Most Incentive Money Spent on More IT

by Paul Cerrato, Contributing Writer for Healthcare IT News

With no federal rules telling providers how they can spend their meaningful use incentive checks, hospitals and practices have their options wide open. While many are investing in more technology, that’s only the tip of the proverbial iceberg.

Acacia Internal Medicine Specialists in Phoenix, for example, has used part of its check to invest in a community room to hold wellness classes, and to hire a tai chi teacher. However, the prevailing trend is to use the money to fund more IT growth and pay down debt incurred while putting in the software and hardware needed to qualify for MU in the first place.

[See also: 2012: The year meaningful use took hold.]

“Most of our clients are considering the incentive funds paid as an offset for funds they are spending in advance to qualify for meaningful use and to pay for anything additional they will require to meet Stages 2 and 3,” wrote a member of a hospital technology group on LinkedIn in a discussion about how hospitals will use their MU dollars.

“The clear pattern we’re seeing among the hospitals we work with is that they are using their incentive payments to fund current and future IT initiatives.”, said Jim Adams, executive director, research and insights at The Advisory Board Company. Most have earmarked the money for EMR enhancement or optimization, he added, and some hospitals are also investing in their own health information exchanges, or rolling out an ambulatory EMR for physicians’ offices affiliated with the hospital.

The Advisory Board Company estimates that to date each Medicare eligible professional received on average about $17,300, while Medicaid eligible professionals received about $21,600. A hospital with about 34,000 discharges per year, two-thirds of whose revenue came from Medicare, can expect to receive about $13 million over the next few years, according to Adams.

[See also: EHR incentive payments top $12 billion.]

Many healthcare organizations are unable -- or unwilling -- to go on record about how they are spending the money. Some providers may be unwilling to disclose this information because they consider it proprietary, but it’s also possible they have miscalculated the anticipated ROI.

A recent analysis reported in Health Affairs came to the conclusion that EHRs are a money losing proposition for most physicians. Julia Adler-Milstein, from the University of Michigan in Ann Arbor, and her associates, surveyed 49 community practices and projected that the average doctor “would lose $43,743 over five years; just 27 percent of practices would have achieved a positive return on investment; and only an additional 14 percent of practices would have come out ahead had they received the $44,000 federal meaningful use incentive.”

2012: US remote patient monitoring $10.6B market

by Jonah Comstock

Kalorama Information released a report this year on remote patient monitoring, stating that the US market increased from $8.9 billion in 2011 to $10.6 billion in 2012, an increase of 19 percent. Kalorama’s numbers looked at what the New York-based research firm calls “advanced remote patient monitoring”, which it defines as technologies that have wireless or remote capabilities and can potentially interact directly with an EHR.

“Patient monitoring systems with advanced features, especially wireless or remote capability, are among the fastest-growing medical devices,” the report’s abstract reads. “The aging population and the associated increases in diseases such as congestive heart disease and diabetes as well as the cost of treating those conditions, is driving sales of these devices. Use of new patient monitoring technologies can result in a need for fewer personnel, increased coverage by existing personnel, and a reduction in errors and are expected to lead to better patient care and the recognition of serious health problems before they become an issue.”

That 19 percent growth tracks with a prediction Kalorama made last July, when it asserted the market would grow by 18 percent annually. That rate would put the US market at $20.9 billion by 2016, the previous report said. That same report indicated there had been a 23 percent annual growth rate between 2007 (when the market was worth $3.9 billion) and 2011’s $8.9 billion.

At the start of 2011, Kalorama predicted that remote monitoring technology would hit $6 billion that year — a prediction that appears to have been surpassed. Back then, the firm was more ambitiously predicting a 26 percent annual growth rate.

If these numbers seem high compared to, for instance, GBI’s March 2012 report, which predicted an $8 billion market in 2017, it could be because Kalorama has an unusually wide definition for remote monitoring: the firm includes some in-hospital patient monitoring in its numbers, not merely telehealth.

“This year we tried something different: we segmented the market between two types of information that customers request from us,” Publisher Bruce Carlson wrote on Kalorama’s blog. ”We have a segment on hospital patient monitoring, which is still remote ([patient monitoring] between the rooms or floors or even buildings of a hospital) and telemedicine, where the patient monitoring occurs between patient and provider.”

In addition to US data, Kalorama tracks the global markets in its paid reports. In the same blog post, the firm revealed that worldwide market growth from 2011 to 2012 for advanced patient monitoring was 17 percent.

EHR Incentive Payments Top $12 Billion

Mary Mosquera, Sr. Editor at healthcareitnews.com

With some healthcare providers now into their second year of meaningful use reporting, Medicare and Medicaidelectronic health record payments were estimated at $12.3 billion paid to a total of 219,000 physicians and hospitals through February since the program’s inception.

The Centers for Medicare & Medicaid Services will post final figures for February later this month as it captures more complete data, said Robert Anthony, a specialist in CMS’ Office of eHealth Standards and Services at Thursday’s Health IT Policy Committee meeting, which was broadcast live.

 

In February, 27,500 Medicare physicians received $425 million; 5,500 Medicaid clinicians and eligible professionals, $100 million; and 90 hospitals in either program, $200 million, for a total of $725 million to 33,090 providers.

 

[See also: EHR incentives over $10B to date.]

 

“February was a big month, as we expected. A lot of Medicare eligible professionals came in and attested in the final month to be counted in the 2012 program,” Anthony said.

 

“We expect that February number will continue to grow as we process them through the month. We’re already seeing some providers come in for 2013,” he added.

 

The incentive program has been operating long enough now that some providers are second-time participants, so CMSlists only unique providers paid.

 

Since the program’s inception through February, CMS has paid 140,000 Medicare physicians, 75,500 Medicaid clinicians and 3,757 hospitals, according to latest estimates.

 

The number of eligible providers registered for the EHR incentive program was just shy of 85 percent of hospitals, and 73.2 percent of hospitals have been paid as of January.

 

“For eligible professions, two-thirds are registered and almost 40 percent have been paid under Medicare, Medicaid or Medicare Advantage,” Anthony said.

 

CMS also found that the performance level was comparable between providers attesting for the first time in 2011 or 2012 on their core and menu objective measures.

 

“We’re seeing consistently high performance. If anything, we see a slight increase as we move to a full year, but most is not statistically significant,” Anthony said.

 

However, there were indications that as providers move into a second year of meaningful use, “the workflow becomes more routine, and they are performing at a slightly higher level than when they began,” he said.

7 Signs That You've Lost Your Audience

By Gretchen Rubin

Like most people, I have several pet subjects – that may or may not be interesting to other people. Don’t get me started on happiness, or habits, or children’s literature, or Winston Churchill, unless you really want to talk about it.

By noting how I behave when I’m trying to hide my own boredom, I came up with a list of indicators that I might be boring someone:

1. Repeated, perfunctory responses. A person who says, “Oh really? Oh really? That’s interesting. Oh really?” is probably not very engaged. Or a person who keeps saying, “That’s hilarious.”

2. Simple questions. People who are bored ask simple questions. “When did you move?” “Where did you go?” People who are interested ask more complicated questions that show curiosity, not mere politeness.

3. Interruption. Although it sounds rude, interruption is actually a good sign, I think. It means a person is bursting to say something, and that shows interest. Similarly…

4. Request for clarification. A person who is sincerely interested will need you to elaborate or explain. “What does that term mean?” “When exactly did that happen?”

5. Imbalance of talking time. I suspect that many people fondly suppose that they do eighty percent of the talking because people find them fascinating. Sometimes, it’s true, a discussion involves a huge download of information; that’s a very satisfying kind of conversation. In general, though, people want to add their own opinions, information, and experiences. If they aren’t doing that, they may just want the conversation to end faster.

6. Body position. People with a good connection generally turn fully to face each other. A person who is partially turned away isn’t fully embracing the conversation. I pay special attention to body position when I’m in a meeting and trying to show (or feign) interest: I sit forward in my chair, and keep my attention obviously focused on whoever is speaking, instead of looking down at papers, gazing into space, or checking my phone (!).

Along the same lines, if you’re a speaker trying to figure out if an audience is interested in what you’re saying:

7. Audience posture. Back in 1885, Sir Francis Galton wrote a paper in 1885 called “The Measurement of Fidget.” He determined that people slouch and lean when bored, so a speaker can measure the boredom of an audience by seeing how far from vertically upright they are. Also, attentive people fidget less; bored people fidget more. An audience that’s upright and still is interested, while an audience that’s horizontal and squirmy is bored.

I also remind myself of La Rochefoucauld's observation: “We are always bored by those whom we bore.” If I’m bored, there’s a good chance the other person is bored, too. Time to find a different subject.

Emdeon and Atigeo Enter into ‘Big Data’ Collaboration

John DeGaspari, Healthcare Informatics

Nashville-based Emdeon, Inc. and Atigeo, Bellevue, Wash., a data analytics company, announced an agreement at last week’s HIMSS13 conference to collaborate on the development of new software solutions. The companies will explore the use of intelligent analytics layered on top of petabytes of healthcare data to improve health outcomes.

“Ultimately, the combination of a network of connectivity, universal health information exchange and freakishly intelligent analytics can help to significantly improve healthcare in the U.S.,” Miriam Paramore, executive vice president and product development for Emdeon, said in a statement. 

The agreement calls for using Ategio’s x-Patterns data analytics platform to rapidly expose insights abstracted across vast repositories of structured and unstructured data.  Given the sharp rise of big data in healthcare, there is a need for technology solutions to piece together data into meaningful pictures, the companies say. Atigeo’s x-Patterns platform is a cloud-based application framework for rapidly building enterprise-grade, intelligent applications that make big data more accessible and actionable, according to the announcement.

In an interview with Healthcare Informatics, Atigeo CEO and founder Michael Sandoval said the combination of the data analytics platform and Emdeon’s data repository will reveal insights that would not have been possible before. He described x-Patterns as a “data agnostic” platform with regard to whether the data is structured or non-structured. He says the way the x-Patterns platform absorbs and integrates data in a way that avoids the problems of traditional data mining with disparate data systems and dissimilar taxonomies.

“In true ‘big data,’ analysts talk about volume, variety and velocity,” Sandoval said. “We are able to do that well above the petabyte scale on the volume side, of any type of varietal, and in the velocity category in microseconds in an automated way.” He added that on the human language side, the platform is able to identify the proper context and apply the data against any existing application or workflow of the provider, “so that it appropriately optimizes the applications and workflows.”

Sandoval said the relationship has two basic goals: to leverage the x-Patterns platform across Emdeon’s data to expose patterns for their existing products, and to bring new products to market.

David Talby, Atigeo’s vice president of engineering, said one example of an application, which was showcased at HIMSS, was a hospital readmissions application that uses Atigeo’s analytics platform to build a statistical model for when a patient is likely to be readmitted. “We are thinking about the patient, have more signals, and we have the algorithm to actually use those signals,” he said. Talby added that the collaboration encompasses national coverage, and that the application is compliant with the Health Insurance Portability and Accountability Act (HIPAA) regulations.

How to Juggle Multiple Job Interviews

by Alan Carniol, founder of InterviewSuccessFormula.com

We often hear of job seekers struggling to land interviews. However, what if you’re one of the lucky ones to be offered multiple job interviews with different companies?                                      

Though you are in a good position, you may slip up since there is so much on the table. For instance, you could mix up company values. You may forget important documents. You could even accidentally name drop an executive at one of the other companies. All of these don’t represent you as the awesome candidate you are — and they certainly don’t help your chances.                           

However, juggling multiple interviews shouldn’t be seen as added stress. They should be used as an opportunity to steer your interviewing experiences in the right direction. Check out these tips to make it happen.                            

Create a plan
Mapping out how you’re going to succeed in your interviews is important. Establishing a tentative “interview plan” can help you to avoid any mix ups. Creating a simple spreadsheet or completing a worksheet that lists dates, times, interviewer background and basic company information can keep your interviewing experiences in check and separate from one another.                             

Noting some talking points for each interview can also be written in your plan. For instance, if a company had a recent merger, you can plan to discuss this with the interviewer. Or, if you are also interviewing with a rival company that sees this merger as a threat, you can offer them an alternative perspective. Without the necessary research and planning process, there’s a large chance you may make a mistake and damage your interviews. Creating a plan helps you avoid this.

[read more]

6 Questions to Ask During Your Interview That Will Make an Employer Want to Hire You

[full article here]

1. If I were to start tomorrow, what would be the top priority on my to-do list?

The answer to this question will give you more insight into the current state of the position, while the question shows that you’re invested and interested in learning how you can start things off with a bang. The added bonus lies in the Jedi mind trick: now you’ve already got your interviewer picturing you as the position holder.

2. What would you say are the top two personality traits someone needs to do this job well?

The answer to this will be very telling. “Creative” and “intuitive” can be translated to mean you will be on your own, while “patient” and “collaborative” could mean the opposite. Not only will this question allow you to feel out whether you’re going to be a good fit; it will also get your interviewer to look past the paper resume and see you as an individual.

3. What improvements or changes do you hope the new candidate will bring to this position?

This answer can shed light on what might have made the last person lose (or leave) the job, and it also tips you off on the path to success. Asking this shows an employer you are eager to be the best candidate to ever fill this position.

4. I know this company prides itself on X and Y, so what would you say is the most important aspect of your culture?

This type of question is sure to impress, as it shows that you’ve done your research on the company and gives you a chance to gain insight into what values are held to the highest ideal.

5. Do you like working here?

This question might take interviewers back a bit, but their answer will be telling. A good sign is a confident smile and an enthusiastic “yes” paired with an explanation as to why. If they shift in their seat, look away, cough and start with “Well…”, consider it a red flag.

Regardless of their answer, employers appreciate getting a chance to reflect on their own opinions, and this turns the interview process into more of a conversation.

6. Is there anything that stands out to you that makes you think I might not be the right fit for this job?

Yes, asking this question can be scary, but it can also be beneficial. Not only does it give you a chance to redeem any hesitations the employer might have about you; it also demonstrates that you can take constructive criticism and are eager to improve—valuable qualities in any candidate.

Why Happy Job Seekers Get Better Networking Results

by J.T. O'Donnell

This article on the differences between happy and sad people really hit home for me:

15 Powerful Things Happy People Do Differently

Why? It reminded me how some job seekers are struggling to find work because they are in “attitude denial.”

Our Happiness Assessment Can Be Off-base

If you are like me, when you read the article above, you'll give yourself a little quiz. I went through each one and asked myself, “Which one is more like me?” At the end, I concluded, while I could do an even better job, overall, I’m a happy person. I bet a good number of people who read it felt that way too.

However, I guarantee some of those people didn't evaluate themselves accurately. Especially, some job seekers. Here's proof…

She's Got an Excuse & Criticism for Everything, Yet…

I sent this article to a former colleague who has been going through a tough time in a job search. I wanted her to give herself the quiz and hopefully we’d be able to have an honest dialog about how she needed to change her attitude and approach the search differently. To me, she displays all fifteen of the “bad” traits on this list. Well, imagine my surprise when she emailed me back and said, “This is so true! It proves I’m a happy person. I’m all the things on this list. And yet, I can’t find a job. What’s wrong with employers?! How come they don’t see how what an asset I’d be?” I almost fell off my chair. Was it possible that she truly couldn’t see she wasn’t a happy person? Obviously, by her email, the answer is “yes.” It reinforced for me how we can't always be objective about our attitude. There are a lot of job seekers out there assuming they exude happiness and approach the hunt with a positive attitude. Meanwhile, the rest of the world sees them as miserable - and secretly opts not to help them with their search.

Nobody Risks Their Professional Reputation for a "Debbie Downer"

Years ago, the show Saturday Nite Live had a character called, Debbie Downer. She was negative about everything. (Wah, wah WAH!) It caused the people she came in contact with to want to run in the other direction. Anyone who watched a segment of that skit could identify with someone in their life who acted like Debbie. Job seekers can take on these traits as well. They become negative and needy, causing their closest circle of friends, family and colleagues to avoid them. Why? They too, know it's pointless to try to help someone who is so negative. And, they certainly aren't going to recommend a "Debbie Downer Job Seeker" to members of their network for fear they will hurt their reputation. When it comes to our careers, people want to be associated people with a winning attitude - not a losing one.

[read the rest]