physicians

SPOTLIGHT: Website allows consumers to talk to MDs live

Anne Zieger — Sat, 12 Jul 2008 13:04:02 -0400

Consumers often want to talk to doctors at inconvenient times--in the middle of the night, particularly--but can't do so unless they wake their PCP up or head to the emergency department of their local hospital. However, a new website may offer an alternative. The site, TalktoaDoc.org, allows patients to talk to local physicians live, through text, voice or video. Article

U of Pittsburgh asks physicians to order drug samples through 'e-closet'

Anne Zieger — Sat, 05 Jul 2008 14:59:11 -0400

In a step designed to further tighten up its providers' relationships with pharmaceutical companies, the University of Pittsburgh Medical Center is implementing a new web-based technology that doctors will use to order drug samples. The move follows a February 15 decision by UPMC officials to implement a tough new conflicts-of-interest policy regarding interactions with drug companies. Among other things, the new policy banned affiliated medical practices from accepting lunches in their offices from drug companies.

The system, the UPMC eSample Center, is a "virtual sample closet" developed by vendor MedManage Systems of Bothell, WA. And it comes at unbeatable price. In fact, there's no cost whatsoever to the school, since MedManage charges fees to pharmaceutical companies for its sampling system. UPMC officials have begun sending out letters about the system to its providers, and will make some medications available to providers as early as August 1. Samples will be sent to physicians directly from the pharmas' distribution centers.

To learn more about the system:
- read this Pittsburgh Post-Gazette article
- read this MedManage press release

AT&T, Covisint and Microsoft plan to expand health network nationwide

Anne Zieger — Sun, 29 Jun 2008 02:02:49 -0400

AT&T, Microsoft and Compuware subsidiary Covisint have announced plans to create a nationwide health information exchange which expands on a smaller network already in place state-wide in Tennessee. In Tennessee, the MidSouth eHealth Alliance and the Governor's eHealth Council had already been running an electronic health network for doctors across the state, running on Covisint's On-Demand Healthcare Platform.

The broader eHealth network will use Covisint's platform and run over AT&T's MPLS network. The new network will give consumers access to records based on Microsoft's HealthVault PHR technology, while giving them the ability to share that information with all providers who connect to AT&T's Healthcare Community Online. The Healthcare Community Online is a virtual private networking-based portal which allows electronic health data exchange between existing systems used by providers and physicians, including large files such as X-ray images, MRIs and CT scans. The AT&T network allows doctors, hospitals, labs, pharmacies and patients to access test results, prescription records and medical histories. It also offers physicians the ability to use e-prescribing functions.

What's interesting here is that the parties involved don't mention what their services will cost, or even what pricing model they'll use (a connectivity charge, a flat fee, a fee per transaction, some other option?). I wonder if this model will be any more affordable than the costly, largely unsustainable RHIOs/HIEs not-for-profit groups and governments have attempted to bring together.

To learn more about plans for the network:
- read this Microsoft press release

Related Articles:
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RHIOs and HIEs backed by states will win
NJ set to move ahead with statewide HIE plans
Minnesota backs statewide HIE

DEA releases e-prescribing regs for controlled drugs

Anne Zieger — Sat, 28 Jun 2008 21:05:47 -0400

After months of waffling, the Drug Enforcement Administration has finally come out with regulations that would allow doctors to prescribe controlled drugs such as opiates electronically. These regs could prove to be a turning point in the emergence of e-prescribing generally, as many physicians have complained that switching from paper for controlled drugs to e-prescribing for the others was too awkward to sustain.

The new regs are designed to fight forgery by imposing a "closed system of controls" on dispensing of controlled substances. Ideally, the new system will actually cut prescription forgery levels by helping pharmacists and DEA officials to more easily trace controlled-substance scripts to legitimate prescribers. They could also make sure that the meds get dispensed by the intended pharmacist and received by the intended patient. Of course, e-prescribing these scripts would also have the benefit of avoiding illegibly-written prescriptions, as it does for non-controlled drugs.

To learn more about the pending rules:
- read this Modern Healthcare article (reg. req.)

Related Articles:
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Report offers national e-prescribing plan

Anne Zieger — Fri, 13 Jun 2008 18:52:25 -0400

Despite considerable political pressure on physicians to adopt e-prescribing, few have gotten on board. In fact, only 2 percent of prescriptions eligible for electronic routing were transmitted that way in 2007. However, the right combination of incentives, regulatory changes and infrastructure improvements could go a long way toward reversing this trend. Article

Texas EMR resistance shows extent of adoption problem

Mon, 02 Jun 2008 06:59:57 -0400

If Texas is any indication, the EMR adoption movement has more problems in store than many people think. According to a new survey on the subject by the Texas Medical Association, one-third of physicians are using some form of EMR, up from 27 percent in a similar survey in 2005. However, about one-fourth of respondents said that they still have no plans to implement an EMR, the same level as the previous survey. Meanwhile, about 2 percent of respondents had used an EMR in the past, but quit, most often saying that reliability problems, difficulty in using the EMR or insufficient benefits doomed the installation.

Top vendors adopted by EMR-equipped practices answering in the survey included e-MD, used by 15 percent of respondents, followed by eClinicalWorks, with 9 percent.

That being said, those who have adopted an EMR seem to be glad they did, the TMA report said. Eight-one percent of practices with an EMR said that the system is in full use by all of its doctors. Also, roughly three-fourths of practices reported being very satisfied or somewhat satisfied with their systems. Still, even those physicians had plenty of gripes, with 27 percent saying one of the things they liked least about their systems was that costs went up without generating complimentary savings.

To learn more about the study (and other related studies):
- read this Modern Healthcare article (reg. req.)

Related Articles:
Study: Physician EMR adoption up, but systems chosen are limited
Study: EMR adoption held back by multiple issues
Study: Physicians at EMR 'tipping point'
Smaller practices still behind in IT adoption

MN lawmakers approve e-prescribing measure

Tue, 27 May 2008 06:59:55 -0400

The Minnesota state legislature has approved a broad healthcare bill that would, among other things, require physicians, pharmacists and others who prescribe or dispense medication in the state to use electronic prescribing as of 2011.

The bill also creates new rules intended to boost quality and price transparency and tie payment to care coordination and performance. For example, the state would create a "healthcare home" certification by July 2009; clinics earning the designation would encourage primary care use, develop comprehensive care plans and focus on those who have or are at risk of developing chronic conditions.

To learn more about the state's e-Rx initiative:
- read this Modern Healthcare article (reg. req.)

Related Articles:
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HHS head encourages payers to demand e-prescribing
Group says controlled-substance rules block e-prescribing
E-prescribing: What's holding it back?

ALSO NOTED: CMS official admits industry unready for NPI switchover; HHS to announce EMR demo project participants; and much mo

Tue, 27 May 2008 06:59:50 -0400

> Now, even CMS officials are admitting that the industry may not have been prepared for last week's deadline for switching over to using the National Provider Identifier for Medicare claims processing. Article

> HHS will soon announce which 30 communities it has chosen to participate in its EMR demonstration project, under which participating doctors will get Medicare incentive payments for using certified systems. Article

> Maryland-based Erickson Retirement Communities is working with three Baltimore-area health systems to create a health information exchange. Article

> A group of specialist volunteers soon plan to begin offering long-distance telemedical consultations over the Internet to physicians trapped in war zones. Article

And Finally... Want to relax, but too tired to travel? Try a 'staycation.' Article

Non-profits wondering how IRS feels about RHIOs

Mon, 19 May 2008 06:59:59 -0400

As most readers know, it took what felt like an eternity for the IRS just to come out with it and say how it felt about non-profit hospitals' plans to make EMR donations to physicians. So complex and mighty is the IRS that even its "yes" doesn't appease everybody--so its memorandum on the subject, while helpful, hasn't exactly led to a rush of free or low-cost EMR rollouts. Still, it has gotten the ball rolling.

Now, it's looking like yet another promising, if slow-moving and costly, movement could get caught up in the IRS gears. If you read the entire Modern Healthcare story excerpted below, which talks about how not-for-profits are finally starting to give away EMRs to doctors, you'll see the problem. In a small aside, the story notes that the groups behind some RHIOs have begun to ask the IRS for guidance on what they can and cannot do to build their networks.

Their worries seem more than justified. After all, if they want to put an effective health data sharing organization in place, the non-profits getting involved in RHIOs may have to give away or subsidize a few technologies. Depending on how their network is configured, it may be enough to supply EMRs and follow the existing rules--but maybe they'll need to supply additional gear and software as well. At that point, arguably, the water gets murky again.

With any luck, this issue will be addressed faster than the EMR issue was. I hold out some hope that it will, given that IRS officials (who are, after all, human) may simply feel that they've worked some of the key issues out for themselves already. But it remains to be seen.

Folks, here's hoping that one of the world's most ponderously slow agencies decides to go into overdrive this time. With many RHIOs struggling to stay afloat financially, an indefinite series of delays could be deadly. - Anne

Kaiser finishes major phase of costly EMR project

Mon, 12 May 2008 06:59:58 -0400

Kaiser has put the finishing touches on a major phase of its costly, high-profile EMR project, giving all of its 8.7 million enrollees and 13,000 physicians access to its outpatient system. To date, Kaiser has spent $4 billion on the EMR installation, which has been in progress for years. In recent times the project has been dogged by allegations that it had been botched, so much so that last year the California Department of Managed Health Care formally requested information on its progress.

Despite reaching an important milestone, the Kaiser EMR project still has a ways to go, given that it's got miles to travel on its inpatient rollout. To date, only 13 of the system's 36 hospitals have put Kaiser's Epic EMR system in place. It expects to see 14 hospitals to bring up the system this year, with the remaining nine hospitals slated for implementations in 2009 and early 2010. No word yet as to how much that $4 billion number will increase over the next year or two, but I doubt the remaining inpatient installs are going to be cheap.

To learn more about the Kaiser EMR project:
- read this Healthcare IT News article
- read this Pacific Business News article

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The whistleblower speaks: the Kaiser EMR drama