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. 

Truly Epic! R&D Spending sensation 


In a story published on September 13th , 2016 by Healthcare IT News (HIT News), Epic Systems’ founder Judy Faulkner  ( just ‘ Judy’ to many in the Healthcare IT world) revealed that Epic invested something like 50% of its operating expenses on research and development, outstripping all organization in and out of the Healthcare IT ecosystem. 

HIT News verified through federal filings that Cerner spent 19%, Allscripts spent 34% and athrnahealth was at 10%. Google spent 45% of its operating expenses on R&D  (or $12 billion) and seemed to be the closest when it came to a percentage of operating budget. 

The thought that ran through my mind was ” Has this translated to better and more efficient and streamlined patient care at Epic’s customers versus provider organizations that have implemented a competing product? I’m all for R&D and believe that it’s really what makes America great  (I don’t think we’ve lost the ‘greatness’ since 1776 when the Founding Fathers declared independence, but that’s another story for another day). The technology of the 21st century has indeed been spurred by American innovation and ingenuity  (Facebook,  Twitter and the entire world of Social Media). R&D brings us medicines that have been life changing to many and previously were inconceivable even in the latter part of the 20th century, but with the cost of patient care rising and many Americans wondering how to get them within reasonable limits anymore, does this only add to our costs in the patient community or will it be the savior of millions and have a lasting impact for the country and the world. Makes you think. …

Omaha, Omaha, Yay Putin?

As always, the opinions expressed here are mine and nobody else’s. 

What a wild ride this year has been so far. As my son and I watched the Broncos -Panthers game, it dawned on me that I’ll never hear the famous words from the just retired Peyton Manning anymore. The young next generation QB on the Broncos team though didn’t do too badly though and seemed to keep his cool as he faced the Panthers and end up getting the better of them in the end. Flipping to the wacky Presidential election we’re going through, apparently Vladimir Putin is the new standard of excellence in leadership. 
I always look at our nation’s Declaration of Independence and focus on the words “We the people ” in the Constitution therafter, in the 18th century, those were indeed revolutionary words to even think about,  let alone write as a declaration. 

In our world we need to think ever more about empathy and healthcare as never before. Working at Healthcare Providers for some time now, I see the need for a better more efficient and effective way to care for people and believe truly that a combination of collaborative project management, appropriate resource allocation and technology that enhances patient care and safety has the ability to transform patient care in a positive way. 

I’ve also seen of late, the return of racist elements I’m society that were previously kept at bay which disappoints me greatly. 

Stay focused on the real substance of the world, the care and empathy that we all should have to better understand the human connection that makes us live a more harmonious existence. 

If you’re reading this blog post, just look around you and realize all of the good that is in your life and appreciate the ability to be able to give more of yourself for causes such as better patient care through information technology. 

Go get ’em!

Mid Year Healthcare IT Report

Report CardIt’s been a while since I blogged. Whether it’s because of being a parent caught up in America’s great pass time, baseball or work or a combination of the two, life seems to have a profound effect on getting my thoughts down. Firstly, I’m always wary of commenting on politically sensitive topics such as the recent violence and tragedies that have affected all of America so profoundly this last week, but I wanted to give thought to the sad loss of life that was start and end of last week’s violence.

As a strong opponent of firearms, I don’t believe that guns are the answer to anything. Maybe due to my Indian roots and the way that India got it’s freedom through mostly a non-violent freedom movement, that has been etched in my mind. That and having lived my early and formative years in cities and nations that do not have guns as rampant as is the case in the United States. Sad and tragic for the entire country.

That said, within healthcare, I have seen folks focus more on the daily routine of Healthcare IT as well as the focus on growth in opportunities. I saw the news that healthcare added 39,000 new jobs in June alone which is a good sign for the ecosystem. In another sign though of the world that we live in, June was also the month that saw the highest number of 11 million patient record breaches and has been deemed the worst month for information security breaches in 2016. A chilling reminder that we live in a very interconnected world that is global in it’s reach. I sometimes see the statistics of this blog and see that it reaches the far corners of the world and can be read anyplace and at anytime. Security also needs to happen on a global level and many organizations I believe, don’t do enough. One of the Information Security Officers whom I spent time with during our Spring CSO HIMSS conference told me that he felt that his users were the worst security hazard that he had. One wrong click was all it took.

Out Fall CSO HIMSS conference in the fall is not going to have a theme this season, but we are looking to cover a broad range of topics, though we do hope to cover the new MACRA regulations with an expert speaker or two.

So far, I don’t think anyone has seen any major shifts or movements (surprisingly) this year. With ICD-10 now but a distant memory and MACRA coming up as the next thing on people’s minds, I believe that so far, I’d give Healthcare a B for good behavior. Still lot of time left for the end of the year, but that’s my mid year assessment (I know I’ll get grief from both sides on this one…we can talk about it over beverages…)

Enjoy the summer folks!

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.