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DrChrono and Sermo, what are you thinking?

Free, mobile ambulatory EHR developer DrChrono made a minor ripple of news this week, claiming to be the first vendor to release an EHR for the new Apple iOS 7. But that’s not why I’m writing this post. I’m calling out DrChrono co-founder and COO Daniel Kivatinos for this tweet:

I was quick to respond on Twitter.  


Indeed, the HITECH Act and Meaningful Use are about the Triple Aim of producing safer care, improving population health and lowering overall healthcare costs. The incentive money isn’t supposed to make physicians rich or even cover the cost of the typical EHR. (Yes, “free” EHRs have costs in terms of changing physician workflows and interfacing with practice management systems, and the advertising may cause patients to lose trust in their doctors, as John Lynn seems to have found with Practice Fusion.) Frankly, I don’t want to go to a doctor who views Meaningful Use as “cashing in.” That’s not “meaningful” in the spirit of the incentive program.

I’m making a big deal out of this because this is not the first time DrChrono has made misleading and hyperbolic statements. As I wrote a couple years ago, the company claimed its patient check-in app was “groundbreaking,” despite a lot of evidence to the contrary. The same post also had a video from DrChrono in which the vendor explained to physicians how they could qualify for Meaningful Use “tax breaks.” The incentive payments aren’t tax breaks. In fact, the money counts as taxable income.

The video is still up on YouTube, and it’s been viewed more than 57,000 times. That’s 57,000 times people have heard a patently false statement. DrChrono, stop misleading clients or you won’t have any clients left to mislead.

Also from the “what were they thinking?” department, physician social network Sermo marked the start of the NFL season this month with the launch of the “Pro Football Injury Challenge.” I know this because I received this e-mail:

Sermo injury challenge

Yes, I know I’m not a doctor. Sermo sent a follow-up a few days later saying that I received the invitation in error. But actual physicians still are competing against each other in kind of a fantasy football injury pool. Do you find this as tasteless as I do?

 

September 20, 2013 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Automation is good. Robocalls are bad.

I just got a robocall from my primary care physician’s office asking first if this was actually me — not that anyone would actually lie — and then if I had received a flu vaccine this season. Well, the practice itself administered the vaccine last month, so they should have known that the answer was yes. I did say yes to the interactive voice-response system and also provided the month, as asked.

I realize it is good to make sure that patients get the  recommended preventive care and that it may be impossible for staff in a small practice to call every last patient, but robocalls are awfully impersonal. If the system had actually been connected to the practice’s EHR, I wouldn’t have needed to get the call in the first place. Or maybe someone forgot to enter the vaccination into the record? In either case, the process is imperfect.

Yes, it’s a small deal, but how many imperfect processes are there in medicine? Little things have a way of adding up.

December 11, 2012 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

My first portal experience

Yes, after all these years of writing about EMRs, EHRs, PHRs, patient portals and the like, I have had my first real personal experience with a patient portal, courtesy of my internist.

He still has a small practice, with four other physicians, including one fresh out of residency. Those small practices are a dying breed, but this doctor is changing with the times, too. He recently offered a concierge option for a few hundred patients. I declined because I don’t need to reach him that urgently.

The portal has been in place for a couple of years, and I may have logged in once or twice before to set up an account, but didn’t really do anything other than look around. This time, prompted by an e-mail informing me of a new URL, I logged in and checked my medication list. I remembered that another doctor had changed the dosage of one of my medications a while back, so I fired off a secure message informing this practice of the change. (It was a new URL presumably because the EHR vendor formerly known as Sage Healthcare adopted the Vitera Healthcare Solutions name a year ago and was switching its customers to a common, white-labeled portal.)

I also looked at some of my test results from a year and a half ago just to confirm that everything was more or less OK then, though I did see one abnormality with my HDL cholesterol. I last went for a physical in March 2011, about a month after I ungracefully cut my face open on a bathtub in Orlando during HIMSS11, so I was probably due. This practice lets patients request appointments — not actually choose open slots — online, so I sent my request. Tonight, about 24 hours later, I got my confirmation, and I’ll be seeing the doc in a couple of weeks.

It’s not a perfect system, but it was convenient enough for a night owl like myself who might not remember to call during business hours to make an appointment or simply not want to wait on hold or press a bunch of buttons to navigate a telephone menu. I did not see the Blue Button option to download my record that the federal government is pushing private vendors to adopt, but I’m sure that will be there by the time the practice is ready for “meaningful use” Stage 2 in a year or two. I don’t have a PHR anyway, so I wouldn’t be able to do anything with the data other than print it.

I suppose I should set up an emergency PHR at some point, even though I doubt any hospital or specialist I might get referred to would take the time to download my data from a USB drive or log into someone else’s portal. Untethered PHRs simply don’t fit physician workflow. That might change in MU Stage 2 when providers will have to send electronic discharge statements and patient summaries during transitions of care, but I’m still not convinced a patient-controlled PHR will be the right vehicle for these data transfers.

 

October 31, 2012 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

A dubious honor from Health Wonk Review

For the very first time, I captured the top spot on the biweekly Health Wonk Review blog carnival, this time hosted by Dr. Jaan Sidorov of the Disease Management Care Blog. Unfortunately, I had to endure my dad’s untimely death after a miserable hospital experience in order to write the piece in question. But if it brings more traffic to that post and, more importantly, more awareness of multiple system atrophy (MSA) and the problem of poorly coordinated care and broken processes in hospitals, I’ll take it.

Since you’re here primarily for health IT, I’ll point you to a couple of relevant items that Sidorov summarizes. In a post actually written back in February, Martin Gaynor, chairman of the Health Care Cost Institute, discusses the organization on the Wing of Zock (the name is explained here) blog. The institute is aggregating claims information from the likes of Aetna, Humana, Kaiser Permanente, UnitedHealthcare and CMS to provide researchers with rich data sets related to healthcare costs and utilization.

“At its most basic, HCCI was formed because a better understanding of health spending can improve the quality of care and save money. If we generate information that makes a difference, then we will be a success,” Gaynor says.

Also, consultant Joanna Relth makes it known on the Healthcare Talent Transformation blog that she is no fan of ICD-10. “I’m sure that the intent of making this massive change to the codes is to improve the accuracy of diagnosis coding so providers will bill more accurately and insurance companies will pay providers and insureds in a more timely fashion. Seriously?? Did anyone ask a learning professional about how large a list is reasonable and at what point does the number of data points become impossible to follow?” she wonders in what comes off a little as an anti-government screed.

But I prefer to end this post on a happy note. In the comment section, Relth links to a video from EHR vendor Nuesoft Technologies that parodies Jay-Z’s “99 Problems.” Enjoy.

May 25, 2012 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Conference overload, meet conference overlap

Normally this time of year, I’m making plans to attend the many fall conferences in health IT and related industries. This year, my decisions are harder. You see, it seems like everyone decided to schedule their events during the last week of October:

AMIA 2011, Oct. 23-26, Washington

MGMA Annual Conference, Oct. 23-26, Las Vegas

TEDMED 2011 Oct. 25-28, San Diego

CHIME11 Fall CIO Forum, Oct. 26-28, Austin, Texas

Just for kicks, I’m scheduled to participate in the Institute for Health Technology Transformation’s Health IT Summit, Nov. 2-3 in Beverly Hills, Calif.

All are worthwhile, and all will be great places to find relevant stories for this blog and my various media clients. It probably makes most sense to go west, hitting MGMA and TEDMED, then spending the weekend in California before IHT2. But AMIA and CHIME always produce quality stories for me and supply me with leads which could pay off months later.

If you were in my shoes, which would you choose?

September 1, 2011 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

AdvancedMD sale to ADP shows new side of EMR consolidation

Here’s an interesting one from the world of mergers and acquisitions: Human resources and payroll services and firm Automatic Data Processing (ADP) announced Tuesday that it has purchased EMR and practice management systems vendor AdvancedMD for an undisclosed sum.

I’d say this is part of the expected consolidation that federally sanctioned certification was supposed to bring to the market, except that ADP’s only experience in healthcare to date has been in providing HR, payroll and benefits management services to approximately 13,500 physician practices. Those are the same types of services ADP offers to any business, so the AdvancedMD purchase represents uncharted territory for the company. ADP now bills itself as “uniquely positioned as an integrated, single-source provider of Medical Practice Optimization,” whatever that means.

Interestingly, I learned at HIMSS last week that at least a couple of new EMR vendors had spent tens thousands of dollars developing systems then getting products certified, but still hadn’t found or even looked very far for customers. They were at HIMSS to find marketing partners.

Right now, the EMR market doesn’t seem to be consolidating into the hands of a few, large vendors, but actually branching out. As of this evening, ONC’s Certified Health IT Products List includes 298 ambulatory systems and 129 inpatient products. That’s greater than 400  total, or about a third more than the last time I looked back in December. The market may actually be expanding faster than it’s consolidating. The ADP acquisition of AdvancedMD represents a different kind of consolidation, one with a company outside healthcare repositioning itself as a health IT vendor.

March 1, 2011 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.