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Friday, June 29, 2012

I have found this article yesterday, and I am glad to say that I have been Practice Fusion Certified Consultant and Academic Partner for almost 3 years now. With a lot of skepticism from both providers and patients on the FREE software model, we have implemented it as part of our EHRS (Electronic Health Records Specialist) curricula and I am very happy we did. Having met with Ryan Howard in person, as well as key team members two years back at Practice Fusion user conference in San Francisco I was so moved and found by the whole idea of their business and the quality that they brought to the table. 
Implementation of EHR systems within small and medium size practices has always been a challenge, primarily for the users. Building the workflow for the practice and making sure that your staff is computer savvy enough to navigate a system that is being implemented is very hard. 

Interesting to see how in such a short period of time they were able to really build a presence for themselves in the healthcare community. 

Way to go!
Practice Fusion Pulls In $34M Series C led by Artis to crush the other eMeadical Record Startups
by Josh Constine. Original article is published by Techcrunch (full body of the article is enclosed below)






Practice Fusion Red Cross Logo
Practice Fusion is the frontrunner in the fevered race to become the electronic medical record platform, and today it finished raising a $34 million Series C led by hedge fund Artis Ventures to make sure it wins and lead it towards an IPO. Practice Fusion’s valuation is now around a half a billion dollars, it tells me. Startups trying to compete? “We’re squashing them” founder and CEO Ryan Howard tells me. It now hosts 40 million patient records of its 150,000 doctor and other medical professional clients, up from  25 million records and 130,000 clients seven months ago.
The money will fund a patient acquisition strategy, the build-out of its app platform, hires, and attracting more docs to ditch pen and paper for more efficient, accessible electronic records. Howard beams ”We’re excited to light it up. The company’s on fire, growth is maddening. The problem needs to be solved.”
Practice Fusion develops a free, web based electronic medical record platform for physicians that lets them chart data, schedule appointments, electronically prescribe medicine, work with labs, and distribute referral letters — all things that can get in the way of actually helping the sick. It makes money by letting labs, pharmacies, and other service providers to doctors pay to advertise within the platform. There’s both a Practice Fusion desktop interface and iPad app for doctors.
Howard was careful choosing Artis Ventures to lead the round, telling me “it’s a wedding. You’re married to that investor. Artis is a hedge fund with a venture fund. It’s preparing us. It’s who would be buyers in a public market” indicating the company has its sights on an IPO. Artis also backed YouTube.
Practice Fusion now has a total of over $64 million in funding, and Howard admits, “We have a lot of cash on hand.” The full list of investors joining the Series C round includes long-time investors Felicis Ventures and Band of Angels, plus Glynn Capital, Ali and Hadi Partovi, Founders Fund, Morgenthaler Ventures, Scott Banister, SV Angel, Ghost Angel, and several other institutional and individual investors. Practice Fusion now ranks amongst Castlight ($160 million), and ZocDoc ($95 million) as the most heavily funded health startups.
It needs it at the rate its growing. Howard tells me “we brought on about 20 people last month”. It’s got 170 employees now and expects to have 250 by year’s end. Hiring employees that quick is tough right now. “It’s more competitive than ever, especially for engineers” says Howard. But its applying its funding to becoming an attractive place to work, even compared to perked-up giants like Google and Facebook. That’s why it’s investing in a gorgeous San Francisco office, wellness programs, healthy food, and more.
Howard spoke candidly about how he views Practice Fusion’s competitors like Elation EMR. “I see them getting smaller in the rear view mirror. There’s no one in the Valley that keeps me up at night.” As for the big medical companies, “Our largest competitor is Allscripts, and we took on 4x as many new users as them last quarter.” While it wouldn’t disclose exact revenue numbers, the startup told me “in Q1 2012 revenue generation was comfortably in the seven figure range, an increase of more than 500% from the same quarter in 2011.”
With it pulling away from startups in the space, now it just needs to worry about huge, long-standing medical companies. Luckily it’s got a big headstart, and startup power. Howard explains “We’re making sure we can out-innovate anyone else.” And attracting the best talent to make that possible isn’t so hard thanks to its mission. “Someone could die because [a doctor] can’t get access to their chart. Understand, we’re saving lives.”

Launch Date:July 10, 2005
Practice Fusion provides a free, web-based Electronic Medical Record (EMR) system to physicians. With charting, scheduling, e-prescribing, billing, lab integrations, referral letters, unlimited support, Meaningful Use certification and a Personal Health Record for patients, Practice Fusion’s EMR addresses the complex needs of today’s healthcare providers and disrupts the health IT status quo. Practice Fusion is the largest and fastest growing EMR community in the country with over 160,000 users and 35 million patients. For more information on Practice Fusion,...

Wednesday, June 27, 2012

EHR Implementation in the Hosptials - Where are we?

Despite doubts about finances, hospitals moving forward with EHRs

Originally posted in HealthITNews

According to this article only 48% of healthcare business leaders said they're "somewhat comfortable" with the budgets allocated for the EHR deployment. 

Although there are incentive programs, and the obvious benefit of enhanced communication between departments as well as consolidation of the Electronic Medical Records for a given patient, a lot of learning has to take place between new and existing workforce to have the comfort level using the systems systematically. 

 We look at training as an integral part of the implementation that must be catered to different groups of workforce based on their involvement with the system. It is not just about the technology, it is about the staff that will use this technology.

NEW YORK – A new study from KPMG finds nearly half of business leaders at hospitals and health systems are more than halfway through full EHR deployments, even as many harbor doubts about how much funding their organizations have planned to support the initiatives.

Some 49 percent of hospital and health system business administrators who participated in the poll said they were more than 50 percent of the way to completing EHR deployment.

Meanwhile, almost the same number (48 percent) of health system business leaders said they're "only somewhat comfortable" with the level of budgeting their organization has planned for EHR deployment, according to KPMG. Nine percent said they weren't comfortable at all while 18 percent said they were unsure. Only 25 percent said they were "very comfortable."

"There is a level of uneasiness as to whether there is adequate funding to complete these projects," said Gary Anthony, principal with KPMG Healthcare. "In most organizations, EHR deployment will most likely be one of the most transformational projects that they've ever undertaken, as well as one of the largest investments outside of the construction of a new hospital they've ever made."
Nonetheless, he added, many hospitals still look at EHR deployments as "just an IT project, and that may be why we are seeing multiple extensions to scope, timeline and budget."

In terms of resource strategies used to complete EHR deployment, 46 percent of hospital and health system execs said they're using a multiple-resource strategy. This was followed by leveraging existing staff (16 percent), hiring new or additional staff (13 percent) and securing third party assistance (10 percent). Fifteen percent said they didn't know.

When asked whether their organization had a mobility access strategy that provides clinicians and patients with "anywhere" access to EHRs, roughly half of the administrators said they didn't know.

"EHR deployment isn't an end point," said Jerry Howell, principal with KPMG Healthcare. "It's an important step in an organization's journey to automate the clinical functions within the hospital or health system and improvement to quality and patient safety. There needs to be continued focus on resourcing and having the correct sponsorship and commitment to deploy an EHR and to continue to support and use it."


Tuesday, June 26, 2012

NYeC Digital Accelerator

As many of you know, I take an active participation in the events around implementation of EHR and health related technologies in general, training programs that surround these initiatives as well as user experience for providers, healthcare professionals and patients.

Recently NYeC (New York eHealth Collaborative) has partnered up with the New York City Investment Fund in a New York Digital Health Accelerator program that will enable New York State to expand and potentially build a unique ecosystem for the healthcare industry. Many technology companies, start-up and otherwise participated in the conferences and information session.

Below is a full text of a newsletter regarding the applications received for the program.


NY Digital Health Accelerator
Receives 250 Applications

Maria Gotsch
After a flurry of applications just before deadline, the review process for theNew York Digital Health Accelerator (NYDHA) begins. A total of 250 early- to growth-stage software development companies submitted applications, anxious to participate in the 9-month long program. Up to twelve chosen companies will receive up to $300,000 of funding each for the development of new health IT products, along with invaluable mentorship from those healthcare provider organizations who their innovations will serve.
The NYDHA, run by the New York eHealth Collaborative and the New York City Investment Fund, also provides developers with access to the technology platform that is connecting electronic health records across New York State, theStatewide Health Information Network of New York (SHIN-NY). The SHIN-NY will be the platform for innovators to develop products and software solutions to meet the needs of healthcare providers across the state.
“The Partnership and our investment fund have been thrilled with the response we have received from innovators in healthcare technology,” said Maria Gotsch, CEO of the Partnership for New York City’s Investment Fund. “Our investor syndicate is looking forward to working with all of the healthcare providers involved to help grow the emerging health IT sector in New York City.”
Dr. Nirav R. Shah, the New York State Commissioner of Health gave the opening remarks at a packed launch event in May at The TimesCenter in New York. The event brought together over 400 attendees curious to learn more about the Accelerator program, from startup software development companies, to healthcare providers and policy makers, and strategic investors.
Along with a panel discussion with providers, Maria Gotsch and Dr. Herbert Pardes, Executive Vice Chairman of the Board, New York-Presbyterian Hospital and New York-Presbyterian Healthcare System also spoke. Dr. Pardes related the growth of health information across New York State as “the twenty first century’s Erie Canal.”
New York Digital Health Accelerator - Panel Discussion
The impressive number of applications came as no surprise in a time when health IT is growing at such a clip. Along with the fact that the program provides such a substantial amount of funding as compared to other accelerator or incubator programs, it also offers something extremely coveted among health tech developers: direct, one-on-one access to healthcare organizations, allowing for a more custom-made product to suit the very particular demands of a very particular market.
“The economy and healthcare are the two most important issues facing the state, and the New York Digital Health Accelerator will allow us to tackle them both at once,” noted David Whitlinger, Executive Director of NYeC. “This initiative represents the best kind of marriage between the public and private sectors. We are leveraging New York’s investment in our statewide health information exchange network and empowering it with the free market.”
Applications for the New York Digital Health Accelerator will be reviewed by a selection committee comprised of the participating provider mentors and the investors. The top 20 finalists will present their company to the selection committee in late July, and program participants will be selected in early August. The program will begin in September.
Cocktail Reception
Video highlights of the event are available

Does EHR leads to decrease in malpractice claims?

Docs who used EHRs showed lower malpractice claims

June 26, 2012 | Mike Miliard, Managing Editor - Original Article posted in HealthcareITNews
The general idea here is that with the EHR implemented the number of the malpractice claims went down.

I believe that if a provider has access to more accurate and just more information about his/her patient it can and will lead to a higher quality of treatment. With the information at hand treatment plans are developed with more accuracy, given that a provider is aware of the pre-existing conditions and medications that patient is currently on. Although we have a long way to go for a full EHR implementation, even at this stage both providers and patients already notice the difference in the workflow and treatment.

I am enclosing one of the slides from the study as well as a full body of the article with appropriate links below.

BOSTON – A study by Harvard Medical School researchers, published Monday in the Archives of Internal Medicine, showed that Massachusetts physicians who used electronic health records saw a reduction in malpractice claims.
Correlation does not imply causation, of course. But the report's authors say their findings suggest that "implementation of EHRs may reduce malpractice claims and, at the least, appears not to increase claims as providers adapt to using EHRs."
The study, titled "The Relationship Between Electronic Health Records and Malpractice Claims," was written by Mariah A. Quinn, MD; Allyson M. Kats; Ken Kleinman; David W. Bates, MD; Steven R. Simon, MD.
"Given the potential of EHRs to reduce adverse events and health care costs, the question of whether EHRs reduce the risk of malpractice lawsuits is a logical one," they write.

"Risk factors for medical error and resultant malpractice claims, including poor communication between providers, difficulty in accessing patient information in a timely manner, unsafe prescribing practices, and lower adherence to clinical guidelines, may be ameliorable by health information technology," the report notes. "The high quality and availability of proper documentation in EHRs may increase the likelihood of successful defense against malpractice claims."
For this study, the researchers assessed groups of Massachusetts physicians who had previously been surveyed in 2005 and 2007 – tracking their malpractice claims over time.
"Because physicians in the sample were insured for different durations and used EHRs for variable amounts of time, the number of insured years was calculated for each physician before and after EHR adoption," they write. "We used Poisson regression to determine whether EHR use was associated with malpractice claims, modeling the rate of malpractice claims per year in periods with and without EHRs and adjusting for clustering by physician. We used the generalized linear mixed models version of Poisson regression to account for correlation between periods."

Of the 189 doctors surveyed in both 2005 and 2007, they note, 27 were named in at least one malpractice claim. Overall, 33 of the 275 physicians from multiple surgical and medical specialties who responded in 2005 and/or 2007 incurred a total of 51 unique claims. Forty-nine of those claims were related to events occurring before EHR adoption. Two were related to events occurring after EHR adoption.
"We found that the rate of malpractice claims when EHRs were used was about one-sixth the rate when EHRs were not used," the researchers write. "This study adds to the literature suggesting that EHRs have the potential to improve patient safety and supports the conclusions of our prior work,which showed a lower risk of paid claims among physicians using EHRs. By examining all closed claims, rather than only those for which a payment was made, our findings suggest that a reduction in errors is likely responsible for at least a component of this association, since the absolute rate of claims was lower post-EHR adoption."

The report does concede that other factors may be at work. "For example, physicians who were early adopters of EHRs may exhibit practice patterns that make them less likely to have malpractice claims, independent of EHR adoption; these early adopters contribute a disproportionate amount of time in our analyses, favoring an effect of EHRs on reducing malpractice claims."
Still, they argued, despite the small sample size, the reduction in malpractice claims shown in the EHR study "lends support to the push for widespread implementation of health information technology."
Access the report here.

Monday, June 25, 2012

EHR Adoption - Are we there yet?

"Docs adopt and adapt, yet still cling to old ways"


In the article published in HealthcareITNews, shocking statistics on the implementation of the EHR. We are so far behind on the technology use among healthcare practitioners. Even those that recognize the need and benefit of the technology in their practice are still staying behind the curve, with Fax machines being the dominant technology. 

In providing training/educational services to providers and their staff the constant struggle is with the consistent, continuous usage of the technology that is being implemented. 

I am sure that we will come to the point when everyone is going to be using EHR technology and beyond but it is a rocky road so far. 


"ATLANTA – The technology takeover has begun, and physicians nationwide are acclimating one step at a time, a new physician survey reveals. Laptop, smartphone and iPad usage is increasingly common among U.S. physicians, but the report finds old-fashioned methods of communication continuing to stand their ground.  
The second annual National Physicians Survey, conducted by the little blue book and Sharecare, polled 1,190 U.S. practitioners representing more than 75 medical specialties. It reveals physicians' perceptions about the ongoing changes in the healthcare system and how those changes are impacting their daily practices as well as their ability to provide optimal patient care.  
Two out of three physicians (66 percent) say the integration of electronic medical records (EMRs) is among their practice challenges. Despite that, most doctors (66 percent) acknowledge EMRs will at least improve or have a neutral effect on their future business. 

Almost one out of three doctors (30 percent) are using laptops regularly for e-prescribing, EMRs and more. Almost a quarter (20 percent) are using smartphones, and 12 percent use iPads, for clinical needs. 
Additional survey highlights:

  • Peer-to-peer communication is occurring via email – despite not being a "secure channel."
  • Thirty-four percent of physicians communicate with other clinicians via email – not defined as a "secure channel" by HIPAA.
  • Telephone (95 percent) and fax (63 percent) are still the primary forms of communication.
  • A dinosaur in most other office environments today, the fax is still king with physicians, supporting hand-written notes, insurance forms and lab test result transmissions.
  • Fifty-eight percent of doctors communicate with peers in person.
  • Five percent use social networking sites
  • Doctor-to-patient communication remains fairly traditional, with some online inroads.
  • The majority of physicians (91 percent) talk with patients via phone, 84 percent in person, 20 percent via email, 8 percent via personal health records (PHRs) and 6 percent via text.
  • Few physicians are opting for solo practices these days -- a good portion are "employed" by hospitals, large practices or accountable care organizations (ACOs).
  • Twenty-two percent of physicians are in ACO talks, up from 12 percent last year
  • Of those who said they were aware of ACOs, 37 percent stated that they would participate as a member of a group practice, 27 percent as a member of a physician-hospital organization, 10 percent as a hospital-employed physician.
  • Only 17 percent of the respondents were unfamiliar with the ACO term, down from 45 percent last year.

Doctors say new patients find them via:

  • Word of mouth (71 percent)
  • Practice networks referrals (33 percent)
  • Print directories (29 percent)
  • Internet searches (22 percent)
  • Despite an onslaught of healthcare regulations and requirements and shrinking practice margins, physicians are finding some advocates.
  • Forty-one percent say their state medical organization/society advocates for them. 
  • Thirty-nine percent say their national medical organization/society does.
  • But 40 percent report "no one."
  • Still, overwhelmingly burdened by obtaining reimbursements from insurers (81 percent) and patient approvals (77 percent), most doctors (71 percent) believe the quality of healthcare will deteriorate over the next five years.
  • Fifty-five percent fear they aren't spending adequate time with each patient.
  • Thirty-eight percent are concerned they aren't seeing enough patients in a day.

"Physicians today are practicing in a healthcare environment that they never could have predicted much less prepared for," said Keith Steward, MD, senior vice president of medical affairs at Sharecare. "This year's National Physicians Survey provides valuable insight into the frustrations and opportunities of the day-to-day management of practices, administration tools doctors use, and how communication with both colleagues and patients is evolving.  
"Arming doctors with innovative solutions to ease administrative burdens is a top priority for the healthcare industry," he adds. "Doctors need to get back to what they were trained to do – provide their patients with the best care possible."