Two weeks have passed since we released the latest data from our Meaningful Use Dashboard. In the interim our news has gotten noticeably better. Check out the updated dashboard here. While we show progress on providing clinical summaries and other measures, we can also say this week that a whopping 28% of our eligible doctors have attested to Stage 1 Medicare Meaningful Use. This update reveals an eleven point jump from our last look and we’re pretty darn pleased to see our work paying off.

Last spring when we first piloted the attestation process, we wanted to see exactly what doctors would have to endure to prove to the Centers for Medicare and Medicaid Services (CMS) that they deserved an incentive check—putting ourselves right “where the rubber meets the road.” We knew that achieving the measures would try the patience of some doctors but what about proving to the federal government that they should be paid for their efforts?

It quickly became clear that by serving as proxies and completing the attestation process for our clients, we would be able to assume more work, increase process integrity for our clients and be 100% sure that incentive checks were on the way. Once we ran the betas, our early suspicions were confirmed and we decided to dive in. For providers, attesting could be a giant hassle. For us, it was a no-brainer.

The Meaningful Use Enrollment Services (MUES) Team was formed to handle all the attestations for clients. There are eight athenistas on the team and each one’s in contact with CMS so often they’re on a first name basis with counterparts there. At this point, they arguably know more about the CMS Meaningful Use process than anyone else in the country. And the MUES Team has so much experience dealing with CMS for payer enrollment they’ve been able to pounce on problems others probably wouldn’t see as fast.

Now that the MUES Team has done a few hundred attestations, they’ve honed the process pretty well. Once a provider grants them proxy access to attest to Meaningful Use, all the steps that can take over 2 hours of submitting data on the CMS website is done seamlessly and efficiently by the MUES Team.

Practices on the path to Meaningful Use have noticed the difference when athenahealth takes the wheel during attestation. If they know they are achieving Meaningful Use with us, they will get paid. We will make sure they are all complete with CMS, and we track their payment and post it for them.

Kerin Joyce is the director of Practice Operations and EHR for Mount Auburn Professional Services in Cambridge, Mass. Eighteen physicians at Mount Auburn hospital will be attesting to Meaningful Use this year with the help of athenahealth’s combination of software, knowledge and service.

“Because we were looking at the Pay-for-Performance dashboard regularly, and our physicians and our office managers were as well, as soon as we were ready to attest, the dashboard would tell us we’re ready to attest,” she says. “And from there our EHR associate would go into the practice and work with the physician to get the proxy number.  And then we left it in athena’s hands to submit the data on our behalf and go through the attestation process.  We were confident that the information in there was accurate, and that they would follow through with the process.”

We’ve received a lot of great feedback on our dashboard so far.  What do you think?  Send a comment to the blog and tell us what it was like to attest to Meaningful Use, if you got paid and whether you feel the process has been good, bad or ugly. In the meantime, stay tuned for our next data release two weeks from now.

• As many of you are probably aware, the transition to ANSI 5010 looms on the horizon. We will be publishing some more information in the short-term that you will find interesting. But in the meantime, there’s also the ICD-10 code set changeover to consider with its deadline in October 2013. The Wall Street Journal did a bang-up job describing this serious issue in a somewhat humorous way but the comments from doctors and others were priceless.  As one Florida doctor wrote, “Doctors closing their practices in droves; is there a code for that?” As FierceHealthIT reports, the federal government has taken steps to make sure the ICD-10 train runs on time.
• During a visit to Minnesota, Dr. Farzad Mostashari, the federal government’s chief for HIT, spoke not only about how that state has been leading the way in EHR adoption but also how digitizing medical records is important in rural settings. He is known in shorthand as ONC, for Office of the National Coordinator for HIT, and that office was central to National HIT Week earlier in September. Look for an upcoming blog post from that event from our newest contributor, Lauren Fifield, athenahealth’s senior policy advisor.
• Maybe you are on your way to the airport for the flight to San Francisco to attend the Health 2.0 fall conference from Sept. 25 to 27. If you are headed out there, you might want to block out some time after lunch on Sept. 25 when Dan Orenstein, our general counsel, takes his place on a panel around the critical topic of patient privacy. We’re betting he’ll bring up information security in relation to cloud-based services. And on Sept. 27, athenahealth’s Chief Operating Officer Ed Park takes part in a 9am discussion under the title “The Next Generation of Health 2.0 in the Doctor’s Office.” More clouds in the forecast.
• A few weeks ago we launched our Meaningful Use Dashboard to demonstrate how our cloud-based EHR service allows us to track the progress of our clients on the path to Meaningful Use and how we can take corrective steps along the way. Achieving the measures continues to be a hot topic in HIT though it may soon be eclipsed by the aforementioned ANSI 5010 and ICD-10 transitions. Either way, thousands of doctors are stepping up for their shot at incentives, as this report demonstrates. They are also getting paid, to the tune of $653 million so far.
• Finally, here’s a social entrepreneurship story from Technology Review at MIT about using telemedicine to serve poor communities in India with $1 virtual checkups. It’s an effort that got help from some angel investors who might be known around here.

If you’ve been reading this blog, you know that our growing roster of writers includes our CEO, senior leadership, folks from product strategy, user experience, as well as clients. I’m a little different. I manage government affairs and in this role I think of myself as equal parts nerdy evangelist and early warning system. I do the wonky blocking and tackling for our clients—in many ways, a service for them just like the CSC or account management.

In order to share what I learn on Capitol Hill or in San Francisco or points between—and transmit from that early warning system—I will be contributing to this blog regularly. Between posts you can look for me @lfifie on Twitter if you want to get deeper on the wonky stuff.

Truth be told, I think I’ve got one of the coolest jobs around – OK, one of the coolest in HIT at least. I get to represent a company whose leadership doesn’t just think big but actually does big, innovative things.  When I look out at the health care policy landscape and dream up all the ways we might tackle health care’s thorniest problems, I know we will be right there in the middle of the mess, trying to find a solution.

As such, I experienced a bit of cognitive dissonance at the Care Continuum Alliance Forum 11 in San Francisco earlier in September. 

The Care Continuum Alliance is an organization that brings together members of the health care industry that are committed to improving population health through wellness initiatives, chronic care and quality management, care coordination, and so on.  Given that athenahealth is the only alliance member from the EHR services community, I didn’t exactly expect to be the belle of the ball. 

However, I was continually surprised by the number of enthusiastic-but-curious greetings we received:

“Is this conference really relevant to you?” Yes.

“You’re a software vendor, right?” No.

“What’s your role in this space?” Really?

At first, I couldn’t understand what was happening.  I’ve seen firsthand through our Meaningful Use pilot just how the athenaClinicals quality management platform can lead to better quality and improved patient care.  And our ability to place relevant quality measures at that elusive point-of-care has recently been validated by NCQA in our partnership on a PCMH Accelerator program. We believe the EHR is critical to delivering the right information to providers at the right time—foundational to quality improvement, accountable care and care coordination endeavors. 

But when I attended sessions during the forum I realized what was happening.  While the sessions reflected the most talked-about initiatives in the HIT industry, they were speaking a slightly different language.  The health care industry has grown so complex and so fast that silos of expertise have formed with the players running down parallel tracks looking for the same solutions but blind to those on either side. There needs to be more cross-pollination, collaboration and learning so we can better realize the power of speaking the same language to develop aligned solutions for providers and patients. 

Stay tuned for the lowdown on National HIT Week in Washington, D.C.

It’s that time already. We have new Meaningful Use Dashboard data to share.

If you will remember from our initial opening of the kimono back on Sept. 8, we weren’t doing so hot on the measure for clinical summaries, based on our performance information as of August 27. Compared to other measures we could point to with pride, we were limping along with 31.5% of our Medicare Meaningful Use providers satisfying the measure that requires providers to give patients a summary of their visit, within three days of the visit. Two weeks later? It’s now up to 52.1%. How did we do it? First, let’s look at why it was a problem in the first place.

The truth is, we knew clinical summaries were going to be a problem a long time ago. When we released all of the functionality and workflows to our clients in April after our MU pilot, this was one of the biggest workflow changes for practices.  

 This measure faced a set of legitimate behavioral and workflow hurdles:

• Many providers resisted sharing this level of info with patients for many reasons, including the concern that patients would not be able to interpret the contents or it would be incomplete and therefore misleading. Up until now, many providers haven’t been documenting their encounters with patients as a primary audience for their notes.
• Providers also told us that in some cases where visits were frequent—such as OB/GYN practices—the patients simply didn’t want a new summary of the visit every time. The difference from the last trip to the doctor was not significant enough to warrant a written explanation they need to take home.
• The workflow built for certification required the staff to remember to print these out for each patient, once the provider gave them the OK—sometimes yelling down the hall to the front desk that they were ‘good to go!’—as opposed to making it an integrated, required step within the normal encounter. This made doctors feel pressure to push out documentation in a way that made them feel uncomfortable.  
• There were questions about the security of protected health information, now leaving the office with each patient to end up stuffed in a backpack, under a coffee cup or who knows where.
• And some doctors—rightly so—pointed out the irony of Meaningful Use promoting the adoption of ELECTRONIC health records with functionality that required them to print out reams of paper for patients.

So how did we go about tackling this for providers? In each of the last few monthly releases we’ve provided to clients via the cloud and across athenaNet, we’ve made the fulfillment workflows easier for the staff and providers. 

First, we improved the provider’s ability to review the information in the clinical summary before it was printed for the patient.  Those changes didn’t really move clinical summary performance as dramatically as we had hoped, and providers still complained about all of that paper.  Then, we gave providers the option to fully eliminate the use of paper by providing a secure electronic delivery option for all patients in our August release. And that clinical summary is made available electronically to the patient as soon as the provider closes the encounter.

That’s what we did. And it seems to be working well. It’s moved the needle 20 points in the past two weeks. And it’s continuing to climb.

Stay tuned. We’ll update the dashboard again in two weeks.

The federal government and several payers are encouraging the adoption of the Patient-Centered Medical Home model. They have several good reasons.

On top of empowering patients and providing them better care, PCMH has shown to reduce health care costs in several key areas. But while it has proven beneficial to practices, the transition must be carefully planned, patiently implemented, and pay off in the end in order to be worth the effort. Using the right technology can help a practice become a PCMH model but the assistance of a partner with expertise in the transition is critical for a smooth and successful shift.

We’re on it.

The National Committee for Quality Assurance, or NCQA, and athenahealth share the goals of streamlining the PCMH recognition process and reducing the administrative efforts associated with becoming a PCMH. To this end, our software and services have many elements designed to facilitate the PCMH model. In fact, athenahealth’s cloud-based EHR service is the first to undergo the NCQA PCMH Corporate Review process. This means that a practice using athenaClinicals and athenaCommunicatorwill receive approximately 19 automatic credits in the areas where athenahealth has met or exceeded NCQA’s 2011 PCMH requirements. We wrote about this new programat the end of last month.

At athenahealth, we are working to reduce the complexity of transitioning to PCMH, as we are doing with industry transitions to Meaningful Use of EHR, ANSI 5010, and ICD-10. Along with sponsored pre-validated credits, we are developing a suite of services, available to clients in early 2012, which will offer pre-filtered reporting for NCQA PCMH applications, quality management tools to track PCMH measures, and consulting services to help clients implement PCMH successfully and optimize their rewards. We even identify payer programs to help subsidize the cost of transitioning to PCMH. Many of our clients who have sought NCQA PCMH recognition have achieved Level 3, the highest recognition level given.

Learn more about what your practice can do to make the most of PCMH opportunities. Register now for our free webinar on Wednesday, September 14th, 2011 at 12:15 PM.  Attendees also receive a 16-page whitepaper.