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Over-rated patient portals?


Todd Johnson, writing for Med City News, takes a skeptical look at the pitfalls, promises and potential of patient portals. Among his observations:

“{H}ere is the problem with most portals today: Patients have little interest in using them because they don’t offer enough value.

“Patients don’t care about ‘Meaningful Use’ and the fact that their provider will lose money if they don’t create an account and actually use the portal. Patient portals are notoriously obsolete and difficult to navigate, and patients often struggle to interpret medical information, such as test results.

“An extensive body of research exists related to patient portal usability and satisfaction among users. Until now, few studies have looked at the impact of portals on hospital outcomes. A new study out of the Mayo Clinic Hospital in Jacksonville, Florida, and published in the Journal of the American Medical Informatics Association in December last year found that 30-day readmissions, inpatient mortality, and 30-day mortality were virtually the same when comparing hospitalized patients who used portals with those who did not. The researchers concluded that patient portals might not ultimately improve hospital outcomes.”

To  read all of Mr. Johnson’s article, please hit this link.

The new MU


Is Meaningful Use — the Feds’ electronic health record incentive program — really going away? Well no, but it will change a lot, as this Medscape article explains.

AMA president says physicians need more payment-system consistency


Steven J. Stack, M.D., says that physicians need  more consistency and predictability in new alternative-payment models.

He made his remarks in a Physicians Practice interview after CMS’s new multi-payer initiative  aimed at improving primary care was announced earlier this week.

The program will give practices an upfront care-management fee that they can  keep if they meet performance-based quality and use-performance thresholds.

Dr. Stack said, among other things:  “There needs to be predictability and stability. We need to not be changing the rules every 12 months to 18 months. You can’t run a business when the payment method is changing year over year. Predictability and stability are important. The other thing is there needs to be candor and transparency.”

“Some of the methodologies for the current programs — the Value-Based Modifier or Meaningful Use — have set physicians up for failure. They are not good methodologies to do some of the things that are required. The likelihood of failure is high. Meaningful Use is an all or none, pass/fail paradigm. You get 100 percent you pass, you get 99.9 percent, you fail. Those kinds of things I think most Americans would feel are unreasonable and not fair.

“CMS has to (design) programs that are reflective of the variation in healthcare that’s appropriate and (accommodate for the fact) there are multiple ways to achieve different outcomes. If CMS can design programs that reflect the variation in physician care and patient needs, and hold physicians accountable for more reasonable deliverables … if that’s able to be done over a period of years, physicians can come to learn to be accepting of CMS and less frustrated by it.”

Meaningful Use attestation deadline extended

CMS extends 2015 Meaningful Use attestation deadline

MU hardship exemption soothes providers and CMS



Herewith a look at how letting eligible hospitals and  other providers participating in CMS’s Meaningful Use  electronic health record apply for a blanket hardship exemption to avoid reimbursement penalties will  help CMS as well as the providers.

Congress  recently passed bill S. 2425, which lets any eligible hospital or  clinician to apply for an exemption for 2017 from MU penalties. Previously, hospitals and professionals had to meet certain criteria  to apply for the exemption.

As Becker’s Hospital Review noted, the hardship exemption “offers an obvious respite {to providers} in their journey to Meaningful Use attestation. Not only does it stave off penalties, but it softens the burden of meeting the newly released stage 3 requirements….”

The news service added: “What’s more, CMS eases the burden on itself with this blanket exception. Since the agency no longer has to review hardship exemptions on a case-by-case basis, that eliminates thousands of applications it needed to individually review….”


Healthcare leaders react to final MU stage 3 rules


Five healthcare-industry leaders react to the Centers for Medicare & Medicaid Services’ release of the final rules for Meaningful Use stage 3 and the modification rules for 2015-2017.

Key provisions  include a 90-day reporting period in 2015 and for new participants in 2016 and 2017. Stage  3 will become mandatory in 2018, although providers can attest to stage 3 in 2017.



The growing good of health-information exchanges


Here’s a look around America  by MedPage Today at how health-information exchanges (HIEs) — some regional,some statewide — “help clinicians avoid productivity-sapping phone calls and faxes, and meet some challenging Meaningful Use requirements.”

It notes that “the forces that are making these HIEs essential include streamlining workflow utilizing Integrating the Healthcare Enterprise’s EHR-to-EHR integration and Direct secure messaging connectivity built into meaningful use–compliant EHR software, exchanging summaries of care when EHR integration is not yet present, and responding to business pressures such as accountable care.”

But one observer noted:

“The payers and the state are really critical, because the HIE doesn’t have an automatic business case. In fact, a lot of people, including some imaging centers and hospitals, don’t want to see it succeed, because sequestering data makes their lives easier and more financially productive.”

Wide range of EHR experiences


Surveys show   a wide range of happiness and misery among physicians about their electronic health record  (EHR) systems. Some of it depends on whether the system is server- or cloud-based.

Because they have more administrative support and can afford better and more expensive systems, physicians in large-group practices are having better EHR experiences.

Satisfaction rises over time as physicians learn how to better use the systems regardless of the size of the practice.

Still,  many small practices  don’t have the  money, time and other resources to use  EHR systems beyond the basic demands of Meaningful Use, especially regarding inter-operability, whose lack can be one of the great frustrations of EHR.




First-time MU hospitals can attest this summer


Becker’s Hospital Review reports: “Hospitals participating in the Meaningful Use program for the first time this year will now be allowed to attest this summer.

“First-time hospital meaningful users who began the attestation process in 2015 can attest anytime between now and August 14. Previously, hospitals participating for the first time were required to wait until Jan. 1, 2016 to attest due to system changes.

“Those hospitals choosing to attest this summer must attest to stage 1 meaningful use requirements that were set in place in the beginning of 2014. They will not be able to attest to the new, revised meaningful use requirements that were announced for the 2015 through 2017 time frame.”


Meaningful Use fraud in Texas


Tip of the iceberg?

A KXXV-TV  says that Center, Texas-based Shelby Regional Medical Center’s former CFO, Joe White, “has been ordered to pay more than $4.4 million in restitution for his role in a healthcare fraud scheme,

According to a Becker’s Hospital Review paraphrase, “The station said that Mr. White admitted he had attested to successful Meaningful Use of an EHR, even though Shelby Regional did not meet Meaningful Use requirements. Mr. White also made false statements regarding other hospitals converting to electronic records technology….”

“As a result of Mr. White’s false statements, the group of hospitals collected nearly $17 million in government incentive funds, according to the report,” the station said.

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