Will Health Systems Own Healthcare?

In all of my many conversations this past week, there was an underlying understanding that health systems are getting bigger and bigger. The trends of hospitals acquiring other hospitals is having a major impact on healthcare. Hospitals acquiring ambulatory clinics is probably having an even bigger impact.

As I ponder on this trend, I really can’t imagine a way that we return to the previous status quo. Certainly some doctors will tire of being employed by health systems, but I’m sad to say that once they’re ready to leave they may not find many doors available for them to take.

Aside from a limited number of direct primary care doctors in affluent areas, I believe it’s going to become extremely difficult for a doctor to leave a health system. In some areas, this is already the case. However, value based reimbursement is going to make this an impossibility for many.

I don’t think we know all the unintended consequences of this change in healthcare. As a capitalist, I love economies of scale and you can see how healthcare could benefit from some of these economies. However, what isn’t clear to me is that health systems do a great job capitalizing on economies of scale. In fact, I bet if you studied it you’d probably find that small physician practices run much cheaper than a large health system. If someone knows of a study that looks at this, I’d love to see it.

I do think that some specialists are bonding together in some areas to create super groups in order to combat this trend. In many ways they essentially create a monopoly of sorts around a certain specialty physician service in a local area. I’ll be interested to see how this plays out. Might be a short term win, but I’m not sure they can survive long term.

I’m still chewing on all the ways that we’ll benefit and suffer in a health system owned healthcare system. I’d love to hear your thoughts in the comments on these trends and the impact for good and bad of these changes.

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Where Are All the Doctors at HIMSS15?

As I think about the past week in Chicago at HIMSS 2015, I’m wondering where all of the doctors are at HIMSS. Yes, I know there are actually quite a few doctors at HIMSS, but the vast majority of them are now administrators or are working for vendors. There are very few practicing doctors at HIMSS. It’s really quite unfortunate, because their voice is so important to everything that we’re doing.

I know why many doctors don’t go to HIMSS. I’ve seen multiple times where a practicing doctor comes to HIMSS and they’re overwhelmed by the disconnect between what’s being spouted by vendors and what they’re experiencing in their daily work. Most of them say, “I’m never coming back.” It’s really sad for me when this happens, but it also provides us with an opportunity to keep what’s said at HIMSS in perspective.

I wish that HIMSS would work to resolve this problem since having many practicing doctors at HIMSS would really elevate the quality of the conference. I realize that it’s hard to get a busy doctor to leave for a few days where they’re not making any money. However, with some effort and creativity they could make it a reality.

For example, they could create some sort of physician scholarship program that would help encourage more doctors to come. They could reach out to the doctors in the local area to get them to come and participate in the event. They could offer a number of quality CME options since we know that doctors need CMEs.

HIMSS has a ton of value for a large number of groups. In fact, many people have argued that HIMSS has grown so large that it needs to be divided into a number of different conferences. I don’t share that view since I like the mixing of various parts of healthcare, but HIMSS has become pretty unwieldy. As I said to someone today, I just had to let go and ride the wave. It made for a great ride. I just wonder if the ride would have been even better with more physician participants.

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CMS Releases First Ever Hospital Compare Star Ratings

Comparison Ratings that Help Consumers Compare and Choose Among Hospitals

Today, the Centers for Medicare & Medicaid Services (CMS) for the first time introduced star ratings on Hospital Compare, the agency’s public information website, to make it easier for consumers to choose a hospital and understand the quality of care they deliver. Today’s announcement builds on a larger effort across HHS to build a health care system that delivers better care, spends health care dollars more wisely, and results in healthier people.

The Hospital Compare star ratings relate to patients’ experience of care at almost 3,500 Medicare-certified acute care hospitals. The ratings are based on data from the Hospital Consumer Assessment of Healthcare Providers and Systems Survey (HCAHPS) measures that are included in Hospital Compare. HCAHPS has been in use since 2006 to measure patients’ perspectives of hospital care, and includes topics like:

•           How well nurses and doctors communicated with patients

•           How responsive hospital staff were to patient needs

•           How clean and quiet hospital environments were

•           How well patients were prepared for post-hospital settings

“The patient experience Star Ratings will make it easier for consumers to use the information on the Hospital Compare website and spotlight excellence in health care quality,” said Dr. Patrick Conway, Acting Principal Deputy Administrator for CMS and Deputy Administrator for Innovation and Quality. “These star ratings also encourage hospitals and clinicians to strive to continuously improve the patient experience and quality of care delivered to all patients.”

The Hospital Compare ratings are just one example of how CMS is committed to helping consumers make informed health care decisions. The Nursing Home Compare site already uses star ratings to help consumers compare nursing homes and choose one based on quality. Physician Compare has started to include star ratings in certain situations for physician group practices, and CMS recently added star ratings to the Dialysis Facility Compare site to help to make data on dialysis centers easier to understand and use. Star ratings are planned for Home Health Compare later this year.

These ratings continue to move the health care system toward the Affordable Care Act call for transparent, easily understood and widely available public reporting. They also are a part of the Obama Administration’s Digital Government Strategy by providing content in customer-centric ways.

Consumers will now see 12 HCAHPS Star Ratings on Hospital Compare, one for each of the 11 publicly reported HCAHPS measures, plus a summary star rating that combines or rolls up all the HCAHPS Star Ratings. These star ratings will be updated each quarter.

For more information on today’s announcement, please visit here:


For more information about the HCAHPS Survey please visit the official HCAHPS On-Line Web site, here:  www.HCAHPSonline.org.

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IBM Acquires Explorys to Accelerate Cognitive Insights for Health and Wellness

Armonk, NY and Cleveland – 13 April 2015: IBM (NYSE: IBM) today announced it has acquired Explorys, a healthcare intelligence cloud company that has built one of the largest clinical data sets in the world, representing more than 50 million lives. The acquisition strengthens IBM’s leadership position in healthcare analytics and cloud computing, and will help bolster its ability to extract and share deep insights to improve wellness and benefit patients.

Since its spin-off from the Cleveland Clinic in 2009, Explorys has secured a robust healthcare database derived from numerous and diverse financial, operational and medical record systems comprising 315 billion longitudinal data points across the continuum of care. This powerful body of insight will help fuel IBM Watson Health Cloud, a new open platform that allows information to be securely de-identified, shared and combined with a dynamic and constantly growing aggregated view of clinical, health and social research data.

Explorys provides secure cloud-based solutions for clinical integration, at-risk population management, cost of care measurement, and pay-for-performance. Headquartered in Cleveland, Explorys clients include some of the most prominent healthcare systems in the United States, together accounting for over $69 billion in care, 360 hospitals and more than 317,000 providers. Explorys’ HIPAA-enabled cloud-computing platform is used by 26 healthcare systems and clinically integrated networks to identify patterns in diseases, treatments and outcomes. Its network includes Cleveland Clinic, Trinity Health, St. Joseph Health System, Mercy Health, Adventist Health System and many others with patients across the country. Market intelligence firm IDC just named Explorys global leader in Healthcare Clinical and Financial Analysis.

“As healthcare providers, health plans and life sciences companies face a deluge of data, they need a secure, reliable and dynamic way to share that data for new insight to deliver quality, effective healthcare for the individual,” said Mike Rhodin, senior vice president, IBM Watson. “To address this opportunity, IBM is building a holistic platform to enable the aggregation and discovery of health data to share it with those who can make a difference. With Explorys, IBM will accelerate the delivery of IBM Health Cloud and IBM Watson cognitive solutions to model and apply medical evidence and large scale analytics to data.”

“Every encounter that a patient has across the continuum of care spins off a meaningful piece of data that can help tell the whole story about an individual’s health to improve the quality and effectiveness of their care,” said Stephen McHale, CEO and co-founder, Explorys. “Information is changing the way care is delivered and paid for. The combination of Explorys technology with IBM’s powerful Health Cloud and Watson cognitive capabilities will expand the reach of health insights so that Big Data can finally be used more easily to transform healthcare. This relationship will not only accelerate but enhance many of the projects underway with our provider organizations.”

Explorys is now part of IBM’s new Watson Health unit, launched today. Its offerings complement and strengthen the IBM Watson Health Cloud platform and will empower IBM’s vast ecosystem of clients, partners and medical researchers to surface new connections among diverse and previously siloed healthcare data sets. Access to these insights is expected to spur the creation of a new generation of data-driven applications and solutions designed to advance health and wellness.

Financial terms were not disclosed.

About Explorys

Originally inspired by physicians and informatics leaders, Explorys combines the most powerful healthcare computing platform in the world with turnkey solutions for clinical integration, at-risk population management, cost of care measurement, and pay-for-performance solutions. Explorys addresses the national imperative to leverage Big Data in healthcare for the improvement of medicine and delivery of care. For more information, please visit www.explorys.com.

About IBM Watson Health

IBM and its vast ecosystem of clients, partners and medical researchers are accelerating the development of a new generation of data-driven applications and solutions built on IBM Health Cloud and IBM Watson cognitive solutions to advance health and wellness. For more information, please visit ibm.com/watsonhealth.

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Mostashari’s Call for “Day of Action” Is a Double Edged Sword

Neil Versel has a great article on MedCity News that covers some comments from Farzad Mostashari at HIMSS 2015. Here’s a section of his article:

Patient advocates are planning a “day of action” to generate mass demand for consumer access to medical records in the wake of a plan to roll back the Meaningful Use requirement for engaging patients in their own care.

“I think we need to show the policymakers that they’re not just pushing rope here. We need to show that there’s demand,” former national health IT coordinator Dr. Farzad Mostashari said Sunday afternoon during a preconference symposium on patient engagement before the start of HIMSS15 in Chicago.

While I think that Farzad’s suggestion is noble in idea, my gut tells me that it could backfire in a very significant way. You have to remember that a call for a “day of action” is a double edge sword. If that day goes off successfully, then it could make a great case for why we should be requiring the 5% patient engagement in meaningful use as opposed to the single patient record download that’s just been proposed.

However, the opposite can also happen too. If you call for a day of action and then patients don’t request access to their records, then it will lead many to say “We were right. Patients don’t care about accessing their patient records.” This conclusion would be incredibly damaging to the movement towards patients’ getting access to their medical records.

This would be true even if there were other reasons that the day of action wasn’t successful. For example, if you do some poor PR and marketing of the day of action, then It could very likely fail. I’m talking big boy PR and marketing to really get the word out to patients. Healthcare social media and even all of the attendees at HIMSS won’t have the power to get the word out about this idea in order to really see it take off.

While I think the goal is noble and Farzad is right that patients need to really start demanding their data, I think this idea of a “Day of Action” could end really poorly if we’re not careful about it.

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Meaningful Use Reporting Period Changed to 90 Days and Other Proposed Changes

In case you missed the news, CMS posted the proposed rule that modifies meaningful use in 2015-2017 (Here’s the rule on the Federal Register). The 210 page document dropped late on Friday right before HIMSS. If you think we’ve seen CMS do this before, we’ve seen it happen a lot. They love to issue the rules on Friday and often right before HIMSS. At least that’s better than when they released the rule during HIMSS, but not much.

The summary of the changes is pretty straightforward:

  • Streamlining reporting by removing redundant, duplicative, and topped-out measures
  • Modifying patient action measures in Stage 2 objectives related to patient engagement
  • Aligning the EHR reporting period for eligible hospitals and CAHs with the full calendar year
  • Changing the EHR reporting period in 2015 to a 90-day period to accommodate modifications

The patient engagement was changed from 5% to a single download, view, and transmit as it’s been called. I think many will look on this as a very favorable change since you can’t force a patient to do something and so your incentive and penalties shouldn’t depend on their action.

It also makes sense that they change the hospital reporting period to the calendar year like it’s been for EPs. The change probably has some logistical questions for many hospitals, but it will make the process cleaner.

The big one of course is the 90 day attestation period. We knew it was coming and I think everyone’s glad that it’s here. Now it will be interesting to see how many wait until October to start their attestation period. That’s pretty risky if you ask me, but that didn’t stop organizations from waiting just the same.

I don’t think there will be many issues with what’s in this proposed rule. Although, we’ll see over the next week what other things people find as they dig into the rule. I know many were waiting for this to drop and are now breathing a sigh of relief over the 90 day reporting period.

Let us know in the comments if there are other details you find that we didn’t talk about or nuances we might have missed. Enjoy the light reading on the flight to HIMSS.

Posted in Healthcare CIO, Healthcare Scene, Hospital CIO, Hospital EHR, Hospital Electronic Health Record, Hospital Electronic Medical Record, Hospital EMR, Hospital Healthcare IT, Meaningful Use | Tagged , , , , | Comments Off

Patient IO Care Coordination Platform Launches Mobile SDK for iOS and Android

April 10, 2015, Austin, TX – Patient IO today announced the launch of their mobile software development kit (SDK) for iOS and Android, which embeds the power and depth of the Patient IO platform into any mobile app with just a few lines of code. Integrating Patient IO’s technology can enable more efficient care management, drive better outcomes and quality metrics, and provide a differentiated standard of care. Patient IO is the first and only care coordination platform that offers patient engagement as an embeddable technology solution.

Patient IO helps health professionals coordinate care and engage with patients inside and outside of the clinic. At the core of this is a shared care plan and messaging framework between the provider, patient, and family. Health professionals can review submitted health information in real-time as patients complete their care plan, or have the data piped into their existing EHR.

“With our SDK, customers can enhance their existing app or build entirely new experiences with proven technology that’s architected for enterprise scale and security,” said Patient IO’s CPO and Co-founder Colin Anawaty. “The typical patient portal is not enough for patients with complex conditions. Their outcomes are dependent on themselves and their providers taking an active role in managing their health.”

For patients, Patient IO’s patent-pending technology synthesizes multiple care plans into a unified list of daily tasks, making it easy for patients to follow treatment-specific tasks, receive reminders, and read educational content on their smartphone or desktop computer. Patients can also sync their connected wearables and devices with Patient IO to complete tasks automatically and provide additional insights for the provider.

Patient IO’s SDK is a drop-in solution that works seamlessly across iOS and Android development environments. “We use the SDK to power our own apps,” said Sebastian Celis, Patient IO’s Head of Mobile. “The SDK is a key component of our platform for helping customers maintain support and parity with iOS and Android’s rapid advancements like Apple Health, or, supporting an ecosystem of connected devices.”

About Patient IO

Patient IO is a collaborative care coordination platform that helps health professionals communicate and engage with patients inside and outside the clinic. Patient IO was founded in March 2013 by CEO Jason Bornhorst (Mobiata, Expedia), Chief Product Officer Colin Anawaty (Plerts, Rev Worldwide), and CTO Brian Gambs (HealthShare, WebMD). They are joined by Head of Mobile Sebastian Celis (Mobiata, Expedia).

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Rule to Change MU Reporting Period to 90 Days is Issued

Today, CMS issued a new proposed rule for the Medicare and Medicaid EHR Incentive Programs to align Stage 1 and Stage 2 objectives and measures with the long-term proposals for Stage 3.

The modifications would allow providers to focus more closely on the advanced use of certified EHR technology to support health information exchange and quality improvement.

The new rule proposes a change in the reporting period for meaningful use from one year to 90 days in 2015.

Proposed Changes for EHR Incentive Programs
Together with the proposed Stage 3 notice of proposed rulemaking (NPRM) issued on March 20, 2015, the proposed rules align and merge the “stages” of meaningful use requirements.

The proposed rule changes the programs by:

  • Streamlining reporting by removing redundant, duplicative, and topped-out measures
  • Modifying patient action measures in Stage 2 objectives related to patient engagement
  • Aligning the EHR reporting period for eligible hospitals and CAHs with the full calendar year
  • Changing the EHR reporting period in 2015 to a 90-day period to accommodate modifications
Posted in EHR, EHR Incentive, Electronic Health Record, Electronic Medical Record, EMR, Healthcare IT, HITECH, Meaningful Use | Tagged , , , , , , | Comments Off

Remember, HIMSS is a marathon, not a sprint

At the risk of sounding too cliché, I’m going to say that HIMSS is a marathon, not a sprint. (Actually, I said it twice, if you count the headline.) And I’m exhausted already.

Planning for the annual madness, which starts this weekend here in Chicago, is almost as grueling as the conference itself, and I got a late start because I didn’t know until a couple weeks ago who I would be covering the event for. In case you were still wondering, I’m now a full-time staffer for MedCity News, so you can read my work there. In less than a week on the job, I’m already feeling a better vibe than I ever did with the last attempt at full-time work.

I have a feeling others are as exhausted as I am, or at least can empathize with all the scheduling that has to go into HIMSS  for a journalist. I need to find stories, but I also need to leave myself time to, you know, actually write the stories. We shall see if I succeed, because I feel overscheduled already.

How do I know it’s a common feeling? This semi-exasperated tweet I sent out a few days ago has gotten favorited a dozen times, which is just about a record for me.


The “1,400 of you, one of me” line has kind of become a mantra for me when dealing with people who are begging for a bit of my time. I did not violate my Rule #2 of HIMSS, which is never schedule back-to-back meetings in different locations. (Rule No. 1, of course, is wear comfortable shoes.)

I just hope I can get all my work done, and that I can get a solid six hours of sleep a night next week, even though it’s a home game for me this year. I’m not terribly far from McCormick Place, but it’s a pain to get to from where I am on the North Side. It’s either an hour-plus on public transit, with one transfer, or $21 per day to park. I’d ride my bike down there, but you probably don’t want to see me in spandex. I still may do that on Saturday before most of you are in town. Be warned.

I probably won’t be blogging on this site during HIMSS, though I may have some multimedia to post at some point. If you want to read my coverage, head over to MedCity News. My HIMSS preview should be up by the time you get to town this weekend. And if you haven’t done so already, click on the above tweet and follow me on Twitter.

Welcome to Chicago.


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Ambir Technology Introduces Innovative Solutions for Capturing and Harnessing Patient Information at HIMSS15 Annual Conference & Exhibition

Chicago, April 9, 2015—Ambir Technology, an industry leader in digital capture and document management solutions, introduces new solutions at HIMSS15 Annual Conference & Exhibition April 12-April 16 in Chicago for capturing, transferring and managing patient information. Visitors to the Ambir Technology booth (number 2819) will see demonstrations on how the new solutions can impact operational efficiency and productivity.

“Helping healthcare providers efficiently capture and manage patient information is a cornerstone of Ambir Technology’s product development,” said Mike O’Leary, CEO of Ambir Technology. “Today, our signature pads, ID card scanners and document scanners assist many practices in capturing information. At HIMSS 2015, we are introducing new, innovative solutions to push the envelope in regard to patient information capture, transfer and management, boosting office operational efficiency and productivity in meeting Meaningful Use Requirements.”

Ambir nForm  Ambir nForm solution enables totally paperless, convenient and secure capture and transfer of forms and signatures through the Ambir 410x wired tablet and iOS or Android tablets.

The groundbreaking tablet-based solution is available immediately as a yearly subscription. In addition, Ambir introduces Ambir nForm 410x. This dedicated tablet features a larger screen area than signature pads currently on the market.

nForm is easy to use and practices can use existing forms—no requirement to purchase special or customized forms.

Users simply send forms and documents to the Ambir 410x, iOS or Android tablet using the Ambir Document Printer print driver or through nForm Connect (to which users can upload and save their own forms), input information and upload the forms using their scanning application or as a PDF file to their information management solution. There is zero integration needed to use nForm with commercially available EHR or document management applications as it employs nForm by Ambir Technology TWAIN driver known for its plug-and-play ability.

New Generation Sheet-Fed Document and Card Scanners Ambir’s new generation scanners open new doors in operational ease, maintenance, and provide real time solutions for capturing and organizing information by doing more at capture—in office and mobile applications.

The new scanners consist of four models:

  • Ambir ImageScan Pro 490 ix Scanner is a duplex document and card scanner. It scans both sides of a document in about 10 seconds.
  • Ambir ImageScan Pro 687ix Scanner is a duplex card scanner for scanning two-sided identification cards, scanning both sides of a card in approximately 3 seconds.
  • Ambir ImageScan Pro 667ix Scanner is a simplex card scanner for scanning one side of an identification card in about 3 seconds.
  • Ambir TravelScan Pro 600ix Scanner is a simplex document and card scanner designed for mobility and speed. It scans one side of a document in approximately 10 seconds.

The scanners come with AmbirScan Lite Capture Software, elevating document and ID card scanning to a true information capture and management solution by enabling users to save scanned information as PDF, TIF and JPEG files, automatically saving the files to any folder on a computer and/or popular cloud services including Box, DropBox, Evernote and Google Drive.

Having one button operation, the scanners are easy to use.

All are USB port-powered, eliminating the need to find an electrical outlet or carry an AC adapter and enhancing the ability to work wherever and anywhere. They are Energy Star compliant.

Featuring lightweight, compact designs, the scanners are ruggedly constructed for continuous use. In addition, all models have a Kensington Lock Slot to keep them securely on desks or mobile carts. The scanners feature flip-open tops to give unrivaled access for thorough and quick cleaning of the transport area.

All are factory calibrated, requiring no calibration upon installation providing high-quality image quality right out of the box —simply plug in the scanner, install the drivers and start scanning.

The scanners have industry standard TWAIN drivers to provide quick installation and compatibility with thousands of commercially available electronic healthcare record solutions.

For information about Ambir Technology products and solutions, access www.ambir.com.          


About Ambir Technology

Ambir Technology, Inc. is an industry leader in digital capture and document management solutions. Combining professional-grade ID card and document scanners, unique digital imaging software and expert-level customer service, Ambir provides their customers with comprehensive, enterprise-level business solutions. Specializing in the healthcare, legal and financial sectors, Ambir helps organizations reduce costs, increase productivity and strengthen data security. For more information, visit www.ambir.com.

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