in some form or fashion. At least given the current market dynamics.


This caution from Workflow Chuck should have us all nervous about the shift. I see a lot of healthcare organizations going after the target as opposed to the goal of value based care.


MACRA is going to impact your biz. I liked the way Kelly broke it out into 4 areas. No doubt some of these things could be argued both ways.


This is still how most doctors I know feel about MACRA and even meaningful use before it. They feel like they’ve been thrown under the bus.

Here are two forward looking resources that look at what we might get from the MACRA Final Rule:

What else are you hearing about MACRA? Would love to hear your thoughts, insights, questions, perspectives, rants, etc in the comments.

Optimizing Your EHR for MIPS and Other Quality Payment Programs – MACRA Monday

Posted on October 9, 2017 I Written By

The following is a guest blog post by Meena Ande currently acts as Director of Implementation for Advantum Health. This post is part of the MACRA Monday series of blog posts where we dive into the details of the MACRA Quality Payment Program (QPP) and related topics.

As quality reporting requirements ramp up under value-based payment programs like MIPS, healthcare organizations are busy retrofitting their EHRs to make way for new measures. In some settings, not much has changed by way of tech utilization since initial EHR investments were made. Many outpatient settings still lack the internal expertise needed to optimize their implementations.

The truth is many EHRs have the functionality providers need for quality reporting, but many providers don’t know that due to limited exposure to the system. Couple that stunted tech knowledge with the well documented lack of familiarity with MACRA and the recent rise of the service model in healthcare is no surprise. Many practice administrators are relying on their EHR vendor or engaging outside experts to help lead the charge on system reconfiguration to meet Quality Payment Program demands.

There are several EMR capabilities providers can take advantage of to support QPP reporting efforts. Here are a few tips to keep in mind as you customize your EHR for MIPS and other value-based models.

Don’t boil the ocean when selecting CQMs.

Most EHRs give the option of tracking more than what is required for quality reporting. Initially, track applicable measures that exceed reporting requirements. After three to four weeks you’ll know which are your strong areas. Pick the best of the litter and proceed.

Providers can be overwhelmed by too many measures, particularly in multi-specialty practice settings. While it can be difficult to find overlap in measures between specialties, taking advantage of shared metrics whenever possible can reduce reporting burdens. Sit down as early as possible and develop an EHR configuration that works for your practice’s various clinicians.

Case in Point:

A gastroenterologist and a cardiologist may work in the same multi-specialty organization and on the same EHR, but the clinical quality measures they care about differ. There is no reason to give the gastroenterologist access to the cardiology problem list in the EHR. Specialty views improve ease-of-use and support more complete documentation.

Most EHRs offer role-based and specialty-based customization. Administrators can enable or disable EHR features related to some quality measures at the practice level and sometimes at the individual provider level. Clinical quality measures are based on details about the patient, but what is captured at each point of care should be tailored to the specific provider role.

Consider the roles impacted by different CQMs.

Keep the role of the person who may be responsible for different quality measures and Advancing Care Information workflows in mind when selecting and carving out space for CQMs in your EHR. Select measures that spread reporting work across multiple roles to relieve clinicians of unnecessary burdens.         

Case in Point:

The insurance eligibility verification required under Meaningful Use is managed by the front office. Front-office staff members should be made aware of the processes they need to complete before a patient checks in, and where to document that task in the EHR.

Control what is included in MIPS denominators.

Like Meaningful Use, patient encounter volume is important under MIPS. The size of the patient pool under any given quality measure directly impacts your adherence percentage. While most primary care encounters do meet patient visit requirements under MACRA, that is not always the case in specialty settings. Clinicians can exercise some control in determining what is included in patient denominators when reporting under MIPS.

Case in point:

Some primary care visits can be omitted. Let’s say a two-physician practice sees 50 patients a day. Only 15 of those patients might be seen by a physician. The rest of the patients may be there for a simple procedure like a blood pressure screening, stress test, or echocardiogram, where quality reporting elements are not verified. Such visits should be excluded.

Evaluate your reporting paths.

MIPS offers both EHR-based and registry-based reporting paths. Most specialties can submit CQM data via their EHR while others will have to rely on paid registry reporting. Additional reporting options might include submitting through associations that member clinicians are affiliated with, or through registries created by large hospital affiliates to help related providers.

Another hurdle for clinicians is deciding whether to submit data as a group or independently. Groups interested in participating in MIPS via the CMS web interface or administering the CAHPS for MIPS survey had until June 30, 2017, to register. Beyond that, clinicians have until the March 31, 2018, MIPS submission deadline to decide whether to report independently or as a group.

Case in point:

Big groups with different levels of EHR proficiency among providers may be better suited reporting at an individual level. Individual reporting takes more time for attestation, but the advantage is that higher-performing clinicians can avoid a penalty if the group doesn’t collectively meet reporting criteria.

Each month, sample 10 percent of EHR CQM data, including instances where criteria have been met and where it has not. Catch outliers with trouble following through on processes and extend targeted training to the team members bringing numbers down.

Conclusion

Optimizing the EHR and other tech resources providers have in place can be a huge MIPS enablement factor. Up-front customization work helps providers meet reporting requirements and save time over the long run. EHR optimization also enables future value-based care initiatives and lays the groundwork for population health management programs. Gains made in EHR use benefit the life of the practice through increased efficiency and, at the end of the day, better patient care.

About Meena Ande
Meena Ande currently acts as Director of Implementation for Advantum Health where she manages Implementation of services along with EHR optimization, with emphasis on workflow management for value-based reporting.

MACRA Preparation, Are You Ready? – MACRA Monday

Posted on October 2, 2017 I Written By

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

This post is part of the MACRA Monday series of blog posts where we dive into the details of the MACRA Quality Payment Program (QPP) and related topics.

I’ll admit that the timing of this week’s MACRA Monday is a bit rough for me given the tragedy that’s occurred in my town, Las Vegas. Instead of dwelling on the tragedy and the person who could do such an awful thing, it’s been amazing even in these early hours to see how many people in Las Vegas and around the world want to and are supporting the victims of this tragedy.

We heard that there was a need for blood and thought we could help. Turns out that hundreds of others had the same idea and the blood banks have their schedules full through Wednesday. We’ll go after that to replenish the blood banks that no doubt will take a while to replenish their supply.

Thanks to everyone on Facebook, Twitter, and other social media that have reached out to myself and the rest of us that live in Las Vegas. We’re in a bit of shock and it doesn’t feel real.

To keep with our tradition of MACRA Monday, I thought I could at least share this infographic from Integra Connect on how prepared specialty practices are for MACRA:

No doubt there are a lot of healthcare organizations that aren’t ready for MACRA and they are confused on how they should be ready. Hopefully, those who have read our weekly MACRA Monday posts feel better prepared than most. MACRA is upon us whether you’re ready or not. However, MACRA certainly seems much less important on this day of mourning in Las Vegas.

On this tragic day, it’s worth noting all the incredible stories I’ve heard about Las Vegas healthcare professionals that were prepared and ready for a tragedy like this. I read stories of UMC, a major Las Vegas hospital that was so full of victims that they asked to stop bringing people to UMC that didn’t have life-threatening injuries. I read of EMS people who were at home and went into the danger to help transport victims. No doubt there will be hundreds of other stories of heroism by healthcare professionals. Many that likely won’t be heard or seen, but saved people’s lives. We thank them for their preparation, care, and work that no doubt has saved hundreds of people’s lives.

A big thank you from Vegas to each of you for all of your support.

New EHR Certification Rules Including Self-Declaration – MACRA Monday

Posted on September 25, 2017 I Written By

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

This post is part of the MACRA Monday series of blog posts where we dive into the details of the MACRA Quality Payment Program (QPP) and related topics.

Elise Sweeney Anthony and Steven Posnack recently announced on the ONC Health IT Blog two major changes to the EHR certification program. In some ways, it shows a maturity of the EHR certification program, but in other ways, it’s ONC kind of taking a more hands off approach to EHR certification.

Here are the two big changes they made:

  1. Approving more than 50% of test procedures to be self-declaration; and
  2. Exercising discretion for randomized surveillance of certified health IT products.

The first one is really fascinating since they’re making 30 out of the 55 certification criteria as “self-declaration only.” That basically means that EHR vendors will just have to claim they meet the requirements. The ONC-ACBs won’t be certifying those 30 test procedures. In many ways, it reminds me of the meaningful use self-attestation. Does that mean that ONC-ACBs will cut their costs in half? Don’t be holding your breath on that one.

Let’s just hope that most EHR vendors don’t self-certify the way eCW approached EHR certification. Although, the eCW EHR certification issues are the perfect example of why a company self certifying their EHR software or the ONC-ACB certifying the EHR software is just about the same. I haven’t seen which test procedures will be self-declared, but my guess is that it was the ones that the ONC-ACBs weren’t really doing much to test and certify anyway. Ideally, this will free up the ONC-ACBs to dive deeper into the 25 test procedures they’ll still complete so they can avoid another eCW like incident.

Some might wonder why we don’t just take the self-declared EHR certification tests altogether if there’s no one that’s going to be checking them. What those people miss is that the self-declaration still keeps the EHR vendors on the hook for properly implementing the EHR certification criteria. If it’s discovered that they claimed to be compliant but aren’t, then the government can go after the EHR vendor for false claims.

The second change has me a little more puzzled. I’m not sure why they would want to release ONC-ACBs from the requirement to randomly audit EHR certifications. Maybe they didn’t discover any issues during their random audits and so they didn’t see a need to continue them. Or maybe the ONC-ACBs said they were going to pull out as certifying bodies if the government didn’t lighten the EHR Certification load. This is all conjecture, but they could be some of the reasons why ONC decided to make this change. They did offer the following insight into their reasoning:

This exercise of enforcement discretion will permit ONC-ACBs to prioritize complaint driven, or reactive, surveillance and allow them to devote their resources to certifying health IT to the 2015 Edition.

I wonder how many complaints the ONC-ACBs have gotten about the EHR software they’ve certified. Have they just been so overwhelmed with complaints that they need more time to deal with those complaints and so audits aren’t needed? I’d be surprised if this was the case. At this point I imagine most people with EHR certification issues will be calling the whistle blower attorneys, but I could be wrong.

All in all, I don’t think these EHR certification changes are a huge deal. It’s largely a maturing of the EHR certification program and does little to help the EHR certification burden on software vendors. Maybe the ONC-ACBs will charge a little less for their certification, but that’s always been a negligible cost compared to the development costs to become a certified EHR. I’m sure the ONC-ACBs are happy with these changes though.

What do you think of these changes? Any other impacts I haven’t described above that we should consider?

Mental Health EMRs And MIPS – MACRA Monday

Posted on September 18, 2017 I Written By

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

This post is part of the MACRA Monday series of blog posts where we dive into the details of the MACRA Quality Payment Program (QPP) and related topics.

Recently, I began researching the mental health EMR market on behalf of a client. I had expected to find it dwindling as a) the big EMR players have always insisted that an all-purpose EMR could be adapted to serve mental health providers effectively and b) more importantly because mental health professionals weren’t eligible for Meaningful Use payments, which presumably made them lousy sales targets for vendors.

However, my research concluded that there’s roughly a dozen mental health EMRs out there and kicking and that at least two large medical EMR vendors had bought into the mental health technology niche. (Allscripts bought a stake in NetSmart Technologies last year, and Cerner acquired Anasazi outright in 2012). With their investments, the two vendors effectively admitted that supporting mental health providers wasn’t as easy as they’d suggested.

Now, with MIPS imposing new demands on clinicians, mental health providers are likely to expect even more from mental health IT vendors, said Bob Ring, a consultant with Mica Information Systems.

Right now, few mental health EMRs defining themselves as “therapy specific” are CEHRT technology, which could become an issue if MDs on staff in a mental health setting want to meet MIPS requirements, Ring notes.

Under MIPS, psychiatrists must provide a wide range of mental health-specific data, some of which calls for specialty-related technology. For example, one category under the Clinical Practice Improvement Activity Performance Category calls for enhancements to an EMR to capture added data on behavioral health populations and use that data for additional decision-making.

But uncertified EMRs are likely to stay that way, Ring says. “Because these therapy-specific [EMRs] are generally priced very low, and it is expensive to go through the ONC certification process, it’s questionable whether many of them ever will be,” he concludes.

Not only that, things could get even trickier for both mental health clinicians and mental health EMR vendors in the future, if CMS follows through on its threat to hold therapists to the same standards as MDs beginning in 2019.

This could create chaos, however, according to my colleague John Lynn, who contends that putting mental health therapy EMRs under MIPS would be “a disaster.” Instead, mental health should not piggyback MU or MIPS, but instead, focus on incentives for mental health focused EHR incentives.

“The relationship between a mental health provider and a client is totally different than the relationship between a medical provider and their patient,” said John, whose first EMR implementation came when he rolled out a medical EMR in a health and counseling center. “Their methods of documentation are different. Their methods of billing are different. Their approach to care is different. We made it work, but it took a lot of duct tape and jerry rigging to fit it in.”

Xerox Files Patents For Blockchain-Based Tech With Healthcare Applications

Posted on September 5, 2017 I Written By

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

According to a site focused on blockchain technology, Xerox has filed patents for technology using blockchain to securely revise electronic documents. The patent application was filed in February of last year, but the move became news this month when it was reported by Coin Telegraph.

According to the site, the patent filings propose a network of nodes that can create and update documents and share data using blockchain technology. The system can be used by regional hospital organizations to exchange electronic health records, Xerox says in its application.

In a more-recent blog post, Xerox India’s director of global document outsourcing, Ritesh Gandotra, asserts that the use of blockchain can offer unique benefits.

“Historically, EHRs were never really designed to manage multi-institutional and lifetime medical records,” he writes. “…Adopting the blockchain structure to EHRs will help manage authentication, confidentiality, accountability and data sharing while allowing medical researchers to access insights into medical treatment.”

Xerox is hardly the first organization to take an interest in blockchain’s potential as a backbone for health data management. Not only that, but leaders in the industry are developing what look like practical models for using blockchain in this manner.

For example, my colleague John Lynn recently shared an infographic outlining a use case for blockchain in healthcare. You’ll probably learn more by clicking through and looking at the infographic yourself, but in summary, the model outlines a process in which:

  • Health organizations direct administrative information to the blockchain via APIs and track clinical data in parallel using existing health IT
  • The blockchain stores each transaction with a unique identifier
  • When they need information, healthcare organizations query the blockchain
  • Patients share their identity with healthcare organizations, using a private key that links their identity to blockchain data

Not only that, high-profile industry thinkers like John Halamka, MD, CIO at Beth Israel Deaconess Medical Center, have developed their own models for the use of blockchain in healthcare. (In a Harvard Business Review article, Dr. Halamka describes a system for managing EHRs using blockchain which he and his co-authors call “MedRec.”)

What’s striking here is that while Xerox may have filed some patent applications, it probably doesn’t know anything we don’t. The applications it describes for blockchain in healthcare document management certainly sound fine, and may be the basis for something great in the future.

If you look around the web, however, you’ll see that virtually anyone with an interest in health IT is out there making predictions about its applications for healthcare. What will really be interesting is when we get beyond ideas — as intriguing as they can be — and pilot some real, concrete technology.

In the meantime, let the blockchain games continue. Obviously, Xerox won’t be the last company angling for a piece of this market. There’s little doubt it will come to something eventually, and the rewards will be great for the company that helps to shape its future.