CPOE, EHR utilization linked to professional burnout and dissatisfaction

The use of EHRs and computerized physician order entry is resulting in lower doctor satisfaction and larger amounts of professional burnout, in accordance to the outcomes of a national survey of practicing physicians.

Results of the research, issued in Mayo Clinic Proceedings, indicated that doctors’ satisfaction with their EHRs and CPOE was basically low due to the amount of time spent on clerical activities, and as an outcome, those physicians were at larger threat for professional burnout. Additionally, researchers discovered that utilization of CPOE was the characteristic of the electronic practice setting most strongly associated with the danger of burnout.

The research of 6,560 physicians, surveyed between the months of August and October of 2014, was led by the Mayo Clinic and taken in collaboration with investigators from the American Medical Association.

Professional burnout is a syndrome featured by exhaustion, cynicism and feelings of ineffectiveness, in accordance to Tait Shanafelt, MD, a researcher at the Mayo Clinic. “Physician burnout has been connected to reduced quality of care and medical mistakes as well as an increase in the likelihood physicians will cut back their work hours or leave the profession,” he claims.

Physicians across entire specialties were surveyed, offering data regarding to their utilization of EHR systems, CPOE and sufferer portals, with satisfaction varying instantly by specialty. Researchers discovered that family medicine physicians, otolaryngologists and neurologists were among the specialties with the reduced satisfaction amount with EHRs due to the increased clerical burden.

“We require searching ways to incorporate EHRs, sufferer portals and electronic order entry in a way that doesn’t increase clerical burden for physicians or decrease their efficiency,” claims Shanafelt, lead author of the study. “A variation of innovative approaches, like utilizing medical scribes, having nurses filter and respond to electronic messages from sufferers and having support staff handles queries using verbal communication instead of electronic messaging, have all been discovered to make better the efficiency,” he states.

 “The information from physician burnout surveys are merely getting worse year after year,” Jain on the day of Tuesday told the Healthcare Financial Management Association's Annual National Institute in the state of Las Vegas. “They feel like the network is aligning to make their work and their jobs complex.”

The Electronic Health Record Association refused to comment on the outcomes of the study and survey information.

This is not the 1^st time an AMA-associated survey has demonstrated these types of results. In the year of 2013, AMA and RAND Corp. conducted a research in which doctors recognized EHRs as the leading cause of emotional fatigue, professional dissatisfaction, depersonalization and lost enthusiasm. Particularly, doctors explained poor EHR usability that didn’t match clinical workflows, time-consuming data entry, interruption with face-to-face sufferer care, and overwhelming figure of electronic messages and alerts.

 

Healthcare Finance execs observe role for IT in transition to value

As healthcare shifts toward new payment and care delivery models made to make better the quality and decrease prices, financial management is at the heart of the industry’s transition to become more value-based.

That is the consensus of healthcare finance experts meeting this week in the state of Las Vegas. At its Annual National Institute, leaders of the proposed Healthcare Financial Management Association appreciated the momentous alterations that confront the industry as it shifts from fee-for-service to value-based care, but at the similar time discussed that HFMA members are well positioned to take on those issues head on.

 “We’ve faced as an industry a broad ranging set of alterations that we had to manage so that our communities could sustain to get the very best healthcare,” stated Mary Mirabelli, newly elected chair of HFMA’s board of directors. “We’ve gone through huge legislative changes, and each and every time, we have figured out a way to make it work.”

Mirabelli, vice president of global healthcare practice at the Hewlett Packard Enterprise, emphasized that the latest move in healthcare means “new procedures, jobs, posts, systems and technologies” as well as the “proposed integration of services, blurring of roles, and the merging of agencies.” Finally, she claimed the changes that finance experts have been inquired to handle are endless.

As the industry sustain to evolve to alternative payment models, Mirabelli considers believes that HFMA members must find to “thrive” during these uncertain periods, working hard to “comprehend the implications of our economical statements, our revenue, our clinical care, and to do the accurate thing.”

Nevertheless, outcomes of a newly issued KPMG poll of almost 300 healthcare executives indicate that a majority now claim that value-based contracts will harm the profitability versus 47% 2 years ago. Additionally, the survey discovered that the most important affect from the changes in the delivery of care will come from increasing connections with lower acuity healthcare centers, disease management and increased utilization of telemedicine.

In accordance to Jim Landman, HFMA’s director of healthcare finance policy, views and analysis, both contributors and payers are feeling the pressure of market forces that are reconstructing the industry. He asserts that consumerism, population health, and value-based payment are removing the conventional boundaries between hospitals, physicians and payers, which need latest levels of collaboration in this quickly changing atmosphere.

“One of the things we are observing are latest combinations emerging in all kinds of ways and forms, whether it is an official merger, a joint venture, an affiliation, or a partnership,” stated Landman. “We are analyzing the healthcare systems and health policies doing this, and physician practices and health policies doing it.”

With sufferers at the center of care, he discusses that it is more significant than ever for health policies, hospitals and physicians to be “on the similar page,” working together for economical and clinical alignment and that there are primary capabilities that agencies must establish to succeed under value-based payment and care delivery models, involving health IT and healthcare analytics.

Gordon Edwards, chief financial officer of Wisconsin-based Marshfield Clinic Health System, stated that his agency sustains to contribute in IT and analytics. “Data assists to drive decisions that we make on a routine basis,” exclaimed Edwards.

Marshfield’s ambulatory EHR system is homegrown. The proposed regional healthcare contributor, which makes $2 billion in revenue evenly classified between its health policy and care delivery, gives a portal for sufferers—25% of whom utilize it—and empowers that it has been offering telemedicine services for almost twenty years.

“IT has been and will sustain to be a place of focus and investment,” said Edwards. “In some regards, it is become more significant than ever.”

 

Most agencies unprepared for information theft by workers

As agencies spend billions of dollars a year attempting to secure their data from hacking, they confront another threat closer to home—data theft by their own workers.

That is one of the findings in a survey issued by management consultant Accenture and HfS Research on the day of Monday.

Of 208 agencies surveyed, 69% “experienced an attempted or realized information theft or corruption by corporate insiders” over the past twelve months, the survey discovered, compared with 57% that experienced similar activities from external sources. Media and technology firms, and enterprises in the Asia-Pacific region reported the highest amounts—77% and 80%, respectively.

 “Everyone’s always known that part of designing security begins with considering that your workers could be a risk, but I do not consider anyone could have said it was much that high,” stated Omar Abbosh, Accenture chief strategy officer.

Each year, businesses and agencies spend an assumed $84 billion to defend against information theft that charges them about $2 trillion, and that destruction could rise to $90 trillion a year by the year of 2030 if present trends continue, Abbosh predicted.

He suggested that agencies change their approach to cybersecurity by cooperating with competitors to establish joint strategies to outwit increasingly sophisticated cyber-criminals.

“There is a large business rationale to share and collaborate,” Abbosh stated. “If one bank is essentially violated in a way that ruins its trust with its customer base, I could be and say they are all going to come to me, but that is a false comfort (because) it pollutes the entire sphere of clients, because it makes everyone fearful.”

Despite recent high-profile information violations of Sony Corp., Target Corp. and the U.S. Office of Personnel Management, several agencies don’t yet think cybersecurity a top priority, Accenture found. Some 70% of the survey’s respondents stated that they lacked correct funding for technology, training or personnel required to sustain their company’s cybersecurity, while 36% claimed that their management considers cybersecurity “an unessential cost.”

 

Low-cost technology might make better the rehab for stroke victims

New technology being established at the Tandon School of Engineering at New York University is made to assist stroke victims more rapidly to regain lost motor qualities compared with traditional therapies.

The technology, projected to charge $1,000 for per unit, can be placed in sufferer homes, negating the requirement for frequent trips to a hospital or clinic for rehabilitation.

The project utilizes “mechatronic devices,” which is a marriage of mechanical and electrical engineering disciplines to generate smart products with embedded intelligence, claims Vikram Kapila, a professor of mechanical and aerospace engineering at NYU’s Tandon School of Engineering. An instance of such tools is airbags in a car, he elaborates. Sensors track a crash, and the bags deploy.

Stroke sufferers mostly lose functionality in their arms and hands; it is complex to choose a glass or to know if sufficient pressure is being placed on the glass to keep it from falling. A sufferer might have lost functionality in the right hand, but has the proposed functionality in the left hand.

The idea behind the project is to begin with the good left hand doing an activity and then transferring data gathered by wearable mechatronic devices to the right hand. These tools involve a jacket to measure arm placement and a glove to measure wrist and finger placement and finger joint angles. Other measures, like grasping force and lifting force, also are gathered.

When a sufferer conducts an exercise, like lifting a water bottle, microcontrollers quantify the action and measure grip strength, with data reflected on a small computer-like tabletop device that enables a sufferer and clinicians to observe the force being applied to lift the bottle or do a different activity.

Wearing a proposed jacket embedded with sensors, a sufferer will utilize the good left hand to lift the bottle with the extreme force of lifting and grasping charted. If too much force is implemented, a ball on the tabletop tool will turn red. If medium correct force is implemented, the ball will turn yellow, and if correct force is implemented, the ball will turn green. The key task is to attempt to replicate those measures with the disabled right hand.

With repetition, doing the activities with the good left hand over time will enable the brain to transfer data from the left hand to the right hand so it can do the similar activity. Data gathered by smartphone also can be transmitted to a physician or physical therapist to detect growth and change therapy processes if essential. There are several separate modules for these exercises covering the hand, arm and fingers.

The emerging technology also has an economical advantage for physicians and therapists, Kapila claims. A clinician can do one rehabilitation treatment at a period in an office and bill once for the treatment. But if various sufferers are at home doing the rehabilitation and sending outcomes to a clinician through email or a text image, the clinician can bill for each of those home-deployed rehab sessions.

The project is presently being performed by students and faculty, but funds are being sought to shift the concept from the lab to a pilot project with rehabilitation clinics and sufferer in their homes, after which feedback will be gathered and any essential improvements will be made. The objective is to have fifty devices being piloted. Entire materials, involving smartphones, lithium batteries and sensors are off the shelf or open source products.

Just in the United States of America, the project has the possibility to serve 300,000 sufferers yearly, Kapila states, and once commercialized the expectation is to get 1 or 2% of that market in the 1^st year after getting regulatory approvals.

 

CMS issues service utilization data by state and county

The Centers for Medicare and Medicaid Services issued an updated data device that produces interactive state and county maps with metrics explaining the health service utilization, like emergency, non-emergency and skilled nursing services.

Utilizing the ambulance and HHA paid claims information within CMS systems for Medicare fee-for-service beneficiaries, the maps indicate whether a place has an active moratorium in a specified geographic place. The maps also have color variations to demonstrate distribution of the metric.

The information enables comparisons of contributor services and utilization information by geographic places, enabling drilldown comparisons to the county level of states. Maps are coded to unveil which places are in particular quartiles of distribution.

Information can show the number of Medicare contributors serving a geographic region, as well as the number of Medicare beneficiaries who utilize a health service in an area.

CMS used authority given by the Affordable Care Act in the year of 2013 to enforce temporary enrollment moratoria to combat fraud, waste and abuse, in accordance to a blog post by CMS’ Center for Program Integrity Director Shantanu Agrawal. CMS has expanded the moratoria in 6 month phases since then; the most recent occurred on the day of January 29.

The moratoria implemented to the enrollment of new home health agencies and ground ambulance suppliers. Agrawal wrote that the moratoria offered “CMS the chance to observe and monitor the existing provider and supplier base, as well as further focus extra fraud prevention and detection tools in these places.”

The analysis is deployed on the paid Medicare claims data from the CMS Integrated Data Repository (IDR). Claims data are observed for a 12-month reference period, and outcomes are updated quarterly. The reference period dates back as far as the month of October 2014.

The methodology differs from other kinds of public use data in determining the geographic location of a contributor. Claims are utilized to define the geographic area served by a provider, instead of the provider’s practice address.

 

CMS grants $100M to assist docs to adopt payment system

The Centers for Medicare and Medicaid Services hopes to spend $100 million over 5 years to give Medicare clinicians customized direct assistance, like training and education to acquire success under the Merit-based Incentive Payment System.

The funding is needed as part of the Medicare Access and CHIP Reauthorization Act of 2015, or MACRA.

These funds will target minor practices of 15 or fewer clinicians, predominantly in rural places, health professional shortage places and medically underserved regions, with the aim of easing the transformation from fee-for-service to value and outcomes-based reimbursement.

“Doctors and healthcare contributors in small and rural practices are critical to our aim of building a health care system that works for everyone,” stated Secretary Sylvia Mathews Burwell, Secretary of the Department of Health and Human Services. “Supporting local healthcare contributors with the resources and data essential for them to offer quality care is a top priority for this administration.”

CMS is finding partners to give the services to physicians, like quality improvement agencies, regional extension centers and other regional health collaborative agencies. Under CMS’ plan, there’ll be no cost to physicians for the services.

Participating agency would assist physicians to work through what they require to be successful, like which quality measures or EHR system would be most suitable for their practices. Clinicians also would get clinical practice improvement training, which would involve assessing new workflows and whether they should join an alternative payment model.

“Giving these tools to assist physicians and other clinicians in small practices navigate new programs is key to making certain they are capable to concentrate on what is most significant: the requirements of their patients,” stated B. Vindell Washington, MD, principal deputy national coordinator. “As with the Office of the National Coordinator for Health IT’s funding for Regional Extension Centers, this assistance will help healthcare contributors leverage health information technology to modify their practices and the care they deliver.”

 

HIE collaborative empowers sharing of summary data by 1,349 percent

Health information exchange might be an issue for few contributors, but it is become less of an issue for members of the Northern California HIE Collaborative. Between the years of 2013 and 2015, clinical summary exchange volume increased by 1,349% across eleven healthcare agencies that belong to the collaborative.

That is the finding of a new study issued in the Journal of the American Medical Informatics Association, which investigated the relationship between electronic exchange of sufferer health information across agencies and organizational HIE policy decisions. It is the 1^st large-scale empirical study to analyze the local HIE organizational policy decisions in a diverse group of health networks and to assess their affect on the volume of information exchange, its authors claim.

The HIE policies of the eleven health systems assisted to enable the dramatic increase in the volume of exchange over the 2-year period, asserts Julia Adler-Milstein, co-author of the article and assistant professor in the School of Information and School of Public Health at the University of Michigan.

“All healthcare agencies wrestle with the similar type of operational decisions around how to execute HIE,” claims Adler-Milstein, adding that all twelve members of the Northern California HIE Collaborative have Epic electronic health record systems and its associated HIE platform, called Care Everywhere. She stated that 11 of the 12 health networks consented to have their data observed for the study.

9 of the 11 agencies’ Epic EHR systems were set up to enable an auto-querying feature, which was associated with an important increase in the monthly amount of exchange. The JAMIA article points out that Epic employs an “all or nothing” access in which any agency that engages in its exchange network must wholly agree to principles that define suitable use of transmitted information as well as other governance problems. That approach eradicates the requirement for participating agencies to discuss terms with each agency in the network.

“If an agency has auto-query enabled, there is an attempt to develop a patient link for each visit, and if there is data available, the link is developed,” claims the JAMIA article. “If an agency doesn’t have auto-query enabled, a user must take the time to seek out data before or during the visit.”

“As soon as an agency turns on auto-query, it means that any sufferer visit triggers the system to automatically search for any potential relevant data about the patient in any of the other sites,” analyzes Adler-Milstein. “That was a big driver of the increase in data exchange.”

Furthermore, seven of the eleven agencies didn’t need patient consent particularly for HIE, and these agencies experienced a greater increase in volume of exchange over time, compared with agencies that needed consent.

“The implications of these decisions ripple through the network. When 1 agency needs patient consent, that changes the procedures that have to go on in all of the other agencies,” contends Adler-Milstein. “The more your agency makes policies that favor the flow of data, the more exchange that is going to take place.”

Although, she and the other co-authors of the JAMIA article appreciate that one of the limitations of their research is that only health systems utilizing a single vendor-based HIE platform were observed. “Our findings may not be generalizable to other approaches to HIE, because Epic’s Care Everywhere is somewhat distinctive in terms of its approach to technical interoperability and standards governance,” the article noted.

“Yet, the reason they have been so victorious in building up their HIE network is they have made the capabilities and adopted a take-it-or-leave-it governance approach in which they say, ‘If you need to use Care Everywhere, and you are an Epic site, you must agree to our terms,’ ” she summarizes. “There is no negotiating over data use agreements, which often trip up and slow down the progress of several multi-stakeholder HIE attempts.”

 

Contributors fail to stratify risk, care suffers

Healthcare agencies entering risk-based contracts mostly do not adequately think how difficult it will be to stratify the risk of sufferers who will be treated under the contracts, and as an outcome, they do not get the results that they envisioned.

The reason is very simple, Chilmark Research asserts in a new report. Only 10% of results are driven by medical care, 20% of results are driven by genetics, and 70 are deployed on individual behavior and social context, claims Jody Ranck, an analyst at Chilmark and lead author of the report.

Moreover, behavioral and social data assist clinicians to observe the barriers that sufferers face, like not being capable to walk in the neighborhood each day due to high crime rates or the inability to pay for medications.

Risk stratification was established by healthcare payers to launch fairness into physician compensation based on sufferer severity, claims Ranck. Now, new models of risk stratification focus not merely on triaging high-risk sufferers but on what to do to keep them from utilizing excessive rates of medical services.

That is a huge change in approach, because physicians have been paid for triaging—incentives were such that doctors gave routine care and the onus was on the sufferers to follow their suggestions—if sufferers did not follow instructions, they just returned for more care, and physicians got an extra payment for that care encounter. That will not wash in a latest era of accountable care, where reimbursement will be deployed on quality, not the volume of services.

Accountable care needs access to real-time clinical data, patient-reported information and health assessments that can be fed into an analytics program, in accordance to Ranck. That is different from conventional data sources based on claims data and sufferer health risk assessment forms.

Although, getting behavioral and social information into EHRs is difficult, Ranck appreciates. But there are start-up companies emerging that could solve that issue over the next 5 years.

One of the newer vendors, Forecast Health, gathers 4,000 data elements on patients, like transportation options, finances, lifestyle factors and social media activity. Another vendor, Scio Health, utilizes claims, clinical, census and ZIP code information to understand risk well enough to intervene and reach out to sufferers.

Provider agencies can use these data to recognize sufferers that should be called by a nurse to observe why they are not adhering to their care plan; for instance, if the hurdle is transportation, a contributor might decide to give transportation services to pick up a sufferer for care. The data also can show which sufferers best respond to phone calls, texts or emails, as well as their literacy levels, and get personalized messages with scheduling options for appointments.

As these sufferers are being recognized and contacted, risk stratification can show if sufferers have a pattern of not showing up for appointments, resulting in subsequent hospitalizations, Ranck claims.

“You require a 360-degree view of high-risk sufferers and a strategy. What is the context of the sufferers, and how can we customize a care policy to keep them healthy? It is intelligence gathering and transferring that intelligence into an actionable intervention.”

For example, analytics can indicate that most falls happen in certain types of apartment buildings, and contributors can utilize this intelligence to find ways to decrease falls, which could lower hospitalizations.

With social factors conventionally being a hurdle to getting care, the job of making better the access to care has fallen on social services agencies, Ranck notes. Leaving the job completely to such agencies is not enough in an accountable care era. “It was always someone else’s job, and now it is the physician’s and hospital’s job to augment traditional social facilities.”

Consequently, contributors require to focus on the highest-risk sufferers under their risk-based contracts, then utilize the predictive analytics to find the next level of high-risk patients that could transition to become high utilizers of services, Ranck claims. “That is the holy grail of predictive analytics—seeking out who they are.”

 

Wireless tech augments treatment begins for cystic fibrosis sufferers

New contemporary technology from Hill-Rom Holdings is made to more easily clear airways for sufferers with cystic fibrosis, and let the clinicians know at a distance how sufferers are responding to the proposed treatment.

The product, known as the VisiVest System, utilizes high-frequency chest-wall oscillation, which assists to clear the mucus from lung airways. It comes out with the wireless connectivity from the Qualcomm that sends information to a portal from Razorfish that reflects the information trends to clinicians through a dashboard.

The information also is present to sufferers so they can help in treatment decisions with the aim of better therapy adherence, in accordance to Hill-Rom.Full introduction of VisiVest followed a 6-month pilot test with 160 sufferers from 7 clinics specializing in the treatment of cystic fibrosis.

“What I like much about the VisiVest System is being capable to see my sufferers’ session information and trends,” Tom Newton, a pulmonary therapist at Miller Children’s Hospital in Long Beach, Calif. “Now, I am not merely telling my sufferers the more adherent they’re to their therapy the larger their pulmonary function numbers are likely to be. We can really look at their adherence score accumulatively and have a more detailed conversation about their numbers.”

 

Security firm seeks online market selling approach to 70,000 servers

(Bloomberg) Cyber-security firm Kaspersky Lab claims that it has disclosed an online marketplace where criminals from all over the world sell approach to more than 70,000 hacked corporate and government servers for as much as $6 each.

Kaspersky founded the forum after getting a tip from a European internet service provider. The market, known as xDedic, is handled by hackers, who are possibly the Russian speaking, that have ditched their conventional business model of merely selling passwords and have graduated rather than earning a commission from each transaction on their black market.

"It is a marketplace very much similar to EBay where persons can trade data about cracked servers," claimed Costin Raiu, head of global research at Kaspersky Lab. "The forum owners determines the quality of the hacked information and charge a commission of 5% for transactions."

An aerospace company from the U.S.A, oil firms from the states of China and the United Arab Emirates, a chemical company from the state of Singapore and banks from various different countries are among companies whose servers were compromised by xDedic, Kaspersky stated, declining to reveal any names.

As businesses ranging from the field of healthcare to retailers go digital, hacking is getting more advanced and is often instrumental to traditional crime. Markets offering criminals both the devices to hack into networks and the spoils of victorious attacks like credit card data are increasing in size and complexity. U.S. authorities operated with counterparts from more than a dozen other countries in the year 2015 to dismantle a sophisticated computer forum called as the Darkode, explained as an online, invitation-only market for cyber-criminals to purchase and sell products for infecting the proposed electronic tools.

Cybercrime services permit even low-skilled criminals to utilize the acquired malicious software to attack their aims, Kaspersky stated. Persons who purchase approach to servers on xDedic used the data for denial-of-service attack on businesses or to steal credit-card details from servers linked to systems like computer terminals in shops, in accordance to Raiu. Few have utilized the compromised servers to mine bitcoins, he stated. The marketplace is present on the internet, needing users to register and deposit $10 in bitcoins.

“It was not just government networks, but also corporations, research institutions, banks, telecommunication companies, to name a few," Raiu claimed.

 

Contributors Require info release plan in the occasion of mass casualties

When a mass casualty tragedy appears like a crime or disaster, loved ones of victims mostly gather at a hospital to seek data. That scenario recently played out in the state of Orlando following the shootings at a nightclub there.

Although, during those chaotic period, hospital executives might become simply confused about policies for data release, and information networks might be overwhelmed or not even come into utilization. It is for these challenging times that hospitals require adequate plans and processes to appropriately disseminate data.

Sometimes loved ones get data and sometimes they are told HIPAA stops the dissemination of data or limits it to blood relatives. But that is not right, claims Ann Bittinger, a healthcare attorney at the Bittinger Law firm in Jacksonville, Fla. If a sufferer is not incapacitated, then HIPAA principles apply.

If the sufferer is incapacitated, HIPAA guidance from the HHS Office for Civil Rights permits offering patient data to family, friends, loved ones like partners, clergy and others if the healthcare professional considers the sufferer would need those individuals engaged in the care, as they can inform clinicians about the medical conditions, allergies or other data that caregivers should know, Bittinger claims.

Media reports claim that Orlando Mayor Buddy Dyer inquired the White House for a waiver of HIPAA needs to share data with the loved ones of victims, but such a waiver is not needed and it was not granted.

To stop confusion and better serve loved ones, hospital disaster policies should involve one or more designated emergency department liaisons to interact with family, friends and the media, Bittinger suggests. Liaisons could involve a privacy or security officer, a public relations representative helped by an attorney, or a health information management professional.

Bittinger got an email from Marissa Padilla, principal deputy assistant secretary for public affairs at HHS, offering guidance on release of data during mass casualty occasions.

“HIPAA permits healthcare professionals the flexibility to reveal limited data to the public or media in suitable circumstances. These disclosures, which are made when it is evaluated to be in the best interest of a sufferer, are permissible without a waiver to assist to recognize incapacitated patients, or to locate family members of sufferers to share data about their condition. Disclosures are permissible to similar sex, as well as opposite sex partners.

“In accordance to 45 CFR 164.510, permitted uses and disclosures of health data involve disclosure to a family member, other relative or close personal friend of the person, or any other person recognized by the individual; the secured health information straightly relevant to such person’s involvement with the individual’s healthcare or payment regarded to the individual’s healthcare; disclosure to help in the notification of (involving identifying or locating), a family member, a personal representative of the person, or another person responsible for the care of the person; of the person’s location, condition or death.”

 

The transformation to ICD-10 was easier than several had hoped

When the expensive and exhausting transformation to the ICD-10 coding system occurred in the month of October, few experts within the healthcare industry hoped large-scale disruption and cataclysmic hits to contributors’ cash flow.

But dire predictions about negative impacts of the move did not come to pass and now, 8 months later, one of the leading agencies tracking the transformation says its most recent survey indicates minimal impacts.

Coding accuracy is hovering nearly 65% now, and the average productivity decrease was just 14%, much lower than hoped, in accordance to a research by the American Health Information Management Association (AHIMA) and the AHIMA Foundation.

“Health Information Management (HIM) experts are already coding with the similar degree of precision as (they were) in the ICD-9,” AHIMA CEO Lynne Thomas Gordon claims in comments on the outcomes. “With any change, there’ll be an initial time of productivity decline, but we completely expect this decline will be short term in nature. In fact, respondents showed in the survey that they’ve become more comfortable with the latest code set with per day, and productivity decreases sustain to lessen.”

Several survey respondents pointed out that the implementation of latest computer-assisted coding (CAC) technology appeared at the similar time as the introduction of the ICD-10 code set, which might account for few portion of the productivity decline. Health information management experts who worked in inpatient environments had less of a productivity decline instead of those who worked in outpatient environments, survey data indicated.

AHIMA and the AHIMA Foundation plan to take another survey in the month of May 2017 to evaluate trends in productivity and accuracy.

The U.S. was believed to be one of the last established countries to turn to the ICD-10 code set, which sustain many more codes than ICD-9 and enables medical records and bills to consist of much more detail. The switchover had been postponed or delayed at least twice, but previous year, federal organizations were clear that the latest code set would be needed for bills submitted to Medicare.

“The greater specificity in ICD-10 will offer for a more precise and complete patient story and a more meaningful way to detect the results of care,” Thomas Gordon stated.

 

EHRs must become more instinctive to help patient engagement

As more contributors move to accountable care and population health compensation arrangements, several realize the significance of improving attempts to engage sufferers in their care.

While understanding that engagement attempts will be important to support changing reimbursement methodologies, these new attempts so far have been perplexing to execute, claims Nick van Terheyden, MD, chief medical officer at Dell Healthcare & Life Sciences.

Part of the reason is that data technology in utilization by contributors has been constructed to automate routine transactions and present useful data and services, but does not always meet that aims, he elaborates.

Physicians were asserted under the federal meaningful use program to execute electronic health records (EHRs) to store sufferer data, but EHRs in large part haven’t saved prices, Terheyden emphasizes. Nor have EHRs become instinctive and give to physicians services they and everyone else can get on their smartphones, van Terheyden considers.

Smartphones provide the potential to give intelligence that offers insights without disruption to workflows, and that is what EHRs require to do, he adds. One way to make better the workflow and intuitiveness of EHRs could be utilization of technology like Amazon’s voice-command Echo Alexa smart home appliance that has Wi-Fi and streaming music, and can be served as a personal digital assistant.

Technology like that given by Echo Alexa delivers relevant insights at the correct time to the right user, van Terheyden claims, and EHRs require doing that—like automatically informing a physician at the point of care that the sufferer hasn’t had a tetanus shot in ten years. This kind of technology also can make better the patient and physician engagement and foster better results, in accordance to van Terheyden.

Right now, engagement is proposed to foster better results, but in huge measure is not yet doing so, he asserts. “You go observe the doctor who tells you what to do and you do it, but that is not engagement. That is simply consumption and I am not certain if that is the best selection for me and my situations and preferences.”

In short, sufferers may be following instructions, but not taking extra steps to acquire optimal results. Physicians, Terheyden claims, require a more interactive access to patient engagement; they can advise the requirement to decrease the calories and exercise more, but that generally doesn’t equate with a reduction in weight. What is needed is a change not merely in sufferer behavior, but physician behavior as well.

While sufferer engagement might not be optimal much of the time, there is an increasing subset of sufferers who do research on their own. They are inquiring what the physician advises and maybe even know more about a specific medical condition than the physician, van Terheyden claims. “We doctors have to come to the realization that we are not always the smartest personality in the room anymore. Sufferers require being their own primary care manager, and physicians have to admit it.”

With technology like that employed by Echo Alexa, a physician could generally inquire the EHR for the last time a sufferer had a CAT scan or another process. And if a red dot can occur on your phone demonstrating a message, the EHR could reflect a red dot indicating that a lab outcome is now available.

 

Xerox observes progress in telehealth, makes new product line

A company with a deep background of offering communications and analytics facilities to a variation of businesses is expanding its offerings within healthcare to an emerging care delivery venue—telehealth.

Xerox claimed that it is extending offerings to help contributors support care delivered in virtual settings, and integrate that care with data in EHRs (electronic health records).

The company stated that it will give Virtual Health Solutions, a customizable combination of consulting, facilities and technology based on contributors’ specific telehealth aims.

This type of healthcare delivery has good progress prospects because clients are open to getting virtual care. A latest survey conducted for Xerox by Harris Poll in May discovered that 61% of U.S. adults are eager to get non-urgent healthcare advice, exams or counseling in a virtual setting; although, only 16% have used virtual health, the survey discovered.

In accordance to the research, 77% of respondents claimed that they would be excited about the possibility of getting healthcare virtually. Convenience was cited as the top advantage (59%), followed by potential cost savings (40%) and the capability to observe or communicate with healthcare experts for minor ailments and the choice to easily refill prescriptions, both mentioned by 35% of respondents.

Xerox claimed that its new line of services involve interface design and development, to help overcome interoperability challenges to enable contributors to verify a sufferer’s identity and medical history; virtual health consulting services; and virtual clinic services, which involve front and back office facilities that enable contributors to connect with sufferers in a virtual setting.

“Healthcare agencies require to prepare for an ‘anytime, anywhere’ paradigm – one in which care is generally delivered outside the 4 walls of a hospital,” stated Connie Harvey, chief operating officer, Xerox Healthcare Business Group. “We understand that healthcare agencies are in very different places when it comes to their telehealth strategy. Our approach to virtual health permits us to give customized services deployed on a client’s specific requirements.”

 

Practice Fusion settle down with FTC over health information disclosures

Electronic health record (EHR) vendor Practice Fusion has accepted to settle Federal Trade Commission charges it misled clients by soliciting reviews for physicians utilizing its EHR.

The FTC contends the company did so without accurately unveiling that the feedback would be publicly posted on the Internet, resulting in the unveiling of sufferers’ sensitive personal and medical data.

In reaction to the settlement agreement, the company reports that its practices have altered and it doesn’t agree to wrongdoing. No fine was levied.

The FTC claimed its proposed charges are based on how the EHR vendor operated a treatment satisfaction survey feature from the time period of April 2012 to April 2013. The agency complaint alleges that Practice Fusion started sending emails in the month of April 2012 to sufferers of healthcare contributors utilizing its EHR service; the emails appeared to be sent on behalf of the sufferers’ doctors, inquiring them to rate their contributor. The data gathered then was utilized for a public-facing provider directory posted online in the year 2013.

“Practice Fusion’s actions led clients to share incredibly sensitive health data without realizing it would be made public,” stated the Jessica Rich, director of the FTC’s Bureau of Consumer Protection. “Companies that accumulate personal health data must be obvious about how they will utilize it—particularly before posting such data publicly on the Internet.”

Because sufferers mistakenly considered the data would only be shared with their contributor, the FTC claims some sufferers responded to Practice Fusion’s email solicitation by involving the inquiries about personal health data.

As part of the FTC settlement, Practice Fusion is prohibited and condemned from making fraud statements about the privacy of the data it gathers from clients. And before making any client data publicly present, the company must clearly reveal the expected utilization for information and gain consumer consent for that utilization.

 

ONC decides standards, specifications for API

The Office of the National Coordinator for Health IT has released a challenge to industry seeking application programming interface (API) solutions that will enable clients to protectively and electronically authorize the movement of their health information to destinations they opt.

In accordance to Caroline Coy, a HIT program analyst in ONC’s Office of Standards and Technology, one of the aims of the Move Health Data Forward Challenge is to assist to fill important gaps in health data exchange that are having a negative effect on sufferers.

 “One in 3 individuals who have observed a healthcare contributor in the last year experience gaps in data exchange,” Coy stated during a June 7 webinar on the challenge. “These involve: having to bring an X-ray, MRI, or other kind of test result with them to their appointment; waiting for test outcomes longer than they thought was affordable; having to redo a test or process because the previous test results were not present electronically; having to give their medical history again because their chart can’t be discovered; and having to tell their healthcare contributor about their medical history because they had not got their records from another healthcare contributor.”

Coy stated that ONC has collaborated with various health IT stakeholders to establish a set of privacy and security specifications made to enable individuals to control the authorization of approach to their health information. One such initiative is the Health Relationship Trust (HEART) Working Group, an attempt that leverages RESTful health-related information sharing APIs, as well as open standards like OAuth 2.0 security profiles, OpenID Connect, and User Managed Access.

Participants in ONC’s challenge will assist to make API solutions combined with the new implementation specifications established by the HEART Working Group, in accordance to Coy.

The challenge has 3 phases, with a cumulative prize rate of $250,000 and a maximum prize value each participant of $75,000.

Phase 1, the proposal phase, will give $5,000 to as many as ten winners, deployed on submitted proposals. Those winners then will move to Phase 2—the prototype and pilot phase—in which as many as 5 finalists will be given $20,000 each based on prototypes. The information for the API and solution must be given by Phase 2 finalists.

The last 5 Phase 2 awardees will proceed to Phase 3, where $50,000 each will be given to up to 2 winners, deployed on their capability to execute their solution. This final phase will include testing the solution in “real-life” conditions.

 

EHR violation at 2 ProMedica hospitals

ProMedica Bixby and Herrick Hospitals, both part of 13-hospital ProMedica based in the area pf Toledo, are notifying over 3,500 sufferers after founding that workers were searching at electronic medical records without authorization.

The tragedy is a reminder that while cyber attacks from the outside get important media attention, other security risks that have been around for several years need continued monitoring.

In its public filing on the violation, ProMedica reported that while the violation was founded in the month of April, the breaches had occurred since the month of May 2014. During that time, 7 workers approached the electronic records for sufferers they were not straightly treating and without valid business and clinical reasons, a ProMedica statement demonstrated.

Potentially compromised data involved the sufferer names, addresses, phone numbers, birth dates, and insurance, diagnoses, medications and other clinical data. ProMedica has disciplined some of the workers and fired others; in addition, it has started a new auditing program that involves the software that monitors worker activity in the EHR.

The agency is offering impacted individuals one year of credit monitoring services.

What Health Insurance exchanges Should do to Decrease the Premium prices

State health insurance exchanges may require taking the example set by California and beginning negotiating premium prices and contracting more selectively between payers.

The costs of premiums sold on the state health insurance exchanges tend to vary greatly, finds a report from The Commonwealth Fund. For instance, in the year 2016, the state of Tennessee saw a 38 percent increase in their health insurance premium costs while the exchange in Texas dropped premium costs by 8%.

Across the country, the monthly premium prices of all policies sold on the health insurance exchanges rose by 6 percent on average in 2016. Within employer-sponsored health plans, however, the premium costs increased by only 4% this year.

The report from the Commonwealth Fund also discusses how, in the year 2016, the 6% premium increase among marketplace plans varies drastically from the results in 2015 where marketplace premium costs did not rise on average across the country. However, in 2015, benchmark silver plan premiums did rise by 1 percent, but the same prices jumped to 6 percent in the year 2016

With mHealth level, the Smartphone is Merely the Beginning

Healthcare contributors are investing much time and money in enterprise-wide communications, and conclusion that the smartphone is a very versatile device.

Health networks are finding that an enterprise-wide smartphone level is much more than merely a cool way to give everyone a latest phone.

For Autumn Foy, director of clinical informatics at the Onslow Memorial Hospital, putting few 325 iPhones into the hands of the staff and clinicians at the North Carolina hospital is 1 measure toward improved care team coordination, which means better sufferer safety and better clinical results. When you are a small hospital on a tight budget taking a close look at a million-dollar project, those results resonate.

 “Our concentration at first was on sufferer safety,” claims Foy, who had to sell hospital executives on the merits of the level. “From there we observed at (the benefits in) making better the workflows, and making our employees more mobile. It is been a long, complicated procedure and a little problematic at times, but when you take a look at the sufferer first, that is a great 1^st step.”

How a Proactive Approach Make better the Healthcare Cybersecurity

A recent survey indicated that most companies do not utilize a data security vendor until after a data breach, which could affect the effectiveness of healthcare cybersecurity policies.

While healthcare data breaches were the most reported data security incident in the year 2015, it is not shocking that more agencies are employing or seeking a third-party managed security services vendor to assist identify and react to healthcare cybersecurity threats. Yet, many healthcare agencies are waiting until a significant data loss before using cybersecurity professionals.

According to a recent survey from Raytheon and the Ponemon Institute, about two thirds of businesses reported that their agencies only engage a cybersecurity vendor after a significant data breach occurs. This reactive approach to data security has been attributed to an increase in data loss.

Secure Email Key in New DirectTrust Sufferers Program

A new DirectTrust program expects to make better the communication with patients and providers, utilizing the secure email as one of the key components.

Previous week DirectTrust launched its Partnership for Patients Program (P4PP), a new initiative that expects to improve communication between patients and their providers, utilizing secure email to ensure that health information can be safely exchanged.

Even with technological advances, two-way digital communication can mostly be hindered by cost and overly complex systems, according to DirectTrust. However, P4PP aims to break down those barriers and will feature DirectTrust members.

Hospitals, offices, clinics, and other locations are all hoped to be part of P4PP, and four DirectTrust members currently participate in P4PP.

VA EHR Optimization Attempts an Uncertainty for Congress

A House subcommittee is looking a GAO research of the EHR optimization attempts underway or planned at VA.

The Department of Defense (DoD) is not the only federal agency in the midst of a huge EHR modernization project, with the Department of Veterans Affairs (VA) also working to upgrade its present EHR technology called as the Veterans Health Information Systems and Technology Architecture (VistA). And it is the latter that is raising concerns among members of Congress.

In a letter to the head of the Government Accountability Office, Representatives Will Hurd (R-TX) and Robin Kelly (D-IL) of the Committee on Oversight and Government Reform Subcommittee on Information Technology inquired the federal agency to study the VA's EHR modernization project of VistA.

"Given the importance of VA's electronic health record information system to the performance of its health care mission, and in light of VA's repeated attempts to modernize VistA, the Subcommittee is requesting data on the attempts to modernize VistA," wrote Hurd and Kelly.

"In specific, we would like to get data on the history of VA's efforts to modernize VistA, involving the prices and results of the efforts, the key contractors that have been involved, and the work that these contractors performed," the letter continued. "In addition, we inquire that the study determines VA's current plans and estimated costs for modernizing VistA."

Turnkey Access to Fighting Healthcare deception, Waste, Abuse

Collaboration is key to the fight against healthcare deception, waste, and abuse.

Healthcare deception, waste, and abuse (FWA) investigators have a tough job. Keeping pace with the new schemes, continuously weeding through hundreds of false-positive leads, and understanding the corect time to pursue a case are just a few of the issues a health plan’s special investigative unit (SIU) face. When armed with the right data to instantly open a solid case, SIUs can rapidly take intelligent action to educate providers, recover funds, or even prevent payment before it is made.

Why McKesson might sell its health Information Technology business

As reports surfaced previous week about McKesson considering the possible sale of its technology solutions unit, industry observers recommend that few factors may be aligning for the healthcare giant to reassess its stake in the healthcare information technology business.

To a degree, such assessments are a proposed part of the general course of business for industries in today’s economical world, claims John Osberg, managing partner at Informed Partners, a consulting firm that gives strategic business development services for healthcare industries. It is usual for huge companies to consider their portfolios and make strategic decisions, he emphasizes.

Few reports have recommended that McKesson may think about a sale now due to the present investment requirements needed to remain competitive in healthcare IT. Osberg, a mergers and acquisitions consultant, stated that he considers that McKesson for various years has not adequately funded research and development by the unit and may be recognizing that it would have to increase R&D considerably to sustain competitive.

“It has been a ignored asset to certain degree for a while now, and that compounds things,” he asserts. He likens the situation to Siemens Healthcare selling its products in the time of early 2015 to Cerner because upgrading would charge too much.

McKesson isn’t commenting on its policies or reacting to comments from industry insiders; a spokesman late Friday stated that the company doesn’t comment on rumors and speculation.

Initially this year, McKesson agreed to sell its small physician practice EHR and practice management systems to e-MDs, appreciating the purchaser could better service the clients. The acquired software involved the Practice Choice, Medisoft, Medisoft Clinical, Lytec and Practice Partner product lines.

In the time of accountable care and value-based compensation, vendors are under the gun to empower investments and come out with latest product features. In specific, McKesson’s competitors, like Epic and Cerner, have been investing hundreds of millions of dollars into their products, claims the Ken Kleinberg, managing director of the research and insights at the institute of Advisory Board Company, a consultancy.

 

Remember to Register for This Week's Webinar on MIPS Performance Category

Join Webinar on June 8 to Learn More about the Resource Use Performance Category

The Centers for Medicare & Medicaid Services (CMS) invites the public to join an upcoming listening session to learn more about the Resource Use performance category, which is part of the Merit-Based Incentive Payment System (MIPS) proposed in the recently released Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Notice of Proposed Rulemaking (NPRM).

MIPS: Resource Performance Category Overview

• Date: Wednesday, June 8, 2016


• Time: 12:00 – 1:00 p.m. ET


• Register: To participate, visit the registration webpage.


• Details: This webinar will provide an overview of the MIPS Resource Use performance category, as outlined in key provisions of the recently released MACRA NPRM.
  
  One of the four proposed performance categories included in MIPS, the Resource Use category would account for nearly 10 percent of the MIPS score in the first year. The proposal would replace the Value Modifier for Medicare physicians. During this webinar, CMS subject matter experts will discuss the proposed category’s principal changes from Value Modifier, and how CMS envisions its measures can provide clinicians with the information they need to deliver the appropriate care and advance the health outcomes for their patients.

Please note: Participants are invited to share initial comments or questions using the webinar’s chat feature and during the Q&A portion of the webinar, but only comments formally submitted through the process outlined in the Federal Register will be taken into consideration by CMS. See the proposed rule for information on how to submit a comment. Comments are due by 5:00 p.m. ET (for mail or courier submissions) and 11:59 p.m. ET (for electronic submissions) on June 27, 2016.

For More Information

Visit the Quality Payment Program’s events page to learn more about CMS’ upcoming webinars. For more information on the NPRM and MIPS, visit the website and review the press release and fact sheet.

McKesson reportedly considering sale of its HIT unit

McKesson may be mulling a move to divest its Technology Solutions unit, which offers a range of information systems to hospitals, physician practices and other contributors.

McKesson executives were contacted for comment on the potential sale, but refused to comment. A spokesman for McKesson reacted that the company does not comment "on rumors and speculation."

McKesson’s tech unit had sales of $2.9 billion in the fiscal year which lasted on the day of March 31, 2016. The unit could fetch up to $5 billion, stated that The Wall Street Journal, which 1^st reported the possible move. The company is mulling the moves that will empower profit margins overall, The Journal claimed.

Initially this year, McKesson sold its small physician practice electronic health records (EHRs) and practice management product lines to e-MDs. The McKesson products for small practices were utilized by some 35,000 physicians. That sale to e-MDs did not depict a change in McKesson’s overall health information technology strategy, stated the Scott Sanner, senior vice president and general manager at McKesson’s business performance unit at that time.

The product suite involves the Paragon electronic health record system, and separate data systems for the emergency department, home care, surgical, supply chain, enterprise resource planning, sufferer access, revenue cycle, clinical decision support, diagnostic imaging, data analytics, controlled substances management and chronic care management.

Whether the RelayHealth interoperability unit is part of the deal or retained isn’t still obvious. While McKesson’s HIT portfolio is among the greatest in the industry, the company’s main business is drug distribution.

 

Global market for cancer therapies Rises to $107 billion in the year 2015

The global market for oncology drugs swelled to $107 billion in the year 2015, fueled by a steady surge of innovation and new therapies that flooded the market, a new study issued by the IMS Institute for Healthcare Informatics revealed. More than 70 new cancer treatments have launched in the last five years, and more than 20 tumor types now have new adversaries because of them.

The study, called Global Oncology Trend Report: A Review of 2015 and Outlook to 2020, indicated an 11.5% increase in growth in global spending on oncology therapeutics and supportive care drugs in constant dollars, which are adjusted for inflation. The growth was calculated using ex-manufacturer prices, and doesn’t reflect off-invoice discounts, rebates or patient access programs.

Projected annual global growth in the oncology drug market is forecasted at 7.5 – 10.5% through 2020, which would translate to $150 billion. Utilization of new products, especially immunotherapies, is hoped to drive much of the growth.

MD Anderson changes to analytics, big data to battle the cancer, empower efficiencies

MD Anderson Cancer Center is sitting on 23 petabytes of data, involving more than 2 billion diagnostic radiology images, generated by its massive IT infrastructure. But Chris Belmont, vice president and CIO, is not intimidated by the amount of data—he’s just scared of staring at it too long.

“Our biggest fear when we decided to move into Big Data was that, like many healthcare organizations, we would have a 2-year data ‘ingestion’ process where we’d keep thinking about that massive set of data, and connect all our systems big and small together, go get even more data from external sources, and then eventually offer our users an add-on tool and tell them to go at it,” Belmont says. “By the time we’d be done ingesting all that data, the time to change the game in terms of costs or population health would have already passed.”

MD Anderson, the Houston-based health system devoted to cancer care, is not the kind of organization to let time slip by.

The center has embarked on a large-scale analytics effort to better understand the myriad forms of cancers it treats and establish the therapies and medication regimens to combat them. In the past six months, it’s also put together a Big Data infrastructure focused on pulling nuggets from every nook and cranny from the enterprise to make it more efficient, be it procurement data, cost data, enterprise resource planning or another data set hanging out there. Central to that effort is speed: The center needs to be capable to take ideas for data tools, assess and quantify their value, and then build them within a matter of weeks.

Will the DoD EHR Modernization Project Remains on Schedule?

An internal audit of the DoD EHR modernization project asks whether the schedule for the EHR implementation is realistic.

Department of Defense Office of Inspector General earlier this week released an audit report of the EHR modernization that raises doubts about the federal agency's ability to meet the end-of-the-year goal for EHR implementation.

The intention of the audit was to make sure that "had approved system needs for the DoD Healthcare Management System Modernization (DHMSM) program and whether the acquisition strategy was properly approved and documented."

While the IG determined that procedure to have satisfied requirements for identifying its EHR technology needs and the EHR selection process, it expressed doubts about the EHR implementation schedule.

AHA: Commercial ACO Tax Ruling hinders Value-Based Care Models

In a letter to the IRS, AHA elaborated that the recent decision to disqualify a commercial ACO from charitable tax exempt status could discourage value-based care for other contributors.

By stripping commercial accountable care organizations (ACOs) of their charitable tax exempt status, the IRS could be threatening the future of value-based care and care coordination, in accordance to the American Hospital Association (AHA).

In a letter addressed to IRS Commissioner John Koskinen, the AHA described that the recent ruling against upholding tax-exempt status for an unnamed ACO was unfounded. Non-Medicare ACOs promote better healthcare for different communities like Medicare Shared Savings Program (MSSP) ACOs and, therefore, deserve a nonprofit, tax-exempt designation.

“We’re seriously concerned that the IRS has adopted a ruling position that means nonprofit hospitals threat losing their tax exemption if they pursue a modern approach to clinically integrated health care that holds the largest promise for improving outcomes and reducing costs,” wrote Melinda Reid Hatton, the AHA’s Senior Vice President and General Counsel.

Blue Cross premium rises in Texas, Oklahoma could mean Illinois sticker surprise

Illinois residents who purchase Blue Cross and Blue Shield health care coverage through the state insurance exchange may be in for Obamacare sticker surprise, if proposed rate rises by the greatest insurers in Texas and Oklahoma are any indication.

Texas and Oklahoma are potential harbingers of Blue Cross' costs on the Illinois exchange because entire 3 health policies are owned by the similar company, Chicago-based Health Care Service Corp. Blue Cross is the most famous insurer on the Illinois exchange.

In Texas, Blue Cross and Blue Shield is finding the increases averaging 53.7% across its Affordable Care Act plans, in accordance to documents posted online by the federal government. In Oklahoma, Blue Cross and Blue Shield is seeking rate increases that average 49.2%. It is far from certain if the amount increases will hold up on review, or how much they might change.

Illinois' proposed amounts have not been made public by the state so it would be premature to discuss, stated HCSC spokesman Mark Spencer. But he cautioned against speculating on the company's prices in the year of 2017 Illinois individual market because there are differences between states and health insurance is priced regionally.

Consumer group claims Wade recuse herself on Cigna merger

A consumer group claims Gov. Dannel P. Malloy should ignore “going back to the days of Corrupticut” and replaces Insurance Commissioner Kathleen Wade as the primary state regulator on a proposed mega-merger between Anthem and Cigna insurance companies.

The Connecticut Citizen Action Group (CCAG) and its allies, which involve the Connecticut State Medical Society, condemn the proposed merger and another planned by Aetna and Humana, claiming they could drive up premiums and limit treatment and coverage choices.

On the day of Thursday, CCAG started circulating a petition inquiring the Malloy to replace Wade, a former Cigna worker, in the review of the Anthem-Cigna merger with “a truly independent actor who will put Connecticut’s interest over insurance companies.”

Connecticut Department of Insurance spokeswoman Donna Tommelleo declined comment. The governor’s office had no instant response.

Opponents of the merger were angered by Wade’s decision to provide state approval to the marriage of Aetna and Humana on the day of Jan. 22 without public notice or a public hearing. Wade disclosed her decision merely last week, responding to questions about the issue from the Connecticut Mirror.

ONC Issues the Educational Videos on HIPAA Rights for Sufferers

The Office of the National Coordinator issued the videos to better clarify HIPAA rights for patients, ensuring individuals understand how to access their data.

In an effort to better educate individuals on HIPAA rights for patients, the Office of the National Coordinator (ONC) issued a series of videos that explain the rights patients have to access their health information.

Additionally, ONC disclosed a Patient Engagement Playbook, designed to help providers, practice staff, hospital staff better engage with patients through health information technology (health IT).

“Many people are not completely aware of their right to access their own medical records under the Health Insurance Portability and Accountability Act (HIPAA), including the right to access a copy when their health information is stored electronically,” ONC’s Chief Privacy Officer Lucia Savage, J.D., said in a statement. “The videos we issued today highlight the basics for individuals to get access to their electronic health information and direct it where they wish, including to third party applications.”

Studies: mHealth SensorsAssist the Seniors Ignore the Hospital

2 mHealth projects at the University of Missouri are touting the value of sensors in monitoring seniors' activity and sleep patterns at home.

An innovative mHealth program at the University of Missouri is using 2 different kinds of mobility sensors to monitor seniors for trending health concerns.

MU researchers are testing radar sensors to measure daily activity levels in seniors at Tiger Place, the university’s independent living community. They have also established the sensors that, when placed underneath a mattress, can measure cardiac and breathing activity in sleeping seniors.

How to Manage ICD-10 Implementation Updates, Maximize Revenue

AHIMA has issued a guide on how to prepare for upcoming ICD-10 implementation updates that could assist agencies to boost claims reimbursement.

Just as most healthcare stakeholders reported that ICD-10 implementation ran smoother than expected, CMS will be issuing the 5,500 new codes beginning in October. While it may sound like a large update to the system, the new codes could help contributors submit more specific claims and boost their reimbursements.

To help agencies prepare for the updates, the American Health Information Management Association (AHIMA) has released a guide on how to implement upcoming ICD-10 updates.

As the CMS freeze on the addition of new codes thaws, AHIMA reassures providers that ICD-10 implementation for the updates could be convenient than the initial transition.

AMIA Calls For Sufferer Access to Complete Health Information

AMIA has asserted the federal government to repeal a regulation on unstructured EHR data that could assist the patients access their health data.

At the 2016 ONC Annual Meeting, the American Medical Informatics Association (AMIA) has asked the federal government to repeal the prohibition on the use of unstructured data in case to assist the patients access all of their health information.

In a statement on its website, AMIA elaborated that the regulation that limits the use of unstructured data has caused healthcare stakeholders to only access certain parts of EHR data for patients, such as summaries, and not the entire medical history.

“The prohibition – originally involved to prevent unstructured data overload – has outlived its usefulness,” stated the Douglas B. Fridsma, MD, PhD, FACP, FACMI, AHIMA President and CEO. “Further, this prohibition has muted conversations on data portability for providers looking to switch EHRs, who currently only have access to summary records of their patients’ data.”

DoD inspector asks whether EHR decline of agency will be met

The Defense Department’s policies to implement a new electronic health record (EHR) system by the month of December may not be realistic, in according to a new audit from the DoD Office of the Inspector General.

In July 2015, the Pentagon granted a $4.3 billion contract award to a Leidos-Cerner team to modernize DoD’s EHR system. Called the Defense Healthcare Management System Modernization (DHMSM), the integrated system is designed to replace legacy military health systems and promote greater efficiencies by leveraging commercial-off-the-shelf Cerner Millennium solution.

An initial deployment is slated for December, when the EHR will be rolled out to DoD locations in the Pacific Northwest. But the OIG is concerned that the DHMSM program schedule might not meet initial operational capability needs by the end of this year.

“While the DHMSM program office has recognized the threats and mitigation strategies, it is still at risk for obtaining an EHR system by the December 2016 initial operational capability date due to the risks and potential delays involved in developing and testing the interfaces required to interact with legacy systems, ensuring the system is secure against cyber attacks, and ensuring the fielded system works correctly and that users are properly trained,” concluded the OIG report, which was released on Tuesday.

However, speaking that similar day at the ONC Annual Meeting in Washington, DC, Stacy Cummings, program executive officer for the Defense Healthcare Management Systems program, gave no indication that the EHR implementation schedule might be at risk because of potential delays with interfaces and inadequate training.

“We are going to be doing testing both prior to and during the deployment to make sure that our interfaces are working, to ensure that the workflows are working, as well as to make sure that it’s operationally suitable for our needs in the Department of Defense,” said Cummings, who oversees DoD’s EHR modernization, including the operational, infprmation exchange and interoperability initiatives.

She added that DHMSM is contributing in training, change management and coaches to aid the deployment of the new EHR. “As we deploy to a location, we are not just training people how to use the system,” stated Cummings. “We’re actually teaching them how to take advantage of the business processes and the decision support that is inherent in the commercial tool.”

Nonetheless, the OIG suggested that Cummings, as the program executive officer for Defense Healthcare Management Systems conduct a schedule analysis to determine whether the December 2016 initial operational capability deadline is achievable and remain to monitor DHMSM program threats and report to Congress quarterly on the progress of the program.

CMS Healthcare Payment Strategies Decrease the Hospital Readmissions

The Health Care Innovation Awards project has brought benefits to sufferers as well as new ideas for healthcare payment strategies to CMS.

The Centers for Medicare & Medicaid Services (CMS) Innovation Center was created in case to develop more revolutionary healthcare payment strategies that could reduce the cost of Medicare, Medicaid, and the CHIP programs. One of its initiatives, the Health Care Innovation Awards, was recently profiled in a CMS Blog.

The Health Care Innovation Awards project has brought benefits to sufferers as well as new ideas for healthcare payment strategies to CMS. For example, Innovative Oncology Business Solutions, Inc. adopted a medical home approach that improved access to care by extending same-day appointments and weekend hours as well as improved patient engagement through disease management guidance.

There was greater sufferer satisfaction found for the increased office hours on the weekends. The results also show that all of this led to fewer emergency room visits and hospital readmissions for more than 2,100 patients.

Most 2016 Healthcare Data Violations From Unauthorized Approach

While most of the top healthcare data violations in the year 2015 were because of hacking, the majority of the greatest breaches so far this year stem from other problems.

Last year is often referred to as the “Year of the Hack” for healthcare, with the majority of healthcare data violations being caused by third-party cyber attacks. The top 3 tragedies alone combined to potentially affect almost 100 million individuals, and were all involved hacking.

So far, 2016 is not immune from healthcare data violations, but the leading cause of incidents is unauthorized access, according to the Department of Health and Human Services (HHS) Office for Civil Rights (OCR) data breach reporting database.

There have been 114 tragedies reported to OCR between Jan. 1, 2016 and June 1, 2016. Of those, 47 were classified as being caused by unauthorized access or disclosure. The rest of the classification breakdown is as follows:

• 34 - hacking/IT incident


• 26 - theft


• 5 - loss


• 2 - improper disposal

However, the greatest healthcare data breach so far this year was because of a hacking incident.

ONC Posts Updates on Health IT Certification Transparency

Updates to certified health IT product list now involve the details about the costs and limitations of their implementation and utilization.

The Office of the National Coordinator for Health Information Technology is beginning to make good on its promise to increase transparency of information on certified EHR technology and health IT systems.

Before the beginning of the 2^nd day of its annual meeting, the federal agency declared the updates to its certified health IT product list (CHPL) to involve disclosures of information — costs and limitations related to implementing and using various certified technology.

“These new attempts to provide more and easier-to-understand information are critical to helping clinicians find the right tools to provide better care and make better the health of their patients,” said National Coordinator Karen DeSalvo, MD, MPH, MSc, said in a public statement Wednesday.

“This information and our new websites," she sustained, "will make the process of comparing and buying certified health IT simpler and better, discourage information blocking, and create clear incentives for developers to focus on the quality and usability of their products."

CMS Permots Few ACOs to Join New Value-Based Care Model

CMS has extended the participation requirements for the value-based care program CPC+ to include certain Medicare ACOs, involving the MSSP ACOs.

CMS has expanded the eligibility needs in the Comprehensive Primary Care Plus (CPC+) model to involve primary care physicians in certain Medicare accountable care organizations (ACOs), according to an updated fact sheet.

Up to 1,500 primary care practices out of the total 5,000 permitted in CPC+ can also be part of an ACO, reported CMS.

Although, only primary care practices that are participating in the Medicare Shared Savings Program (MSSP) are considered eligible for the new payment model, which is scheduled to begin on the day of January 1, 2017. Practices that are part of the Accountable Care Organization Investment Model, Next Generation ACO Model, or any other shared savings program are ineligible.

Fremont City Council gives approval to reimbursement price for Costco plan

The Fremont city council has unanimously passed the reimbursement of nearly $200,000 for engineering services if Costco comes to the town.

It was standing room only as several persons were opposed to the chicken processing plant to build in southeast Fremont.

But city leaders stated that this would benefit the city.

"To say no to this agreement tonight would generally place the city on unessential financial risk and that is not in the best interest of the city," stated Greater Fremont Development Council executive director Cecilia Harry.

Tuesday night's meeting concentrated on getting utilities to the place the proposed Costco chicken processing plant would make.

Security practices are not adapting to quick changes in IT strategy

Healthcare agencies and other companies require changing security approaches as their agencies pursue changes in IT strategies and operations, in accordance to results of recent research.

Slightly more than half of the 500 security experts stated that their organizations have altered security approaches based on changes in IT operations, like depending on more cloud-based solutions or making wider use of mobile devices and apps.

Although, the study also discovered that 43% of respondents prioritize other technology requirements in their companies over security.

The Practices of Security Professionals study was taken by CompTIA, a not-for-profit association for the technology industry.

“Far more than half of all industries have adopted cloud computing and mobile devices,” stated Seth Robinson, senior director, technology analysis at CompTIA. Results of the survey “recommend that several companies are embracing new technology solutions without taking the corresponding actions essential to build a proper defense. This poses huge challenges for the IT security professionals tasked with security responsibilities.”

IT security professionals confront several challenges, CompTIA said in its analysis. Slightly less than half of respondents (47%) say there is a belief within their agency that existing security is “good enough.” Four in 10 cite a lack of security metrics, while a slightly smaller percentage (37%) point to a deficiency of budget dedicated to security.

A majority (90%) of IT professionals say security is of greater significance today to their companies than it was 2 years ago. While some improvements in security have been noted, many companies require improving their standing, CompTIA asserts.

“Simply placing a higher priority on security might not lead to improved measures,” Robinson said. “Companies may not completely understand the nature of modern threats. It is incumbent on the IT pros to adequately communicate the needs for modern security, the potential cost of weak defenses and the specific actions that should be taken.”