“This sounds like a very positive incremental improvement in the use of patient portals in the Epic customer base,” said Dr. David Kibbe, CEO of the not-for-profit governance group DirectTrust. “But it doesn’t seem to me to be a global solution. The most obvious limitation is that it’s available only to customers of Epic who also have MyChart accounts,” he said, referring to Epic’s patient portal.

According to Charles Christian, vice president of technology and engagement at the Indiana Health Information Exchange, Share Everywhere doesn’t quite count as interoperability. “It’s not really moving data around but providing access to it.”

Pamela McNutt, chief information officer at Dallas-based Methodist Health System, agreed, calling Share Everywhere “another vehicle for access to very important information. It’s really exciting, and it’s moving us closer to a patient having a personal health record that they can control.” Her system, which uses Epic, will advertise the new feature on its website and when it encourages new patients to sign up for MyChart.

Epic argues that this kind of data exchange does indeed qualify as interoperability and, more importantly, makes that interoperability patient-directed, said Sean Bina, Epic’s vice president of access applications. “Whether traveling internationally, receiving home care, or simply seeking a second opinion, patient-driven interoperability is now a reality even when the caregiver doesn’t have an interoperable EHR,” he said.

Patient control over medical records is a requirement under meaningful use, which specifies that patients are supposed to be able to view, download and transmit their data. Epic’s Share Everywhere achieves the crucial “transmit” portion of that trio, centering the data around the patient rather than around a single provider and maintaining a patient’s privacy under HIPAA along the way, since the patient is the one moving the information.

The industry has long touted the potential benefits of patient-centered care, calling it an important part of the Triple Aim, since it will improve outcomes and lower costs. But, Christian said, “at times, we may be asking too much of the patients.” Sometimes, he said, patients want providers to initiate the exchange of data.

“It’s an idea that makes a ton of sense, to put patients in the middle of interoperability,” said Dr. Christopher Longhurst, CIO for UC San Diego Health. But, he said, he’s found that “when you ask our patients, most of them tell you they don’t want to be in the middle.”

Epic’s Care Everywhere—not to be confused with Share Everywhere—helps in that quest. Using the technology, organizations exchange 2 million records per day with Epic and other vendors’ systems. Epic is also a member of Carequality, an initiative of the Sequoia Project whose framework supports data transfer among its members. Carequal- ity members will soon be able to exchange data with members of the Commonwell Health Alliance, co-founded by Epic market rival Cerner Corp., greatly expanding interoperability.

Share Everywhere will be available for free in November to Epic users. Epic declined to say what the average cost of implementing its EHR is. But installing new systems can be expensive: The installation of an Epic EHR at Vanderbilt University Medical Center in Nashville this fall, for instance, is estimated to cost $214 million.

Asked if providers might be drawn to purchase Epic because of Share Everywhere. Longhurst said likely not. “It’s not a game-changer,” he said.

Article source: http://www.modernhealthcare.com/article/20170916/NEWS/170919908

read more

Until recently, pharmacists relied on their intuition and network of other pharmacists they would call if a suspicious prescription surfaced. Today, nearly all prescription pads are tamper-proof, if physicians haven’t already transitioned to electronic prescribing. More Cincinnati doctors are using e-prescribing, said Hart, who lauded the trend. And more states are also using interstate communication systems that track the types of prescriptions and where they are filled.

The Ohio Automated Rx Reporting System is one of the statewide databases that collect real-time information on controlled substances sold to pharmacies, including when and where they are dispensed. The statewide databases feed into an interoperable communication system called PMP Interconnect that connects pharmacists throughout the country to track usage, prescribing and dispensing patterns. The prescription monitoring program, headed by the National Association of Boards of Pharmacy, was started in 2011 and is online in 42 states, with more in the queue.

Providers in 27 states have also integrated PMP Gateway into their EHR systems, bringing prescription-usage and -filling trends to their fingertips. It alerts physicians when a patient has received several opioid prescriptions over a short period of time, among other behaviors.

These types of systems are vital in curbing the number of counterfeit prescriptions, advocates argue. Some 33,000 illegal online pharmacies are operating at any given time, driven by attractive profit margins and fragmented regulations, according to the Alliance for Safe Online Pharmacies. A new push for “.pharmacy” domains has helped patients identify legitimate sources for online drugs, said Libby Baney, ASOP’s executive director.

Arming providers, pharmacists and law enforcement with interoperable data is crucial and those throughout the industry should be encouraged or even compelled to buy in, Baney said.

“Policy and enforcement have not kept pace with the consolidation of the supply chain and distribution of medicines, particularly with online sales,” she said. “We need to harmonize domestic and international regulations and increase transparency.”

But the databases are not a panacea, critics warn, and much more needs to be done to improve coordination among regulators and those in the drug supply chain.

Under the recently implemented Drug Supply Chain Security Act, manufacturers will need to create individual serial numbers for every prescription, which ideally would help determine where the drugs came from and how they got to the patient.

“We will start to get a lot more visibility in not only the flow of these drugs but understand who held them and where they traveled along the supply chain, said Paul Cianciolo, who heads health systems development for TraceLink, a company that provides a digital track-and-trace network for the pharmaceutical supply chain.

Article source: http://www.modernhealthcare.com/article/20170916/NEWS/170919916

read more

Kentucky health systems to merge

On September 23rd, 2017, posted in: Industry News by

Two health care providers in eastern Kentucky have announced plans to merge.

Appalachian Regional Healthcare and Highlands Health System say they hope to finalize the deal by early next year. No terms were disclosed

Highlands Health System President Harold C. Warman said the merger would ensure that the communities served by the Prestonsburg-based system will continue to have local access to quality health care.

Under the agreement, Highlands Regional Medical Center will operate as Highlands ARH Regional Medical Center, and will become the 12th hospital in the Appalachian Regional Healthcare system. Outpatient facilities in Floyd, Johnson, Martin and Magoffin counties also are included in the merger.

Appalachian Regional Healthcare is a not-for-profit health system serving 350,000 residents across Eastern Kentucky and Southern West Virginia.

Article source: http://www.modernhealthcare.com/article/20170921/NEWS/170929973

read more

Hospitals have a newfound cushion of time to meet stage 3 meaningful use measures, which they now won’t have to satisfy until 2019, a year later than was previously required.

According to a new timeline issued by the CMS Wednesday in the final Medicare Hospital Inpatient Prospective Payment System rule, hospitals can continue to use 2014 certified electronic health record technology through the end of 2018 and will be required to use 2015 certified EHR technology starting in 2019. This applies to Medicare payment and policies for patients discharged from hospitals between Oct. 1, 2017, and Sept. 30, 2018.

The change to certified EHR technology requirements mirrors the change for physicians in the Quality Payment Program proposed rule issued in June, which would also allow providers to continue using 2014 certified EHR technology for another year.

Right now, there are 96 products certified for the 2015 edition, according to the Office of the National Coordinator for Health IT’s Certified Health IT Product List, compared to 3,749 certified for the 2014 edition. Trade groups and CIOs have been worrying as of late that leaving the 2015 certification requirement in place would have providers scrambling to get new technology in place. “By no longer requiring these new systems be in place by the start of 2018, a huge weight has been lifted off our collective shoulders,” said Liz Johnson, chair of the College of Healthcare Information Management Executives.

The final IPPS rule also changes the reporting period requirements. Now, hospitals can report clinical quality measures for just one quarter of 2017, rather than for the full year, thereby easing another burden and potentially putting off when hospitals need to be ready to report, as they could start reporting as late as October of 2018.

 

Article source: http://www.modernhealthcare.com/article/20170803/NEWS/170809953

read more

Healthcare hiring rose at a sizzling 39,400 jobs in July, marking the second straight month that job growth surpassed the white-hot average monthly gain of 32,000 last year.

The July hiring binge by hospitals and clinics happened even as the Senate debated most of the month on different plans to repeal the Affordable Care Act and dramatically scale back Medicaid funding.

A final repeal bill failed by a narrow 51-49 vote in the Senate on July 27.

Hiring in ambulatory care centers led the way in July, adding 30,000 jobs.

And though admissions have flattened in recent months, as evidenced by the second-quarter earnings releases of investor-owned hospital giants HCA, Community Health Systems and LifePoint Health, hospitals added 7,300 jobs in July.

The healthcare sector joined a broad-based surge of hiring for the month. The Bureau of Labor Statistics Friday identified an increase of 209,000 non-farm jobs nationally in July, beating an analyst consensus forecast of 180,000.

The national unemployment rate fell to 4.3%.

The July healthcare hiring surge followed a strong gain in June of 36,600 jobs, the statistics show. In July, the labor department slightly revised up the June numbers by 100 jobs.

Before the hiring jump in June and July, hiring in 2017 had muddled along at about a 24,000 monthly average. Healthcare economists pointed to the cloud in Washington over the possible repeal of the ACA as a factor.

The Congressional Budget Office estimated the Senate bills being debated would cause about 20 million people to lose their insurance and slash Medicaid budgets whose expansion is largely responsible for a burst of newly insured since 2010.

But healthcare providers expanding especially the number of ambulatory centers and clinics they operate have pushed past the political turmoil to hire workers to serve an ever-growing number of seniors needing care.

Home healthcare agencies did the most hiring among providers in July, bringing aboard 11,300 more employees.

Outpatient centers and hospitals tied as the next biggest hirers, each adding 7,300 jobs in July.

Article source: http://www.modernhealthcare.com/article/20170804/NEWS/170809947

read more