Category: athenahealth

Covid-19 made an already challenging healthcare system even harder to navigate. If we want the industry to come back stronger than before, then we must ask ourselves, “What is healthcare’s next act?” 

What You Should Know:

– New KLAS report finds acute and ambulatory care EMR
vendors Cerner, Epic and NextGen are best at making outside patient data usable
for clinicians (data from outside the clinician’s health system).

– KLAS report examines adoption and usability among advanced
users of the main acute and ambulatory care EMR vendors.

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The national interoperability networks of Carequality and CommonWell Health Alliance have become some of the primary means by which patient records are shared between healthcare organizations in the US. Despite progress in delivering interoperability, the number of providers connected to these plug-and-play networks, and the usability of the shared data varies significantly depending on the EMR in use. The KLAS report, Interoperability 2020 (Acute/Ambulatory) examines adoption and usability among advanced users of the main acute and ambulatory care EMR vendors.

Epic, NextGen, Cerner Best at Making Outside Patient Data
Usable

The report reveals Cerner, Epic and NextGen are the best
acute/ambulatory EMR vendors at making outside patient data
usable for clinicians (data from outside the clinician’s health system). Epic
continued to enhance the end-user experience with its Happy Together solution delivering
the most natural integration of outside data into the clinician workflow,
including the recent addition of basic lab trending.

KLAS named NextGen as the only ambulatory specific EMR vendor
to provide a strong usability experience for all interoperability workflows,
while Cerner customers validated its strong capabilities for accessing and
incorporating a wide variety of outside data into the patient record.

Duplicate PAMI Data a Growing Problem

Customers of both Cerner and Epic say the next step is for
the vendors to reduce the duplication of problems, allergies, medications, and
immunizations (PAMI).

NextGen Healthcare is the only vendor whose customers report
significant improvement in this area. The NextGen EMR is able to filter out duplicate
medications, even for inexact matches (e.g., Tylenol vs. acetaminophen). While
other solutions may be capable of flagging duplicate information and removing
some of it, customers say the process is often still very manual.

Other key findings of the report include:

– athenahealth and Epic continue to lead in overall
adoption, with nearly all customers connected to CommonWell Health Alliance
network.

– Cerner has been encouraging customers to adopt the
CommonWell connection for some time, and over the past 18 months, the number of
customers live has doubled, meaning a majority of clients are now connected.

– NextGen Healthcare has also continued to advocate for the adoption of Carequality among its customer base.

– eClinicalWorks customers have been actively connecting;
their usability experience remains similar to what it was in the past.

– Since early 2019, many organizations have implemented Expanse, but the adoption of CommonWell among MEDITECH customers has increased only slightly (from two customers to eleven).

– Allscripts was a founding member of CommonWell in 2013 but
never connected. After multiple delays and a shift to Carequality, they
connected their first customer (via dbMotion) in the second half of 2020.

What You Should Know:

– New Chilmark Research report on revenue integrity
in healthcare reveals a transitional market making strides to address the new
burdens of modern care economics.

– The ongoing COVID-19 public health emergency underscores
the imperative need for automation and reduced administrative costs even
clearer.

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Revenue cycle
has and continues to be one of the most difficult challenges in healthcare.
These issues manifest in the claims process of submission, appeal, and
remittance, but the causes are found much earlier in clinical workflows. Rather
than think of these as separate issues, they should all be considered under a
broader category of revenue integrity. The latest report from Chilmark Research,
Revenue Integrity in Healthcare: Solutions Driving Payment Performance,
reveals a market in flux as new technologies are applied to old problems,
increasingly complicated by contracts that include performance and reporting
requirements.

Modern Revenue Integrity Solutions Can Improve Financial
Performance

New software and platforms can accelerate, automate, and
improve the accuracy of these activities. Automated outreach, demographic and
eligibility checking, computer-assisted coding, natural-language processing,
and more traditional revenue cycle platforms.

These tools are offered by:

– Electronic Health Records (EHRs)

– Independent Platforms

– Best-of-Breed Solutions from outside the Revenue Integrity
space, but with powerful tools to address payment needs

These activities are essential for healthcare enterprises of
all sizes, scopes, and specialties. They are needed whether the organization is
primarily concerned with fee-for-service (FFS) reimbursement or value-based care (VBC).
The ongoing COVID-19 public health emergency has made the need for automation
and reduced administrative costs even clearer. With appointment volumes
dropping, provider organizations are faced with the need for reliable, accurate
payments for their care activities more than ever. These solutions are equally
valuable for traditional provider care and for modern virtual care solutions
like telehealth.

 “Accounting and revenue cycle work can never fix these issues. They need to be addressed where they occur and prevented from showing up in revenue cycle in the first place. One mistake in patient registration that was easy to fix can cause millions in complicated denials down the road.”– Lead Analyst Alex Lennox-Miller

Each type of solution (EHR, Platform, Best of Breed) is
evaluated based on how they address the needs of provider enterprises. The
report reviews the current state of the market, the maturity of solutions, and
the strengths and weaknesses of each solution type. While the current market is
valued at more than $20 billion, projections within the report show its
expected growth to nearly $35 billion in the next five years. The report shows
which segments of this market can expect annual growth rates exceeding 10% and
which will slow to under 2.5%.

Profile of Leading Revenue Integrity Vendors

In addition to the categorical analyses, this report includes 13 profiles of major and promising vendors: 3M, Allscripts, athenahealth, Cerner, Change Healthcare, Hayes|MDAudit, Medicomp Systems, Optum, PatientMatters, RevSpring, Sift, and ZOLL. Each profile includes an assessment of the vendor’s strengths and challenges, detailed descriptions and evaluations of the product capabilities and market execution, and rankings across 24 categories.

Managers and directors of healthcare organizations looking
for ways to address revenue cycle issues, lower clean claims rates, or improve
strategic revenue projections will appreciate the report’s clear breakdown of
vendor offerings and the impacts on their clinical and non-clinical staff.
Payers, including self-insured employers, and other organizations interested in
the total cost of care will find the market overview and product evaluations of
great value, helping them understand the tools and challenges their partner
organizations will be using.

The report is available to subscribers of the Chilmark
Advisory Service or may be purchased
separately.

What You Should Know:

– The latest Chilmark Research report examines how data-oriented APIs are contributing to development and integration efforts across healthcare from the perspective of the developer.

– Reeling from the impact of the COVID-19 pandemic and
seeking more effective ways to implement new functionality, healthcare
enterprises of all kinds are looking to alternatives for prevailing development
and integration practices.

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Unlocking value
from the data scattered across healthcare communities was once a tantalizing
opportunity. After COVID-19,
it is an existential necessity. Chilmark
Research’s latest Market Trends Report, Open APIs in Healthcare: The Future of Data Integration, captures a market whose approach to data access and
integration will be changing substantially in the coming years and introduces a
subvertical within healthcare
IT that anticipates a 16% CAGR through 2025.

APIs Are Still New in Healthcare

Outside healthcare, the ascendance of
data access and integration facilitated by application programming interfaces
(APIs) is the culmination of decades of technology evolution and implementation
lessons with distributed applications. Across the SaaS landscape in particular,
APIs have become the preferred method for accessing data and conducting
transactions across applications and organizations. Developers recognize and
appreciate the value of loosely coupling their applications and data, wherever
each is located.

Inside healthcare, many enterprises are
hesitant on the topic of APIs, seeing them as too big a leap from established,
successful software practices. But they also recognize that eliminating the
need for hard-coded interfaces that must be re-implemented every time an
application or its underlying data changes will deliver higher programmer
productivity and more-responsive applications.

Traditional Integration Methods Fall
Short
Conventional development and
integration approaches proved cumbersome and slow in efforts to contribute to
understanding or responding to the current health crisis. Unlocking more value
from the data scattered across healthcare communities is — post-COVID-19 —
a critical element in clinical and
financial renewal.

“Enterprises across healthcare were already wrestling with challenging market forces and government mandates,” says Brian Murphy, the report’s lead author and analyst. “Open APIs will play a central role for providers, payers, or any healthcare enterprises that intend to better utilize their data and pursue development efforts that make them — and the broader healthcare community — more responsive and adaptable to the demands of a post-pandemic healthcare system.”

Developers Require Accessible Data

Developers find data wherever they can from among a large
and confusing mix of data holders and associated vendors. This report
identifies the sources where different kinds of health-related data are most
likely to be API-accessible. It shows how APIs are already contributing to
development and integration efforts across healthcare and estimates the much
larger potential of widespread adoption.

This report includes detailed profiles on 20 public and
private organizations and their offerings, including 1upHealth, 4Medica,
Allscripts, Apple, Athenahealth, Availity, Blue Button 2.0, Cerner, Change
Healthcare, Datica, Epic, Human API, Meditech, NextGen, NCPDP, Particle Health,
The Sequoia Project, Redox, Surescripts, and Validic.

For more information about the
report, visit https://www.chilmarkresearch.com/chilmark_report/open-apis-in-healthcare-the-future-of-data-integration/

What You Should Know:

– According to a recent KLAS report, Allscripts and
eClinicalWorks EMRs are not a good fit for pediatric practices, while Greenway
Intergy is improving.

– PCC, athenahealth, and Office Practicum EMRs named best suited for pediatric offices.

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Despite their unique needs, many ambulatory pediatric
offices are expected to “make do” with generalized EMR templates and charting.
From growth charts, to well-child visits, to immunization tracking, to registry
integration, pediatric offices often find their EMR doesn’t meet their
needs. KLAS’ latest report, “Pediatric
Ambulatory EMR 2020: Best EMR Performers in Pediatric Settings”
examines which EMR vendors best ensure pediatric provider success by providing
an outstanding EMR and tailored service. Note that this report is focused on
ambulatory-focused vendors, including pediatric-specific EMR vendors.

Allscripts and eClinicalWorks EMRs Not a Good Fit for
Pediatric Practices; Greenway Intergy Making Improvements

While Allscripts’ EMR is highly customizable and can be
tailored for use in pediatric settings, customers report that in order to make
the solution work for their needs, KLAS reports customers have to dedicate
large investments of time and resources (e.g., hire an IT team to run and
customize the EMR) for customization/optimizations. These investments are not
always communicated to pediatric practices during the sales process, leading to
mixed results and expectations around Allscripts’ pediatric functionality. In addition,
customers cited issues with Allscripts’ support is often subpar or nonexistent.

Although KLAS conducted a limited number of interviews with eClinicalWorks
customers, they cited a negative view of the EMR’s quality, saying it does not
meet the needs of pediatric practices and does not come with necessary
pediatric-specific content or workflows. Multiple respondents also complain
about bugs, crashes, and problematic upgrades that introduce new problems
without bringing substantive fixes. Historically, Greenway Health customers
have felt the solution falls short in aspects like ease of use and needed
functionality; however, a number of interviewed customers feel the vendor is
making more of an effort to listen to customers’ problems and deliver requested
pediatric-specific functionalities.

PCC, athenahealth, and Office Practicum EMRs Best Suited
for Pediatrics

KLAS reports PCC (one of two pediatric-specific vendors in
this report) stands out with the highest overall score and the most consistent
customer satisfaction. They have a proven history of and reputation for
supporting customers and delivering the pediatric-specific technology needed to
successfully run an ambulatory pediatric practice.

KLAS reported athenahealth’s EMR also performs well in
pediatric settings; more than 90% of pediatric customers are satisfied with the
solution and its pediatric specific functionality. Additionally, customers of
Office Practicum (the other pediatric-specific EMR vendor) are generally
satisfied with the functionality they receive and feel it helps make their
practices successful. Recent issues with nickel-and-diming and buggy updates
have caused some frustration for a number of interviewed customers.

For more information about the KLAS report, visit https://klasresearch.com/report/pediatric-ambulatory-emr-2020/1378

What You Should Know:

– Fenway
Health has been selected as the pilot site to participate in the Advancing
Standards for Precision Medicine (ASPM) project.

– The ASPM project
is focused on how healthcare providers can systematically identify the
socio-economic factors that may impact the health of patients in order to
provide more individualized care that reflects patients’ needs. 

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Fenway Health, a
Boston, MA-based Federally Qualified Community Health Center (FQCHC) dedicated
to making enhancing the wellbeing of the LGBTQIA+ community, people living with
HIV/AIDS and the broader population has been selected as the pilot site to participate
in the Advancing
Standards for Precision Medicine (ASPM) project. Conducted by the U.S. Department of Health and
Human Service’s Office of the National Coordinator for Health Information
Technology (ONC), in partnership with Audacious
Inquiry, the University of Washington’s Clinical Informatics Research Group
and athenahealth, the project aims to develop standards for the
collection of social determinants of health data (unmet needs in areas such as income, educational attainment, employment
status, food security, housing, and more). 

Advancing Standards for Precision Medicine Background

Data sharing is critical to realizing the future of
precision medicine. Launched in 2018, the Advancing Standards for Precision
Medicine (ASPM) project works to further the development and testing of
standards for new and diverse types of health data. The ultimate goal is to
make health data easier to share, curate, aggregate, and synthesize.

– ASPM is focusing on standards in two areas:

– Mobile health, sensor, and wearable data

Social determinants of health (SDOH) data

The project will leverage digital tools and questionnaires
to advance the standardized collection of data. Social determinants of health
play a major role in individual health outcomes. “athenahealth’s
partnerships with Fenway health and others ground us to the realities and
challenges of healthcare today to improve health outcomes” said Kedar
Ganta, athenahealth’s Product Leader for Interoperability Strategy.
“Transforming Patient Care by prioritizing the collection and sharing of
interoperable SDOH data will better identify patient needs and create impact
across the communities”

In fact, patients’ unmet social needs have been found to
account for up to 40 percent of individual health outcomes. Increasingly,
health care organizations are focused on addressing these needs to help improve
treatment and care in a way that addresses the whole patient.

EHR Data Collection Approach

Fenway Health will employ their current web-based assessment
tool, ePRO, which was developed by the University of Washington’s Clinical
Informatics Research Group (CIRG), as a prototype for testing and transmitting
the systematic capture of SDOH data, as well as ASPM’s proposed standards and
implementation guides as part of their effort. That data will then be sent to
athenahealth, Fenway Health’s electronic health record (EHR) vendor, and be
incorporated into the patient’s health record in a standardized format.

“Standardizing SDOH data and incorporating that information into the EHR along with other patient-reported outcomes, allows health care providers to better understand the context in which their patients live and what they experience, and helps providers offer more personalized and relevant care”, said Dr. Bill Lober, Professor at the University of Washington, and director of CIRG.

 Pilot Project Timeline

The ASPM project is set to last through the Fall of 2020 and
will culminate in an evaluation report to be shared with ONC and the National
Institute of Health (NIH). The evaluation will be used to identify challenges
in data collection and sharing between health care providers and to develop
solutions that will lead to better implementation of collection initiatives and
protocols in the future.

The project hopes to expand the types of data that can be
integrated into EHRs
to create a more complete picture of the patient that would reflect the
patient’s practical reality and the issues that may impact their health in the
future. Ultimately, the project’s goal is to give health care providers the
data and tools needed to provide patients with individualized treatment and to
help them achieve better outcomes.