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Docs, stop whining, start e-prescribing

The whining is getting old.

Per Surescripts, in 2012, the latest year for which statistics are available, about 69 percent of physicians nationwide used e-prescribing technology in one way or another, and 44 percent of all prescriptions written nationwide were routed electronically. (That report came out in early May 2013, so expect some new numbers soon.) Both are up substantially from the previous year, probably due in no small part to the Meaningful Use EHR incentive program, which does require a minimal level of e-prescribing.

But what about the holdouts? A recent article in the journal Perspectives in Health Information Management found that cost remains the No. 1 reason why physicians still haven’t ditched the paper prescription pad in favor of electronic prescribing.

“While e-prescribing offers many benefits, not all providers have been excited about implementing e-prescribing systems. A major barrier, reported by more than 80 percent of primary care physicians, has been lack of financial support. New technology requires training and information technology support for installation and upkeep. A practice must take these costs into account when deciding whether to implement an e-prescribing system and also when choosing a stand-alone system or one that is integrated into an EHR system. According to the Health Resources and Services Administration, in a 2007 study the total cost of implementing an e-prescribing system was found to be $42,332, with annual costs after implementation of about $14,725 per year, for a practice of 10 full-time equivalent psychiatrists,” the authors reported.

Yes, but the paper also says this: “E-prescribing improves the efficiency of the prescribing process. Though the actual entering of a new prescription takes about 20 seconds longer per patient than writing a prescription, this time is offset by the time saved because of the fact that less clarification is needed for electronic prescriptions. Prescribers spent more time on the computer, on average an extra 6 minutes per prescriber per day or an increase of 20 seconds per patient when seeing 20 patients per day. If implemented correctly, e-prescribing should cause little disruption in the workflow of ambulatory care settings.”

In other words, those resisting the switch are being penny-wise and pound-foolish.

Besides, e-prescribing systems don’t have to cost that much. In fact, they don’t have to cost anything. Allscripts offers a free, standalone e-prescribing system online, while PracticeFusion, DrChrono and Kareo have e-prescribing modules in their free EHRs. A startup named ScriptPad has an e-prescribing app for Apple iOS that’s free to prescribers; transaction fees get billed to pharmacies. I can’t vouch for the efficacy of any of this software, but cost doesn’t have to be an issue.

I think the real problem here is intransigence. Some doctors simply don’t want to get with the times, and the only losers are patients.

April 24, 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.

Back from CES, and ready to, um, laugh about digital health

I got home from the Digital Health Summit at International CES in Las Vegas late Thursday night, and have spend most of the time since them just catching up on things. Among important news I missed was that Stephen Colbert took on health apps on Wednesday, specifically Doctor on Demand. Colbert joked that the app is going to “revolutionize medicine.” (“Why waste time getting an exam when you can just shoot your doctor an emoji of your shattered femur?”)

Ah, yes, revolutionary health apps. It has to be a joke, right?

“Clearly, app-based healthcare is the future of medicine,” Colbert continued, before introducing one of his own, from “sponsor” Prescott Pharmaceuticals.

The Doctor on Demand part starts around 3:30, but the earlier part is pretty funny, too. Some might be offended by this segment.

I will have more on the Digital Health Summit on MobiHealthNews and right here on this blog later this week.

January 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.

Videocast with ATA: Mobile health predictions for 2014

A couple of weeks ago while I was in Washington for the U.S. News & World Report Hospital of Tomorrow conference, I stopped by the headquarters of the American Telemedicine Association to record a videocast with ATA CEO Jonathan Linkous. We discussed some of my predictions for 2014 in the fields of mobile health and telehealth:

  1. Imperative to cut costs will drive demand.
  2. More mental health services will be delivered remotely.
  3. Clarity from the FDA means more diagnostic apps and smartphone add-on devices.
  4. Patient engagement in Stage 2 Meaningful Use might finally make untethered PHRs and consumer-facing apps viable.
  5. Home monitoring and video chats will help prevent hospital readmissions.
  6. State licensing issues persist but some states are looking to adapt their rules to facilitate telemedicine.

I’m going to try to embed the video here. If not, here’s the ATA’s link.

 

November 15, 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.

Follow-up from ATA Fall Forum

Last week, I joined Steve Dean of Falls Church, Va.-based Inova Health System’s Inova Telemedicine Program on stage at the American Telemedicine Association’s Fall Forum in Toronto for what turned out to be a very well-received session on mobile apps and devices finding their way into clinical workflows. It was either a Letterman-style top 10, or, as Dean described it, a Siskel and Ebert-style discussion and review of 10 popular and/or interesting apps.

In one example, Dean noted that Aetna’s iTriage consumer app had been downloaded more than 9.5 million times. One audience member questioned the relevance of that number, suggesting that many people download an app, try it once and decide not to use it again. She asked if we had any actual usership statistics. I said I would contact Aetna and find out, then post the answer here on this blog.

An Aetna spokeswoman didn’t have data on the number of iTriage users, but told me that iTriage has nearly 60 million user sessions per year. (For what it’s worth, the app also passed 10 million downloads last week, she added.)

Here are our slides from that presentation. We alternated, with Dean presenting AirStrip OB, AliveCor, Asthmapolis (which changed its name last week to Propeller Health), iTriage and Welldoc. I opened discussion on DrawMD, mym3, Walgreens, Fitbit and various apps from the VA and CMS. Download ATA Fall 2013 v3.pdf

I realize context might be missing from just looking at these slides, but the ATA tells me video will soon be available online through the ATA Learning Center. (For now, access is restricted to ATA members, but the site promises non-member access “soon.”)

 

September 18, 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.

Apple highlights Skyscape, Health eVillages, other health apps

As you may know, I am on the advisory board of Health eVillages, The program got a huge honor Monday by being featured in a video shown at Apple’s World Wide Developers Conference — you know, the annual meeting that’s always a hot ticket among Mac-heads and app developers because Apple usually unveils its latest products there. (Last week was no exception. Apple CEO Tim Cook introduced iOS 7, albeit to mixed reviews.)

In the video, called, “Making a difference. One app at a time,” Apple highlighted Skyscape, the company that makes the mobile medical reference software that Health eVillages, and sent a camera crew to a Health eVillages pilot site in rural Lwala, Uganda. A nurse from the clinic showed how he visits patients by motorcycle, using an iPad to help treat and educate the area’s residents. (Skyscape parent company Physicians Interactive provides operational support to Health eVillages, and CEO Donato Trumato, also featured in the video, co-founded the program with Kerry Kennedy.)

Two of the other three apps that Apple chose to include also are related to healthcare: Galileo, an app from Orthocare Innovations that helps amputees adjust prosthetic limbs; and Proloquo2Go, a product from AssistiveWare that in the video helped an apparently autistic child learn to speak.

June 13, 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.

Urgent news from Health 2.0

SAN FRANCISCO — The Health 2.0 Conference stopped in its tracks late Monday with this stunning news: fictional EHR vendor Extormity has agreed to acquire every one of the hot, buzzworthy, break-the-mold, think-outside-the-box, too-cool-for-school (and smarter than you because they live in Silicon Valley, went to MIT and/or once knew a guy who worked at Google) app developers showcasing their “solutions”* and explaining why a killer UX in a 99-cent app is the key to all that ails the $2.5 trillion healthcare industry.

From the horse’s mouth:

Extormity announces plans to acquire every application developer at Health 2.0

The Health 2.0 conference currently under way in San Francisco features hundreds of developers, health IT firms and device companies demonstrating innovative applications designed to improve clinical outcomes, reduce medical costs and revolutionize healthcare delivery.

“It would take a dedicated team of talented professionals months to sift through all these disruptive innovators to determine who has the next killer app capable of interrupting the significant revenues we realize from maintaining the status quo,” said Extormity CEO Brantley Whittington from his yacht moored in the San Francisco Bay. “It’s more expedient for us to simply acquire every start-up, playing the role of angel investor sent to answer the capital formation prayers of each young entrepreneur wearing premium denim and a sport coat.”

“Acquired organizations become part of our strategic portfolio and are assigned to our innovations business unit, the division where new ideas fester,” added Whittington. “Developers from digested companies are housed in a bullpen where they engage in a never-ending code-a-thon that breeds fierce competition, resentment and angst – as you might imagine, turnover is epidemic.”

“Meanwhile, the principals who come on board join the Extormity think tank where they are paid handsomely as they wait for their options to vest.”

Extormity personnel will be stationed in each breakout session room with agreements and checks.

 

About Extormity

Extormity is an electronic health records mega-corporation dedicated to offering highly proprietary, difficult to customize and prohibitively expensive healthcare IT solutions. Our flagship product, the Extormity EMR Software Suite, was recently voted “Most Complex” by readers of a leading healthcare industry publication. Learn more at www.extormity.com

 

Enjoy your new-found wealth!

* Marketingspeak for “vaporware.”

October 9, 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.

Podcast: This time, I’m the interviewee

In a rare turn of events, I’m the one being asked the questions on a podcast by Sivad Business Solutions, which hosts regular audio discussions on a variety of business topics. I give kind of a high-level view of health IT and offer my very strong opinions on patient safety and healthcare reform. There’s an interesting discussion about EHRs being designed to maximize reimbursements rather than assure safety.

Interestingly, we recorded this via Skype. I like the audio quality, if not the nasal quality of my own voice, more than usual that day.

Hopefully the embedded audio works. If not, click here.

September 18, 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.

Health Wonk Review, unadorned but chock full of health IT

In the latest edition of Health Wonk Review, hosted by Chris Fleming on the estimable Health Affairs blog, there’s not much in the way of a fun theme, but that’s OK. It’s still full of some good perspectives, including more than the usual share of health IT.

My post that aggregated a bunch of tweets from the Health 2.0 Conference made the biweekly blog carnival, as did a much longer-form way of covering the event, David Harlow’s series of video interviews. Harlow got 18 different people on camera, including HHS gurus Todd Park and Dr. Farzad Mostashari.

Elsewhere, patient advocate Jessie Gruman,  president and founder of the Center for Advancing Health, took on mobile apps as a means of changing patient behavior, Tom Lynch of the Workers’ Comp Insider blog discussed predictive modeling in healthcare claims administration and Healthcare Economist blog author Jason Shafrin wonders why patients don’t seem to care much about healthcare quality.

In particular, I invite you to share Shafrin’s short post, if for nothing more than a conversation starter.

October 13, 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.