News

VisualDx will debut a new version of its clinical decision support system at HIMSS16. The company is growing its image- and graphics-oriented software from supporting skin, eye and oral care decision-making to include more chief medical complaints.

The Baylor College of Medicine revenue cycle department has come back from dire situation that saw the division hemorrhaging staff over what CTO Alex Izaguirre called a lack of vision for department.

Advanced degrees and credentials literally pay off for health IT professionals. Additional credentials such as certifications, in fact, roughly double the chances professionals have of earning an annual salary greater than $130,000, according to a new survey from the University of South Florida Morsani College of Medicine, Bisk Education, and HIMSS. While 29 percent of survey respondents said they make more than $130,000 annually, only 12 percent without credentials rank in that category. Women lead in the realm of furthering education, with 232 reporting additional credentials compared with 150 male survey respondents, the survey said.  [Also: Healthcare IT workers shortage stings in Georgia] The majority of health IT professionals earn salaries greater than $80,000 per year, the study found, and 140 survey respondents said they were very satisfied with their career in health informatics compared with only 18 describing themselves as very dissatisfied,. The survey included 404 health IT professionals from 7 countries and 42 U.S. states. There is a correlation between the level of education and job satisfaction: Professionals with advanced degrees (master’s and doctorates) are more likely to be very satisfied (89 respondents) or at least somewhat satisfied (55) with their career choice, compared with people who are very dissatisfied (4), the survey determined. [Also: Big salary gap between men, women healthcare pros] Of the 404 survey respondents, 303 reported unique job titles. The potential exists to categorically break down job titles and discover how the different categories correlate with income and education, the University of South Florida Morsani College of Medicine said; however, there is a larger narrative here concerning the profession’s many niches, which require professionals with a wide range of skills and backgrounds. Health IT professionals overwhelmingly see career growth over the next five years: 337 survey respondents believe their career will continue to grow, compared with only 41 who do not. Twitter: @SiwickiHealthIT

As if healthcare executives don't have enough worries about implementing electronic health records, yet another issue is starting to ramp up. "What's been happening more frequently in the last few years is that certain plaintiffs' lawyers – a kind of group of them who communicate with each other – have started to see the medical record as an opportunity for litigation," said Mary Re Knack, a Seattle-based attorney for the firm Ogden Murphy Wallace. Knack will be presenting an exploration of these emerging litigation troubles in the session "Just Press Print: Challenges in Producing EHRs in Litigation" with colleague Elana R. Zana at HIMSS16, beginning in late February. Twitter: @HealthITNews Electronic health record design is paramount among those issues, Knack said, because EHR vendors quite naturally did not build the software with litigation in mind. "The data is all stored behind these templates, and depending on what you are trying to look at, whether it's a summary or lab reports or such, the data then populates the template on a screen. But when you print it, it doesn't print out as cleanly or as nicely,” Knack said. One of these obvious challenges in trying to review somebody's care is how do you see it? How do you even read what the care was? Who did what? And when? "You may have a case that's very straightforward medical malpractice, but because of the way the medical records get printed out, the same piece of data may appear in five places. Somebody who looks at it, whose goal is to show how it's confusing, can then start to challenge the care that was given based on the fact the medical record is confusing,” Knack explained. “They can take another step, and that is questioning whether the data in the medical record is accurate or if it has been changed." As a result, Knack said, a healthcare provider can find itself in litigation that is ostensibly about the care provided, when in actuality that organization has to " defend how the medical record works." [Like Healthcare IT News on Facebook] Practically speaking, she said, the potentially expensive situation needs to be addressed by enhanced communication between provider organizations, particularly C-suite staff, and their vendors, and also internally within provider systems. "In the healthcare community, the medical negligence work, because of the way it's insured, tends to kind of be off on the side,” she added. “This isn't true in every healthcare setting, of course, but it's off to the side many times so the people who are the decision makers with respect to bigger issues aren't necessarily aware of how these particulars are being used in litigation, because litigation is handled 'over there.'" Knack and Zana will be presenting "Just Press Print: Challenges in Producing EHRs in Litigation" from 2:30 - 3:30 p.m. March 1 at the Sands Expo Convention Center, Palazzo L. Twitter: @HealthITNews

(SPONSORED) Mobile devices are an important part of the modern health landscape, but the industry needs to go further than that.

Privia Health will expand its work with athenahealth to ratchet up its focus on population health, the accountable care organization announced on Wednesday. Arlington, Virginia-based Privia Health will fully integrate athenahealth’s population health offering into its existing framework of athenaOne services for all 1,200 of its multi-specialty independent providers across five states and Washington, D.C. [Also: Jonathan Bush performs CPR on San Francisco sidewalk] Athenahealth will assign evidence-based health risk statuses to patients. The goal is to enhance patient engagement, and provide insight to better direct and align clinical protocols and team-based capabilities – all in an effort to provide value-based care. Privia Health CEO Jeff Butler credits athenahealth with helping the medical group become one of the top ACOs in the country, with care models and incentives fully-aligned around driving value into the system. In 2014, the first year Privia assumed shared-risk in the Centers for Medicare and Medicaid Services Shared Savings ACO model, Privia saved Medicare nearly $5.7 million and received half of that back in an incentive payment, according to CMS data. Privia Health has worked with athenahealth since 2014 to support clinical integration and connectivity between its medical groups and clinically integrated networks. Privia and athenahealth have already integrated athenahealth’s platform with Privia’s proprietary population health workflow systems and technology, bringing automation and scale to Privia’s programs that are focused on improving outcomes and reducing healthcare spending. Twitter: @HealthITNews

Steve Sisko, aka @Shimcode on Twitter, did not originally embark down the path toward healthcare IT. His primary career choice, rather, was in the field of aviation technology.

After facing an unacceptable 70 percent patient matching rate, the San Diego Health Connect health information exchange said it has turned its performance around using identity validation technology to better match patients and in the process clean up its master patient index. Its current patient matching rate is 98 percent. "To a certain degree, we caused the problem ourselves," said Dan Chavez, executive director of San Diego Health Connect. "We use very strict matching criteria. Not every HIE uses the strict matching criteria we do. We require a 100 percent match on six variables to automatically match patients. Other HIEs make the governance decision not to match on such strict criteria. If you loosen the rules in probabilistic and deterministic matching, you can have a higher rate. We want the machine to do as much as possible, but we don’t make it easy because we want the faith and trust that what comes out of the HIE is 100 percent correct." [Also: 'New value propositions' emerge for HIE.] At the 70 percent matching level, San Diego Health Connect had a backlog of requests that had to be manually reviewed. For example, Dan Chavez and Daniel Chavez and Daniel J. Chavez could all be the same person, with different records at different facilities in the San Diego area. Further, when consumers get married or divorced and change names, multiple different records may exist. "There are more than a few Chavez's in San Diego, as you might expect, so my name might go into the exception queue — and I’ve received care at Sharp and Scripps, and maybe my records do not match," he said. "Prior to using Verato, someone from the Sharp medical records department and someone from the Scripps medical records department would have to get together through an e-mail or phone call. If I had additionally been to UCSD, or if someone fat-fingered my Social Security number, the exception would pop up yet again for me, and UCSD would have to get online with Sharps and Scripps. So you see the magnitude of the problem." The exceptions queue grew so large and the backlog so long that medical records departments in the community said this HIE thing was killing them. [Also: New HIE, vendor members for CommonWell.] Verato's Carbon is a cloud-based identity data management system, what the company claims to be the most complete and accurate database of U.S. identities. "We source billions of records including credit agency and telecommunications provider data, along with government and legal data; and we use proprietary technology to produce our view of individual identities," said Joaquim Neto, senior solutions architect at Verato. San Diego Health Connect, for instance, automatically ran its exception queue against the Carbon database and quickly matched 80 percent of the exceptions to their correct records, Chavez said. "Then, with a little bit of examination, we could much more easily deal with the additional 20 percent — associating pediatric patients with parent addresses," Chavez cited as an example. "One of the challenges of patient ID in pediatrics is naming conventions. With the interactions with Carbon, we then could go back to the community and say, 'We all are doing some things incorrectly.' It gave us some guidelines in community-wide naming conventions, so we could go back to participants in the HIE and say, 'If it’s a hyphenated last name, let's place the second name in this field and the first name in that field.'" Improving the patient matching rate earned San Diego Health Connect a higher degree of confidence in the information coming out of the health information exchange among healthcare organizations in San Diego and Imperial County, Chavez said. "People know if the HIE is delivering information for Dan Chavez that there is a 98 percent-plus chance that we in fact have the right Dan Chavez," he said. "That confidence was not there before." [Like Healthcare IT News on Facebook] The HIE declined to share the cost of using the Carbon system from Verato, but the vendor said the ticket could be between $250,000 to $500,000 a year for an organization the size of San Diego Health Connect. "The soft return on investment is the confidence in the HIE as we deal with the medical records in the entire community of 3.2 million people; these providers know when they get patient information from SDHC, it is correct," Chavez said. "The hard ROI comes in no need for medical records departments to call up anyone to check exceptions. They do not have to challenge the data or make 3-5 phone calls to reconcile. Those phone calls at a minimum of 5 minutes a head are expensive." Twitter: @SiwickiHealthIT

Cincinnati, Ohio-based Mercy Health has saved more than $42 million on drugs since 2010 by building a formulary within its electronic health record platform. The move, according Wayne Bohenek, vice president of care transformation at Mercy Health, makes it easier for the system’s network of providers to order medications that are on its list and compliant with Mercy’s pharmaceutical contracts. The 23-hospital system went live with its Epic EHR in 2010. It took Mercy Health’s pharmacy and therapeutics committee three years to create the formulary -- a comprehensive list of medicines that Mercy Health would prescribe, said Bohenek. The committee, composed of prescribers from all specialties, evaluated the cost-effectiveness, side effects, comparable efficacy, indications and available literature for medications in 100 classes. [Also: Managed care pharmacies reap benefits of EHRs] Mercy places drugs in one of four categories: on the formulary and available from order sets; on the formulary but not available from order sets; restricted to a specific disease state or provider type; and neither on the formulary nor in order sets. These categories correspond to Mercy’s “bullseye” -- a visual representation of each medication class that committee members use to review their decisions.  For drugs that are neither on the formulary nor in order sets, Mercy built more than 800 therapeutic interchanges. When providers order a non-formulary medication, the system suggests formulary alternatives. If providers don’t choose an alternative, they document a reason. Mercy reports on the data to identify providers who routinely order non-formulary medications. “We generate reports on non-formulary drugs -- how many times they were ordered, and what the cost savings would be if we were to use a formulary drug instead,” Bohenek said. “We can provide that report by region and provider and have discussions with providers who are using non-formulary drugs. The reports show providers how much non-formulary drugs are costing the region.” “We’re pretty prescriptive about it,” said Susan Mashni, chief pharmacy officer at Mercy Health. “An extensive drug monograph is completed for each class of medications.” So far, Bohenek and Mashni said providers have been receptive tot eh workflow. “I think most prescribers see the reality of how much drugs cost and what the impact of prescribing them is,” Mashni said. “As long as it’s just an educational discussion, they’re very responsive to the concept that you’re going to improve patient compliance if you don’t give them the most expensive drug out there.” Mercy Health now has an average formulary compliance of more than 98 percent. [Like Healthcare IT News on Facebook] The formulary management is most effective with a single EHR across the health system because it enables the health system to make modifications as their contracts change and to monitor compliance.   The move to Epic – and the health system board’s insistence that 85 percent of content be standardized – provided the impetus Mercy needed to adopt a formulary. Prior to rolling out Epic, Mercy employed a mix of technology, primarily from McKesson and Meditech  – and paper. Twitter: @HealthITNews

(SPONSORED) Telehealth technologies are on the rise. For hospitals and providers, telehealth enables more frequent connections with existing patients, and the ability to reach new patients in new markets. Here are the top ten questions providers ask when considering telehealth.