Broader Approach Urged for Evaluating Financial Performance of Employed Physicians

(Nov. 21, 2014, Westchester, Ill.) – Current approaches to measuring the financial performance of employed physicians can obscure the value that employed physicians bring to an organization, according to new research released today by the Healthcare Financial Management Association (HFMA).

Based on productivity alone, fewer than 25 percent of senior financial executives surveyed expected to see a positive return on investment during the first two years of physician employment, a finding that researchers described as “not surprising” in light of current payment methodologies and productivity decreases that often occur when physicians move into an employment setting. However, instead of using “loss per physician” as a financial metric, researchers say, a health system should fully account for the value that employed physicians bring to the system. That is, looking at the system as a whole, management should determine an acceptable level of expense to generate sufficient revenues to maintain the system’s financial health and invest in physician financial support accordingly.

“It’s vital to ensure that the contributions of physicians are accurately valued and described,” said HFMA president and CEO Joseph J. Fifer, FHFMA, CPA. “Physician commitment to care transformation is critical to an organization’s success in making the transition to a value-based health system.”

The report was issued against a backdrop of continued growth in physician employment by hospitals and health systems, with 64 percent of hospital- and health system-based senior financial executives surveyed pursuing a physician employment strategy. The report also addresses clinically integrated networks and accountable care organizations as viable alternatives to physician employment for those providers seeking greater alignment.

Fundamental elements of a physician strategy identified and addressed in depth in the 24-page report include the following:

  • Determining the best alignment opportunities for physician practices in a particular market
  • Building a sufficient primary care base to support specialty services
  • Communicating the need for flexibility and change in physician compensation agreements
  • Developing physician leadership and governance structures

The research findings are detailed in Strategies for Physician Engagement and Alignment, based on quantitative and qualitative research conducted by HFMA in March 2014. Of 118 responses to the survey of senior financial executives, 55 percent represented stand-alone hospitals and 45 percent represented health systems. Site visits and interviews also were conducted with five hospitals, health systems, and medical groups.

To download the full report, visit hfma.org/valueproject.

About HFMA
With more than 40,000 members, the Healthcare Financial Management Association (HFMA) is the nation’s premier membership organization for healthcare finance leaders. HFMA builds and supports coalitions with other healthcare associations and industry groups to achieve consensus on solutions for the challenges the U.S. healthcare system faces today. Working with a broad cross-section of stakeholders, HFMA identifies gaps throughout the healthcare delivery system and bridges them through the establishment and sharing of knowledge and best practices. We help healthcare stakeholders achieve optimal results by creating and providing education, analysis, and practical tools and solutions. Our mission is to lead the financial management of health care. hfma.org

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When Would It Make Sense to Share Your Healthcare Data Findings?

During a recent visit with Stoltenberg Consulting, we had a really interesting discussion about the future of innovation in healthcare. I think we all saw the potential that healthcare data findings can do to improve healthcare. I believe we’re sitting on top of amazing untapped potential in healthcare data that’s going to start being mined over the next few years.

With this in mind, I asked the questions, “Will hospitals and health systems share their data findings? How will we share the data findings?

I think these are extremely important questions as we enter the new world of healthcare discovery and I don’t think the old methods of published journal articles is going to get us to where we want to go. Think about how hard it is to go through the process of getting a journal article published and then the time it takes for the journal article to diffuse through the healthcare system.

Many people fear that health systems won’t want to share their healthcare data findings thanks to competitive concerns. While this may be true in some specific cases, I’ve found the opposite to be the case in healthcare organizations. When they find something that benefits their patients or health system, they are happy to share it with everyone. I think it’s something about the nature of healthcare that makes us want to improve the lives of everyone versus bowing to competitive pressures.

While I think that many want to share their healthcare data findings, the reality is that most of the healthcare data findings aren’t shared. I think that many health systems discover something in their data, but they don’t have an easy way to share it with the broader healthcare community. The choice isn’t to deliberately not share the findings, but they don’t have the time to share it.

We need to find a way to solve this problem. I think social media will play one small part in this type of sharing, but it’s only one element. We need a platform in healthcare that simplifies the sharing of healthcare data discoveries. If it’s not dead simple for a healthcare professional to share their discoveries, it doesn’t make sense for them to do it.

Given the lack of a healthcare discovery platform, this presents a great opportunity for companies like the aforementioned Stoltenberg Consulting to package up these discoveries in easier to consume packages. I’m not sure that this is a terrible model either.

In a simplistic view, one hospital could share their health data discoveries online and another hospital could replicate it. However, the process is rarely that simple and often requires a bit more work to make the results a reality. This is where it makes sense for an outside company to bring the full package of services and software to make the discovery a simple reality for a hospital. The hospitals I know often want to buy the full stack solution. They don’t have the bandwidth to recreate the solution themselves.

Regardless of how it happens, I hope we can find better ways to diffuse healthcare innovations and discoveries across all of healthcare.

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Google’s Efforts in Healthcare

I thought it would be interesting to take a quick look at what Google is currently doing in healthcare. While Google Health was shut down a long time ago, Google still has an amazing interesting in health and healthcare. Actually, I’m not sure how much Google cares about healthcare, but the Google Founders do seem to care. I call it the Tech Geeks Got Old Effect (ie. They get old and have money they need to spend. So, they spend the money to try and prolong their life.)

By far, the biggest project that Google has announced in healthcare is Calico. They even have a website for the project. However, the website really doesn’t say much. Luckily, the wikipedia page offers a bit more info:

Calico is an independent R&D biotech company established in 2013 by Google Inc. whose goal is to tackle the process of aging. More specifically, Calico’s plan is to use advanced technology to increase understanding of the biology that controls lifespan, and to use that knowledge to increase longevity. The company is led by founder & CEO Arthur D. Levinson, who is the current chairman of Apple Inc. as well as the former chairman of Genentech and was on the board of directors of Hoffmann-La Roche. The name Calico is shorthand for California Life Company. Arthur Levinson had posted he and four others were principal in Calico on Google+. Those four people mentioned were: Robert Cohen, Hal V. Barron, David Botstein and Cynthia Kenyon. Three of the four named are or were previously affiliated with Genentech.

In Google’s 2013 Founders’ Letter, Larry Page described Calico as a company focused on “health, wellbeing and longevity.”

The thing I like most about Calico is that it seems like they understand the need to mix scientists, programmers, medically trained personnel, and more in order to solve many of the really challenging problems we face in healthcare. We’d love to think that one programmer in a garage at a computer could solve things, but my guess is that the next big change in healthcare will come from a scientist, programmer, data scientist and medical professional in a garage. I guess Calico doesn’t have the garage, but I like the cross disciplinary approach to the problems.

I’m hopeful they’re successful in their mission since I’m getting old as well. I think their goals are quite ambitious and so I think they’ll likely fail in the stated goals, but still do some amazing good along the way. That’s fine. I have a feeling that’s why Calico’s goals are so ambitious.

The other major project that Google’s doing in the healthcare space is Google Fit. I was and am still skeptical of Apple Health and it’s possible impact on healthcare. I’d say the same things about Google Fit. I’m not suggesting that either will be a massive flop. I think they’ll gain some traction and provide some benefit to a few people. However, I don’t see Google Fit as the transformative platform that Google and Apple want their solutions to be. Healthcare is much more complex than they realize and I don’t think either company wants to dive deep enough into healthcare to really make a massive change in how we view healthcare.

The #1 Google product for healthcare is actually something we probably take for granted. That’s the Google search results themselves. I know my wife has turned to Dr. Google plenty of times when her, my children or myself come down with something. Is this right or wrong? It doesn’t really matter. It’s just the reality. The quality of Google’s health search results could have as big of an impact on healthcare as almost any other healthcare company. That’s a really big deal and something that Google probably doesn’t even realize.

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Epic Salary Info

Many of you probably remember that we helped promote an Epic Salary Survey. As promised, they’ve published the results of the survey and we thought that many readers would be interested in the Epic Salary survey results.

The survey had 753 responses. Not bad for an online survey that was promoted across various blogs and social media outlets. Although, as you can imagine, some states are better represented than others. It’s the challenge of having 50 states.

This is my favorite chart from the Epic salary survey results (you can download the full survey results and data by states here):
Average Epic Salary by Job Position

As I look at some of these salaries, I’m reminded of the doctor who said that they shouldn’t be spending time learning their EHR. The hospital CFO then told the doctor, “I’m sorry, but that Epic consultant costs a lot more than you.”

Now I’d like to see one from Meditech and Cerner.

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ONC Welcomes 2 New Members to their Office of Communications and Public Affairs

ONC Acting National Coordinator Lisa Lewis about two new hires at ONC’s Office of Communications and Public Affairs.  Here’s her letter to the ONC team:

Team –

We have two new members on the ONC Team. Chartese Day and Amanda Woodhead started with ONC on Monday, November 17th. Chartese and Amanda bring a wealth of knowledge and experience to the Office of Public Affairs and Communications (see bios below). We are very excited to have them on the team! Both of their offices are in HHH 729D. Please stop by and say hello as schedules allow.

Also, let’s extend our thanks to Peter Ashkenaz for serving as the acting OPAC Director for the last few months. Peter, you are greatly appreciated!

Sincerely, Lisa

*************************************

Chartése Day

Chartése joined ONC on Monday, November 17th as the new Director of the Office of Public Affairs and Communications (OPAC). Prior to ONC, Chartése spent more than a decade as a senior strategist at top international public relations firms leading award-winning programs and campaigns for Fortune 500 companies, major healthcare trade associations and non-profit groups. Chartése has deep expertise in public health awareness and education campaign programming, stakeholder engagement, regulatory communications, issues management, crisis and litigation communications and multicultural outreach. Chartése’s specific therapeutic area and category experience includes implementation of the Affordable Care Act (ACA), infectious disease, cardiovascular, pain management, respiratory, women’s health, mental health and food and nutrition. Her past clients have included Universal Health Services, CareFirst, Kaiser Permanente, Pharmaceutical Research and Manufacturers of America, American Nurse Credentialing Center, Wal-Mart, Merck, Pfizer, and  Johnson & Johnson among others.

A native of Washington, D.C., Chartése began her career as an aide for the Honorable Eleanor Holmes Norton, District of Columbia Delegate to the U.S. House of Representatives.

Chartése earned a Masters of Business Administration from the University of Maryland and a Bachelors of International Business from George Mason University.

Amanda Woodhead

Amanda Woodhead joined ONC on Monday, November 17th as the Stakeholder Engagement Lead in OPAC.  Amanda comes to ONC following six years at health IT vendor, Emdeon. While there, she led corporate communications and media efforts including traditional, tradeshow, social media and crisis communications as well as industry relations and executive events. She previously served as a public relations manager at Windsor Health Group, a senior publicist for Harper Collins/Thomas Nelson publishers and a public affairs officer for the U.S. Naval Hospital, Okinawa, Japan.

Amanda holds a BA in Journalism from Mississippi University for Women and a MS in International Relations from Troy State University. She is an active volunteer with the Leukemia and Lymphoma Society in honor of her father, a multiple myeloma survivor. In 2012, she participated in the Washington DC area Man and Woman of the Year campaign to benefit LLS and was awarded the community involvement award for outstanding community outreach. She lives in Arlington with her spouse and 8 year old daughter and spends most weekends (in the fall at least) watching SEC football and cheering on the Mississippi State Bulldogs!

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The most news I’ve ever gotten out of Meditech

If you think Epic Systems, which doesn’t issue press releases and infrequently shares much with the press, is tough for the media, you should try Meditech. I’ve never gotten a response from anyone there and never written any actual news about the company. Until now.

Today, this tweet appeared:

 

So there you have it: Meditech is at a conference in Ireland today. That’s the most news I’ve ever had on that EHR vendor.

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John Glaser to Stay on as Senior VP of Cerner Upon Close of Acquisition

In case you’re living under a rock (or more affectionately, you’re too busy working to follow the inside baseball of EHR company acquisition), Cerner is set to acquire Siemens in late winter or early spring pending all the needed approvals for companies this size. Watching the merging of these two companies is going to be very interesting indeed.

Neil Versel just reported that John Glaser, current CEO of Siemens Health Services, has announced that upon close of acquisition he’ll be joining the Cerner team as a Senior VP. I also love that John Glaser made this announcement on the Cerner blog.

I think this is a big deal since I believe John Glaser is at the point in his career that he could do just about anything (or nothing) if that’s what he desired. The few times I’ve interacted with John Glaser, he was sincerely interested in moving healthcare forward through the use of advanced IT. I imagine that’s what’s motivating him to stay with Cerner. No doubt, Cerner is sitting on a huge opportunity.

In John Glaser’s blog post, he provided an interesting insight into Neal Patterson’s comments at the Cerner user conference:

In his CHC keynote address, Cerner CEO Neal Patterson did a masterful job of conveying Cerner’s commitment to patient-centered care. Before he spoke, a patient and her nurse were introduced with explanation that the woman’s life was saved by a Cerner sepsis alerting system. Neal then shared the incredible challenges he and his wife have faced in her battle with cancer because of limited interoperability.

Neal’s keynote was very personal – about how we can make a loved one’s care journey easier by ensuring that all records – every detail – are available electronically and accurately wherever the patient receives care. It was the case for interoperability but also the case for making a patient’s life easier and the care better.

It’s hard for me to say how much of this was theatrics, but I’m glad they are at least talking the right talk. I really do hope that Neal’s personal experience will drive interoperability forward. Neil Versel suggested that interoperability would be John Glaser’s focus at Cerner. I hope he’s successful.

While at CHIME, I talked with Judy Faulkner, CEO of Epic, and we talked briefly about interoperability. At one point in our conversation I asked Judy, “Do you know the opportunity that you have available to you?” She looked at me with a bit of a blank stare (admittedly we were both getting our lunch). I then said, “You are big enough and have enough clout that you (Epic) could set the standard for interoperability and the masses would follow.” I’m not sure she’s processed this opportunity, but it’s a huge one that they have yet to capitalize on for the benefit of healthcare as we know it.

The same opportunity is available for Cerner as well. I really hope that both companies embrace open data, open APIs, and interoperability in a big way. Both have stated their interest in these areas, but I’d like to see a little less talk…a lot more action. They’re both well positioned to be able to make interoperability a reality. They just need to understand what that really means and go to work on it.

I’m hopeful that both companies are making progress on this. Having John Glaser focused on it should help that as well. The key will be that both companies have to realize that interoperability is what’s best for healthcare in general and in the end that will be what’s best for their customers as well.

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Glaser to focus on interoperability as Cerner SVP

A big question surrounding Cerner’s $1.3 billion acquisition of Siemens Health Services has been answered: John Glaser, head of the health IT division of Siemens AG, will join Cerner as a senior vice president, concentrating on  “driving technology and product strategies, interoperability and government policy development,” according to a post on the Cerner blog.

Glaser wrote about his experience at the recent Cerner Health Conference in Kansas City, Mo. “For me, the conference, its energy and vision of patient-centered care and health, cemented my decision to become part of the Cerner organization once the transition is effective,” he said.

“At CHC, the message that resounded most clearly was, “It’s all about the patient.” When our industry talks about the HITECH Act, the drive toward electronic health records (EHR), and about greater efficiency and effectiveness, it’s usually from the perspective of helping the clinician and the organization. But, in the end, those clinicians, those organizations and those of us in the industry, know that it is about the patient,” Glaser continued [emphasis in original].

As Cerner President Zane Burke told me a few weeks ago, the acquisition is still on track to close in late winter or early spring. Still unknown is the fate of other Siemens Health Services executives and thousands of employees.

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Virtual Care Provider Zipnosis Secures Capital Investment from Arthur Ventures

Partnership will Help Accelerate New Market Growth for SaaS Company

Minneapolis, MN (Nov. 18, 2014) – Arthur Ventures, a venture capital firm focused on software companies in the healthcare market, has invested in the seed round for SaaS start-up, Zipnosis, a simple-to-use online diagnosis and treatment option for minor health conditions (www.zipnosis.com).

Minneapolis-based Zipnosis partners with health systems across the country to power virtual care services that are white labeled. By connecting patients and local clinicians online, Zipnosis makes mainstream medicine not only affordable, but easily accessible to anyone with a web-enabled device.

According to new research by Deloitte, 75 million “virtual” doctor visits, or 1 in 6 will occur this year alone. Revenue in the telehealth services industry is expected to increase by an annualized 30.7 percent to $320.2 million in the next five years, including revenue growth of 23.1 percent in 2014, according to a new report from market researcher IBISWorld.

“We recognize the increasing role telehealth will play in improving the country’s existing healthcare landscape,” said James Burgum, managing partner of Arthur Ventures. “Arthur Ventures invests in businesses that help solve clearly defined problems by leveraging the power of technology as a business amplifier and accelerator. We believe Zipnosis is making it easier and faster to connect for care—impacting healthcare delivery in our country by improving access and increasing clinical capacity.”

“Arthur Ventures’ investment will help accelerate our exponential, organic growth over the next two years,” said Zipnosis Co-Founder and CEO Jonathan Pearce.  “Their experience growing massively successful software companies provides Zipnosis with key strategic guidance through this exciting phase of our company.”

Through the Zipnosis platform, patients can receive prompt, high-quality care for common medical conditions such as sinus infections, female bladder infections, pink eye, or cold, cough and flu through via mobile phone, computer and tablet—all for a flat-rate $25-$35 service fee payable by a credit card or health savings card.

The company’s asynchronous model ensures adherence to evidence-based medicine, while guiding connections between clinicians and patients. The platform is incredibly efficient, leading clinicians to provide diagnosis and treatment for common ailments in less than two minutes a visit.  Additionally, the platform attracts new patients to a health system, building an incremental revenue stream for hospitals without adding additional clinical headcount.

About Zipnosis:

As one of the nation’s leading virtual care providers, Minneapolis-based Zipnosis is defining digital medicine, providing virtual care for common medical conditions from the convenience of a web-enabled device. Founded in 2008, the company is continuing to improve patient care one click at a time by making it easy for patients and providers to connect online. Whether through Zipnosis.com or its white label product offered by hospital and clinic partners around the country, users can be diagnosed, treated and triaged if necessary, to the appropriate level of care—receiving infallible care in a manner that is most convenient to them. Zipnosis’ asynchronous model ensures compliance to the evidence-based clinical guidelines by more than 70 percent for many of the conditions it treats. Find out more about Zipnosis, at www.zipnosis.com, Facebook.com/Zipnosis, and Twitter.com/Zipnosis.

About Arthur Ventures:

Founded in 2008, Arthur Ventures is a venture capital firm focused on early-stage software companies. The firm has offices in Fargo, North Dakota and Minneapolis, Minnesota.  Additional information on Arthur Ventures can be found at www.arthurventures.com.

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Do Hospitals Want Interoperability?

I’ve had this discussion come up over and over again today in a series of discussions that I’ve had at the NYeC’s Digital Health Conference in NYC. Many people are blaming the EHR vendors for not being interoperable. Other people are blaming standards. Some like to blame HIPAA (which is ironic since it was passed to make health data portable). There are many more reasons that people give for why healthcare isn’t exchanging data and that interoperability isn’t a reality.

Although, in all of these discussions, I keep going back to the core question of whether hospitals and healthcare organizations really want that healthcare data to be interoperable. As I look back on the past, I can think of some doctors who’ve wanted it for a while, but I think the healthcare industry as a whole didn’t really want interoperability to happen. They would never admit this in public, because we all know on face that there are benefits to the healthcare system and the patient for interoperability. However, interoperability would have been a bad thing financially for many healthcare organizations.

It’s one of the dirty little secrets of healthcare. Sure, the EHR vendors never provided the interoperability functionality, but that’s largely because the healthcare providers never asked for it and largely didn’t want that functionality. They were all a little complicit in hiding the dirty little secret that healthcare organizations were benefiting from the inefficiency of the system.

I’m extremely hopeful that we’re starting to see a shift away from the above approach. I think the wheels are turning where hospitals are starting to see why their organization is going to need to be interoperable or their reimbursement will be affected. ACOs are leading this charge as the hospitals are going to need the data from other providers in order to improve the care they provide and lower costs.

Now, I think the biggest barrier to interoperability for most hospitals is figuring out the right way to approach it. Will their EHR vendor handle it? Do they need to create their own solution? Are CCD’s enough? Should they use Direct? Should they use a local HIE? Should they do a private HIE? Of course, this doesn’t even talk about the complexities of the hospital system and outside providers. Plus, there’s no one catch all answer.

I hope that we’re entering a new era of healthcare interoperability. I certainly think we’re heading in that direction. What are you seeing in your organizations?

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