Are EHR vendors becoming Population Health corporations?

An interesting article surfaced in Healthcare IT News that suggested that executives at some healthcare software vendors want to transform themselves from generically being deemed as an EHR vendor and become a Population Health company like Cerner’s CEO Zane Burke told Healthcare IT News. 

Being able to access data relevant for patient care should be possible regardless of the format it is presently in or whether it is in an EHR,  national database or in pdf format. 
The constraints that “EHRs” are presently may not allow for this functionality  (yet). The article goes on to state that providers are also moving towards precision medicine, accountable care management, chronic care management and value based reimbursement. 
Movement for many on the ground is still in the initial stages and only those provider organizations with deep pockets and the ability to leverage collaborative working relationships with solution vendors can think about moving forward with all of the initiatives mentioned above in a meaningful way. 

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Holy MACRA! Patient Engagement rides again!

Regulatory-signage“What was that masked legislation? Why that, my boy was CMS! The greatest regulator in the west!” (Cue The March of the Swiss Soldiers in the William Tell Overture aka, theme song for one of my childhood heroes, The Lone Ranger).

What is MACRA?

MACRA is the abbreviated version of the “Medicare Access and CHIP Reauthorization Act of 2015” which was signed by President Obama on April 16th of this year. (Healthcare and CMS sometimes really can’t help it’s communication to the public when they make these abbreviations something that only so called “healthcare insiders” will understand).

The new law repeals Medicare’s sustainable growth rate (SGR) formula and creates a way to increased Medicare payments. At HIMSS16 this year, there was a focus was on “MIPS” or Merit Based Incentive Payment System which is the program that the SGR will be replaced with.

Physician rates are understood to be increased by 0.5% starting in July and each January through 2019 and then, bonuses could reach 12% and then 27% by 2022 (physicians could also face penalties for not meeting quality targets down the road).

On the CMS site, it asks the question, “How does the Medicare Access & CHIP Reauthorization Act of 22015 (MACRA) reform Medicare payment?”

Apparently, in a couple of ways:

It makes 3 changes to how Medicare pays those who give care to Medicare beneficiaries. The changes create a Quality Payment Program (Abbreviated to ‘QPP’).

  1. Ending the SGR formula for determining Medicare payments for health care providers services.
  2. Making a new framework for rewarding heal care providers for giving better care not just more care.
  3. Combining CMS’ existing quality reporting programs into one system.

The changes have been named QPP and replace other Medicare reporting programs with a flexible system that allows providers to choose from 2 paths that link quality to payments either MIPS or something called Alternative Payment Models (APMs)

MIPS – This combines parts of the PQRS (Physician Quality Reporting System), the Value Modifier (VM or Value Based Payment Modifier) and the Medicare Electronic Health Record (EHR) incentive program in which EPs (Eligible Professionals) will be measured on:

  1. Quality
  2. Resource Use
  3. Clinical Practice Improvement
  4. Meaningful Use of Certified EHR technology.

APMs – Alternative Payment Models give new methods to pay healthcare providers for the care they give to Medicare recipients as from the year 2019 to 2024, CMS will pay some participating healthcare providers an incentive lump sum; increase transparency of physician focused payment models and starting in 2026, offer some participating healthcare providers higher annual payments.

 

 

 

 

 

HIMSS16 Recap

Opening Keynote
Opening Keynote

From the opening keynote of HIMSS16, I’m always enthralled with the size of the event and what the HIMSS team based out of Chicago has to work on all year to make the event a great one. From making sure that the speakers are great to working on the logistics and the events within the event, it is a spectacle like no other. This time, I had a few newbies to the event that were more enthralled than I was (which is certainly something to behold). I must say though, that the opening keynotes were interesting as the audience first heard from Sylvia Matthews Burwell, Secretary of Health & Human Services and Michael Dell, Chairman and Chief Executive Officer, Dell Inc who spoke in a “fireside chat” between him and Mark D. Barner, Senior Vice President and Chief Information Officer, Ascension; Chief Executive Officer, Ascension Information Services. Right after the opening keynote, we went to the vendor area on the first floor for the reception that allowed us to mingle with the smaller vendor booths, which for startup organizations or those that wanted to have conversations with their potential buyers, was a great idea by HIMSS. Kudos to whomever thought of it.

Interoperability Showcase
Interoperability Showcase

The Interoperability Showcase this year, which was what I was most eager to see, didn’t light up my interest as it had done last year. During my conversations with the team at HIMSS at the HIMSS Spot location (it’s usually located at the center of it all), I understood that the conference had probably attracted somewhere around forty three thousand people which is on par with what I had expected.

HIMSS Spot
HIMSS Spot

On Tuesday March 1st, one of the first sessions I attended was titled “Actionable Analytics: From Predictive Modeling to Workflows” which was presented by the awesome team of Ari Robicsek, MD (Vice President, Clinical Analytics) & Chad Konchak, MBA, (Director, Clinical Analytics) from Northshore University Health System in Illinois. They really fired up the imagination of the audience when they were able to show the progression of flu on a map on the screen that had the audience very impressed with the work that they did. This session was so packed that there were people sitting on the stairs as it was so in demand. From sessions on analytics, process improvement, Office365, constructing a new hospital organization from the ground up where Sajid Ahmed, CHCIO, (Chief Information & Innovation Officer, Martin Luther King, Jr. Community Hospital) in a neighborhood that needed it badly presented a great story of personal and community achievement in”A Connected Hospital and Connected Community Partnership”, visiting the exhibit hall and getting in some networking while we were at it, this conference was one to remember. Oh and the DeLorean below was one that I’d like to take back to Monday, February 29th, 2016 and try and go to HIMSS16 over again and try and see some of the sessions that I would have liked to if I was able to be two places at once!

Back to HIMSS16 DeLorean

Live from HIMSS16. .it’s Wednesday March 2nd

The story so far from HIMSS16:

Sylvia Mathews Burwell from HHS spoke at the Opening Reception of the HIMSS16 conference and talked about some of the great work that organizations like Davies Award Winner OSUMC are doing along with saving nearly $7.7 million.

The Dell fireside chat did not go as well as was expected with a number of people walking out of the session in the middle due to what I heard was, sadly not a very interesting conversation that captured the spirit and enthusiasm of the conference. It seemed like more of an advertisement for Dell than anything else.

In addition, today I’m heading through the Interoperability Showcase which I enjoy going through. The basis for everything this blog is all about

image

HIMSS16 – One week to go!

Las VegasI know many folks are eagerly looking forward to next week in Vegas and HIMSS16. I’m looking forward to meeting my “Conference Buddies” those folks we see once a year at the Big Show! I’ll be looking forward to the keynotes from  Sylvia Mathews Burwell, Secretary of Health & Human Services & Michael Dell, Founder of Dell, Inc next Monday the 29th at the Palazzo Ballroom at the Venetian Hotel.

I try and encourage a balanced approach; educational sessions in the morning, lunch and then exhibit hall and vendors in the afternoons. This gives me the opportunity to experience a full conference experience along with some of my friends from the CSO HIMSS chapter and other chapters I’m connected with. Areas focused on project management in the areas of interoperability solutions (of course focused on CCD’s) analytics and datawarehousing, tele- health (after my recent visit to Cisco in Bangalore), Clinically Integrated Networks and revenue cycle optimization post ICD-10 are at the top of my agenda of mandatory sessions to attend. The Interoperability Showcase is my favorite area of the exhibit hall area to visit after my HIMSS15 experience. Best part of the entire conference in my humble opinion. Don’t miss it. You’ll be glad you saw it when you did. I’ve been pushing for it to go on the road to each state. I’m rarely a petition type of guy, but I’ll sign a petition for an “Interoperability Road Show” if I have to. It’s basically the essence of this blog entirely so “hell ya!” I’ll sign it.

If you haven’t already, register for the CSO HIMSS Luncheon on Tuesday March 1st. I’ll be there as well as many of our CSO HIMSS Board and our esteemed Chapter President, Scott Mash.

We can’t end without obviously the perfunctory “Viva Las Vegas!”

See you on the flip side folks!

Ajay Sharma - Professional Photo-10-25-14

Miami University Healthcare IT Speaker Series – November 3rd, 2015

Come and see us at the Miami University Healthcare IT Speaker Series where Victor Simha and I will be talking about what we call “Healthcare Version 3.0” and where we believe, when we look into the crystal ball, that the healthcare IT ecosystem is heading and the opportunities for students in the program to focus their attentions on. Check out the link for more information about the series.
http://www.regionals.miamioh.edu/hit-speakers/schedule.htm