The Situation Report: Is the CIO Job at VA About to Lose Its Influence?

The Situation Report: Is the CIO Job at VA About to Lose Its Influence?

VistA Watch

I'll start collecting links to VA's EHR known as VistA. Politico had a history of it. They omitted some key names and I'll get back to that. Anyways, I'll be posting more on this procurement on a system the majority of Medical Residents work with at some point.

Halamka on MACRA Final Rule: “CMS is Listening and I Thank Them”

Halamka on MACRA Final Rule: “CMS is Listening and I Thank Them” | Healthcare Informatics Magazine | Health IT | Information Technology



Thank them?  They work for Americans and shouldn't be thanked for keeping the "burden" lighter than it could be.  What's the payoff for Americans to the government imposing any burdens on providers off our care?  I fear the policy wonks and theologians over healthcare have priorities and mission badly screwed up.

HHS finalizes streamlined Medicare payment system that rewards clinicians for quality patient care

It's MACRAolypse.



HHS finalizes streamlined Medicare payment system that rewards clinicians for quality patient care

CMS Answers Family Physicians' Questions About MACRA

CMS Answers Family Physicians' Questions About MACRA: CMS officials answered family physicians' questions about the Medicare Access and CHIP Reauthorization Act during a standing-room-only meeting at the 2016 Annual Chapter Leader Forum.

AMA Releases Value-Based Care, MACRA Resources for Providers

AMA Releases Value-Based Care, MACRA Resources for Providers

Bundled Payments for Care Improvement (BPCI) Initiative: General Information | Center for Medicare & Medicaid Innovation

Bundled Payments for Care Improvement (BPCI) Initiative: General Information | Center for Medicare & Medicaid Innovation



Just saving this to add to my list of links.  Trying to start some threads on experiences with these bundled payment arrangements.

Data Governance as a Field of Study | David Raths | Healthcare Blogs

Data Governance as a Field of Study | David Raths | Healthcare Blogs



Data Herding may make more sense than Governance....



...anyways, a link to the papers here: http://repository.edm-forum.org/egems/vol4/iss2/

Transitional Chaos or Enduring Harm? The EHR and the Disruption of Medicine — NEJM

Transitional Chaos or Enduring Harm? The EHR and the Disruption of Medicine — NEJM: Perspective from The New England Journal of Medicine — Transitional Chaos or Enduring Harm? The EHR and the Disruption of Medicine

Politico Morning E Health: Vanishing VistA

My thoughts on this one coming...

VANISHING VISTA?: Rep. Phil Roe, who has seen plenty of twists in the VA-DoD EHR saga in his seven years on the Veterans Affairs committee, was not surprised to hear of another turn last week –“it’s the gift that keeps on giving,” he said. At an appropriations hearing, the VA’s CIO, Laverne Council, said the agency had pulled back $40 million from the budget of its VistA update program and was considering whether to ditch the fabled EHR. 

— Roe, a physician from Tennessee and head of the GOP Doctors Caucus, thinks that might be a good idea. If the VA decides to go commercial, Roe said, “I hope they use the same system” as the Pentagon (that would be Cerner). Roe noted that the Cerner contract to replace the Pentagon’s EHR stands at less than $4 billion, despite earlier estimates of up to $11 billion. It may be cheaper, in the long run, to replace VistA rather than updating it repeatedly, he told us. This idea troubles many IT specialists who have worked with VistA. The EHR has pieces that need replacement, they say, but its basic functionality is as good as Epic, Cerner or any other hospital EHR, and it would be a shame to toss a system that has evolved over the decades to fit the needs of VA clinicians.

Read more: http://www.politico.com/tipsheets/morning-ehealth/2016/03/opioid-abuse-in-tech-crosshairs-213071#ixzz42EOTuAlp

Cerner Opens Smart on FHIR Developer Website | Healthcare Informatics Magazine | Health IT | Information Technology

Cerner Opens Smart on FHIR Developer Website | Healthcare Informatics Magazine | Health IT | Information Technology

Hospitals Lagging Behind in Population Health Management

Hospitals Lagging Behind in Population Health Management

Modern Healthcare: Obama administration's proposed insurance reforms incite industry backlash

Re: The American Academy of Family Physicians asked the CMS to go a step further and build network standards for appointment wait times. found here.

I was the "Wait Times Guy" for Veterans Health Administration and can say this is no easy task. On any given day every Veteran using a VA Hospital had on average 2.5 pending appointments. Some were for that day, some the next day, or week, or month, or months but sorting out the "wait" from when the Vet wanted the appointment, and when the Vet needed to be seen for a followup appointment got very murky.

Make tinkering with those calculations a criminal offence and you've got quite a mess.

Texas Health Physicians Group Leaders Take on the Practical Data (and Process) Challenges of Population Health | Healthcare Informatics Magazine | Health IT | Information Technology

Texas Health Physicians Group Leaders Take on the Practical Data (and Process) Challenges of Population Health | Healthcare Informatics Magazine | Health IT | Information Technology

With regard to IT development, strategically speaking, what do you need to do in the next year or two?

Adams: The Holy Grail for an IT-techie person like me—patient attribution remains one of the number-one challenges. People underestimate how hard it is to attribute patients to physicians. I think the Holy Grail is combining EMR and claims data. Because right now, we’re still in the world of, here are your gaps in care, but it’s in the EMR. So I may already have had a colonoscopy and Dr. Parsley if he’s my physician wouldn’t know it. So it’s combining outside claims data with EMR data, to provide a true picture of things. And claims data is 30-45 days behind. And in the next two to three years, it’s going to be real-time notification. We don’t have all those things in place yet. So for the next year, we’ve got to get better at patient attribution and risk stratification, and then be able to combine EMR and claims data.
Parsley: I agree: if there’s a report in an old file somewhere that shows the patient did get their colonoscopy in the timeframe needed, and if we had the payer data in a timely way.

Senate HELP Committee Chairman Once Again Calls for Stage 3 Delay in Latest Hearing

Senate HELP Committee Chairman Once Again Calls for Stage 3 Delay in Latest Hearing

Joe Flower: Does Prevention Save Money for Hospitals?

Joe Flower: Does Prevention Save Money for Hospitals?

Social, Behavioral Data Must Be Included in EHRs, Nurses Say - HealthITAnalytics

Social, Behavioral Data Must Be Included in EHRs, Nurses Say - HealthITAnalytics

Rick Wicklin:The relationship between toothlessness and income

Interesting post on the relationship between toothlessness and income.  Rick ought to throw smoking prevelance into the mix because I expect it will explain more than income would.

And of course the graphs are nice!  

Attribution Identifies Physician-Patient Relationships

Attribution Identifies Physician-Patient Relationships



Something on my mind worth saving.  Attribution not as simple as you'd think.

Join Us At Valence Health’s Value-Based Care Conference

Needless to say, my blogs represent my views and not those of my employers past or present, but below is a plug from my current job about what I think will be a very useful conference.

 Please join us for further 2015, our annual industry conference dedicated to value-based care and reimbursement models. From clinical integration, to shared risk, to provider-sponsored health plans, further 2015 explores the financial, operational and clinical aspects of all types of value-based care and “risk-based” contracting.  Learn more about the expert-led discussions designed for provider-organization executives here: http://go.valencehealth.com/further2015