SMARTDC Monthly Newsletter- A Timely Summary of Your IT News

Ensuring Healthcare Providers Know How to Participate in the Federal Incentive Programs

In an excellent written piece in Information Week by Anthony Guerra, he writes that "now that Meaningful Use and Certification rules have been developed, the Centers for Medicare and Medicaid Services and the Office of the National Coordinator for Health Information Technology are focusing on ensuring healthcare providers know how to enroll in the program" .

The Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) are focused on ensuring healthcare providers know how to enroll in the soon-to-be-launched incentive program. In a "free training" session held by CMS on the final rules, officials from that agency and ONC covered eligibility issues, the relationship between HITECH and other government incentive programs and how the states and federal government will harmonize the Medicare and Medicaid portions of the program.

Beyond actually doing the Meaningful Use work, providers must adhere to administrative requirements. In January 2011, all providers must register via the EHR Incentive Program website; be enrolled in Medicare FFS, MA, or Medicaid (FFS or managed care); have a National Provider Identifier (NPI); use certified EHR technology to demonstrate Meaningful Use (Medicaid providers may adopt, implement, or upgrade in their first year) and all Medicare providers and Medicaid eligible hospitals must be enrolled in PECOS.

States will connect to the EHR Incentive Program Web site to verify provider eligibility and prevent duplicate payments; and ask providers for additional information in order to "make accurate and timely payments" (such as patient volume, licensure, A/I/U or Meaningful Use, and Certified EHR Technology).

The issue of eligible providers who practice at multiple locations is a very big issue for healthcare providers interested in these incentive payments.

You may read more of above article at URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=226200191

Physicians That Use Smartphones Are Overwhelmed

As reported at www.ihealthbeat.org on July 27, 2010, is the following article regarding smartphone usage amongst today's busy physicians.

Ninety-four percent of physicians said they use smartphones to manage personal and business workflows and to access medical data, a report from Spyglass Consulting Group found, Health Data Management reports (Health Data Management, 7/26).

According to the report, growth in smartphone use is driven by physicians' desire to:

• Improve communication and collaboration;
• Streamline productivity; and
• Improve patient care and safety (Dolan, Mobi Health News, 7/26).

The number of physicians who said they used the technology in 2010 has increased by 60% from 2006, when Spyglass conducted a similar survey. In 2006, 59% of physicians used smartphones.

According to Gregg Malkary, managing director of Spyglass, physician use of smartphones is growing more rapidly than use by the general public (Monegain, Healthcare IT News, 7/23).

Smartphone Drawbacks
Roughly 80% of physicians surveyed said they faced difficulties responding to colleagues in a timely manner with smartphones.
Physicians also expressed concerns with the lack of financial incentives for clinician use of the devices.

In addition, respondents said they were overwhelmed by the volume of incoming messages they received on the phones (Health Data Management, 7/26).

Fifty-six percent of respondents said they were concerned that the lack of standardized guidelines for transitioning care between colleagues could lead to errors in patient care.

Methodology
The survey was based on telephone interviews of more than 100 physicians working in ambulatory and acute care environments conducted over a three-month period, beginning in March 2010 (Healthcare IT News, 7/23).

Wall Street Journal Reports More Insurers Open To TeleHealth

In an article written by Avery Johnson at www.WSJ.com he writes that technology that aims to keep congestive heart failure patients out of the hospital is gaining traction. The following are excerpts from this well written new article.

The idea is for heart patients to take readings like their weight, blood pressure and other key metrics using wireless and other technologies; the data are then transmitted to a case manager or medical care giver. That way health care giver's can catch, and address, warning signs before the patient lands in the ER with shortness of breath or a heart attack. In the past, patients have found such technology difficult to use. But a number of managed-care companies are experimenting with electronic devices meant to make the process easier.

A big benefit is that it allows patients to stay in their homes, but the systems can't catch everything, and patients shouldn't be lulled into a false sense of security by the technology.

WellPoint Inc.'s Anthem unit in California is piloting a wireless scale and blood-pressure cuff that communicates in real time with nurses on alert for fluctuations that can signal heart failure, or when the heart can no longer pump enough blood to the body's organs. Humana Inc. in January will launch a program to track heart patients' vital signs wirelessly and link them up via video to chat with nurses if appropriate.

And Aetna Inc. is running a clinical trial with Intel Corp. to assess how remote monitoring of vital signs can cut down on unnecessary hospitalization for heart patients. It is more important than ever for health plans and patients to combat medical costs, growing at a clip of between 6% and 9% a year, according to various estimates. Heart failure, which can be triggered by simple mistakes such as consuming too much salt - is a leading cause of hospital readmissions with 25% of patients returning to the hospital within 30 days. It's also one of the biggest single claims expenses at insurance companies. Aetna estimates that 40% of readmissions are avoidable.
The program puts a scale; blood-pressure cuff and glucose monitor into patients' homes and then collects the data daily via wireless or landline. Nurse case managers follow up with the patients if any of the vital signs seem worrisome.

The plan, which specializes in Medicaid and Medicare and is owned by the New York City Health and Hospitals Corp., says it pays about $6,300 for a Medicaid heart patient's typical hospital stay. The plan foots the bill for the remote monitoring system, which is rented and worth approximately $626.

Such remote monitoring programs have limitations. Doctors can get over-alerted when patients put the cuffs on wrong, or step onto the scale with their shoes on. The technology requires ill patients to remember to use it, and can be troublesome if it acts up. For instance, Ms. Brown's data at first weren't uploading through the modem correctly, a problem that was solved within 24 hours when the machinery was converted to a wireless hookup.

Both Humana and WellPoint are incorporating video-chat into their approaches to connect members more closely with nurses. United Health's wireless scale asks a series of questions in the morning and evening that are followed up by nurses and doctors if appropriate. "The relationship between the consumer and doctor is primary," said Sam Meckey, chief operating officer for disease solutions at United Health's Optum Health unit.

New approaches aim to find problems earlier. A study of 1,450 patients out Tuesday in Circulation, a journal of the American Heart Association, showed that implantable defibrillators that wirelessly transmit data on the patient's heart function, reduced in-hospital evaluations by 45%. Suspected cardiac events were evaluated in less than two days compared with 36 days.

Another approach being tested by device maker CardioMEMS Inc. uses an implantable sensor device to measure pulmonary artery pressure and wirelessly transmit readings to a secure Web site for doctors and nurses. The idea is to detect changes and intervene before the patient has to be hospitalized. The wireless transmitter resulted in a 30% reduction in hospitalization for heart-failure patients, the study of 550 patients released last month showed.

Blumenthal Calls Meaningful Use a 'One-Time Offer'

From Fierce EHR and written by author Neil Versel is the following July 22, 2010 article:

If you aren't going to achieve meaningful use this time around, don't expect the federal government to give you another shot at Medicare and Medicaid subsidies for EHRs.

"[The] federal government is making a one-time offer. We'll put money on the table to help you now but we're not going to put money on the table later," national health IT coordinator Dr. David Blumenthal says in an interview with CMIO , shortly after last week's release of the final rules for Stage 1 of the bonus program.

While HHS only specified the requirements for Stage 1, Blumenthal offers some hints about what to expect in Stage 2, which begins in 2013. For example, some of the measures that are optional in 2011 and 2012 will become "core objectives" later. "We also, I suspect, will be looking at more demanding forms of health information exchange and probably more decision support, more robust use of physician order entry and also administrative simplification," Blumenthal says. "All those things are possible targets for 2013 and beyond."

He believes the federal incentive program will drive improvement in EHRs themselves, thanks to increased demand for better systems. "As physicians and other health professionals adopt EHRs, they are going to become increasingly demanding of vendors for better functionality, better usability and more comprehensive capabilities, and I think they will move the market using their professional understanding of what their patients need," Blumenthal explains. "I also think they will demand of the hospitals that the systems they use work for them and work for their patients."

IPhone 4's motion detectors open up a new class of medical apps for British doc

Neil Versel of www.Fiercemobilehealthcare.com writes " What drives a physician to become a smartphone app developer? " Often, it's curiosity and a little bit of luck.

Such is the case for Dr. Neil Paul, a British general practitioner who's now working on his fourth iPhone app, one that takes advantage of the new iPhone 4's motion-detection capabilities to help treat tennis elbow and related ailments. "[The iPhone 4] has a gyroscope, compass and accelerometers, so it knows the speed and angle of an exercise and can detect if they're being done properly. It's an exciting new area for medicine," Paul tells Canadian Healthcare Technology's Technology for Doctors.

Paul, who is part of a 15-physician primary-care clinic in Cheshire, England, had been developing iPhone apps for about two years, when his practice helped develop cardiovascular risk-screening software. "I ended up looking at the algorithms the programmer wrote," Paul recalls. "Just to see if I could do it, I bought a book on Amazon about programming iPhones and developed iCalcRisk," a free app that calculates risk for heart disease, following on British Cardiac Society recommendations.

Word of mouth among colleagues led Paul into his next project, A2Z of Dermatology. Based on an award-winning reference text, the app explains 115 diagnoses, each with zoomable, high-quality images. To date, Paul has sold more than 7,000 copies in the Apple App Store, at about $2.99 each. Another app is a study guide for medical students.

The popularity of his apps has been a mixed blessing. "The constant demand for new features is very interesting to me as a developer but it's difficult to cope with, because we want to get new apps out but we also need to keep the old ones up-to-date," Paul says.
He has no apprehensions about working to unlock the power of the iPhone 4. The motion detection offers all kinds of potential beyond aiding in treatment of musculoskeletal conditions. "It could be used to measure the patient's chest inspiration and expiration in pulmonary rehab. The level of detail is quite precise in the iPhone, and people always have their phones with them," Paul says.

But as the technology improves, it is becoming more difficult for someone like him to jump into the app game. "Innovation is difficult at large corporations, and I like to think the small guy can get involved," according to Paul. "The problem is, as the complexity grows with iPhone, iPad, different operating systems, it will become difficult for amateurs to keep on top of that. This will break the original wonder of the iPhone: Anyone could pick up a book and learn how to program it."

For more articles like this one, go to www.fiercemobilehealthcare.com