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Video: Farzad Mostashari on patient engagement, ‘physician ACOs’

As I alluded to earlier, I was leaving the press room one afternoon at HIMSS14, and there I see former national health IT coordinator Dr. Farzad Mostashari hanging around Gregg Masters and Dr. Pat Salber of Health Innovation Media. It turns out, Masters and Salber had just pulled Mostashari aside to do an interview on video, but they didn’t have anyone to interview him on camera, so they asked me right there on the spot to be the interviewer. Here is the result.

Mostashari, now a visiting fellow at the Engelberg Center for Health Care Reform at the Brookings Institute in Washington, discussed how the years of searching for a business model to coordinate care and engage patients is finally starting to pay off. Always the champion of the little guy in healthcare, Mostashari also brought up the notion of physician-led ACOs, or, as he called it, the “Davids going up against the Goliaths.”

 

I had pretty much no preparation for this interview. It probably shows. I still think it worked out well.

Here’s a link to Salber’s post about the interview because I don’t want to steal page views. :)

March 14, 2014 I Written By

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

All my HIMSS coverage in one place

The last of my 10 MedCity News stories from HIMSS14 has been posted. It’s a nice mix of news, features, analysis and commentary. Here are links to all of them, in chronological order.
NantHealth launches Clinical Operating System – biggest of big data startups – with $1B (Feb. 25)

Body + biology + behavior: Intel exec explains how technology is making N=1 care possible (Feb. 26)

Tavenner: 2014 is your last chance for a hardship exemption for Meaningful Use 2 (Feb. 27)

HIMSS crowd skeptical of promise for flexibility on MU2 hardship requests (Feb. 27)

Google Glass startup expecting third healthcare client in less than 6 months (Feb. 27)

DeSalvo: True EHR interoperability – and a national HIE – is possible by 2017 (Feb. 28)

DeSalvo meets and greets – briefly – while Tavenner keeps her distance at HIMSS (March 3)

HIMSS Intelligent Hospital tracks patients, pills and clinicians in completely connected loop (March 5)

Interoperability Showcase uses car crash to show how connected data really can improve patient care (March 5)

Athenahealth’s first inpatient product isn’t quite an EHR, but a ‘Trojan horse’ into hospitals (March 10)

 

March 12, 2014 I Written By

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

CMS clarifies MU2 hardship exemptions

As I reported for MedCity News at HIMSS14 nearly two weeks ago, CMS Administrator Marilyn Tavenner announced plans to provide unspecified flexibility in claims for Meaningful Use Stage 2 hardship exemptions this year. Tavenner then left without speaking to the media.

The news left a lot of people scratching their heads and waiting for some details. Today, CMS issued some clarification, confirming that there would be exemptions for healthcare providers unable to have EHRs certified to 2014 standards in place for the 2014 reporting year. This is particularly important now because Medicare penalties for not achieving Meaningful Use take effect next year, but they are based on the 2014 reporting year (Oct. 1, 2013-Sept. 30, 2014 for hospitals, the 2014 calendar year for physicians and other individual “eligible providers.”)

The guidance confirms that CMS is aware of the problems caused by the slow pace of certification to the new, 2014 standards that Stage 2 requires. As of today, according to the ONC Certified Health IT Products List (CHPL), there are 3,736 ambulatory and 1,200 EHRs and EHR modules certified to 2011 standards, but just 899 total that meet 2014 certification.

Here’s the one-page CMS guidance for hospitals/critical access hospitals and the one for eligible providers.

March 11, 2014 I Written By

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

Health Wonk Review, post-HIMSS

While all the health IT reporters like myself were in Florida last week for HIMSS14, plenty of other things were going on in healthcare. David Harlow of HealthBlawg has a roundup of opinions in the latest edition of Health Wonk Review, entitled “In Like a Lion.”

Yes, HIMSS was a big deal, even for non-IT people, as I captured the top mention in a HWR for, I believe, the very first time, with my podcast interview with HIMSS President and CEO Steve Lieber.

(David, per your note, I only suffered superficial injuries this year, with a couple of scrapes on my face. No stitches needed, and no deaths in my family, though my uncle did lose his mother-in-law the day after I returned. I also broke a wine glass in a restaurant, though it was not my glass, it was empty and I was sober. The moral of this story: I need to avoid HIMSS in Orlando, which will be hard, since it’s on a three-year rotation. But next year, the conference is right here in Chicago, and it will be April 12-16 to avoid the dead of winter. The last time it was here, in 2009, I had bronchitis all week. Good times! The following HIMSS will be in Las Vegas, Feb. 29-March 4, 2016.)

Because it was HIMSS week, Harlow featured other IT posts prominently, including one from Lygeia Ricciardi and Adam Dole of the ONC—new national health IT coordinator Dr. Karen DeSalvo said they’re trying to call it “the ONC” instead of just “ONC” these days—about the recently launched Blue Button Connector. Harlow, an attorney, also referenced one of his own posts about HIPAA compliance audits.

Another section of this HWR examines something that I’ve been saying for a long time, that the mainstream media has been not telling the whole story about the Affordable Care Act, a.k.a., Obamacare. Later, Harlow talks about teamwork and collaboration for the purpose of patient safety. Kudos for highlighting those areas.

Click here to read Harlow’s rundown.

March 3, 2014 I Written By

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

HIMSS gossip

ORLANDO, Fla.—Two days of HIMSS14 have come and gone, and I’m not bouncing off the walls just yet. But I did bounce off the pavement Monday night when I tripped exiting a shuttle bus, and have some facial scrapes to show for it. You will see the evidence whenever Health Innovation Media gets around to posting a video interview I conducted Tuesday afternoon.

Health Innovation Media’s Gregg Masters and Dr. Pat Salber have been camped out near the HIMSS press room since Sunday with their video equipment, querying various newsmakers on various health IT topics, and occasionally having guest interviewers. As I walked out of the press room on my way to the exhibit hall, I said hello to former national health IT coordinator Dr. Farzad Mostashari, who looked like he was just hanging around, but was actually waiting to be interviewed. Masters and Salber asked me if I’d be interested in interviewing Mostashari right there on the spot with no preparation, and with just 15 minutes to get down to the show floor.

If you recall, I did a live interview—yes, streamed live on the Web—last year with Athenahealth honcho Jonathan Bush, beers in hand, for the Health Innovation Broadcast Consortium that Masters and Salber were involved in. (I don’t know the status of that project, as there’s nothing new on that site since last July.) So of course I said yes, and I think it went pretty well. Well, there were a couple of hiccups, as in me thinking we needed to wrap up earlier than we actually had to. And then there’s this:

 

Followed by this:

 

Yes, the Twitterverse catches everything.

Now about that facial injury. I think I just need to avoid Orlando. In 2011, the last time HIMSS met here, I needed six stitches above my right eye after I banged my face against the edge of the bathtub in my hotel room. As I arrived for the 2008 conference here, I turned on my phone after landing and got the message that my grandfather had passed away. Just for good measure, I passed through Orlando on my way back from Europe in 2009. As the flight pulled to the gate, the skies opened up with a violent summer thunderstorm, prompting the airport to close the ramp, preventing the ground crew from unloading bags for nearly an hour. I was stuck in the no-man’s land of U.S. Customs for that whole time, where cell phones are prohibited. It was not until I cleared security, took the airport tram to a different terminal, then hustled to the gate that I knew I would make my connecting flight. So yeah, it’s become a pattern.

Anyway, speaking of Jonathan Bush, he is not at HIMSS14 because he is on sabbatical to write a book and who knows what else? Well, here’s a clue. He was spotted at the Winter Olympics in Sochi, Russia, last week with his more famous brother, Billy, host of “Access Hollywood.” (Hat tip to HIStalk for showing this video at HIStalkapalooza Monday night.)

I also heard that Bush is considering a run for political office of some kind, perhaps because it’s, you know, the family business. Anyone care to confirm this?

I do know for a fact that at least one HIMSS attendee is actually seeking office. That would be Dr. Steven Daviss, CMIO of startup M3 Information, maker of a mental health screening app called My M3. Daviss is running for Democratic Central Committee in Baltimore this year. If he wins, he plans on seeking a seat in the Maryland House of Delegates in 2018, in part because he says there is only one other physician among the state legislature.

Daviss himself is on sabbatical from his job as chairman of psychiatry at the University of Maryland’s Baltimore Washington Medical Center in Glen Burnie, Md.

February 25, 2014 I Written By

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

Podcast: HIMSS CEO Steve Lieber, 2014 edition

It’s time for my annual podcast interview with HIMSS President and CEO Steve Lieber, this time from the Orange County Convention Center in Orlando, Fla., on the day before the official opening of the 2014 HIMSS Conference, rather than in his Chicago office a week or so in advance.

Lieber reiterated HIMSS’ position that the federal government should extend the attestation period for Meaningful Use Stage 2 by one year. I wasn’t there, but today at the CIO Forum, one of the preconference educational symposia, ONC Chief Medical Officer Jacob Reider, M.D., hinted that there will be an announcement on Stage 2 flexibility, possibly Thursday morning at a joint ONC-CMS town hall. That session will feature CMS Administrator Marilyn Tavenner and new national health IT coordinator Karen DeSalvo, M.D. I’ve never heard either of them speak, and now I’m excited to be covering that session.

We also discussed other aspects of healthcare reform, trends in health IT and expectations for HIMSS14. Of note, on Monday morning, HIMSS and two other organizations will announce a new initiative on “personal connected health.”

Near the end, I reference the podcast I did last week with Dr. Ray Dorsey about remote care for Parkinson’s patients. For easy reference, here’s the link.

This is, I believe, the seventh consecutive year I have done a podcast with Lieber at or just before the annual HIMSS conference. Another interview that has become somewhat of a tradition won’t happen this time, as Athenahealth CEO Jonathan Bush is not making the trip to Orlando this year.

 

Podcast details: Interview with HIMSS President and CEO Steve Lieber, Feb. 23, 2014, at HIMSS14 in Orlando, Fla. MP3, stereo, 128 kbps, 36.2 MB. Running time 39:35.

0:40 “It’s time to execute.”
1:40 Challenges for small hospitals and small practices
3:10 New ONC EHR certification proposal and continued questions about Meaningful Use Stage 2
5:00 Prioritizing with multiple healthcare reform initiatives underway, including proposed SGR repeal
6:30 Surviving ICD-10 transition
7:35 HIMSS’ position on MU2 timelines
9:05 Remember “macro objective” of Meaningful Use
10:00 Letter to HHS from organizations not including HIMSS calling for what he says are “very vague” changes to MU2 criteria
11:40 Things in MU2 causing providers fits
13:05 Fewer EHR vendors certified for 2014, but more HIMSS exhibitors
15:00 What this means for providers who bought products certified to 2011 standards
17:20 Progress on Meaningful Use so far
21:00 Looking toward Stage 3
22:42 What healthcare.gov struggles might mean for health IT
25:35 Other aspects of the Affordable Care Act being lost in the public debate
27:10 Political considerations related to health IT
29:40 Patient engagement and new HIMSS exhibitors
32:20 Why healthcare spending and provider shortage forecasts don’t account for efficiency gains made from technology and innovation
35:10 Demographic challenges for healthcare
35:45 Shift from hospitals to ambulatory and home care and consolidation of provider organizations

February 23, 2014 I Written By

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

Breaking: ONC releases proposed 2015 EHR certification criteria

If you want something buried, release it late on a Friday so it doesn’t hit people’s desks until Monday morning. If you really want something buried in health IT, put it out there late on the Friday before the annual HIMSS conference because nobody will get any real work done for another week.

I’m not sure if ONC is trying to hide anything, or just wanted to get this done before all its top people head to Orlando, Fla., for HIMSS14, but this afternoon, the office issued proposed criteria for the 2015 edition of EHR certification. This is the first time certification criteria haven’t accompanied Meaningful Use standards, which means ONC wants to tighten certification requirements in the midst of Meaningful Use Stage 2, rather than waiting for Stage 3, which won’t start before 2017.

However, the plan is to make the proposed 2015 standards voluntary; vendors would be just fine with 2014 certification and providers would not have to upgrade their systems to achieve or maintain Stage 2 Meaningful Use, according to ONC.

ONC says the proposal will officially appear in the Federal Register on Wednesday, triggering a 60-day comment period that will run through April 28. Expect a final rule this summer.

UPDATE, 5:11 pm CST:  It appears that they’re just happy to have it done and to be able to talk it up. In fact, ONC’s Steven Posnack seems downright giddy.

 

Also, self-described HIT standards geek Keith Boone is reading through the whole thing and posting real-time updates on his observations.


 

February 21, 2014 I Written By

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

Happy birthday, HITECH, and pre-HIMSS humor

Today is the fifth anniversary of the American Reinvestment and Recovery Act being signed into law, which also means today is the fifth anniversary of the Health Information Technology for Economic and Clinical Health (HITECH) Act, which was rolled into the $831 billion stimulus bill. HITECH introduced “meaningful use” into the lexicon, and for that, it has had a lasting effect.

Through the end of 2013, the program had paid out more than $19 billion in Medicare and Medicaid incentives for EHR usage, and healthcare is still a mess. However, all of that money is for Stage 1, and the goal for the first stage was mostly to get technology in place. Stage 2, which is just getting started, is about interoperability and data capture, while Stage 3, which will not start before 2017, will be focused on actually improving outcomes. It is not until the third stage where we are supposed to see real gains in healthcare quality, though we should start seeing some efficiency improvements in Stage 2.

Penalties for not achieving Meaningful Use kick in next year, though that could change. According to Medscape, the new bill to repeal the much-reviled Medicare sustainable growth rate calls for bringing Meaningful Use, the Physician Quality Reporting System (PQRS) and Medicare’s value-based payment modifier under a proposed new program called the Merit-Based Incentive Payment System (MIPS). This program would eliminate Meaningful Use penalties after 2017, but would base incentives and penalties on more factors than just EHR usage.

On a lighter note, MMRGlobal, the controversial PHR vendor that has been aggressive in defending its many patents but that also has, like every other vendor of untethered PHRs, had trouble landing many customers, has signed on actress and cancer survivor Fran Drescher as a spokesperson. There’s a video on the company’s Facebook page, with a teaser to “Watch For MMRGlobal on TV!” Draw your own conclusions.

On an even lighter note, digital media producer Gregg Masters has started the #HIMSSPickupLines hashtag on Twitter. A few samples:

 


 

Have fun.

February 17, 2014 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 HIMSS agenda

After a couple of weeks of uncertainty, I now know I will be covering HIMSS for MedCity News. A lot of vendors and PR firms have of course pitched me for meetings, and the reality is, I’ve not always found vendor meetings all that interesting. In fact, the absolute worst thing about the annual HIMSS conference—and I’ve covered every one since 2002—is the few weeks beforehand, when I’m trying to juggle my schedule.

I have occasionally double-booked or simply forgotten to enter appointments into my calendar, but these things do happen when you are juggling dozens if not hundreds of e-mails, you don’t have a secretary and, oh, by the way, have regular work to do a the same time. Sometimes I’ve scrambled to change appointments up to the moment I get on the plane. It’s just a mess most of the time because of the sheer volume of requests and the need to fit it into my normal routine. (Interestingly, and scarily, it’s similar to how healthcare often operates, and mistakes made in healthcare can be deadly.)

The bottom line is, there are more than 1,200 vendors at HIMSS these days, and there is one of me. I can maybe meet with 10-12 of them over the five days of HIMSS, counting Sunday and Thursday, and most of the vendors have gone home by Wednesday evening. One thing a I’ve found is that lot of vendors don’t understand that there are also more than 300 educational sessions to choose from; HIMSS doesn’t just happen in the zoo known as the exhibit hall. I tend to find a lot of great stories from those sessions, so I make them a priority.

Anyway, I have about 10 stories to do for MedCity News during and immediately after HIMSS, and some have fairly specific requirements. (I also have to find time to, you know, write the stories. Sometimes, it’s a trade-off between covering a session/meeting with a vendor and doing my work. Doing the work necessarily wins. Two years ago in Las Vegas, I had to cancel two or three vendor meetings after CMS and ONC dropped the proposed Meaningful Use Stage 2 rules during a town hall-style session. If you recall, the thousands of people trying to download the proposal all but crashed the public Wi-Fi network at the Venetian.)

Two stories are about companies I discover at the new Startup Showcase. If you’re among the startups on display there, let me know. I’ve got one story to do on the Intelligent Hospital Pavilion and another on the Interoperability Showcase. I’ll probably just spend an hour or so walking through and asking questions, but if you’re there and think you have a compelling angle for me, I’m listening.

That’s four stories right there. Three more are from coverage of specific sessions, so those are already booked. I’ve also got three opinion/analysis pieces to write in the week after the fact, and I’m pretty flexible on those. I’m just going to see what I discover and what jumps out at me. A theme usually emerges by the second day.

Away from the madness, I will be at the fifth annual New Media Meetup on Tuesday evening, Feb. 25, hosted by the one and only John Lynn, who also hosts this very blog as part of the Healthcare Scene network. It’s free, but there is limited space, so you do need to preregister.

I will see you in Orlando in a little more than a week.

 

February 14, 2014 I Written By

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